Ciencias de la Salud
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Item MANEJO DE LA PILEFLEBITIS COMO COMPLICACIÓN POST APENDICECTOMÍA(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-06-10) Jordán Oña, Rodrigo Andrés; Loaiza Merino, Iván PatricioPylephlebitis is a rare but serious complication, associated with risks such as liver abscesses, sepsis, and acute liver failure that results in post-appendectomy portal vein thrombosis. Therefore, the objective of the study was to evaluate the effectiveness of care and management protocols for post-appendectomy pylephlebitis, in order to identify the best clinical practices and improve patient care. A systematic review of scientific literature was carried out, applying non-probabilistic convenience sampling 40 scientific works published between 2018 and 2023 were selected, using databases such as PubMed/Medline, Elsevier Scopus, Science Direct, and Taylor & Francis. The results revealed that post-appendectomy pylephlebitis has a low incidence, predominantly affecting men, with symptoms such as fever and abdominal pain. The most common causes are diverticulitis and acute appendicitis. The preferred treatment includes broad-spectrum antibiotics and, in some cases, anticoagulants. Research suggests the need for standardized care protocols to optimize the management of this complication.Item Déficit de proteína C y S de la coagulación como causa de trombosis recurrente(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Carrera de Medicina, 2022-06-01) Puruncajas Pila, Katherine Johana; Cruz Castillo, Yessenia Magaly Dr. Esp.Thrombosis is defined as a local obstruction of blood flow in an arterial or venous blood vessel, causing the tissues and cells supplied by the vessel to become ischemic. Its most frequent clinical manifestations are stroke and myocardial infarction as representatives of arterial thromboembolism, and deep vein thrombosis (DVT) and pulmonary embolism as the main venous thromboembolism. In Ecuador, it is reported that 5 to 10% of hospital deaths are due to thromboembolic diseases. The prothrombotic state is defined as thrombophilia which can be acquired or hereditary, so this study is mainly focused on hereditary thrombophilias due to protein C and S deficiency, resulting in the loss of these anticoagulant properties, which leads to a Uncontrolled thrombin generation leading to thromboembolism.. We present the case of a 49-year-old patient with a history of episodes of superficial venous thrombosis in the right leg at the age of 42 and arterial thrombosis in the right arm at the age of 45, the latter complication resulting in a thrombectomy. The patient began with a treatment based on dabigatran 110 mg after arterial thrombosis, but discontinued the medication a year after starting it, due to its high cost. The reason for consultation for which he attended the following care was pain in the lower limbs, on inspection venous dilations were observed in both lower limbs and an increase in the diameter of the right lower limb, symptoms that have been present after the last thrombotic event. After this evaluation, interconsultation was requested from Vascular Surgery to Internal Medicine, to start the investigation of the cause of the thrombosis. Laboratory tests were taken, including biometry, coagulation times, liver function, tumor markers, D-dimer, and measurement of anticoagulant factors. In the first test, the levels of antithrombin III, factor V Leiden, protein C and S were low, which was attributed to xii the use of dabigatran as anticoagulant therapy, but to rule out a new measurement was requested where an antithrombin III 89% was detected ( Normal), protein C 52% (Low), protein S 51% (Low) confirming the diagnosis of thrombophilia secondary to protein C and S deficiency. Treatment with warfarin and enoxaparin was started, then treatment was adjusted to warfarin 5mg 3 times a week and the rest of the days 2.5 mg.Item Isquemia mesenterica en paciente con cardiopatia previa, reporte de un caso(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Carrera de Medicina, 2021-06-01) Fantoni Añazco, Mateo Josué; Yépez Yerovi, Fabián Eduardo Dr. Esp.Introduction: Mesenteric ischemia is defined as the total or partial loss of blood flow to the small intestine and / or right colon. This is one of the most frequent causes of hospital admission. It presents with non-specific symptoms which makes its diagnosis a challenge. Objective: To describe a clinical case of mesenteric ischemia in a patient with previous heart disease. Materials and methods: A retrospective descriptive study based on clinical case analysis is carried out. Discussion: A case report is made of a 68-year-old patient with a history of essential arterial hypertension, hypothyroidism, acute myocardial infarction 5 years ago, diverticular disease, irritable bowel syndrome. She presented pain at the epigastric level for two days, accompanied by vomiting on several occasions. The condition is classified as constipation without clinical suspicion of mesenteric ischemia. Conclusion: The patient had risk factors for developing mesenteric ischemia. Furthermore, the clinical picture presented by the patient resembles that described in the literature. It is worth mentioning that determining the origin of the ischemia is very difficult according to the patient's symptoms, for this reason it was identified that the moment of the surgical act was of arterial originItem "Manejo de síndrome antifosfolípido en el embarazo y prevención de complicaciones materno-fetales”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2019-06-01) Vaca Plazarte, Jose Luis; Belalcázar Sánchez, Yajaira Monserrath Dra. Esp.A 37-year-old female patient with a personal pathological history of antiphospholipid syndrome diagnosed 7 years ago by immunological tests and abortion history on two occasions, without treatment and obesity. Surgical history of a previous caesarean section 7 years ago. Family history of older sister with antiphospholipid syndrome; gynecological-obstetric history: menarche at age 11, beginning of sexual life at 19 years of age, gestations, 4 abortions, 3 deliveries, caesarean section, 1 live births, and PAP test 2 years ago with normal results. CURRENT PREGNANCY: FUM: 05/18/2018 FPP: 02/25/2019 gestational age 37 weeks. Controls 7. Echoes 5. Unplanned pregnancy. Receives calcium 1 gram, acetylsalicylic acid 100 milligrams per day and enoxaparin 40 milligrams subcutaneous day from week 19 of gestation. Patient captured by referral from the first level of health care at 22.5 weeks. At the moment asymptomatic without reporting discomfort. Abdomen: pregnant womb uterine height of 25 centimeters, single live fetus, cephalic, right back, fetal heart rate of 146 bpm, negative uterine activity. Inguinogenital region: there is no evidence of leucorrhoea or genital bleeding. Acetylsalicylic acid 100 mg orally is maintained every day with calcium 2 grams orally every day, enoxaparin 60 mg subcutaneous daily and ferrous sulfate 100 milligrams day; Follow-up is continued by external consultation without complications, she comes to consultation at 37.2 weeks of pregnancy, referring abdominal pain of moderate intensity, her admission is decided for the end of pregnancy, which is carried out without complications by caesarean section obtaining a live newborn without complications , after completing 48 hours of post-surgical observation, patient withdraws in good conditions with newborn and indicated with enoxaparin 60 milligrams subcutaneous daily for 5 days and control by external consultation.Item Síndrome Antifosfolipídico en adulto joven(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-08-01) Palate Amaguaña, Elsa Priscila; Mora Brito, Edgar VicenteDr.Male patient 39 years old. He born in Mother Earth in the province of Pastaza and resident in the Jatari community, mestizo, cohabiting marital status, complete secondary education, occupation agriculture, personal medical history of deep vein thrombosis 4 years ago. Patient comes upon referral Health Center to present about 24 hours ago abdominal pain, continuous type, 6/10, located in epigastric left upper quadrant radiating to further relates that fail nausea vomiting. Physical examination: blood pressure 105 / 78mmHg, heart rate 74 beats per minute, respiratory rate 22 breaths per minute, temperature 36.8ºC, BMI 26.6 m / kg. Abdomen presence of collateral venous network, tenderness epigastric and left upper quadrant, hepatomegaly two traverses palpated below the costal margin. Tips presence of violet plate 10 x 4 cm located in the left wing. According to the clinical and laboratory results, is suspected antiphospholipid syndrome, so tests that are processed through social work, they performed in a private laboratory, confirming the diagnosis so it is processed are prompted for an interconsultation to hematology in a third level institution also hepatosplenomegaly thought of the presence of portal vein thrombosis and Boud Chiari syndrome, which are discarded, continuing his study is studied. The patient is assessed by hematology treatment (enoxaparin 60 subcutaneous milligrams every 12 hours, warfarin 5 mg via daily oral), which evolves satisfactorily, therefore is discharged and continuous controls outpatient service is established, interconsultation also requested to hepatology.Item “Complicaciones hemorrágicas y trombóticas de los accesos vasculares en pacientes con enfermedad renal crónica atendidos en el centro de diálisis “contigo” durante el periodo junio 2010 a junio 2011”.(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2012-04-01) Villalta Ortíz, Jenny Magdalena; Torres Torres, Johny Dr.The current context of the patients was evaluated with Illness Renal Chronicle (ERC) in substitute renal treatment (TRS), to which were carried out vascular access for hemodialysis and they presented complications. The present study is descriptive, retrospective, documental, clinical, epidemic, carried out in the canton Latacunga, county of Cotopaxi, in the period June 2010 - June 2011. They were included 45 patients with vascular access, of all the ages and sex, with complete clinical histories. The necessary data for their study were; age, sex, occupation, personal pathological antecedents, type of vascular access, construction of the vascular access, installation place, complications of the vascular accesses, were gotten of the clinical histories and of the operative reports. The purpose was to discover the complications but you frequent of the vascular accesses in 45 patients with ERC that conformed the sample. At the same time was carried out a meticulous bibliographical exploration of the topic. To collect the information a bibliographical review was done Excel 2010, processed their data by means of charts and graphics for their biggest understanding. Concluding that inside the study the feminine sex prevailed in ages understood among 61 to 70 years; with pathological antecedents of Diabetes Mellitus, continued by Arterial Hypertension, dedicated to the works of the home. The vascular access used construction was the humerus - cephalic at the left superior member's level, presenting as main complication the thrombosis, so much of the fistula and catheter, continued by the infectious processes.