Volumen 33 No. 1 (2015)
Permanent URI for this collectionhttps://dspace-test.ucuenca.edu.ec/handle/123456789/22962
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Item Internado de Enfermería en los Servicios de Salud de la Región 6. Cuenca 2014-2015.(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-06) Buenaño Barrionuevo, Amanda Llaquelina; Cabrera Cárdenas, Carmen Lucía; Robalino Izurieta, GladysItem 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 FabiolaOsteoclast-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 massesItem Intento de suicidio por intoxicación con organosfosforado bajo administración parenteral (síndrome compartimental): reporte de un caso(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-06) Bojorque Iñeguez, Vilma Mariela; Morocho Malla, Manuel Ismael; Jaramillo Oyervide, Julio AlfredoINTRODUCTION: The ideation and attempted suicide are emerging entities for a mental health professional; the intake of organophosphate (OP) is one of the most common ways of poisoning due to their availability and easy accessibility in our country (Ecuador); it is common that people who use these substances, do auto lytic purposes orally. Find someone who uses the parenteral path for this purpose is rare and there is little literature on the subject, for this reason it is considered important the publication of the following case. OBJECTIVE: To describe the psychopathological aspects of the patient who had attempted suicide with use of organophosphate administered parenterally. METHOD: Review, presentation and analysis of the clinical case. RESULTS: The patient aged 32 was admitted to the Homero Castanier Crespo Hospital in Azogues city (Ecuador) due to the severity of their injuries caused by the OP parenteral administration; the assessment of the patient’s mental state led to a diagnosis of attempted psycho-dysplastic suicide with mood disorder and borderline personality disorder; He was diagnosed in addition to abscess in the right arm and compartment syndrome in the left upper limb, so the performance was necessary drainage and fasciotomy respectively. CONCLUSION: The OP pesticide poisonings are the most used methods, it is known that the intake of the OP is common, but not parenteral administration as in the present case, which involved treatment of physical area and the mental sphereItem Salud integral y derechos del adulto mayor. Estudio en la comunidad de Maluay, el Valle(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-06) Soliz Rivero, Gardenia; Martínez Espinoza, Bárbara BelénThe 6.5% of the Ecuadorian population are elderly, died about 34,000 each year. Their welfare is a political and social concern, but their rights are often violated by a society living their daily lives in fighting stronger and forget to reach out to the stars of the past, who show a negative impact on your overall health. METODOLOGÍA: sectional study of 40 seniors Maluay community (95.2%) with comprehensive health was assessed through the MSP application forms. Documentaries and direct observation techniques were applied. RESULTS: Most are women between 65 and 74 years, mean 69.5 years, illiterate / as (93%) with no activity or engaged in fieldwork and no drinking water. Their conditions are affected by chronic degenerative diseases that confers some degree of disability. At risk of malnutrition (73%), cognitive impairment (65%), almost half with some difficulty with balance and gait. Although they are independent in basic activities of daily living, need some help in instrumental activities. Socially are accepted (78%). DISCUSSION: The quality of life of older adults, especially in rural areas is not appropriate despite the support of public policies. Knowledge of risk factors and needs to develop prevention strategies and promoting a holistic approach should be the priority in public health, as we go through a transition that addresses the emerging risks associated with industrialization, urbanization and population agingItem Características socio-demográficas asociadas a la presencia de dolor músculo-esqueletico, en Cuenca-Ecuador(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-06) Guevara Pacheco, Sergio Vicente; Feicán Alvarado, Elsa Astrid; Peláez Ballestas, Ingris; Guevara Mosquera, DanielOBJECTIVE: To determine the socio-demographic characteristics associated with the presence of musculoskeletal pain (MSK) in people over 18 years who are living in Cuenca. PATIENTS AND METHODS An analytical cross-sectional study was conducted in subjects of rural and urban areas, who are over 18 years, using the methodology COPCORD (Community Oriented Program for the Control of Rheumatic Diseases) adapted to Ecuador. We identified individuals with rheumatic symptoms, house by house. The revision to confirm the diagnosis was made by a rheumatologist. The statistical analysis was univariate and multivariate. RESULTS A total of 2500 people were surveyed. The 59.6% were female, with an average age of 42.8 years, the 25.5% of participants performed domestic activities. The MSK pain occurred in 32.2% of people, which was significantly associated with living in rural areas, have lower education, lower income to $ 340, increased physical load of 8 pounds, more functional disability, and cooking with firewood in the rural area. CONCLUSION The MSK pain has a high prevalence in the population of Cuenca, Ecuador; producing disability especially in rural areas. It is associated with lower levels of education, lower income and increased physical loadItem Reporte de uso de clavo TFN en fracturas proximales de fémur en pacientes del Hospital Vicente Corral Moscoso y Hospital del IESS, reporte de 4 casos(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-06) Serrano Barbecho, Wladimir Augusto; Llanos Quilli, Fernanda PatriciaOBJECTIVE: To report the results of proximal femur fractures treated with the trochanteric system titanium nail. Patients: at the Vicente Corral Moscoso Hospital, three cases of patients aged 16, 21 and 30 years old were treated; and another patient in the José Carrasco Arteaga Hospital who is 20 years old, the last one also presented a half-diaphyseal of femur and ipsilateral of tibia fracture. Three patients with subtrochanteric fracture (one with pseudoarthrosis of 8 months evolution), and a fourth patient with neck fracture and ipsilateral femoral of femur. The fracture was designed according to Russell-Taylor classification, and it was treated by open reduction and the T.F.N. system placement. The patients were maintained on radiograph control at 2, 6, 12, 24 weeks after surgery. RESULTS: The clinical and radiographic consolidation of the four cases was observed at 12 weeks after surgery, no significant postoperative complications arose in any case, there was no infection, and also the mobility was recovered successfully, although in one patient was observed a displacement. CONCLUSION: The surgical treatment with the TFN system is well indicated in subtrochanteric femur fractures, it is associated with good functional results, low morbidity and few complications, thus constituting an excellent therapeutic technique.Item 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 MarietaOBJECTIVE: 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 fulfilledItem Construcción de una escala de determinantes sociales de la conducta resiliente adolescente, Cuenca-Ecuador 2014. Investigación realizada en los colegios urbanos de la Ciudad de Cuenca(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-06) Jaramillo Oyervide, Julio AlfredoOBJECTIVE: To build up a scale for measuring the social determinants modulators of resilient behavior of adolescent students in Cuenca. METHOD: A quantitative study of construction of diagnostic test. Reference population 49378 teenage students from schools in Cuenca. A sample of 335 students randomly selected. A Likert form structured ad hoc called EDSRA to measure social determinants was used. The internal consistency of the diagnostic test was determined by Cronbach’s alpha. RESULTS: A 23.6% (79) adolescents have low social determinants influence that means their social conditions modulate negatively the level of resilience in adolescents. CONCLUSIONS: The scale EDSRA has a Cronbach’s alpha of 0.828; it is a reliable tool that makes stable and consistent measurements.Item Remifentanilo como analgesia complementaria en bloqueo paracervical para aspiración manual endouterina. Hospital Vicente Corral Moscoso. Cuenca, 2013(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-06) Espinoza Juela, Miguel Ignacio; Pacheco Bacuilima, Juan Pablo; Morocho Malla, Manuel IsmaelOBJECTIVE: To reduce the pain of manual vacuum aspiration (MVA) in patients involved under paracervical block. MATERIALS AND METHODS: In a clinical randomized controlled blind design, 80 patients were included (in two groups of 40) selected for an incomplete treatment of abortion with manual vacuum aspiration, in the Gynecology and Obstetrics Department of the Vicente Corral Moscoso Hospital. The group “A” (n = 40) received additional to the paracervical block 1 mcg / kg intravenous remifentanil as an initial dose followed by 0.5 mcg / kg every 4 minutes and the group “B” (n = 40), the procedure was performed only under paracervical. Pain intensity was determined by visual analog scale of 10 points, hemodynamic changes and side effects. RESULTS: There is no a significant difference in the study groups in both age (p = 0.118), weight (p = 0.522), height (p = 0.114), BMI (p = 0.668), educational level (p = 0.699). The addition of remifentanil, reduced pain according to the EVA of 7.58 group “B” with respect to 2.98 group “A”, (p = 0.000); it had no significant changes in arterial pressure and heart rate (p> 0.05); the side effect was presented with statistically significant difference (p = 0.001) it is nausea which is higher in group “B”. DISCUSSION: The addition of remifentanil to paracervical block, decreased the pain through EVA by 46%, without much change in hemodynamics and with fewer side effects than has the control group (92.3% nausea with p 0.001).Item Comportamiento de la patología biliar aguda y su manejo en el servicio de trauma y emergencia del Hospital "Vicente Corral Moscoso" Cuenca. Enero a junio de 2014(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-06) Reinoso Naranjo, Jeovanni Homero; Pino Andrade, Raúl Haldo; Salamea Molina, Juan Carlos; Rodas Andrade, Juan Edgar; Fernández de Córdova Rubio, Germán Lenín; Zurita Batallas, María Cristina; Cabrera Ordóñez, Catherine Mercedes; Andrade Gómez, Jorge AndrésBiliary disease affects a large percentage of the adult population, for this reason its treatment now has shifted to a new paradigm of care under the concept of “Acute Care Surgery” (ACS) 1, which is characterized by prioritize the comprehensive patient assessment and the early intervention of pathology. In the Vicente Corral Moscoso Hospital (VCMH) under this model ACS and using standardized protocols, has achieved an important turn in the early treatment of biliary pathology using standard tools such as laboratory tests, radiology and if it is necessary in any case through the resolution by minimally invasive surgical technique or by conventional means. OBJECTIVE: To describe the behavior of the biliary disease and its management in the service of Trauma and Emergency of the “Vicente Corral Moscoso Hospital” during the period January-June 2014, under the model (ACS) during the period January-June 2014. METHODS: A cross-sectional study, which analyzed cases of acute cholecystitis (CAL), choledocholithiasis, acute biliary pancreatitis (ABP) and their management, registered in the digital database service of the Emergency in the Vicente Corral Moscoso Hospital, under clinical criteria, laboratory and imaging, during the period January-June 2014. RESULTS: The study involved a total of 240 patients treated in the Trauma and Emergency in the VCMH during the period January- September 2014. The pathology in order of frequency was 47% choledocholithiasis, 35% acute cholecystitis and acute biliary pancreatitis 18%, the prevalence was higher in women by 85%, 67% and 81% respectively and treatment was adapted to the corresponding pathologies. CONCLUSIONS: The implementation model of Trauma and Emergency Surgery at our institution has achieved an integrated management of the acute cholecystitis, acute biliary pancreatitis and choledocholithiasis, reducing the associated complications and avoiding the recurrence of more serious picturesItem Malestar en la cultura. Suicidio: aspectos transculturales(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-06) Vega Delgado, Armando GustavoThe introduction states that suicide is an epitome of the Discontents in the Culture. It occurs in vulnerable groups, indigenous groups, intellectuals, and it has a relationship with economic catastrophes. It states several prone countries, mentioning some suicide rates, and stopping in cases of collective suicides in the history. It also mentions various methods of suicide, prone times, as well as the relationship between the euthanasia and suicide, and the changes related to the age and gender. Numerous references are listed according to cultures, people and religions. It compares the human suicide with the animal world and alerts about the prevention and drug use. Given a publication offered in Ecuador, the article makes a brief reference about the topic. The colophon remembers that suicide is the most shocking human event