Revista Médica del Hospital José Carrasco Arteaga最新文献

{"title":"Caracterización de las Crisis Hipertensivas en adultos de la Emergencia del Hospital José Félix Valdivieso, Enero 2016 a Diciembre 2018","authors":"Braulio Saavedra Flores, Andrea Catalina Ochoa Bravo, Gabriel Aníbal Hugo Merino, Cristina Fernanda Iñiguez Chacha, Juan Fernando Gálvez Vallejo, Edisson Andrés Mogollón Guzmán, Alcira Cecilia Palacios Moncayo","doi":"10.14410/2020.12.2.AO.17","DOIUrl":"https://doi.org/10.14410/2020.12.2.AO.17","url":null,"abstract":"BACKGROUND: Hypertensive crisis is considered an acute complication of Hypertension, causing 9.4 million deaths annually. Another important problem is the resulting morbidity. Locally, data is limited, that is the importance of presenting the clinical and epidemiological characteristics of hypertensive crisis. The aim of this study was characterizing hypertensive crisis in adults, in Hospital José Félix Valdivieso, Santa Isabel, from January 2016 to December 2018. METHODS: Descriptive, cross-sectional study, the study universe were 151 patients diagnosed with hypertensive crisis in Hospital José Félix Valdivieso from January 2016 to December 2018, by simple random sampling we picked 122 patients. The information was obtained from the patient’s medical chart. The data was processed using Excel 2016, and later interpreted using tables and charts. RESULTS: 57% of the sample were female, 49% had between 40 to 65 years of age, 67% had primary education, 65% came from rural areas. About risk factors; 50% of the population was overweight, 70% had previous diagnosis of hypertension. About the type of hypertensive crisis; 93% were hypertensive urgencies, the most commonly affected organ in hypertensive emergencies was the brain, in 89% of the cases. Headache, was the most frequent symptom(59%), followed by neurological symptoms. Captopril was used as initial treatment in 61% of the cases. CONCLUSION: The majority of affected patients were female, middle aged adults. Most of the sample had overweight or obesity. 70% of the population had previous diagnosis of hypertension, of this patients only 80% had hypertensive treatment. Most of the crisis were hypertensive urgencies, in hypertensive emergencies the most commonly affect organ was the brain. Captopril was used in most of the cases for initial treatment. This study didn’t registered any deaths.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"4 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":"126803472","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":"Serie de Casos: Intoxicación por Amlodipino","authors":"Carlos Fernando Ordoñez Troya, Giovanni Paolo González Pazmiño, Lupe Nataly Mora Robles, María Eduarda Clavijo Izquierdo","doi":"10.14410/2020.12.2.CC.22","DOIUrl":"https://doi.org/10.14410/2020.12.2.CC.22","url":null,"abstract":"BACKGROUND: Drug poisoning is an important cause of morbidity and mortality in pediatric patients. However, amlodipine poisoning, a widely used dihydropyridine calcium chanel blocker, is not fully documented in Ecuador. Treatment consists of classic measures for shock management and specific measures for this type of intoxication. CASE REPORTS: We present two case reports, both of teenage patients admitted into the pediatric intensive care unit for suicide attempt by taking amlodipine and some other drugs. EVOLUTION: During hospital stay, they presented a different evolutionary course. In both cases vasoactive drugs were needed, dosage was modified according to clinical course. Also in both patients, calcium gluconate was administered along with other support measures described in this paper. Finally, both patients presented a good outcome and were discharged after psychological and psychiatric assessment and follow up. CONCLUSION: The low frequency of amlodipine poisoning and the lack of evidence-based knowledge, constitute it as a diagnostic and therapeutic challenge. Based on our experience, we highlight the importance of early suspicion and prioritizing the use of vasopressors over fluid resuscitation. Additionally, we recommend documenting the exact dose of intake and inquiring about consumption of other drugs to properly classify the severity of the poisoning and stablish the treatment plan. Finally, constant clinical monitoring and support of laboratory tests will guide the conduct.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"37 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":"121584352","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":"Prevalencia y factores asociados al abandono del implante subdérmico de Etonogestrel, Azogues, Ecuador, 2014-2017","authors":"María Cristina Cordero Calle, Jaime Rosendo Vintimilla Maldonado","doi":"10.14410/2020.12.1.AO.02","DOIUrl":"https://doi.org/10.14410/2020.12.1.AO.02","url":null,"abstract":"BACKGROUND: The national plan for maternal and neonatal death reduction considers birth control as one of the best methods to reduce unwanted pregnancies, non-therapeutic abortions and maternal deaths, in this way the discontinuation of subdermal Etonorgestrel implant is a public health issue. The aim of this study is to determine the prevalence and associated factors of contraceptive discontinua-tion, of subdermal Etonorgestrel implant, in patients from Azogues (03D01 Health District), from 2014 to 2017. METHODOlOGY: Observational, descriptive, cross-sectional study. The study universe included all sub-dermal Etonorgestrel implant users, the study sample included 234 patients, selected by simple ran-dom sampling. The data was obtained and analyzed with the SPSS Software, 2015 version. Significant association was considered with a value of p < 0.005. RESUlTS:The sample age was between 13 and 46 years, 58.5 % were married, 49.1 % lived in the urban area. The prevalence of contraceptive discontinuation for Etonorgestrel implant was 33.3 % [95 % CI 26.98 - 39.02]; and it was associated with: menstrual cycle disturbances that affected quality of life [PR 3.9, 95 % CI 3 .1 – 5.0, p < 0.001], with weight increase> 10 kg [RP 3.5, 95 % CI 2.8 – 4.0,p < 0.001], severe headache [RP 3.7, 95 % CI 3.0 – 5.0, p < 0.001], pain at the insertion site [RP 3.1, 95 % CI 2.6 – 4.0, p 0.004] and pregnancy planning [RP 3.3, 95 % CI 2.7 – 4.0, p < 0.001]. CONClUSION: The prevalence of contraceptive discontinuation of the subdermal Etonogestrel implant in our population was 33.3% and it is associated with the drug side effects. KEYWORDS: CONTRACEPTION, PREVALENCE, SECONDARY EFFECT, DEVICE REMOVAL, PREGNANCY, RE-PRODUCTIVE HEALTH.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116113528","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":"Prevalencia y Factores Asociados al Sobrepeso en estudiantes de Ciencias de la Salud, Universidad de Cuenca, 2016","authors":"Marcia Alexandra Vanegas Bravo, Marlene Elizabeth Álvarez Serrano, Michael Andrés Cabrera García, Christian Andrés Jaramillo Álvarez, Adrián Patricio Moscoso Vanegas, Juan José Moscoso Vanegas","doi":"10.14410/2020.12.1.AO.06","DOIUrl":"https://doi.org/10.14410/2020.12.1.AO.06","url":null,"abstract":"BACKGROUND: Overweight is a global public health problem and it is associated with modifiable factors. The universitary population is not exempt from its influence and its prevalence is rising, so it is a matter of increasing interest. The aim of this study was to determine the prevalence and the associated factors with overweight in undergraduate students of Facultad de Ciencias de la Salud, Universidad de Cuenca. METHODS: Descriptive, cross-sectional design, included 250 students, randomly selected from the 2016 school year record. We analyzed age, sex, marital status and residence. To determine overweight, we used the Body Mass Index; lifestyle was determined by FANTASTIC test, physical activity using IPAQ and insulin resistance by HOMA-IR. We determined the overweight prevalence; the association between overweight and other variables was obtained with PR (IC95%). RESUlTS: The age of the study population ranged from 18 to 26 years, with an average of 20.4 ± 1.9 years, 70.8% between the age of 18 and 21, 82% were students of first to fifth term. The female sex constituted 55.6% of the sample; most of the sample was single (93.2%) and urban residents (78%). The prevalence of overweight was 26.8% (21.6 – 32.6), more common in women and in students from 18 to 21 years old. There was association between overweight and physical activity [RP 4.2 (IC95%: 1.1 – 16.4)] (p= 0.010) and between overweight and insulin resistance [RP 3.1 (IC95%: 2.1 – 4.5)]( p < 0.00)1. There was no association with the lifestyle. CONClUSION: The prevalence of overweight in the population was similar to the prevalence reported in literature. There was association between overweight and sedentary lifestyle and insulin resistance, but there was not association with lifestyle. KEYWORDS: OVERWEIGHT, LIFESTYLE, SEDENTARY LIFESTYLE, INSULIN RESISTANCE, PREVALENCE","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"10 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129723218","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":"Prevalencia del Síndrome de Combinación y sus factores asociados en la Clínica de la Facultad de Odontología de la Universidad de Cuenca, periodo 2015-2016","authors":"Brian Andrés García Orellana, María de Lourdes León Vintimilla, M. A. Cornejo Córdova, Verónica Cecibel Chamba Montaño","doi":"10.14410/2020.12.1.AO.04","DOIUrl":"https://doi.org/10.14410/2020.12.1.AO.04","url":null,"abstract":"BACKGROUND: The set of pathological changes in the stomatognathic system in the presence of a total maxillary prosthesis and a removable partial mandibular prosthesis has been described as the Combi-nation Syndrome. The main purpose of this study was to determine its prevalence and if features such as age, sex or type of mandibular edentulism are associated with the syndrome in the patients of the Odon-tologic Clinic of the of Faculty of Dentistry, Universidad de Cuenca during the academic period 2015-2016. METhODS: Cuantitative, cross sectional descriptive and correlational study. The sample consisted of 312 edentulous patients. The diagnosis of the syndrome in this study was determined by the presence of a minimum of three associated signs. We determine the prevalence of combiantion syndrome and the association between sex, age and edentulism type and combination syndrome. RESUlTS: The prevalence of combination syndrome is 21.8%. Adults 60 years or older (1.8 times higher probability) and patients who suffer from Kennedy class I partial edentulism (3.6 times higher probability than other types of edentulism), have a higher probability for developing the syndrome. CONClUSiON: The prevalence of CS was 21.8%, age and suffering from Kennedy class I partial edentulism should be considered as risk factors for developing the syndrome. KEYWORDS: PARTIAL DENTURE, COMPLETE DENTURE, PREVALENCE, EDENTULOUS JAW.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129254697","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":"Evaluación de la Escala de Alvarado versus Score de Respuesta Inflamatoria de la Apendicitis, Hospital José Carrasco Arteaga 2018","authors":"Jorge Roberto Rodas Andrade, Marco Vinicio Urgilés Rivas, Julio Cesar Ordoñez Cumbe, Karla Marisela Cabrera Abad, Patricia Piedad Naulaguari Medina","doi":"10.14410/2020.12.2.AO.16","DOIUrl":"https://doi.org/10.14410/2020.12.2.AO.16","url":null,"abstract":"BACKGROUND: Acute appendicitis is the main cause of non-traumatic acute abdomen worldwide, it is still a public health issue and the diagnosis can be challenging. When an atypical case is presented, is necessary to use diagnostic scores, like Alvarado Score, Modified Alvarado Score, RIPASA, among others. The aim of this study was to determine the test validity of Inflammatory Response Score versus Alvarado Score, for acute appendicitis diagnosis in 16 year old and older patients. METHODS: This is a descriptive, cross-sectional, validity test study, to compare AIR Score and Alvarado Score, with the Gold-Standard histopathology results. A sample of 292 patients that went under appendectomy at Hospital José Carrasco Arteaga during 2018 was studied. We considered sensitivity, specificity, positive predictive value (PPV), negative predictive value (VPN), ROC curve and Likelihood Ratio. RESULTS: 49.7% patients were young adults, 62.7% of the patients were male. Alvarado Score showed a 88.5% sensitivity, 29.6% specificity, PPV of 81.7%, 42.2% NPV, 1.23 LR+ and 0.38 –LR; compared to 94.7% sensitivity, 76.5% specificity, 93.5% PPV, 80.3% NPV, 4.02 +LR, 0.611 -LR for Appendicitis Immflamatory Response Score. ROC curve for AIRS was 0.897, higher than Alvarado Score (0.611); being AIRS a more precise diagnostic test than Alvarado Score. CONCLUSIÓN: AIRS showed higher sensitivity (94.7%) and specificity (76.5%) than Alvarado Score (88.5%, 29.6% respectively). Alvarado Score is sensitive enough for acute appendicitis diagnosis, but not specific enough to exclude the diagnosis. AIRS shows a higher Likelihood Ratio and ROC curve than Alvarado Score, but the posttest probability is low for identifying acute appendicitis cases.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124698498","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: Enfermedad de Paget del Pezón","authors":"Yolanda Elisabeth Vintimilla Pogo, Maolly Lucette Schuldt Cruz, Marcia Cumandá Patiño Patiño, Jessica Alexandra Naula Calle, Angélica María Bermejo Álvarez, Manuel Edmundo Espinoza Espinoza, Luis Manuel Tigsi Ganzhin","doi":"10.14410/2019.11.3.cc.37","DOIUrl":"https://doi.org/10.14410/2019.11.3.cc.37","url":null,"abstract":"","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131093514","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":"Serie de Casos Clínicos: Acromegalia, Presentación Clínica y Evolución en los Pacientes del Hospital “Vicente Corral Moscoso”. Cuenca - Ecuador, Mayo 2015 - Abril 2017","authors":"Marcia Gabriela Jiménez Encalada, Wilson Fabricio Barahona Ulloa, Juan Diego García Iñiguez","doi":"10.14410/2019.11.3.cc.38","DOIUrl":"https://doi.org/10.14410/2019.11.3.cc.38","url":null,"abstract":".","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125451645","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":"Serie de Casos Clínicos: Displasia Osteofibrosa Craneofacial. Resolución Quirúrgica","authors":"Jhonatan Heriberto Vázquez Albornoz, Pablo Peña Tapia, Cristian David Sánchez León, Carlos Anibal Yánez Castro","doi":"10.14410/2019.11.3.cc.36","DOIUrl":"https://doi.org/10.14410/2019.11.3.cc.36","url":null,"abstract":"Case Series: Craniofacial Fibrous Dysplasia. Surgical Treatment BACKGROUND: Craniofacial Bone Fibrous Dysplasia is a benign bone lesion where normal bone tissue is replaced with fibrous tissue. Developed from a genetic mutation. Subordinated in variants: monostotic and polyistotic. Few cases are reported on malignancy of the pathology. The diagnosis is determined with clinical suspicion and confirmed by imaging and pathology tests. CASE REPORT: In this paper, we present a series of three cases diagnosed with Craniofacial Fibrous Dysplasia at José Carrasco Arteaga Hospital and Hospital del Río, Cuenca-Ecuador. All of patients were treated with surgery, because of the clinical features. EVOLUTION: In all the cases, the patient evolution was favorable. Reduction of symptoms and general aesthetic improvement were achieved in all cases. CONCLUSION: Better results are obtained with the current surgical treatments (bone remodeling plus bone freezing), among them: good aesthetic results, better quality of life, lower risk of infections. In the present paper, the three patients treated with the surgical procedure indicated that the treatment reflected positively in the functional, aesthetic and emotional aspects.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115468211","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":"Bajo peso al nacer en nacidos vivos a término entre Enero y Junio del 2015, en la Clínica Humanitaria de la Fundación Pablo Jaramillo Crespo","authors":"David Alejandro Torres Jáuregui, Felipe Emmanuel Manzano Lituma, Jorge Esteban Vintimilla Coello, Vivian Alejandra Neira Molina","doi":"10.14410/2019.11.3.ao.32","DOIUrl":"https://doi.org/10.14410/2019.11.3.ao.32","url":null,"abstract":"Low birth weight in live birth newborns, January-June 2015. Clínica Humanitaria, Fundación Pablo Jaramillo Crespo. BACKGROUND: Low birth weight (newborn with less than 2 500gr), is one of the most important causes of perinatal and infancy morbidity and mortality. Every year more than 20 million children are born with less than 2 500gr, more than 96% of these cases occur in developing countries, which demonstrates more likelihood of this situation occurring in poor socioeconomic conditions. Mortality in the first year of life is 14 times higher in newborns with low birth weight. The aim of this research is to study the association of low birth weight in full-term newborns with extra-fetal risk factors in the Humanitarian Clinic of the Pablo Jaramillo Crespo Foundation in Cuenca, between January and June 2015. METHODS: A case-control study, aimed to relate extra-fetal factors to low birth weight in full-term new-borns. We included a total of 453 patients, treated between January and June 2015. Socio-demographic variables of the mother, preventive factors and morbidity were evaluated. According to inclusion and exclusion criteria, 53 cases and 400 controls were obtained. RESULTS: There was a higher frequency of low neonatal weight in young women and adolescents, in those who come from rural areas, in those who had a partner, 14% of mothers with morbidity during pregnancy had low neonatal weights. There was no statistical significance between low neonatal weight and prenatal controls, substance use and maternal morbidity. CONCLUSION: There was a higher frequency of low neonatal weight in young women and adolescents, in those who come from rural areas, in those who had a partner. We didn’t find statistical association between any of the variables and low birth weight.","PeriodicalId":417745,"journal":{"name":"Revista Médica del Hospital José Carrasco Arteaga","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122855217","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}