Medicina
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Item “Enfisema bulloso como causa de insuficiencia respiratoria crónica”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2018-10-01) Toscano Ponce, Andrés Gustavo; Acosta Acosta, Josué Dr. Esp.Bullous emphysema is a chronic obstructive pulmonary pathology of importance in his knowledge at present, this due to the low frequency with which it manifests in young adult patients and more for its short-term mortality when it is not diagnosed early. We report the case of a 44-year-old male patient with a history of recently diagnosed pulmonary fibrosis, who presented a clinical picture of ten hours of evolution characterized by respiratory difficulty of small efforts, accompanied by a sensation of drowning, central and distal cyanosis, anxiety, pain in the left hemithorax, pungent type of moderate intensity radiating to a posterior region, in addition to cough with transparent expectoration with bloody streaks. Physical examination showed tachycardia, tachypnea, 70% ambient air saturation, perioral cyanosis, dyspnea, a pulmonary level showed decreased thoracic expansibility, use of accessory muscles, decreased vesicular murmur in both pulmonary fields, crackles and bilateral wheezing. In complementary studies, hypoxemia and respiratory acidosis, mild neutrophilia, chest radiograph, the fibrotic pattern with emphysematous bullae and small parahily infiltrates are shown. It is classified as an exacerbated blistering emphysema, so it can be treated intrahospitally with high-flow oxygen and antibiotic therapy. The objective of the present is a case of diagnosis and early and timely treatment in patients with bullous emphysema to prevent morbidities and reduce the mortality that can occur in themItem Las inmunodeficiencias primarias humorales, en este contexto la Inmunodeficiencia Selectiva de IgG, es de vital importancia más aun cuando se asocia a patologías como el Síndrome de Stevens – Jonhson y alergias respiratorias, debido a la poca frecuencia con que se manifiesta en pacientes pediátricos, y por la morbilidad y mortalidad que ocasiona cuando no es diagnosticada precozmente debido a su clínica muy variada. Se reporta el caso de un paciente masculino que desde los 3años 11 meses de edad, se le ha dado seguimiento por la especialidad de Inmunología y Alergología en consulta externa por antecedentes de infecciones del tracto respiratorio superior a repetición, y alergias a componentes medio-ambientales, en varias consultas se denota la disminución selectiva de la IgG, el cual a la edad de 5 años 8 meses debuta con lesiones dermatológicas mucocutaneas caracterizadas por placas eritematosas con ampolla central, además de síntomas y signos de afección pulmonar. La biopsia confirma el diagnóstico para Síndrome de Stevens – Jonhson, y la cuantificación de inmunoglobulinas ratifica la Inmunodeficiencia Selectiva de IgG. El objetivo del presente reporte de caso es determinar la importancia del diagnóstico y tratamiento oportuno en pacientes con inmunodeficiencia, para prevenir, a la vez correlacionar la predisposición y susceptibilidad que conlleva este tipo de patología(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2019-06-01) Carranza Sánchez, Luis Alfonso; Acosta Acosta, Josué Dr. Esp.The humoral primary immunodeficiencies, in this context, the Selective Immunodeficiency of IgG, is of vital importance even more when it is associated to pathologies such as Stevens - Johnson syndrome and respiratory allergies, due to the infrequent manifestation in pediatric patients, and due to the morbidity and mortality that it causes when it is not diagnosed early due to its very varied clinic. We report the case of a male patient who, since 3 years 11 months of age, has been followed up by the specialty of Immunology and Allergology in outpatient clinic due to a history of upper respiratory tract infections, and allergies to environmental components. , several consultations denote the selective decrease of IgG, which at the age of 5 years 8 months debuts with mucocutaneous dermatological lesions characterized by erythematous plaques with central bleb, in addition to symptoms and signs of pulmonary disease. The biopsy confirms the diagnosis for Stevens - Johnson syndrome, and the quantification of immunoglobulins confirms the Selective Immunodeficiency of IgG. The objective of this case report is to determine the importance of diagnosis and timely treatment in patients with immunodeficiency, to prevent, at the same time correlate the predisposition and susceptibility that this type of pathology entails.Item Paralisis periodica hipopotasemica tirotoxica(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Carrera de Medicina, 2021-06-01) Torres Villa, Juan Francisco; Acosta Acosta, Josué Dr. Esp.Thyroid pathologies have had an evolution and prevalence that have increased over time worldwide, being especially identified in women. However, its complications affect both sexes equally. In the present case analysis we study one of the less common complications of hyperthyroidism in the less affected population group, the male sex, starting with a hydroelectrolytic imbalance attributed to the chronic pathologies that the patient presented and that with later analysis a thyroid condition is identified. Through the analysis of complementary examinations and the identification of the patient's regular medication, it was concluded that the thyroid pathology is the precursor of the constant hydroelectrolyte imbalances. Several specific analyses such as iodine uptake scintigraphy have been performed to show the functionality of the gland and thus study further treatments and multidisciplinary management. Finally, several risk factors were identified that should be taken into account in patients with thyroid diseases, since they can trigger complications that if not treated in time can put the patient's life at risk