Ciencias de la Salud
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Item TRATAMIENTO ANTICOAGULANTE EN PACIENTES CON FIBRILACIÓN AURICULAR Y ENFERMEDAD RENAL CRÓNICA(2025-06-16) Oñate Gutiérrez, Alan Daniel; Sánchez Salazar, Nelly Alexandra; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaIntroduction. Atrial fibrillation is the most common arrhythmia characterized by premature atrial beats, causing ineffective atrial contraction and promoting thrombus formation. It is associated with chronic kidney disease, where a prothrombotic and prohemorrhagic state coexists, further increasing thromboembolic risk. Treatment with oral anticoagulants is key to preventing thromboembolic events. Objective. To analyze the clinical benefit of oral anticoagulant therapy in patients with non-valvular AF and advanced CKD. Methodology. A bibliographic review was conducted in the MEDLINE/PubMed, Scopus, and ScienceDirect databases. The review included articles published in the last 5 years, open access, and in English or Spanish. Results. The reviewed studies indicate the need to properly stratify thromboembolic and hemorrhagic risk. DOACs are the anticoagulant therapy of choice over warfarin, except in moderate to severe mitral stenoses and in patients with mechanical prosthetic valves. The recommendations and evidence for advanced CKD and dialysis are unclear, especially when CrCl <15 ml/min. Furthermore, factors that could influence therapy, such as the presence of polypharmacy and the assessment of renal function, should be considered. Conclusion. The evidence does not suggest a benefit of oral anticoagulant therapy in preventing thromboembolism in patients with advanced CKD, and alternative non-pharmacological therapies could be chosen.Item Relato de vivencias de un paciente con insuficiencia renal cronica en base al modelo de callista Roy(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Enfermeria, 2022-09) Moreira Proaño, Leslie Elizabeth; Velasco Acurio, Evelyn Fernanda Lic. Mg.A adaptação de pacientes com Insuficiência Renal Crônica (IRC) submetidos a procedimentos invasivos exige uma série de alterações físicas e psicológicas muito significativas. Objetivo: Relatar as experiências de um paciente com Insuficiência Renal Crônica com base no modelo de Callista Roy. Método: Pesquisa descritiva com abordagem qualitativa, do tipo fenomenológico exploratório. Foram analisadas as vivências de um paciente com Insuficiência Renal Crônica em tratamento dialítico, escolhido de acordo com os seguintes critérios de inclusão: maior de idade e familiar. As informações foram coletadas por meio de entrevista semiestruturada baseada no modelo de Callista Roy, explorando o processo de adaptação, função fisiológica, autoconceito e função do papel de cuidador presentes nas experiências relatadas pelo mesmo paciente. Resultados: As informações obtidas mostram que a adaptação de uma doença envolve diversos aspectos sociais, fisiológicos, psicológicos e culturais, desencadeando níveis de estresse, ansiedade e depressão pelo simples fato de seu estilo de vida gerar um impacto negativo, razão pela qual busca melhorar a qualidade de vida de cada paciente que tem uma doença crônica e recebe tratamento por toda a vida, adaptando-se assim às novas mudanças. Conclusões: Existe capacidade de adaptação e enfrentamento em pacientes com Insuficiência Renal Crônica e que recebem tratamento dialítico, mostrando tendências estáveis no uso de estratégias para melhorar a qualidade de vidaItem Diálisis en momentos de covid 19: afrontamiento de la enfermedad en cuarentena(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Carrera de Enfermería, 2022-10-13) Valls Rodríguez, Joel John; Cusme Torres, Nadihezka AmandaPatients with chronic kidney disease are part of a vulnerable group because their immune system is compromised, so this type of patient can more easily develop an associated disease. The aim of this study was to evaluate the coping of patients receiving dialysis during quarantine for COVID 19. Materials and methods: The research presents a quantitative, descriptive, cross- sectional and field approach. The study population consisted of 25 patients belonging to the dialysis ward of the Hospital General Ambato IESS, and was evaluated using the SF-36, EE-D and COPE-28 instruments. Results: Regarding the quality of life of these patients and their future health, 44% of the patients stated that their disease makes them prone to get sick easily, and in a pandemic they feared for their health, and 40% could not say whether they believed their health would improve or worsen because they felt it depended on the supply of medicines, their emotional state or the support of their relatives. Conclusions: it was found that the patient presented an emotional and psychological burden due to their illness added to a pandemic that made their treatment difficult, which presented a fear due to the lack of knowledge of being a new disease and the high contagiousness that it showedItem “Hipertensión arterial y su relación en las variaciones de la función renal residual en pacientes sometidos a diálisis en el centro de diálisis “contigo” de la ciudad de Latacunga en el periodo agosto 2011– febrero 2012”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2012-05-01) Falcón Córdova, María José; Villacís Valencia, SandraThis study was a retrospective cross-sectional approach, spanned the period August 2011 to February 2012. The study population was 64 patients of both genders, with previous diagnosis of kidney disease stage V on dialysis process, attending the Renal Unit of the Clinic "You." A19 we excluded patients, 4 of whom died during the time studied, 3 had anury, 7 had constant post dialysis hypotension and 5 incomplete medical records. The results showed a higher incidence of women with 60%, the age of greatest risk comprises between 46-55 years with 26.7%, between 15 and 81 years of age half 42.2% is the antecedent hypertension followed by diabetes mellitus with a 22.2%, time of dialysis was> 7 months in 66.7%. Was identified that patients older than 66 years only 6.6%, the range of 46-55% decreased filtration majority 17.7%. In this relationship with the initial weight > 4 kg in a dry weight basis, 11.1% of them could control the T/A, but 4.4% was difficult to manage despite the ultrafiltration and antihypertensive medication, in patients 2-3 kg 26.6% controlled his T/A. The group of 0-1kg of water by weight 17.7% was difficult to control because it was renin-dependent hypertension. The decrease in glomerular filtration rate increased in patients with mixed hypertension (renin dependent volume) in 26.6% keeping the filtrate in a 4.4%, normotensive patients glomerular filtration rate increased by 6.6 % and decreased by 2.2% filtration. The renin affected more residual renal function decline in glomerular filtration rate by 20%. In patients who did not control blood pressure 35.5% decreased glomerular filtration rate confirming the hypothesis.