Revista Médica del Hospital José Carrasco Arteaga最新文献

{"title":"Frecuencia de ansiedad y depresión en niñas y adolescentes de la casa de acogida “Miguel León” en el cantón Cuenca, Ecuador","authors":"Andrés Esteban Inga Bravo, Mónica Alexandra Astudillo Sarmiento, Adrián Mauricio Pacheco Naranjo, Manuel Ismael Morocho Malla","doi":"10.14410/2020.12.3.AO.27","DOIUrl":"https://doi.org/10.14410/2020.12.3.AO.27","url":null,"abstract":"BACKGROUND: Depression and anxiety are two pathologies of great personal, social and economic im-pact; in many cases both have an early onset. Domestic violence can separate children and adolescents from their families; being sent, most of the times, to foster homes. Children and adolescents in foster homes tend to develop anxiety, depression and stress triggering lifelong emotional and mental difficulties. In this context, the aim of this study was to determine the frequency of anxiety and depression in girls and female adolescents from “Miguel León” Shelter, Cuenca, during 2016, creating statistical data that will allow set-ting protection projects and future studies. METHODS: Descriptive, quantitative cross-sectional study. The study population was stablished with 35 girls and adolescents, aged 5 to 18 years, from a foster home. For data collection, the SPENCE Child Anxiety Scale and the CDI Inventory were applied. Data was processed with Microsoft Excel 2010 and SPSS 15.0. Data is presented in charts and graphics using frequencies and percentages. RESULTS: The frequency of anxiety was 22.86% and the frequent of depression was 17.14%. The most pre-valent age range for both pathologies was 10 to 14 years old with 62.5% and 50% respectively. In both groups, diagnosed with anxiety and diagnosed with depression, the length of stay in the foster home was 0 to 6 months for the majority of the population ( 50 and 66.67% respectively). CONCLUSIÓN: The frequency of depression in girls aged 5 to 18 years, was 17.14%. The frequency of anxie-ty in girls aged from 5 to 18 years in the foster home was 22.86%, values lower than those found in other studies. The age range in which both diseases were most prevalent was, 10-14 years old. Both disorders were more prevalent the shorter the time spent in the foster home. KEYWORDS: Adolescent Health, Depression, Separation Anxiety, Child Protective Services, Anxiety, Foster Home Care.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134181223","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":"Frecuencia y factores de riesgo asociados a re-sangrado posterior a ligadura de várices esofágicas en pacientes con cirrosis hepática","authors":"María Lisseth Sánchez Garzón","doi":"10.14410/2020.12.3.ao.28","DOIUrl":"https://doi.org/10.14410/2020.12.3.ao.28","url":null,"abstract":"BACKGROUND: Re-bleeding of esophageal varices after endoscopic ligation is a frequent complication, that significantly increases morbidity and mortality in this patients. This study aims to describe the frequen-cy of rebleeding due to esophageal varices after endoscopic ligation, as well as the frequency of certain factors and their association with rebleeding. METHODS: Cross-sectional, descriptive and correlational, observational study. A total of 179 patients who underwent endoscopic ligation of esophageal varices participated. For the association analysis Chi2 test was applied, prevalence ratio was obtained, with 95% IC. Data was presented with charts, with frequencies and percentages. RESULTS: Alcoholism was the main cause of cirrhosis in patients that underwent ligation of esophageal varices (44.1%). Most of the cases were classified as Child Pugh Sore B functional class, with a frequency of 36.3%. The prevalence of rebleeding was 49.2% (95% CI 41.55%- 56.76%), it was more frequent in patients 65 years old and older (58%), and male patients (64.8%). Death rate due to rebleeding after ligation was 43%. We found significant statistical association of rebleeding with factors such as: TPT >33.3 (PR: 1.91, 95% CI 1.07-3.39, p value =0.00); moderate and severe anemia (PR: 1.43, 95% CI 1.05-1.96, p value =0.02), and blood transfusion (PR: 2.23. 95% CI 1.37-3.65, p value=0.00). CONCLUSION: Rebleeding frequency was 49.2% (early and late rebleeding), it was more common in male patients, and patients aged 65 or more. This study found statistical association between rebleeding and: elevated values of partial thromboplastin time, moderate and severe anemia, and blood transfusion. Mor-tality due to rebleeding was 43%. KEYWORDS: ESOPHAGEAL AND GASTRIC VARICES, LIVER CIRRHOSIS, PORTAL HYPERTENSION","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126950511","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":"Estudio Transversal: Riesgo Cardiovascular en Diabetes Mellitus II según Score UKPDS en pacientes del Hospital José Carrasco Arteaga","authors":"Paola Cristina Bacuilima Zhañay, Andrea Catalina Ochoa Bravo","doi":"10.14410/2020.12.3.ao.26","DOIUrl":"https://doi.org/10.14410/2020.12.3.ao.26","url":null,"abstract":"BACKGROUND: Type 2 Diabetes Mellitus (DM2) is a disease of great health and socioeconomic impact. Cardiovascular complications are the main cause of death in diabetic patients, for this reason the application of prevention strategies is important. The aim of the research was to determine the cardiovascular risk according to UKPDS Score in patients diagnosed with DM2, treated at Hospital José Carrasco Arteaga, Cuenca-Ecuador, from November 2918 to August 2019. METHODS:A descriptive, cross-sectional study was conducted with a sample of 118 patients diagnosed with DM2, treated at Hospital José Carrasco Arteaga, between November 2018 and August 2019. Clinical records were reviewed, information was collected on a form with all the variables of the UKPDS Score. Cardiovascular Risk Estimation (RCV) was carried out with the Risk Engine Calculator version 2.0 of the UKPDS Score. RESULTS: The female sex predominated in the study population. The age range went from 32 to 95 years old, the most frequent range of age was 55 to 59 years old (16.1%). The disease duration in 40% of the population was higher than 10 years. 42.4 %(n=50) presented SBP values ≥130mmHg. 75.4% of the sample had poor glycemic control, with glycosylated hemog-lobin levels higher than the normal range for each age group. The estimated 5-year CVR was low for most of the sample; while the 10 year CVR increased, especially for non-fatal CVD(high risk:21.25%) and for fatal (6.8%) and non-fatal(6.8%) AMI. CONCLUSION:Most of the patients had more than 10 years with DMII diagnosis. More than half of the sample had inadequate glycemic control. The CVR at 5 years was “low” for the majority of the population, both for AMI and CVD. The cardiovascular risk at 10 years was slightly higher for all entities, especially it increases for non-fatal CVD, to a “very high risk” of 21.2%, and the risk of AMI also increases to a “very high risk” of 6.8%. KEYWORDS: TYPE 2 DIABETES MELLITUS, CARDIOVASCULAR DISEASES, MYOCARDIAL INFARCTION, CEREBROVASCULAR STROKE","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131345752","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":"Estudio Transversal: Conducta de agresión en estudiantes de quinto año de secundaria de cuatro instituciones educativas periféricas de Lima, Perú","authors":"María de Lourdes Pacheco Salazar, Jesús Dámaso Flores, Miriam Carlota Ordóñez Ordóñez, Diego Mauricio Salazar Montesdeoca","doi":"10.14410/2020.12.3.ao.24","DOIUrl":"https://doi.org/10.14410/2020.12.3.ao.24","url":null,"abstract":"BACKGROUND: Aggression among schoolchildren is a growing problem, affecting their educational, social and cultural well-being. In this context, aggression has become an aim of study for Social Sciences, from various approaches. The intensity of this problem negatively impacts on children and adolescents lives. Numerous studies report that events of violence and/or aggression in schools can generate physical and emotional damage to schoolchildren, learning difficulties due to post-trau-matic stress disorder, demotivation, absenteeism and school dropout. The aim of this study was to establish the level of aggression in fifth-year high school students from high schools in Lima, Peru. METHODS: Descriptive, cross-sectional, quantitative exploratory study. The Buss and Perry, Aggres-sion Questionnaire was applied and adapted to the context. The content validity was obtained with Aiken’s V coefficient (0.80) for each item and dimension. The Kolmogorov- Smirnov normality test was used for data analysis. Data is presented in charts, with frequencies and percentages. RESULTS: The study was applied to a sample of 274 adolescents, aged 15 to 18 years. High levels of aggression were found in the students (54.8%; High aggression level: 38.6%, very high aggression level: 16.2%), with a predominance in the male group (43%), compared to 34% in women. Regarding the aggression dimensions, we found high levels, in verbal aggression (40%), followed by physical aggression and hostility (38%) and finally anger (37%). CONCLUSION: After data processing, high levels of aggression were found among fifth-year high schools students from peripheral areas of Lima. Regarding gender, a predominance of high-level aggression was found in males over females. About aggression dimensions, we found a high level of verbal aggression, followed by physical aggression and hostility, finally by anger. KEYWORDS: BEHAVIOR, AGGRESSION, TEENAGER, ANGER, HOSTILIT","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132881388","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":"A propósito de un caso: Resolución quirúrgica en dos tiempos de Pentalogía de Cantrell","authors":"Andrea Karina Muñoz Mora, María Soledad Ordóñez Velecela, Luis Enrique Marcano Sanz, Miurkys Endis Miranda","doi":"10.14410/2020.12.3.cc.34","DOIUrl":"https://doi.org/10.14410/2020.12.3.cc.34","url":null,"abstract":"BACKGROUND: Cantrell’s pentalogy includes the presence of five birth defects that represent a great challenge for surgeons. Abnormalities of the heart, pericardium, diaphragm, sternumand anterior abdominal wall are the main findings. Its incidence is low, however, it is essential to identify Cantrell´s pentalogy timely to adopt an adequate therapy for all specific defects, since it has high mortality. CASE REPORT: The patient was a full- term male newborn, with a history of abdominal wall defect compatible with an omphalocele detected by prenatal ultrasound. After the caesarean section, the abdominal wall defect was notable, the left liver lobe, intestines and heart emerged through it, the sternum also had a low fissure. The echocardiogram revealed a permeable oval foramen, mild tricuspid regurgitation, and severe pulmonary hypertension. EVOLUTION: Immediate surgical management was decided. Silo was placed, with progressive closure of the midline in 7 days. During the second surgical procedure, the diaphragmatic and pericardial defect was corrected with a bovine pericardial prosthesis. Despite the adequate evolution after surgery, at day 28 he presented with sudden cyanosis and didn’t respond to cardiopulmonary resuscitation and died. CONCLUSIONS: Cantrell’s Pentalogy is a rare disease, with peculiar clinical, anatomical and embryological characteristics, it represents a unique challenge for surgeons. Early diagnosis, as well as follow-up during pregnancy, planning a cesarean section in a high-level center and immediate surgical approach with a multidisciplinary team, are the key components in the management of patients with Cantrell’s Pentalogy. KEY WORDS: PENTALOGY OF CANTRELL, ECTOPIA CORDIS, UMBILICAL HERNIA. CONGENITAL.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126529868","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: Mesotelioma primario de pericardio","authors":"Juan Sebastián Sánchez León, Irene Lucía Torres Washima, Anabel Stefanía Cobos Gálvez, Gladis Margarita Molina Alvarado","doi":"10.14410/2020.12.3.cc.33","DOIUrl":"https://doi.org/10.14410/2020.12.3.cc.33","url":null,"abstract":"BACKGROUND: Primary pericardial mesothelioma is an extremely rare mesodermal tumor, among oncological diseases, with a very low incidence. About 350 cases have been described around the world, most of them diagnosed post-mortem. The short term prognosis is poor, regardless of the treatment, which is mostly palliative. We present a case report regarding this pathology. CASE REPORT: 69 year old patient hospitalized with dyspnea and severe anemia. Complementary workup showed pleural effusion and pericardial effusion. Histopathology report of the pericardial fluid revealed pericardial mesothelioma. EVOLUTION: Due to recurrence of pericardial effusion, it was decided to perform pericardiectomy and left pleurectomy as palliative treatment, to alleviate the patient’s symptoms. Chemotherapy was planned after the procedure, but the patient’s general condition deteriorated severely leading to his death. CONCLUSION: Primary pericardial mesothelioma is a rare tumor, whose symptoms are characterized by the associated pericardial effusion, making the diagnosis difficult due to it low incidence. The prognosis is poor in short- term, and there isn’t an established protocol for the treatment with results that showed improve in mortality. KEYWORDS: MESOTHELIOMA, PERICARDIAL EFFUSION, PERICARDIECTOMY, PLEUROTOMY.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133100795","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":"Intervenciones de la aorta ascendente: Estudio transversal en dos Instituciones de Salud de la Ciudad de Cuenca, Ecuador","authors":"Irene Lucía Torres Washima, Jennifer Paola Pacheco Rodríguez, Marlitt Elisa Ordoñez Arteaga, María Belén Vázquez Quezada, Javier Arturo López Rodríguez, Diego Alejandro Córdova Ochoa","doi":"10.14410/2020.12.3.ao.25","DOIUrl":"https://doi.org/10.14410/2020.12.3.ao.25","url":null,"abstract":"BACKGROUND: The treatment of ascending aorta (AA) aneurysms has evolved over the years. The surgical technique for this pathology should always be chosen in favor of preserving native tissues, as much as possible. Aortic dilation can be secondary to other pathologies. There is an association with arterial hypertension, COPD, smoking, atherosclerosis, congestive heart failure, coronary heart disease, Marfan syndrome. The aim of this study was to characterize patients who underwent ascending aorta surgery in two medical centers in Cuenca- Ecuador, between January 2014 and August 2019. METHODS: Cross-Sectional descriptive and correlation study. The study population was formed by 23 patients undergoing an ascending aortic surgical intervention, in the city of Cuenca-Ecuador, at Hospital José Carrasco Arteaga or Clínica Santa Inés, from January 2014 to August 2019. Data was obtained from the patient’s medi-cal records. RESULTS: The age range went from 27 to 74 years with an average of 55.5 7 years. The most frequently found comorbidities were hypertension (56.5%) and type 2 diabetes (17.4%), 8.7% of the patients presented with Mar-fan syndrome. The most common diagnosis was ascending aortic aneurysm without significant valve damage (39%). 91% percent of the patients underwent surgery with the Bentall-De Bono technique. The majority of patients (52.2%) did not present any post-surgical complications. The mortality rate found in this population was 1.3 per 10 patients. CONCLUSIONS:Men were more frequently affected. The mean age was 55 years. The studied pathologies were heterogeneous, from SAA to primary or secondary aortic diseases. The main symptoms were angina and dyspnea; there was no significant association between clinical onset and mortality. The most frequent comor-bidities were Arterial Hypertension and type II Diabetes. We didn’t found any significant associations between complications and the other variables. The most common complication was bleeding that needed rintervention. Mortality decreased progressively since 2014. KEYWORDS: Aortic Diseases, Aortic Aneurysm, Aortic Valve, Cardiac Surgical Procedures.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128815732","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":"Validación de cuestionario por juicio de expertos: Perfil del Enfermero/a que labora en el Servicio de Emergencia y Urgencias","authors":"Gladys Esther Patiño Villalva, Eduard Lambert, Fanny Lorena Cantos Espinoza, Pablo Enrique Bolaños Dominguez, Juana del Carmen Barrera Medina, Hernán Santiago Segarra Cevallos","doi":"10.14410/2020.12.3.ao.29","DOIUrl":"https://doi.org/10.14410/2020.12.3.ao.29","url":null,"abstract":"BACKGROUND: Nursing professionals that work in Emergency and Urgency services, daily carry out direct patient care, in a high stimuli situation and permanent work pressure; therefore it is important to develop a questionnaire that helps establishing an adequate scientific, technical and ethical profile, for nurses who work in Emergency and Urgency hospital areas. METHODS: The aim of this study was to validate a questionnaire able to identify the profile that Emergency and Urgency Services nurses should have. The questionnaire consisted of 32 items, and was validated by 4 experts; Fleiss Kappa coefficient was used to evaluate the agreement between judges. RESULTS: One of the items ( question No.12) was inadequate for all of the judges and had to be withdrawn; 5 items (questions 1,5,9,11 and 19) needed changes, so in accordance with the judges requirements, these changes were made; a total of 26 items obtained an “almost perfect” concordance of totally adequate items. CONCLUSION: The original questionnaire ended with a total of 31 items and has the required content validity. This questionnaire can be validated in the construct through the use of a pilot test applied to nurses in Emergency and Urgency services. This questionnaire makes it possible to evaluate the profile of the nursing staff prior to working in the emergency area. http://dx.doi.org/ KEYWORDS: Emergency nursing, expert testimony, validation study","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132945015","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: Manejo Perioperatorio en Pacientes con Acromegalia","authors":"María Fernanda Guillermo Quinde, Lenin Eduardo Guillermo Quinde","doi":"10.14410/2020.12.2.CC.19","DOIUrl":"https://doi.org/10.14410/2020.12.2.CC.19","url":null,"abstract":"BACKGROUND: Acromegaly is a chronic, progressive and multisystemic disease caused by growth hormone hypersecretion by a functioning pituitary macroadenoma. Some clinical features of this disease are important for anesthetic management, especially those that affect the upper airway, and the cardiac, respiratory and metabolic systems. CASE REPORT: Male 34 year old patient, with progressive increase of feet, hands, nose, skull bone and tongue size, diagnosed with acromegaly caused by growth hormone producing pituitary macroadenoma. Later he presents with severe SAHOS, mitral and mild tricuspid insufficiency; so transsphenoidal resection of pituitary macroadenoma was programed. During preanesthetic evaluation was classified as ASA III Surgical Risk, Lee Cardiac Risk 0.04%, NYHA I, and high probability of difficult airway. The anesthetic induction scheme was: propofol 120 mg, remifentanil 0.2 mcg / kg / min, rocuronium 50 mg. Atraumatic orotracheal intubation using McCoy leaf N4, with reinforced endotracheal tube N 7.5 was achieved. EVOLUTION: The patient was taken to Intensive Care Unit for post-surgical control. The patient remained hospitalized for 7 days and was discharged in stable condition without neurological deficit. He is still in follow up of the severe SAHOS. It has been reported improvement of the episodes of night apnea. CONCLUSION: Patients with pituitary gland disease undergoing surgery can present some anesthetic challenges, from the airway management, to the important hemodynamic and ventilatory challenges during the surgical procedure. It is important to anticipate and prevent the possible complications and correct them in time in order to avoid irreversible injuries that increase the patient’s morbidity","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131754019","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: Neurofibromatosis Tipo 1, resolución quirúrgica","authors":"Juan Andrés Ávila Narváez, Pablo Andrés Salamea Avilés, Jorge Eduardo Ávila Narváez, Marcos Andrés Aguirre Vintimilla, Zoila Katherine Salazar Torres","doi":"10.14410/2020.12.2.CC.21","DOIUrl":"https://doi.org/10.14410/2020.12.2.CC.21","url":null,"abstract":"BACKGROUND: Neurofibromatosis type 1, first described by von Recklinghausen in 1884, is an autosomal dominant genetically transmitted disease, caused by a spectrum of mutations in the NF-1 gen, with unpredictable evolution, that affects multiple organs and systems, such as the skin and the nervous system, also affecting child development and neurocognitive functions. It often requires complex management decisions from the physician that involve a multidisciplinary approach. CASE REPORTS: 9 year old female patient with a history of type 1 neurofibromatosis. She presented with a mass located in the anterior cervical region, occupying also the left hemithorax, compressing the anterior mediastinum, the trachea from its left side, the heart, and the left lung; the mass produced symptoms: dyspnea, dysphagia and pain, so surgical excision of the mass was scheduled. A left cervical-sternotomy-thoracotomy was performed, a 12 x 7cm mass, located at aortic arch level, closely adhered to the cervical-thoracic spine, was excised. EVOLUTION: During the surgical procedure, the patient had profuse bleeding, coming form the left common carotid colateral artery, so abdominal packing was performed, for later resolution. 24 hours later, bleeding control was achieved after the surgical re-intervention. The pathology lab results established that the mass was in fact a neurofibroma. Subsequent follow-up determined symptoms improvement, without late surgical complications. CONCLUSIONS: Neurofibromatosis is a congenital infrequent, disease, with a complex treatment. Although there is no definitive treatment for type 1 neurofibromatosis, comprehensive management can be achieved to improve the patient’s quality of life. Tumors can be surgically removed, although they often grow back.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122073197","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}