Centro de Posgrado
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Item 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 PosgradosIntroduction: 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.Item COINCIDENCIAS DEL DIAGNÓSTICO DEL GÉNERO STREPTOCOCCUS ENTRE MÉTODO MANUAL Y EL MÉTODO AUTOMATIZADO EN EL LABORATORIO AUTOMATIZADO ZAMORA(Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Centro de Posgrados, 2024-10-01) Zamora Sánchez, María Cristina; Guangasig Toapanta, Víctor HernánThe genus Streptococcus sp. They are gram positive cocci; these bacteria grow in chains or pairs which are oxidase and catalase negative. Among the groups that cause disease in humans are the most frequent such as Streptococcus pyogenes (group A) produces tonsillitis and impetigo, Streptococcus pneumoniae is the cause. Of the majority of pneumonias acquired in the community, Streptococcus viridans and its groups are the cause of dental abscesses, within the subgenus is Streptococcus mutas the main agent that causes dental cavities and without forgetting that it causes endocarditis is a common pathogen that causes severe and potentially complicated infections with the possibility of generating serious sequelae, hence the importance of rapid, accurate and timely identification. In this context, it is essential to evaluate the available diagnostic methodologies to determine their relative effectiveness. In particular, the performance of the manual method should be compared with the Vitek 2 Compact automated system, in order to evaluate the concordance between both approaches in the identification of Streptococcus sp. The objective of this study is To evaluate the agreement of the diagnosis of Streptococcus sp. between the manual method and the automated method in the Zamora Automated Clinical Laboratory in the period July and May 2023-2024. The methodology used for this study was Quantitative, non-experimental, observational, descriptive study with verification of coincidences in diagnostic tests for the identification of 100 culture samples with growth for Streptococcus sp. in two laboratories, verification of coincidences in diagnostic tests for identification in 100 culture samples with growth for Streptococcus sp. in two laboratories, using conventional and automated methods (Vitek 2 Compact). To obtain results, tests were carried out to Differentiation tests were performed, obtaining 100% negative catalase, 100% alpha hemolysis, 100% resistant bacitracin, 94% resistant optochin. The identification of pathogens of the genus Streptococcus sp. was carried out using two different methods: one manual and the other automated. The manual method, revealed the following proportions: 94% corresponded to Streptococcus of the viridans group, 6% to S. pneumoniae, and 0% to S. pyogenes. On the other hand, the automated method provide results with 89% of S. viridans, 6% of S. pneumoniae and 0% of S. pyogenes. These findings show a slight discrepancy in the proportion of S. viridans identified by both methods, while the identities of S. pneumoniae and S. pyogenes remained constant between the two analytical approaches. The kappa index determined a concordance of 1 (almost perfect) according to the table between both methods for the identification of S. pneumoniae and 0.635 (considerable for identifying S. viridans. Based on these findings, a proposal was designed for the improvement of diagnostic skills according to the results obtained, the identification of the Streptococcus sp. by the manual method compared to the automated methodology (Vitek 2 Compact), presents high concordance, especially with S. pneumoniae. Strategies must be reviewed and implemented to improve the identification of this pathogen in laboratories how is the implementation of the automated equipment since it has a better identification in the subgenera of the viridans group which are of clinical interest in the dental areaItem Caracterización de bacterias multidrogoresistentes en infecciones urinarias de mujeres embarazadas(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de posgrados, 2024-09-01) Sánchez Tite, Viviana Paulina Licenciada.; Salazar Garcés Licenciada. Magister., Dolores KrupskayaUrinary Tract Infection (UTI), is a term used to indicate the growth of pathogenic microorganisms present in the urinary system, capable of producing functional and morphological alterations. Multidrug-resistant bacteria (MDR) are microorganisms that have acquired the ability to resist the action of several antibiotics, complicating their treatment. In pregnant women, urinary tract infections are common due to hormonal changes and the pressure of the uterus on the bladder, which prevents proper urine drainage and greatly facilitates the proliferation of pathogens. By carrying out an exhaustive characterization of the multidrug-resistant bacteria present in urinary infections of pregnant women attending clinical laboratory Tecnoanálisis aims to identify the most frequent microorganisms responsible for this type of infections and different resistances originated in this environment for it, the present study was a non experimental cross-sectional, descriptive and observational study with a quantitative approach, as it identified the different bacteria that cause urinary tract infections in pregnant women. Cultures that had a positive growth and met the characteristics for the study were used where different bacteria were isolated as Escherichia coli presented a higher percentage followed by Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Enterobacter cloacae and Streptococcus agalactiae in the lowest percentage. Concluding that the development of gram-negative bacilli microorganisms predominates, while a minimal percentage corresponded to gram-positive bacteria, the analysis carried out showed that there is a high resistance for more than one antibiotic such as Ampicillin, Trimetropin/sulfamethoxazole, nitrofurantoin, amoxacillin+ clavulanic acid, ampicillin/sulbactam, with respect to multidrug resistance bacteria interpretation protocol, was based on the gestational age and results obtained from the samples processed in this research, taking into account natural and acquired resistance in a schematic form for easy interpretation by the beneficiaries.Item Coincidencias en la detección de toxoplasma gondii entre el método inmunocromatográfico y el método elisa en mujeres embarazadas atendidas en el hospital general Alfredo Noboa Montenegro.(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de posgrados, 2024-09-01) Guzmán Arellano, Maryori Tatiana Licenciada; Ana Gabriela. Bioquímica Farmacéutica Magister, Pacha JaraToxoplasma gondii is an obligate intracellular parasite that represents a challenge for public health due to its ability to infect humans and animals, without necessarily showing clinical manifestations. It is considered a Group 2 risk agent, that is, moderate individual risk and low community risk. However, it has a great impact on populations with compromised immune systems because it has the ability to damage the central nervous system. Pregnant women are among the vulnerable groups, as they can have significant complications, such as neurological, visual, and auditory disorders, and even the death of the newborn. This work focused on analyzing the coincidences in the detection of Toxoplasma gondii between the immunochromatographic method and ELISA in pregnant patients treated at the Alfredo Noboa Montenegro General Hospital. The study was carried out using a non experimental cross-sectional and correlational design, with a quantitative approach. The results indicated that the sample presented a balanced distribution in terms of age, with a predominant concentration of low results in the ELISA IgG and IgM tests, and a moderate dispersion around the mean value. The IgG immunochromatography test showed a clear and adequate interpretation, while the IgM revealed a low prevalence of positive results, suggesting the need for further evaluation for indeterminate cases. Although the IgM immunochromatography test presents higher sensitivity, the IgM ELISA presented a greater consistency in the reporting of results. The statistical analysis did not show significant differences between the Immunochromatography and ELISA tests, suggesting a similar capacity to detect positive and negative cases. In conclusion, the results obtained from the comparison between the Immunochromatography and ELISA tests for the detection of Toxoplasma gondii suggest that both methodologies present a similar capacity to identify positive and negative cases in the analyzed sampleItem Estrategia didáctica enfocada en el diagnóstico precoz del cáncer de cuello uterino con base en la caracterización inmunogenética(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-12) Villacrés Franco, Diana Carolina Md.; Carrero Castillo, Yenddy PhD.Cervical cancer is defined as the uncontrolled proliferation of cells lining the lower part of the uterus. It is currently considered a sexually transmitted infection due to its direct relationship with infection by the human papillomavirus. This neoplasm is a highly preventable pathology, which is why education programs should be aimed at promoting cervical cancer prevention based mainly on the risk factors that have been identified in the pathogenesis of the disease, as well as periodic gynecological control. Primary care includes educational programs aimed at reducing the incidence of pathologies that are highly preventable. The objective of this research was to design a didactic strategy focused on improving the competences of the students of the Gynecology and Obstetrics rotating internship of the Medicine career of the Technical University of Ambato for the early diagnosis of cervical cancer based on the immunogenetic characterization, focused on a developmental research work based on a descriptive study. The results show that the level of knowledge of medical interns about cervical cancer is acceptable, since 65% of interns know the risk factors, types of cervical cancer and screening tests. Also, the interns responded that the main cause for the Teaching-Learning process not being adequate in 40% is the lack of didactic strategies. The study showed that the most used didactic strategies are focused on the traditional teaching method which includes lectures and expository classes given by a teacher expert in the subject where student participation is not significant.Item Implementación de un protocolo de diagnóstico epidemiológico para la determinación la incidencia de la infección por Helicobacter pylori en pacientes adultos que se atienden en el centro de salud de Pasa – Tungurahua(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2022-11) Chagcha Frutos, Alexandra Alice; Urbina Salazar, Anabell del Rocío PhDGastrointestinal diseases being one of the main public health problems in Ecuador, they are transmitted by the fecal-oral route, or by the consumption of contaminated water or food; its prevalence depends on the socioeconomic level of the patients, the pathogens involved are viruses, parasites and bacteria. The study aimed to evaluate the diagnostic methods used in the health center of Pasa to establish Helicobacter pylori infection as well as the phase of eradication of the posttreatment microorganism, to implement an epidemiological diagnostic protocol to determine the prevalence of Helicobacter pylori infection Helicobacter pylori in adult patients treated at the Pasa - Tungurahua health center through the systematic use of the Immunochromatography test of the rapid test of the Antigen in feces with the specificity of 98.4% that allowed confirming the diagnosis and the eradication of Helicobacter pylori infection, analyzing the presence of risk factors in the study population. The methodology used was observational field type, prospective during the period September 2021-March 2022, it was carried out in two phases; the first was the determination of the current conditions of the prevalence and diagnosis of Helicobacter pylori infection and the second the determination of the eradication of the infection with the treatment of the patients who required it in the first phase, the collection of data, surveys were applied that were validated by professionals of the institution according to parameters of reliability, validity and objectivity. The results obtained show the prevalence of 52% of the patients of the studied sample that present concomitant factors for infection, the sample was 50 patients, 92.31% of patients, the pharmacological therapy used served for sensitization and eradication, 7.69% were obtained where apparently the treatment did not have an effect, but not due to the action of the treatment but due to the lack of adherence, a condition that can favor bacterial resistance. UNIVERSIDAD TÉCNICA DE AMBATO CENTRO DE POSGRADOS 17 It is concluded that according to the results the prevalence of Helicobacter pylori infection is significant with 52% in the study population. The epidemiological diagnosis protocol was implemented that will serve as a guide in the care of patients who present symptoms related to Helicobacter pylori infection. The use of rapid tests by detecting fecal antigens for the determination of Helicobacter pylori and the performance of the second tests for the eradication of the infection were made known to the medical and technical personnel in the Health Unit. patients on the prevention of infection, diagnosis and treatment to eradicate the bacteria to avoid complications and support the process of timely and efficient care for patients with this morbidity to avoid relevant mortality.