Medicina
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Item “Intoxicación fatal por órgano fosforado de tipo de profenofos, secundaria a intento autolítico”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2018-10-01) Vargas Arboleda, Paola Estefanía; Sunta Ruíz, Mario Leopoldo Dr. Esp.According to statistics from the World Health Organization (WHO), intoxication by cholinesterase inhibitors is one of the most frequent methods of autolytic attempts, especially in developing countries, where autolytic intentionality is 73%. The WHO has reported that approximately 5 million people suffer from poisoning due to different agrotoxins annually; estimating that about 900,000 people die from this figure; where 99% of those affected live in developing countries. With respect to the countries belonging to South America, Ecuador ranks fourth in the use of cholinesterase inhibiting compounds in Latin America. These compounds are widely used worldwide, both in agricultural and domestic activities; and because they are very liposoluble compounds, they are absorbed by all exposure routes. The oral route is important in voluntary and accidental exposures; the dermal, the conjunctival and the inhalatory, in occupational exposures. The mechanism of action of these substances is the irreversible inhibition of the acetylcholinesterase enzyme, causing a cholinergic syndrome, with the consequent muscarinic, nicotinic and central nervous system effects. Within this group of compounds is Profenofos, an organophosphorus insecticide / acaricide, whose toxicity is based on the inhibition of the acetylcholinesterase enzyme, causing the accumulation of acetylcholine in the neuronal and neuromuscular synapses. The present Clinical Case Analysis has been developed through a descriptive investigation based on Epidemiology and Public Health, reviewing the Clinical History of a patient with phosphorus organ poisoning of the Profenofos type, secondary to an autolytic attempt of the Ambato General Teaching Hospital, same that goes to the service of Emergency to receive the therapeutic measures and of necessary handling for the recovery of the picture; despite which the patient dies within a few hours of admission.Item “Accidente cerebrovascular isquémico: infarto de tallo cerebral”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2018-05-01) Carrillo Bayas, Andrés Daniel; Córdova Peñaloza, OpilioDr. Esp.The Ischemic Stroke represents the third cause of death, the first cause of physical disability and the second cause of dementia in adults. Annually an estimated 15 million people in the world suffer a stroke, of these, five million die and another five suffer a permanent disability, which has a very significant impact on families and society. Ischemic stroke is the clinical syndrome that is characterized by symptoms and / or focal signs that develop rapidly, sometimes with global loss of brain function, lasting more than 24 hours, with no apparent cause other than a vascular origin due to obstruction or occlusion arterial. The probable reasons for this deterioration include the extension of the thrombus, the failure of the substitution of collateral circulation, and the progression towards arterial occlusion. The presence of hypotension due to cardiac compromise, or the increase in blood viscosity due to dehydration, can aggravate ischemic stroke and increase patient deterioration. The adequate initial care of these patients allows reducing the morbidity and mortality and sequelae associated with this pathology. Two clear phases are distinguished: 1) Prehospital and 2) Hospitable during the first hour. The knowledge of Controllable or treatable Risk Factors and the non-treatable ones; This starts from the daily practice in hospitals and primary care centers, as well as patients with neurological sequelae due to a Stroke caused by the lack of adequate control. xii The present Clinical Case Analysis was developed through a descriptive investigation based on Epidemiology and Public Health, reviewing the Clinical History of a patient with Ischemic Stroke: Cerebral Stem Infarction of the General Ambato Teaching Hospital of the Intensive Care Unit.