Revista Médica del Hospital José Carrasco Arteaga最新文献

{"title":"Estudio Descriptivo: Caracterización de la anestesia subaracnoidea con levobupivacaína en pacientes intervenidos por cirugía abdominal baja y miembro inferior. Hospitales José Carrasco Arteaga y Vicente Corral Moscoso. Cuenca – Ecuador, 2020-2021.","authors":"Jessica Maribel Reinoso Herrera, Angélica Patricia Bernal Asmal","doi":"10.14410/2022.14.1.ao.03","DOIUrl":"https://doi.org/10.14410/2022.14.1.ao.03","url":null,"abstract":"BACKGROUND: Levobupivacaine is currently the anesthetic of choice in subarachnoid anesthesia; reducing the risk of cardiotoxicity, it provides a shorter time of motor and sensory block compared to bupivacaine, allowing faster recovery of motility. The aim of this study was to characterize subarachnoid anesthesia with levobupivacaine, in a study of patients aged 18 to 65 years, undergoing lower abdominal and lower limb surgery, at the Hospital Vicente Corral Moscoso and Hospital de Especialidades José Carrasco Arteaga in Cuenca, Ecuador. METHODS: Observational, descriptive study. 276 patients who met the inclusion criteria were included. The anesthesiologist monitored the latency time, duration, level of block, and side effects of levobupivacaine. For qualitative variables, we presented frequencies and percentages, for quantitative variables we applied mean and standard deviation. Statistical associations between the variables were sought with Chi-square test, accepting statistical significance with a p value < 0.05. RESULTS: Most of patients were male, between 30 and 39 years old. The majority of patients were overweight, most classified as ASA II, and underwent emergency surgery. Sensory block latency time was 1 to 5 minutes in 57.2% of the sample. Regarding motor block, 8 out of 10 patients had the anesthetic effect in the range of 11 to 15 minutes. In more than half of the patients the duration of the sensitive block was > 200 minutes; most of participants reached a sensory block at T6. The duration of motor block varied between 81 and 160 minutes for 80.4% of the sample. One out of 10 patients had side effects. CONCLUSION: The average sensory latency time is 5.89 minutes and the average motor latency time is 12.69 minutes. The duration of sensory block is greater than 200 minutes in most patients. The higher the dose of levobupivacaine, the longer the sensory block lasted. Motor block duration was 131 ± 31.31 minutes on average. The differences in the sensitive latency time in relation to the use of fentanyl are not significant; on the contrary, there is a significant association between the duration of sensory block and fentanyl administration.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"409 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116948281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caso Clínico: Síndrome nefrótico como presentación de amiloidosis AL, una asociación poco frecuente en nuestro medio","authors":"Jorge Oswaldo Herrera Ordoñez, Oswaldo Mauricio León Cabrera, Jorge Sebastián Coronel Montero, Soraya Puertas Azanza","doi":"10.14410/2022.14.1.cc.08","DOIUrl":"https://doi.org/10.14410/2022.14.1.cc.08","url":null,"abstract":"BACKGROUND: Amyloidosis is a heterogeneous group of diseases with multi-organ involvement and different clinical manifestations; one of them is nephrotic syndrome. Amyloidosis results from the extracellular deposit of fibrillar proteins that form the amyloid substance; amyloidogenic proteins resistant to proteolysis infiltrate tissues extracellularly and are capable of severely altering their structure and function. Amyloid deposits in the renal parenchyma can be observed in the mesangium, capillary wall, interstitium, and arterial vessels. Its diagnosis requires a biopsy of the comprised organs. CASE REPORT: 53-year-old male patient, presented with the incidental finding of microalbuminuria. The only clinical manifestations were mild lower limbs edema and foamy urine. Laboratory tests showed: hypoalbuminemia, hypercholesterolemia, hypertriglyceridemia and nephrotic- range proteinuria. With pure nephrotic syndrome diagnosis a renal biopsy was performed, leading to the histopathological diagnosis of amyloidosis. EVOLUTION: Nephroprotective measures were instituted and the extent of systemic involvement was studied, we diagnosed congestive heart failure and amyloid deposition in the digestive system. The patient initially received treatment based on Cyclophosphamide, Bortezomib and dexamethasone, with no renal or haematological response after four cycles of treatment, so treatment was changed to Bortezomib and Bendamustine. CONCLUSION: It is vitally important to have a high index of suspicion and to make an early diagnosis of the disease through a biopsy with Congo red staining. The treatment depends on the type of amyloidosis, its opportune start allows to increase survival rate, as well as, to avoid the deposit of amyloid in other organs.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123135604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Video Caso Clínico: Síndrome del muñón del cístico, resección laparoscópica del remanente","authors":"Paúl Alejandro Sarmiento Beltrán, Juan Sebastián Ordóñez Peña, María Soledad Ordóñez Velecela, Ismael Francisco Pesántez Brito","doi":"10.14410/2022.14.1.vc.11","DOIUrl":"https://doi.org/10.14410/2022.14.1.vc.11","url":null,"abstract":"BACKGROUND: Laparoscopic cholecystectomy is one of the most frequently performed surgical procedures, which has gradually evolved to become one of the safest surgeries. However, no procedure is without risk; in this context, biliary duct injury (BDI) is the most important intraoperative complication during cholecystectomy. Common bile duct injury reaches a variable incidence between 0.4 to 1.4%, which is associated with significant long-term morbidity, including stenosis and recurrent cholangitis, significant limitations in the life quality of the patient [1]. In order to reduce the incidence of BDI, several alternative procedures can be performed during a difficult cholecystectomy, among which we can list: cholecystostomy, subtotal cholecystectomy and/or conversion to open cholecystectomy. Subtotal cholecystectomy, according to several meta-analyses, minimizes the possibility of bile duct injury, however, it is associated with the persistence or development of symptomatic gallstones in the remnant of the gallbladder or cystic duct; when this occurs, it is necessary to reoperate on symptomatic patients [1,2]. It is estimated that between 5-40% of patients who have previously undergone cholecystectomy, may present episodes of abdominal pain like those that initially motivated the surgical indication, grouped under the term \"post-cholecystectomy syndrome\" (PCS) [3]. PCS is mainly caused by residual lithiasis, which represents approximately 21.3% of readmissions [4]; other causes of PCS include: stenosis or bile leak, neuroma in the scar tissue, biliary dyskinesia, Oddi sphincter dysfunction. It is also worth highlighting, within the causes, the cystic duct remnant syndrome defined as \"presence of a residual cystic duct greater than 1 cm that produces symptoms as a consequence of the lithiasis inside it\", with a prevalence of less than 2.5% among patients that underwent cholecystectomy; however, a high index of suspicion will allow us to recognize it in the immediate postoperative period or even several years later [3,4]. The age range of onset of cystic duct remnant syndrome is from 21 to 90 years. The female preponderance of gallstones is the probable reason for greater frequency of the syndrome in this gender. Clinically, the main reason for consultation is abdominal pain in the right hypochondrium and epigastrium, which occurs in 77% of the patients; accompanied by nausea, in 44% of patients; vomiting in 31% and fever in 19% of patients [5]. Magnetic resonance cholangiopancreatography is the non-invasive technique of choice for evaluating the biliary tree, relegating endoscopic retrograde cholangiopancreatography (ERCP) as a strictly therapeutic technique. In addition, ERCP with sphincterotomy and possible placement of a stent to aid drainage of the main bile duct can be performed, along with definitive surgical treatment, by gallbladder and/or cystic remnant resection [3]. This case report details an experience of surgical reintervention in a p","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116113037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caso Clínico: Bentall De Bono, técnica de elección para paciente con aneurisma de aorta y síndrome de Marfan","authors":"Karen Michelle Novo Pinos, Javier Arturo López Rodríguez, Luis Alfredo Rodríguez Rodríguez, Juan Bernardo Flores Siguenza, Andrés Fernando Cajamarca Taza","doi":"10.14410/2022.14.1.cc.09","DOIUrl":"https://doi.org/10.14410/2022.14.1.cc.09","url":null,"abstract":"BACKGROUND: Patients with Marfan syndrome have a higher risk of aortic degeneration than the rest of the population, presenting with aneurysms, ruptures and dissections. Although the Bentall procedure has been considered the gold standard in the surgical treatment of combined diseases of the aortic valve and ascending aorta; traditionally, aortic manifestations in patients with Marfan syndrome are repaired with open surgical techniques, since endovascular repair in this patients is still controversial. CASE REPORT: We describe the case of a patient with a history of Marfan syndrome and a diagnosis of severe aortic stenosis and aortic aneurysm, in need of an advanced and high expertise surgical procedure for its resolution and considering the difficulty given by his comorbidity. EVOLUTION: Bentall/De Bono surgery with mechanical aortic valve replacement was successfully performed; however, there was a trans-surgical bleeding of 3 600 ml. The patient required pacemaker support, vasopressor support, and administration of blood products. During his hospitalization in the ICU, he presented with pulmonary sepsis, treated with broad-spectrum antibiotics, with complete resolution of the condition after 62 days of hospitalization. After being discharged, he remained in follow-up, with no new complications related to his underlying disease to date. CONCLUSION: Surgical repair of aortic aneurysms in patients with Marfan syndrome has evolved thanks to scientific advances, as evidenced in this case, achieving a decrease in surgical mortality rate and improving the quality and life expectancy of patients with this underlying pathology.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124896825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lesión y reparación de la vía biliar: Serie de casos desde 1989 hasta 2020","authors":"Genaro Miguel Sánchez Piedra, José Adrián Sánchez León, Juan Sebastián Sánchez León, Marcela Nataly Parra Álvarez","doi":"10.14410/2022.14.1.ao.05","DOIUrl":"https://doi.org/10.14410/2022.14.1.ao.05","url":null,"abstract":"BACKGROUND: The benign lesion of the bile duct is a complication of difficult diagnosis and treatment; which has increased due to the use of laparoscopic cholecystectomy (LC) in the management of cholecystolithiasis. Rates of 0.2 to 0.4% of bile duct injuries have been reported, becoming a significant cause of mortality at the time of repair. METHODS: This is an observational, descriptive study, a retrospective case series, based on primary sources of information. The universe of the study are the patients who underwent surgery for bile duct injury from 1989 to 2020, in a private clinic in the city of Cuenca-Ecuador. RESULTS: In more than 30 years, 24 bile duct injury repairs were performed, which occurred: 6 during conventional surgery and 18 during laparoscopic surgery. 54.2% of the lesions occurred less than two centimeters from the confluence of the hepatic ducts. 58.4% of lesions were repaired with Roux-en-Y anastomosis. Antibiotic therapy and drainage were administered to 100% of the patients; 45.83% of the drains placed were tubular drains. 70.8% of the patients didn´t have complications after the repair procedure; the complications that occurred are: bilioma, fistulas, stenosis, cholangitis. CONCLUSION: In most patients who had bile duct injury, the injury occurred during laparoscopic surgery. The injury was most often located less than two centimeters from the confluence of the hepatic ducts. The most frequently performed repair procedure was the Roux-en-Y anastomosis. The most frequent complication after repair was cholangitis.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128894309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hipoacusia laboral en ejecutantes de la Orquesta Sinfónica de Cuenca, 2019","authors":"Wilson Bolívar Cajamarca Cárdena, Karola del Rocío Álvarez Pesántez, Gabriela Nataly Ochoa Urgilés, Guido Esteban Abad Vicuña, Erika Priscila Montaño Loja","doi":"10.14410/2022.14.1.ao.02","DOIUrl":"https://doi.org/10.14410/2022.14.1.ao.02","url":null,"abstract":"BACKGROUND: Noise-induced hearing loss (NHL) is the second leading cause of hearing loss, after presbycusis. It is considered an occupational disease and a public health problem. The aim of this study was to establish the prevalence of occupational noise-induced hearing loss and its association with other sociodemographic and occupational variables in performers of Cuenca’s Symphonic Orchestra in 2019. METHODS: This is an observational, analytical, cross-sectional study, whose universe was conformed by the professional musicians of Cuenca’s Symphonic Orchestra in 2019. We aimed to establish the risk of noise-induced hearing loss in association with variables such as age, sex, hours of daily practice, material of the instrument played, and years of exercise as a musician, throught Odds Ratio statistical test. The 45 musicians were surveyed and audiometric tests were performed. RESULTS: The universe consisted of 45 musicians: 38 males and 7 females. The average age was 40 years. 46.7% played a musical instrument profesionaly for more than ten years and 53.3% for up to ten years. 60% practiced more than 10 hours a day. 53.3% played string instruments, 20% woodwind instruments, 17.8% brass instruments and 8.9% percussion instruments. The prevalence of hearing loss was 17.8%: 13.3% bilateral and 4.4% unilateral. The prevalence of mild hearing loss was 8.9%; moderate in 6.7% and acoustic trauma occurred in 2.2%. Age (>30 years) and working time (>10 years) represented risks for hearing loss development. CONCLUSION: The prevalence of noise-induced hearing loss was 17.8%, mostly mild and bilateral. All those who were affected were male. The prevalence was higher among musicians who played wind-metal instruments; however, no statistically significant association was found. Being older than 30, and having played professionally for more than years are risk factors for noise-induce hearing loss.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132624052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Síndrome Mieloproliferativo Transitorio asociado a Síndrome de Down e Hidrops Fetal: Reporte de caso","authors":"Juan Sebastián Peña Aguilera, Remigio Leonardo Amoroso Palacios, Valeria Estefanía Correa Ochoa","doi":"10.14410/2022.14.1.cc.10","DOIUrl":"https://doi.org/10.14410/2022.14.1.cc.10","url":null,"abstract":"BACKGROUND: Transient myeloproliferative Syndrome can be defined as an abnormal proliferation of immature leukemic cells. It presents in newborns with Down syndrome or trisomy 21 mosaicism, as an uncontrolled proliferation of blasts in the megakaryocytic lineage; it resolves spontaneously during the first three months of life. One of the characteristic manifestations is Non-Immune Fetal Hydrops. CASE REPORT: Premature newborn patient adequate for gestational age, born by C-Section due to ultrasound diagnosis of NIHF. At birth, we evidenced phenotypic characteristics of Down syndrome; in addition, the clinical picture and physical examination (respiratory distress, bradycardia, hypotension, prolonged capillary refill, hypotonia, and thrombocytopenia) supported the diagnostic suspicion of neonatal sepsis. The initial management of the patient in the intensive care unit included: mechanical ventilation, vasopressor support, surfactant administration, intravenous antibiotic therapy, furosemide, fentanyl and midazolam, albumin, and vitamin k. EVOLUTION: During his hospital stay, the patient developed acute kidney injury. In addition, we detected leukocytosis and presence of immature cells, anemia and thrombocytopenia, with diagnostic suspicion of congenital leukemia versus MTS, confirmed by flow cytometry. Subsequently, the patient presented elevated bilirubin, with jaundice and subsequent multifactorial cholestasis. The patient was hospitalized for 48 days and after the resolution of the mentioned pathologies, he was discharged. At the follow up, 15 days after discharge, normalization of leucocyte, red blood cell and platelet values confirmed the TMS diagnosis. CONCLUSION: In this case report, the patient developed MTS in relation to Down syndrome and had a complicated clinical course due to all the complications derived from his prematurity, his congenital disease, and the presence of hydrops fetalis and other manifestations of MTS. In the present case, there were criteria of severity, poor prognosis and high risk of mortality, which advantageously do not affect his current clinical condition, but require continuous and strict clinical surveillance. Multidisciplinary management, a high index of suspicion, timely attention to the multiple manifestations and complications, and proper follow-up allowed for a favorable evolution and greater survival in this patient.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127960984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timoma, un tumor maligno poco frecuente con resolución quirúrgica mediante videotoracoscopia. Reporte de un caso","authors":"Marcos Andrés Aguirre Vintimilla, Jorge Andrés Torres Jerves, Alonso Xavier Quito Becerra, Jennifer Andrea Freire Ochoa","doi":"10.14410/2022.14.1.cc.07","DOIUrl":"https://doi.org/10.14410/2022.14.1.cc.07","url":null,"abstract":"BACKGROUND: Thymomas are rare epithelial tumors which originate from the thymic gland, with an incidence of 0.13 cases per 100 000 inhabitants in one year, more commonly seen between 40 and 60 years of age. These tumors do not present specific clinical signs and 30% to 60% of the patientsare asymptomatic; in most cases, the tumors are found incidentally by CT-scans. The primary treatment involves surgery. There are few reports in Ecuador, thus it is important to publish this clinical case for the knowledge of the medical community. CASE REPORT: 62-year-old male patient, with a history of osteoarthritis and smoking. He came with a four-month history of chest pain, productive cough that progressed later to haemoptysis and significant unquantified weight loss. The chest CT scan reported a mass located in the right anterior and middle mediastinum, causing mass effect on the heart and great vessels; also, there were small pretracheal mediastinal adenopathies. EVOLUTION: After the diagnosis of a mediastinal mass, highly suggestive of a tumor dependent on the thymus, we decided surgical approach by video-assisted thoracoscopy. Incomplete R1 resection (focally in contact with the resection limit) was achieved, with a positive biopsy for thymoma, type AB (WHO classification), stage IIB (modified Masaoka classification). Adjuvant radiotherapy was administered, presenting complete remission of the disease, with no recurrence during 2-year follow up. CONCLUSION:Thymomas are rare malignant tumors; its first-line treatment involves radical surgery in Masaoka stages I, II and III. Video-assisted thoracoscopy thymectomy is a less invasive procedure and reduces complications, improving postoperative life quality; however, the possible need to add adjuvant radiotherapy in cases of incomplete resection with this technique should be taken into consideration.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"26 7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116593049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eficacia de la Litotripsia Extracorpórea por Ondas de Choque en el tratamiento de litiasis renal en el Servicio de Endourología del Hospital José Carrasco Arteaga. Bienio 2015-2016","authors":"Luis Fernando García Ordóñez, Galo Fabián García Ordóñez, Fausto Marcelo Quichimbo Sangurima","doi":"10.14410/2021.13.1.ao.04","DOIUrl":"https://doi.org/10.14410/2021.13.1.ao.04","url":null,"abstract":"BACKGROUND: nephrolithiasis is the third most common urological pathology, followed by infections and prostatic pathologies. One of the treatment options is extracorporeal shock wave therapy (ESWT); it is a minimally invasive technique, easy to repeat, effective, with low morbidity and low cost. The aim of this study was to demonstrate the effectiveness of ESWT as a treatment for nephrolithiasis and its association with some factors. METHODS: We carried out a descriptive, observational, cross-sectional study with retrospective data, with patients diagnosed of nephrolithiasis and treated with ESWT at the Endourology Service of Hospital José Carrasco Arteaga, during the years 2015 and 2016. The sample was constituted of 146 patients. Data was Results are shown with frequencies and percentages in charts, Chi square was applied to measure the association between variables. RESULTS: The location of the stones was mainly intrarenal and on the left side. The mean size of the stones was 12.66 mm and the mean density was 996.97IU. After ESWT, tomographic control reported complete destruction of the stone in 22.6% of the patients and in almost a third of the patients there were no changes. After ESWL, most of the patients received expulsive treatment. 97% of the patients had no complications. CONCLUSION: The effectiveness of ESWL decreased with age, also it was less effective in women, but the association was not statistically significant. The location of the stone, and its size had statistically significant association with the effectiveness of the treatment; ureteral and small stones were completely destroyed more frequently than renal and big stones. The stone density had no association with LEOCH effectiveness.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116647627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caso Clínico: Meningohidroencefalocele Gigante","authors":"Alex David Revelo Villacres, Patricia Elizabeth Guayaulema Cudco, Tatiana Aracely Fuentes Morocho","doi":"10.14410/2021.13.1.cc.07","DOIUrl":"https://doi.org/10.14410/2021.13.1.cc.07","url":null,"abstract":"BACKGROUND: Encephaloceles are a rare congenital anomaly, affecting 1 in 5 000 live births.A meningohydroencephalocele is the herniation of the meninges, ventricles, and part of the brain through a congenital defect in the skull. The prognosis of newborns depends on several factors. The young age and the associated congenital anomalies in these patients contribute to the diagnostic and treatment challenge. CASE REPORT: Male newborn, born at 37 weeks of gestation, by emergency C-section due to latent labor, presenting a large mass over the parieto-occipital region, with lobed, irregular edges, partially covered by the scalp, and in other areas a purplish red tone. The newborn was no very reactive, had decreased tone, absent crying. EVOLUTION: After specialist’s evaluation, due to the significant defect in the cranial shell and the structural brain abnormalities, the patient was not a candidate for surgical treatment. The newborn was discharged with a reduced life expectancy, to receive care at home. CONCLUSION: giant meningohydroencephalocele is a rare neural tube defect. The management of encephaloceles can be complicated and must be individualized, and will depend on the anatomical structures involved. Although in this case the prognosis was bad, multidisciplinary work is always necessary for proper management.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132789057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}