Volumen 31 No. 2 (2013)
Permanent URI for this collectionhttps://dspace-test.ucuenca.edu.ec/handle/123456789/19896
Browse
Recent Submissions
Item Normas para la publicación de la Revista de la Facultad(Universidad de Cuenca. Facultad de Ciencias Médicas, 2013-07) Comisión de PublicacionesItem 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 AdriánThe 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.Item Lepra Histioide(Universidad de Cuenca. Facultad de Ciencias Médicas, 2013-07) Ordoñez V., Soledad; Zeas Domínguez, Iván MarceloItem Vasculitis nodular vs. eritema indurado de Bazín, a propósito de un caso(Revista de la Facultad de Ciencias Médicas de la Universidad de Cuenca, 2013-07) Castillo, Gladys K.; Encalada Orozco, Manuel; Castillo, Gladys C.; Cañarte J., Andrés; Tapia, Carlos F.Nodular vasculitis is infrequent in children. We present the case of an 11-year-old girl from the urban area of the canton Pasaje, who presented resistant dermatosis on the posterior right leg, receiving multiple treatments without a specific diagnosis with no health improvement. The chest X-ray was normal and tuberculin test negative. The patient did not have other symptoms; a sample was obtained for a biopsy, finding adipose lobules with extensive necrosis surrounded by granulomas. PAS analyzes: there was no evidence of fungi and Ziehl; acid alcohol resistant bacilli were not found.This case highlights the importance of suspecting erythema Induratum Bazin and an extensive research about the existence of active tuberculosis is suggested.Item Hernia diafragmática de bochdalek en el adulto reporte de caso(Universidad de Cuenca. Facultad de Ciencias Médicas, 2014-07) Cabrera Santos, José Edmundo; Hidalgo Maldonado, Martha; Quezada, CésarThe Bochdalek hernia is a congenital defect localized in the posterior lateral section of the diaphragm, mostly found in newborns but rare in adulthood. In a revision of global literature, we found 130 reported cases of Bochdalek in adulthood. The use of computed tomography lets an accurate diagnosis of the type and the localization of the hernia that will facilitate its management and choice of treatment. Multislice computed tomography screening with the possibility to perform coronal and sagittal reconstructions should be considered as a standard method to diagnose this entity. To conclude, we should highlight that Bochdalek asymptomatic hernias are nowadays accidentally discovered mostly thanks to the technological breakthroughs in imaging, letting us an accurate diagnosis. We present a case study of a 33-year-old patient with no symptomatology who attended the imaging department at the GENERAL HOSPITAL OF III-D.E, with a medical form for personal issues.Item Prúrigo simple infantil(prúrigo de Hebra), reporte de caso y revisión bibliogáfica(Universidad de Cuenca. Facultad de Ciencias Médicas, 2013-07) Cazar Ruiz, Jorge VicenteChild prurigo is known as a group of skin diseases of doubtful or unknown etiology, characterized by intense pruritus and papular and/or vesicular lesions. It has been described as an allergic reaction caused by the bite of insects; characteristic of the pediatric age, which is difficult to control, with frequent and successive outbreaks that usually are self-limiting in time. It is common to find a group of pruriginous papules and vesicles of preferential location at forearms, abdomen, lumbar area, buttocks, thighs and legs, which affects mostly children, ages two and ten. This is the case of a six-year-old child with impaired nutritional status, who was hospitalized due to papular and pustular lesions, with melicerica scabs and sores at the level of face and upper limbs, with periods of exacerbation and remission the last two years. At the time of admission, tests and corresponding interconsultations were performed, being diagnosed with Prurigo of Hebra; appropriate treatment was performed and 14 days later, patient was discharged in better condition.Item Cesárea por monitorización cardiotocográfica fetal no satisfactoria(Universidad de Cuenca. Facultad de Ciencias Médicas, 2013-07) Salazar Torres, Zoila Katherine; Castro, BorisThis study is attained to establish the sensibility, specificity, positive predictive value, and negative predictive value, of the fetal cardiotocographic monitoring for the diagnosis of acute fetal suffering wich leads to the termination of the gestation with in an emergency cesarean surgery, compared to the APGAR test of the new born as a Gold Standard. The universe of the study consisted in 880 pregnant women to whom a cesarean surgery was made. A 110 new born sample was obtained. 46 of them were diagnosed with acute fetal suffering with Gold Standard test; with an Apgar test < 7 at the first minute, 64 were normal with an Apgar test ≥ 7. This study found that the sensibility of the fetal cardiotocographic monitoring was 21.7% (IC 95% 12.26, 35.57¹).), and the specificity was 84.4% (IC 95% 73.57, 91.29¹). The conclusion was that the fetal cardiotocographic monitoring helps more as a test to value fetal well-being, above everything in high obstetrics risk pregnancies, the test is pretty less sensitive to detect that a fetus is coursing acute fetal suffering.Item Miotomía extendida en el tratamiento de la acalasia(Universidad de Cuenca. Facultad de Ciencias Médicas, 2013-07) Astudillo Molina, Rubén Arturo; Serrano Hinojosa, Bolívar EugenioThe achalasia is a rare esophageal disease that is accompanied by a significant alteration in patients’ quality of life. Its etiology is not fully clarified and its main clinical features are dysphagia and regurgitation. The treatment for achalasia is led to a functional and symptomatic relief through a lower esophageal sphincter opening, being performed at the time of laparoscopic myotomy, the technique of choice while the pneumatic dilatation and botulinum toxin injection should be considered as technical resources in selected cases. Objective: To evaluate the results of the extended myotomy plus Dorr´s previous and partial fundoplication as the achalasia´s laparoscopic treatment compared with our previous experience using the standard technique. Materials and method: design: Prospective, Descriptive and Longitudinal Study. Host: Hospital Latino, Cuenca - Ecuador. Patients and method: From June 1992 through December 2011, 39 patients with diagnosis of achalasia had surgery and received surgical treatment through minimally invasive surgery. We studied age, previous symptoms, classifications according to Stewart, duration of symptoms, surgical technique performed, postoperative control. Results: 39 patients were operated, average age 66 years, 23 years minimum and 81 years maximum. Dysphagia symptomatology was presented in 100%, regurgitation in 74%, weight loss in 71.8% and odynophagia in 28.2%. The duration of symptoms were: less than 2 years 48.7% (n=19), 2 to 4 years 33.3% (n=13), 4 to 6 years 12.8% (n=5), and 6 to 8 years 5.1% (n=2). According to Stewart, these were classified as follows: I 8% (n=3), II 49% (n=19), III 38% (n=15) and IV 5% (n=2). The used technique was Myotomy + Dorr 57% (n=22), Extended Myotomy + Dorr 20% (n=8), Only Myotomy 18% (n=7), Myotomy + Toupet 5% (n=2). We tracked a 75% of patients, excellent results 91%, and good results 9%. The last eight cases underwent extended myotomy plus Dorr´s fundoplication, providing excellent short-term results. Conclusion: Extended gastric myotomy improves the surgical therapy outcome for achalasia without increasing the rate of abnormal gastro esophageal reflux when a partial previous Dorr´s fundoplication type is added.Item Expectativa de emigrar de internos de medicina de la Universidad de Cuenca(Universidad de Cuenca. Facultad de Ciencias Médicas, 2013-07) Gómez Ayora, Andrea Ximena; Carrasco, Claudia; Iglesias, VerónicaObjective: To describe and identify factors related to the expectations of potential emigrant medical interns from University of Cuenca, Ecuador, 2012. Material and Methods: An analytical crosssectional study. Medical interns were surveyed in their places of practice. Measures of frequency, position and dispersion were presented. The Chisquare test and simple logistic regression were used. The odds ratio and its respective confidence interval of 95% were described. Results: 152 medical interns of University of Cuenca participated. Of those, 72.4% said they were interested in emigrating. They were highly motivated for educational reasons. The most requested destinations were: Spain, Mexico, Argentina, Chile and the United States. 3.6% of medical interns said they would not return to Ecuador. Protective factors related to emigration interest were identified as: coming from provinces other than Azuay (OR: 0.19, 95% CI 0.04 to 0.83) and whether it is possible to study their chosen specialty in Ecuador (OR: 0.24, 95% CI 0.08 to 0.69). Risk factors were identified as: working in an urban area (OR: 4.33, 95% CI 1.15 to 16.24) and meeting financial expectations in another country (OR: 2.76, 95% CI: 1.24 to 6.14). Conclusion: The study found that a high percentage of doctors are thinking of emigrating. They are interested in accessing a specialty for their professional development. Countries with better economic development are their preferred destinations.Item Factores asociados a problemas de conducta en prescolares. cuenca. 2011(Universidad de Cuenca. Facultad de Ciencias Médicas, 2013-07) Huiracocha Tutivén, María de LourdesObjective: This study determined the prevalence of preschool children with behavior problems in the classroom of the Child Development Center´s Cuenca Municipal and its associated factors from March to October 2011. Methodology: Analytical Transversal, stratified random sample (10% frequency, inference error of 3%, 99% confidence, plus 20% loss: n=270/N=329). Data were collected by observing children (Conners Abbreviated Teacher), by interviewing the caregiver (family Apgar test) and interviews with teachers. Data were tabulated and analyzed in the SPSS.18. Results: 54.1% are children of the public and private employees, migration is 4.4%, in 77.8% of caregivers are the mothers, 63.3% are nuclear families. 44% of children have poor school performance, 20% of the teachers are college graduates, all centers planned but none have curricular adaptations and they don´t have cohabitation agreements. The prevalence of behavior problems is 24.8% (IC 95%: 19.65- 29.95) and this was associated with male sex (RP: 2,30, IC 95%: 1.23- 4.31, p<0.05) and low academic achievement (RP: 4.60, IC 95%: 2.42 a 8.81, p< 0.05). Teachers were trained in the behavior approach and developed guidelines for intervention centers. Conclusions: The results indicate that the behavior should be evaluated systematically.Item Efectos de la capacitación en el uso de herramientas informáticas en la docencia médica(Universidad de Cuenca. Facultad de Ciencias Médicas, 2013-07) Ortiz Segarra, José Ignacio; Solis Cabrera, Vanessa Alexandra; Espinoza, Alexandra; Mayorga, María; Falconi, Felix; Sánchez, María; Ramón, Jamil; Villacís, MagdalenaObjective: To evaluate the effect of an educational strategy, aimed at teachers and undergraduate and graduate students in the area of health, for the application of information and communication technologies ICTs as support in the training process. Methods: We used a quasi-experimental design involving 477 students and 123 teachers, the same group was seen before and after training as exposed as above. The educational program included techniques for searching, processing, presentation and communication of information. The measure of effect was established as changes in the use of ICT for teachers and students, based on the McNemar test. Results: After the training process, teachers significantly increased their skills in the use of 50% of the tools and equipment and telemedicine resources and ethical September 6. Students improved significantly by 80% in the use of tools, 100% of telemedicine equipment and resources and September 5 ethical values selected for the study.Item Intervención educativa sobre mecánica corporal en el personal de enfermería. 2011. estudio aleatorizado doble ciego(Universidad de Cuenca. Facultad de Ciencias Médicas, 2013-07) Patiño Villalva, GladysObjective: To develop educational program on body mechanics with the methodological support of the constructivist model, Infirmary Staff, José Carrasco Arteaga Hospital IESS/2011. Contribute to improving the use of body mechanics in hospital care, Infirmary Staff, José Carrasco Arteaga Hospital IESS/2011. Method and Technique: Experimental, randomized double-blind. Stratified by intervention group and in charge of Infirmary staff, pre and post test application. January/2012 randomized control group. Instruments: 2 questionnaire produced and validated by the author. The 1st validated knowledge: Cronbach's Alpha 83%, significance 0.000; attitude of body mechanics using validated: Cronbach's Alpha 86%, significance 0.000. The 2nd evaluated: its practical application Cronbach's Alpha reached 94% significance 0.000. Evaluation pre/post test Wilcoxon= p> 0,05 Universe and Sample: 301 Infirmary staff Universe. Sample calculated with Epi Info=109+21=19% of people possible losses, educational treatment remained 5 blocks, 25 people from Monday to Thursday and 30 people Friday. Results: In both groups baseline data: p(Fisher)>0.05. The results obtained after completion of the educational program was: 39.65% knowledge, p(Fisher) 0.000; 22.12% Attitudes p(Fisher) 0.039; and, 55.86% Practice p(Fisher) 0.000, were found to H1. It had showing a significant improvement in knowledge and practical application of body mechanics, as well as for controlling the attitude of discouragement for failure to apply the knowledge/practice is recommended to use the interactive education theory and practice.Item El femicidio: una realidad oculta(Universidad de Cuenca. Facultad de Ciencias Médicas, 2013-07) Pinos Abad, Guido Marcelo; Avila Paredes, Janeth PatriciaThe study, exploratory, seeks to obtain an approximation to the phenomenon of femicide in the province of Azuay, on the basis of complaints and prosecutions of homicide of women registered in the police stations and prosecutors in Azuay during the period 2004-2008, and try to detect cases of femicide. Moreover, a similar study was performed in news sources of the town, in the same period and goals. To this aim, femicide detection criteria were established, to distinguish these cases from deaths for various causes, 49 cases have been detected, although in the press there were another cases. A high percentage of these deaths have not been properly handled judicially. In this research was noticeable that institutional research strategies are insufficient, because of the lack of information and absence of complaints by people who know about the case.Item Valoración de la Técnica de autoayuda en relación a psicoeducación para prevención de abuso de drogas en estudiantes del Colegio Daniel Córdova Toral(Universidad de Cuenca. Facultad de Ciencias Médicas, 2013-07) Morocho Malla, Manuel IsmaelObjective: Evaluate the effectiveness of a self help group in relation to the psycho-education for drug abuse preventing in students of Daniel Cordova Toral High School 2011-2012 school year. Methods: Quasi-experimental study was divided into 2 groups of 45 students each: group A: psychoeducation and group B: self-help group (SHG) directed by high school two fellows previously trained. We measured the knowledges, attitudes and skills (KAS) before and after the intervention, to measure the change caused. They were used tests statistics: t test for related samples and the McNemar test for paired data obtaining the p value. Results: The average age of participants was 15.89 years, all male. The most used drug was ethyl alcohol. Psycho-education versus SHG KAS improved as follows: knowledge of 7.36 improved to 9.62 (CI -4.036 -, 497, p 0.013) compared to 5.87 improved to 6.73 (CI - 1.431 - 302, p .003), attitudes of 2.58 improved to 3.26 (CI -,062-2, 209, p 0.032) compared to 1.60 improved to 4.11 (CI -2.021 to 10.319, p 0000), the practices of 4.31 improved to 5.44 (CI,612-1, 309, p 0197) compared to 3.29 improved to 3.49 (CI, 353 -, 729, p 0470). Conclusions: We obtained statistically significant changes in: knowledge and attitudes in both groups participating. There were no statistically significant differences in relation to skills. The intervention with a self-help group directed by high fellows is more effective at drug abuse preventing compared to psycho-education.