Volumen 32 No. 1 (2014)
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Item Normas para la publicación de artículos científicos en la Revista de la Facultad(Universidad de Cuenca. Facultad de Ciencias Médicas, 2014-04) Comisión de PublicacionesItem Manifestaciones neurológicas en pacientes pediátricos con fenilcetonuria. Revisión bibliográfica(Universidad de Cuenca. Facultad de Ciencias Médicas, 2014-04) Calle Ulloa, Boris Eduardo; Calle S., Angel; Quito C., Paúl; Chasi P., María; Hurtado M., JohannaPhenylketonuria (PKU) is a congenital autosomal recessive disease in which there is a shortage of the enzyme phenylalanine hydroxylase, which produces an injury to the central nervous system (CNS). The global incidence is about 1:20,000 live newborns. (1.2) The treatment is based on phenylalanine restricted diet which should be maintained for lifelong to prevent intellectual impairment. OBJECTIVE: To identify neurological manifestations of pediatric patients with PKU. METHODOLOGY: A review of the literature on the neurological manifestations for PKU by searching several electronic databases (MEDLINE , EMBASE, Cochrane , LILACS , PubMed) with English and Spanish limits from January 1970-2012. RESULTS: One cross-sectional study, one clinical case, three narrative reviews in pediatric populations and one clinical case combine children and adults. Intellectual disability is the main neurological manifestation; the primary diagnostic criterion was the serum level of phenylalanine. There are 29 different classifications on the cutoff to hyperphenylalaninemia and 23 for phenylketonuria.Item Varicela Hemorrágica(Universidad de Cuenca. Facultad de Ciencias Médicas, 2014-04) Salinas Pozo, María Victoria; Escalante Canto, Paúl; Saeteros, XavierFor the few reports in the literature, this case is done with clinical and epidemiological diagnostic of the hemorrhagic chickenpox which was treated with antiviral, immunoglobulins and antibiotics (for over infection), with positive evolution. Chickenpox is a virus primary infection VZV (varicella- zoster) that generates a febrile illness accompanied by a generalized rash. Epidemic form occurs mainly in children aged from 2 to 10 years, it is transmitted by drops that come from the nasopharynx, with a benign course. If there is immune deficiency, the clinical form of hemorrhagic varicella can occur with an unfavorable outcome.Item Probióticos en la prevención de enterocolitis necronizante en neonatos pretérminos del servicio de neonatología del Hospital Vicente Corral Moscoso. Cuenca, 2012(Universidad de Cuenca. Facultad de Ciencias Médicas, 2014-04) Peñafiel Martínez, Eulalia CumandáOBJECTIVE: To compare the frequency of NEC in preterm infants who are receiving probiotics plus conventional therapy in 2012 with patients who received conventional therapy in the neonatal unit of the Vicente Corral Moscoso Hospital in 2011. METHODOLOGY: A cohort study with two groups of 113 premature children in each one. The intervention group received 1g of VSL#3 probiotic in 2012 once daily until discharge, with a maximum of 14 days. During the administration, some cases of NEC were recorded according to the criteria of Bell, and they were compared with the frequency of 113 preterm ECN presented in 2011. RESULTS: In 2011 22.1% of NEC was observed while children who received probiotics showed 10.6%. The groups who represented a statistically significant reduction were the preterm with low weight and moderate preterm (p < 0.05). A smaller percentage (7.5%) of NEC was observed in male infants in relation to females (13.3%) with the administration of VSL # 3. The percentage of NEC was 20% and 25% in male and female respectively who received probiotics. CONCLUSIONS: The VSL # 3 probiotic reduced the frequency of NEC in the preterm neonatal service from the Vicente Corral Moscoso Hospital during 2012, with a relative risk reduction (RRR) of 52%.Item Eventración congénita de diafragma, a propósito de un caso(Universidad de Cuenca. Facultad de Ciencias Médicas, 2014-04) Cazar Ruiz, Jorge Vicente; Ochoa Gavilanes, Eddy RodrigoThe diaphragmatic eventration is a rare anomaly, which is characterized by an abnormal elevation of the diaphragm muscle, can be congenital or acquired. The affected diaphragm displays paradoxical mobility, with respiratory insufficiency of variable intensity; it has been considered as a cause of the defect of a failure in the process of muscularization of the embryonic diaphragm. This is the case of a newly born, without obstetric history of importance, who presented mild respiratory symptoms from birth; in this case, the diagnosis was performed with an X-ray and CT scan of the chest. The surgical resolution was through a technique of diaphragmatic plication.Item Programa educativo virtual para mejorar la prescripción antibiótica en médicos rurales(Universidad de Cuenca. Facultad de Ciencias Médicas, 2014-04) Ojeda Orellana, Marco RibelinoTo evaluate a virtual educational program for rural doctors in the provinces of Azuay, Cañar, Loja and Morona Santiago to improve knowledge and prescription of antibiotics in pharyngitis, urinary tract infection, infectious diarrhea and pyoderma. METHODOLOGY A random experimental double-blind study was made, in which 102 rural doctors from the provinces mentioned before attended during the period February-October 2011. Through the virtual platform MOODLE a course of antibiotics based on OPS, Sandford and from MSP was applied to 53 doctors in the intervention group, and on another platform, a course about “Critical analysis of pharmaceutical promotion” was applied to 49 physicians in the control group. They were evaluated with a questionnaire applied before and after the new knowledge acquired and the quality of prescriptions before and after the course. RESULTS The virtual course improved significantly, the average score of the questionnaire was 7.5 / 10 to 8.07 / 10 (p = 0.037) in the intervention group, as well as the score of the recipes in all diagnoses. The relative risk of the intervention on the presence of a bad prescription was 0.53 (p = 0.0) and about bad questionnaire’s grade was 0.78 (p = 0.0). CONCLUSIONS The virtual education program improved significantly the knowledge and the quality of outpatient prescriptions for pharyngitis, urinary tract infection, infectious diarrhea and pyodermaItem Utilidad de examen de orina en apendicitis aguda(Universidad de Cuenca. Facultad de Ciencias Médicas, 2014-04) Alvear Quito, Nataly Mireya; Martínez, Patricio; Salamea Molina, Juan Carlos; Padilla ZHucuzhañay, Marcia AlexandraINTRODUCTION: The aim of this study is to observe the frequency of positive elementary microscopic examination of urine (EMO) in regard to acute appendicitis appendiceal phase, and at the same time to determinate the sensitivity of the EMO to determine the infectious appendix phase. MATERIALS AND METHODS: We performed a prospective comparative study, which evaluated the sensitivity of the positivity of the EMO, the appendix phase and the urinary symptoms seen in these patients. We included 100 patients (64 women and 46 men) with an average age of 60. RESULTS: From the patients operated on and with histological test, positive signs and symptoms were showed which were obtained in pre-surgical clinical assessment in the Vicente Corral Moscoso Hospital. EMO was considered positive when leukocytes per field exceeded 8, and presence of red cells per field larger than 4. Of the 48 cases (48%) of Suppurative Appendicitis phase only 12 of them (12%) showed positivity to make the EMO, followed in frequency by the inflammatory phase in which inside these 32 cases (32%) only 7 (7% ) of them have to do the EMO positivity. A 100% of patients with acute appendicitis suffer pain at the right fist percussion and 98% of them did not have urinary frequency. CONCLUSIONS: The positive EMO has low sensitivity to determine the appendix phase and it is higher in the gangrenous stage. EMO can be positive in patients with acute appendicitis 4-1 Patients with acute appendicitis may present positive urinary symptoms including right fist percussion and middle ureteral points.Item Factores de riesgo de la luxación congénita de cadera en niños/as de 0 a 9 años del Centro Provincial de de Neurodesarrollo Integral Cuenca, 2012(Universidad de Cuenca. Facultad de Ciencias Médicas, 2014-04) Arévalo Peñafiel, María ElisaOBJECTIVE: To determine the risk factors associated with congenital hip dislocation in children from 0 to 9 years who are attending to the Provincial Center for Integrative Neurodevelopment (CEPRONDI). METHODS: A case-control study was made; the universe consisted of 1200 children from 0 to 9 years of congenital hip dislocation (LCC), who are attending to the Provincial Center for Integrative Neurodevelopment (CEPRONDI). The total sample size was 310 children (155 with congenital hip dislocation and 155 without congenital hip dislocation); they were calculated with confidence interval criteria of 95% and significance level of 0.05 %. We identified the congenital hip dislocation in children according to the family history, breech presentation and pelvic-fetal disproportion. Data were analyzed using SPSS v.20, Excel and Minitab v.15. For the description of qualitative variables, frequencies and percentages were calculated, and for the inferential analysis we used chi -square test to contrast and also multiple proportions to identify the main causes of this problem. RESULTS: The incidence of LCC in children with developmental disorders in the CEPRONDI is about 18.10%; we showed that the risk factors are related to the LCC family history, birth weight and multiple pregnancy because they had higher statistical significance with a p_value of 0,000 the first two and 0,003 the last; however it was shown that the pelvic disproportion - fetal and sex have a lower statistical significance. CONCLUSIONS: The percentage (18.10%) of LCC which was found in CEPRONDI is very alarming because it exceeds the figures in comparison with other countries and even with the global prevalence that is 3%.Item Prevalencia de genotípos del papiloma virus en mujeres de Cuenca(Universidad de Cuenca. Facultad de Ciencias Médicas, 2014-04) Cárdenas Herrera, Oswaldo José; Cabrera Vicuña, José Antonio; Campoverde Cisneros, Manuel AlfredoOBJECTIVES. To determine the prevalence of papilloma virus genotypes of high and low oncogenic grade, to relate to age groups, with genotypes that avoid both existing vaccines and the risk factors for uterine cervical cancer. METHODS. Epidemiological, observational, cross-sectional study. The random sample was 500 women from the urban area of Cuenca city. Two samples of the cervix were taken. Polimeraza chain reaction method and cytopathology Papanicolaou study were used. RESULTS. The prevalence of papilloma virus genotypes of high oncogenic grade was 35,9% and 14,3% low oncogenic grade. The prevalence of cytologic abnormalities, Papanicolaou, was 16%. This prevalence was more frequent in the group of 30-39 years, and 40-50 years. By inference, the coverage of the Cervarix vaccine would be 8% and 13% for Gardasil. Risk factors were related to the number and frequency of intercourse and number of sexual partners. CONCLUSION. The prevalence of genotypes was high and the vaccine coverage was low.