Volumen 36 No.1 (Junio 2018)

Permanent URI for this collectionhttps://dspace-test.ucuenca.edu.ec/handle/123456789/32137

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Now showing 1 - 12 of 12

Artesanos de servicio: Apreciaciones sobre los Barberos, Sangradores, Sacamuelas
(Universidad de Cuenca, 2018-06) Pino Andrade, Raúl Haldo
Barbers over time, have left a trail which is little appreciated. The present account tries to enhance its name, observing it briefly from several aspects: guitar player and singer, navigator and craftsman; trying to break the belief that they were uncultured and uneducated people. There will also be an approach to the barbers who worked in our city “Cuenca de los Andes” from the sixteenth century until its extinction in the twentieth century.
Carcinoma cutáneo de células de Merkel, a propósito de un caso y revisión de la literatura
(Universidad de Cuenca, 2018-06) Castillo Leon, Jhon Paul; Montalvo Burbano, Mario; Ordoñez Izquierdo, Maria Del Cisne
The Merkel cell carcinoma, also known as cutaneous neuroendocrine carcinoma, is a very rare and aggressive neoplasm. It is characterized by its tendency to recurrence, lymph node dissemination and distant metastasis. We present the case of a 88-year-old male patient with a history of basal cell carcinoma in the dorsal region, who presented a large right cutaneous tumor in the right ankle 3 months ago, which produces distant lymph node metastasis. The immunohistochemical study reveals that it is a cutaneous neuroendocrine carcinoma, exeresis is performed with negative histological edges, but after a few months it relapses, so a deeper surgery is performed and it is accompanied by chemotherapy. Emphasis is placed on the aggressiveness and tendency to recurrence of this rare disease that could go unnoticed in centers of less complexity.
Tratamiento laparoscópico de incidentaloma suprarrenal derecho. Informe de caso
(Universidad de Cuenca, 2018-06) Serrano Olmedo, Stefanía del Cisne; Espinoza Saquicela, Edison Ricardo; Idrovo Hugo, Moisés
The adrenal incidentalomas are silent adrenal masses. Its prevalence is 1 - 2% in occasional abdominal TC scans. A directly proportional increase in relation to the age is evident. Approximately 80% are nonfunctioning adenomas, in a lower percentage, they produce subclinical Cushing's syndrome, Pheochromocytoma, and Aldosterone among others and this is closely related to the clinical manifestations presented by the patient. In a tomographic study, suggestive data of malignancy can be evidenced such as: a diameter greater than 4cm, higher density 10HU, and high degree of heterogeneity, calcifications, jagged edges and areas of necrosis. It is important to differentiate between a benign or malignant lesion, hormonally functioning or not, since this depends on the medical action. Patient Information: Female, 29 years old, with no personal pathological history, presented with right hypochondrium pain, nausea, vomiting, chills, generalized pallor, visceromegaly at the right hypochondrium level, laboratory tests, and tumor markers: negative, negative catecholamines, Cortisol negative; Contrast Abdominal-Pelvic TC: hypodense mass with 11.5 x 9.5 cm, regular borders, liquid density, peripheral calcification. A presumptive diagnosis of a tumor dependent on the right adrenal gland versus hepatic tumor is established. Treatment: A diagnostic laparoscopy is performed, showing a giant right adrenal gland tumor of 15 cm in diameter, adhered to the lower face of the liver, completely freed, completely dry, and removed through a laparoscopic umbilical port without complications. Favorable postoperative evolution, medical discharge at 24 hours, stable and asymptomatic. Anatomopathological diagnosis : Adrenal cortical adenoma with hemorrhagic cystic degeneration Conclusions: Adrenal incidentaloma is a pathology of low prevalence, variable clinical and insidious presentation. The importance of its diagnosis lies in the possibility of differentiating between a benign lesion and a malignant and determining its hormonal potential on the host. The laparoscopic treatment has limited indications, but it is an effective and safe strategy.
Malformación de Abernethy tipo 2. Presentación de caso clínico y revisión de literatura
(Universidad de Cuenca, 2018-06) Maestre Calderón, Manolo Patricio; Riera Robles, Andrea Cristina; Lam Astudillo, María Eulalia; Faicán Benenaula, José Francisco; Tenesaca Tenecela, Manuel Jesús
The extrahepatic congenital porto-systemic derivation is a very rare pathology of the venous vascular system of the abdomen described by John Abernethy in 1793. In this malformation there is a passage of substances not metabolized from the liver to the systemic circulation and dilation of the pulmonary capillary bed. It is divided into 2 groups according to the presence (type II) or total absence (type I) of portal flow. We present a case of a 6-year-old child, the product of twin pregnancy of the first pregnancy of a 22-year-old mother, who was treated at the Vicente Corral Moscoso Hospital in Cuenca, with respiratory symptoms, without an initial definite diagnosis. The presence of a portal vascular abnormality was found in a casual abdominal ultrasound study, which was diagnosed as Abernethy type II malformation by abdominal angiography and nuclear magnetic resonance A bibliographical review and subsequent discussion of the case was carried out; finding as important data, the existence of 80 cases reported until 2014 worldwide. In Latin America there is a case report in Venezuela in 2011 and in Argentina in 2016. We conclude by emphasizing the importance of a correct anamnesis, physical examination and use of different diagnostic techniques in terms of respiratory symptoms due to there are rare pathologies that being diagnosed early, can be treated successfully, thus giving the patient a normal life. The present case is the only one reported in Ecuador with a successful approach and treatment.
Pancreatitis biliar necrotizante: a propósito de un caso
(Universidad de Cuenca, 2018-06) Crespo Verdugo, Hernán; Ramón Brito, Maricela Susana; Pillco Guaraca, Mélida Cristina; Cabrera Suárez, Gimson Oswaldo
The necrotizing pancreatitis is a severe form of acute pancreatitis, which causes multiorgan failure, with biliary lithiasis being its main etiology. The description of a clinical case of a 16-year-old patient with abdominal pain of several days of evolution is made. This case and complementary tests are an indicative of acute pancreatitis. Despide of receiving hospital treatment without improvement, the patient is operated surgically. Macroscopic lesions compatible with necrotizing pancreatitis and biliary lithiasis were found. A resection of 60% of the pancreas and a cholecystectomy for vesicular lithiasis was performed. The patient stays in the intensive care unit for antibiotic therapy with a subsequent recovery.
Tuberculosis intestinal y/o peritoneal y su implicación en el abdomen agudo.
(Universidad de Cuenca, 2018-06) Ramón Brito Maricela Susana, Maricela Susana; Maldonado Farez, Vanessa Estefania; Crespo Verdugo, Hernán; Andrade Arizaga, Pedro Francisco; Mosquera Vallejo, Lorena Elizabeth
A clinical case of a 14-year-old patient from the Cost is presented without a pathological history with recurrent episodes of diffuse abdominal pain that exacerbates acute abdomen, so a surgical intervention is decided. During the intervention, areas of necrotic tissue and areas with inflammatory tissue are evidenced, terminal ileum resection and right hemicolectomy plus transverse anastomosis lateral term are performed, samples are sent to pathological anatomy resulting in lesions produced by the Koch bacillus at the level of peritoneum and intestine. After the surgical intervention the diagnosis and treatment for intestinal tuberculosis is given, it was observed a favorable postoperative evolution without evidence of complications. A schematic treatment for tuberculosis is added, the patient was discharged after 10 days. Tuberculosis is a disease that for years has been called the great simulator, and in this case, it was presented as acute abdomen, requiring a surgical resection, as pulmonary tuberculosis, its treatment is based on antibiotic therapy for elimination of Koch bacillus
Síndrome de Lynch: Caracterización genético clínica y epidemiología. Caso clínico
(Universidad de Cuenca, 2018-06) Quezada Morales, Manuel Emilio; Guallasamin Chalco, Edwin Fabian; Jara Sanchez, Hugo Eduardo; Fajardo Morales, Paul Fernando
The obesity is characterized by the higher content of Hereditary nonpolyposis colorectal cancer (HNPCC), also called Lynch syndrome, is the most common form of hereditary colorectal cancer (CRC) (1). It is a syndrome with a high genetic load and penetrance, which occurs in the early stages of life, in several family members (2). It is an autosomal dominant disease due to the presence of mutations in DNA repair genes, mainly MSH2 and MLH1, which represent 90% of the total, and with less frequency MSH6 and PMS2 (3). The 80% of colorectal cancers are sporadic, 10% are familiar and the 5-10% is hereditary. We present the case of a man of 35 years, with multiple recurrences and at least two generations affected. The most important aspects about the diagnosis, management and genetic counseling in these cases are discussed.
Prevalencia de sobrepeso y obesidad en adultos de la ciudad de Cuenca-Ecuador, 2014
(Universidad de Cuenca, 2018-06) Verdugo Sánchez, Adriana Elizabeth
Background. The obesity is characterized by the higher content of body fat, it is a chronic disease of high global prevalence. In Ecuador, ENSANUT-ECU 2013 reported a prevalence of 73% between the fourth and fifth decade of life. In Cuenca, a 30% of overweight and obesity were reported. Objetive: to describe the prevalence of overweight and obesity in adults from Cuenca - Ecuador in 2014 Method: An observational, descriptive cross-sectional study was conducted with a sample of 384 adults from the fifteen urban parishes from Cuenca. Some validated questionnaires were applied to determine the lifestyle, family functionality, as well as anthropometric measurements. The data were analyzed with the SPSS v15 program by frequency and percentage tables with 95% of confidence intervals. Results: At the end of the study, it was evident that overweight represents 42.2% and obesity 40.6%; with predominance in the female sex (69.3%). The prevalence of obesity in Cuenca exceeds the average of countries in the region and the country. The indicators of overweight and obesity in the group of 40 to 64 years were added which reach 83.1%, this data is higher than the prevalence of Ecuador that was 62.8%.. Conclusions: The prevalence of overweight and obesity in adults in Cuenca is higher than the national prevalence and predominantly in females.
Cosmovisión andina relacionada al uso de plantas medicinales, Sayausí – Cuenca 2016
(Universidad de Cuenca, 2018-06) Oñate Álvarez, Pedro Andrés; Ordóñez Vélez, Christian Giovanny; Achig Balarezo, David Ricardo; Angulo Rosero, Aydeé Narcisa
Despite the urbanization of the last 20 years, Sayausí still maintains ancestral Andean customs such as the use of medicinal plants, a preventive and therapeutic resource in health. Objetive: To determinate the principles of the Andean worldview and relate them to the management of medicinal plants in Sayausí. Method: It is a qualitative descriptive study of a narrative type with an intercultural approach. The use of medical plants was investigated under the postulates of the Andean worldwide. Five wise men of the ancestral medicine of the Sayausí parish were interviewed during the months of July and August in 2015. The theoretical basis for the analysis of the data: the narrative design, generating concepts and interpretations from the information obtained from the wise men. The techniques used were interviews. The Instruments were forms with open questions, recordings and photographs. The interviews were written using citations, codes and memos, which were processed with the Atlas program. The main categories were grouped according to taxonomies; the information was complemented with tables and figures. Results: The Andean sages explained in their own words the principles: relationality, reciprocity, correspondence, and complementarity. In its rationality, everything worked as a holistic process, involving all the components of the universe. To heal with plants was a true ritual, including principles, plants, body and spirit. The plants had three main functions: healing, feeding and a sacred element. The ways to classify the plants were: gender, shape, color, and thermal state. The herb harvest, preparation and administration were the three stages of the healing process Conclusions: The Andean sages from Sayausí parish applied the principles of the Andean worldview both in practicing healing with medicinal plants and activities of their daily lives.
Cribado de toxoplasmosis en mujeres embarazadas en el Hospital Básico Provida. Latacunga 2013-2016
(Universidad de Cuenca, 2018-06) Durán Chávez, José Augusto; Pérez Castillo, Andrea del Rocío; Quispe Alcocer, Denys Amilcar; Guamán Flores, Wendy Yadira; Jaramillo Puga, Marilin Estefanía; Ormaza Buitrón, Diana Elizabeth
Objetive: To determine the frequency of toxoplasmosis in pregnant women. To evidence the frequency of positive and negative IgG and IgM results.To describe the frequency of acute infection based on results of IgG affinity tests.To show the frequency of toxoplasmosis and the distribution according to the age and years of presentation. Method: A non - experimental, observational - cross - sectional study was conducted at the Basic PROVIDA Hospital, in Latacunga, Ecuador. About 989 IgG and IgM screening results for toxoplasmosis were analyzed from pregnant women aged between 14 and 45 years in the first trimester of pregnancy, 9 IgG avidity tests and 4 DNA amplification tests for T. gondii. It was developed between 2013 and 2016. The statistical analysis was carried out with the software SPSS v.23, descriptive statistics were applied, with age, mean, minimum and maximum standard deviation were obtained. The frequency of positive and negative IgG and IgM results were calculated and their distribution according to age and behavior in the years of study. Frequency of acute infection by IgG avidity test and T. gondii amplification by PCR were identified. Results: The mean age is 29.36 years, standard deviation of ± 5.67. In 989 IgG tests, 340 were positive. Of the total 40.34% were in ages of 27 to 32 years. Of the positives for IgM 0.3% (95% CI: 0.1-0.89) were in ages 22 to 26 years. The frequency of positive and negative IgG and IgM results does not show significant variation over the 4 years. About 0.3% avidity tests for IgG, have low avidity. No DNA amplification test for Toxoplasma gondii amplified. Conclusions: This study reported a positive IgM frequency of 0.3% (95% CI: 0.1-0.89) in ages between 22 to 32 years, the frequency of acute infection with determined Toxoplasma gondii according to the IgG avidity of 0.3%. The results did not vary significantly in the years of study. The seronegativity of IgG for T. gondii was 65.6%. It should be noted that the analyzed results were from patients who can access to a private health service.
Antropometría del neonato de madres indígenas y mestizas, Hospital Básico de Saraguro, 2016
(Universidad de Cuenca, 2018-06) Tacuri Quezada, Juan José; Maldonado Merino, Kathia Del Cisne
The gaps between the indigenous and mestizo population are notorious for the different socioeconomic practices that differentiate them, so the state of health of the newborns is closely related to the conditions in which the pregnant woman develops. Objective: To determine the anthropometry of the newborn of indigenous and mestizo mothers born in the Basic Hospital of Saraguro, 2016. Method: This descriptive study was carried out through the review of 143 clinical records of term pregnancies, without risk, whose delivery was attended at the Saraguro Hospital between January and October 2016, with the obtaining of a single live product without apparent pathology. The maternal variables (age, ethnic self-identification, marital status, education, residence, occupation, type of feat) and neonatal variables (sex, age, weight, height, head circumference and thoracic perimeter) were compiled in a questionnaire structured by the authors, and they were analyzed in the SPSS 20 program. Results: The average age of the mothers was 23.8 years, the 46.8% were indigenous, 49% had primary education and 51% had multigestations; On the other hand, the means of weight (3295 g, p: 0.024), length (49.7 cm, p: 0.013) and head circumference (34 cm, p: 0.021) were closely higher in neonates of mestizo mothers than the averages of children of indigenous mothers (weight: 3147 g, length: 49.0 cm, head circumference: 33 cm), the thoracic perimeter did not obtain significant differences (p: 0.71). Conclusions: The weight, height and cephalic perimeter of neonates of mestizo mothers are superior to the neonates of indigenous mothers of Saraguro - Ecuador.
Inestabilidad de los microsatélites en cáncer colo-rectal y su distribución de acuerdo a factores pronósticos en SOLCA Cuenca 2004-2014
(Universidad de Cuenca, 2018-06) Murillo Bacilio, Magdali del Rocío; Palta Gonzalez, Araceli Miroslava; Correa Martínez, Fabián Gerardo
Worldwide, colorectal cancer is the third most common neoplasm in men and the second in women. Tumorigenesis pathways allow us to subclassify patients and protocolize treatments. The microsatellite instability constitutes one of these pathways; it is present in a 15% to 20% in colorectal carcinoma; its presence is associated with a better prognosis. Objective: To determine the frequency of microsatellite instability and its distribution according to prognostic factors in biopsies of patients with colorectal cancer in the Solca-Cuenca Cancer Institute during the period 2004-2014. Method: It is an observational, analytical study. About 240 patients with colorectal cancer were studied, they were diagnosed in the Pathology Department of the Cuenca Cancer Institute and who had their biopsy material where the immunohistochemical techniques were performed with 4 markers MLH1, MSH2, MSH6, and PMS2. Results: The 37.9% corresponded to men and 62.1% to women. The average age was 66.2 years. The 58.75% (n = 141) had localization in the colon. A lack of protein expression was observed in 24.2% (58 patients). Regarding to proteins, 68.96% (40 cases) were MLH1 / PMS2; 1.72% (1 case) MSH2 / MSH6. About the cases that did not express the proteins, 87.93% were located in the colon; 79.3% were adenocarcinoma; 58.6% were moderate grade and 37.9% were stage II. In the bivariate analysis, a statistically significant association was established between microsatellite instability with tumor location (OR 7.4, CI 3.2-17) and degree of differentiation (OR 2.8, CI 1.5-5 .4). Conclusions: The protocolized use is recommended within the treatment of colorectal cancer.

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