Browsing by Author "Freire Montesdeoca, Juan Gabriel"

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    Anemia Megaloblástica
    (Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-09-01) Freire Montesdeoca, Juan Gabriel; Naranjo Perugachi, Jeaneth del Carmen Dra.
    This research aims to determine the cause of megaloblastic anemia, which depends on the treatment promoting studies to generate scientific evidence involved in the management of deficiency of vitamin B12 and folic acid and the resulting megaloblastic anemia. The most common causes of metabolic disorders megaloblastosis are vitamin B12 and folate (maturation factors). These involved in the transport of methyl, essential for cell proliferation and division. For this purpose in the current analysis, a clinical case of a male patient 63 years old with a history of Type 2 diabetes mellitus more hypertension patient attended the Emergency Teaching Hospital Ambato to present three weeks ago generalized fatigue with dizziness occurs , but paresthesia in lower limbs. On physical examination generalized paleness. Where it is entered and evaluated with laboratory tests meeting: HGB: 5.7 g / dL HCT: 17.1% MCV: 125.4 fl, MCH 41.9 pg, MCHC: 33.4 g / dl, PLT 87000 u / L. Urea in blood chemistry: 58.6 mg / dL, glucose 350.6 mg / dL, CREATININE 1.40 mg / dL. Where it is valued by deciding to transfuse Nephrology 3 packs Globular more treatment and Hematology orders who decide to perform additional tests quantification of Vitamin B12 + Folic acid and iron profile meeting ferritin 1753 mg / dL. A stable once the patient is discharged waiting for tests and bone marrow puncture, but for outpatient follow-up will be decided. It is not possible to establish behavioral changes regarding risk factors and progression, so that the neglect of both the patient, family, and poor monitoring and control by primary care, allowing the disease to progress. For this case the pattern of research should be tailored to each patient, giving importance to the clinical presentation. In laboratory settings with limited facilities, a therapeutic trial of vitamin B12 or folic acid is useful to determine the specific vitamin deficient megaloblastic anemia. During the analysis we can infer that both folate and vitamin B12 are essential to the human body components, so the lack of these nutrients can cause not only anemia but also alterations at the cellular level, which will reveal to the range of clinical manifestations present. In turn, the deficit thereof, constitutes a risk factor for cardiovascular, oncological diseases and pregnant women cause neonatal pathologies. At the end of the improvement opportunities, to the author, can be important and desirable to improve the management and the recording of individuals with these diseases are discussed.
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    Estrategia pedagógica y didáctica para la presentación y discusión de Casos Clínicos sobre el Cáncer de Mama, por los Internos Rotativos de la Carrera de Medicina en el Servicio de Medicina Interna del Hospital Docente Ambato
    (2025-04-02) Freire Montesdeoca, Juan Gabriel; Acosta Acosta, Josué; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Centro de Posgrados
    Introduction: Breast cancer represents one of the leading causes of morbidity and mortality among women worldwide. The training of rotating medical interns is crucial for developing clinical competencies. Objective: The objective of this study is to propose a pedagogical and didactic strategy to improve the understanding and clinical management of breast cancer among rotating medical interns in the Internal Medicine Service at the Ambato Teaching Hospital. This strategy aims to promote active learning and critical reflection through the presentation and discussion of clinical cases in the Internal Medicine Service at the Ambato Teaching Hospital. Methodology: An explanatory, experimental, and prospective study design with deliberate intervention was carried out. This included the selection of representative breast cancer cases. Presentation sessions were conducted, during which interns presented the background, diagnosis, and treatment of the cases. Subsequently, a space for group discussion was facilitated, guided by a specialized faculty member. Results: The results showed a significant increase in the interns' understanding of the diagnostic and therapeutic aspects of breast cancer. Surveys indicated that 85% of the interns considered that the methodology used enhanced their learning and enabled them to address patient care more effectively. Conclusions: The design of a pedagogical and didactic strategy focused on the presentation and discussion of breast cancer clinical cases is effective in enhancing the training of medical interns. This methodology not only improves their understanding of the disease but also strengthens their clinical competencies.