Medicina
Permanent URI for this collectionhttp://repositorio.uta.edu.ec/handle/123456789/815
Browse
6 results
Search Results
Item NATIONAL EARLY WARNING SCORE 2 Y COVID-19 SEVERITY INDEX, PREDICTORES DE MORTALIDAD EN EL SARS-COV2(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-06-10) Quimbita Ramon, Bryan Marcelo; Bombón Pozo, Caroll AlexandraThe COVID-19 pandemic has led to a global health emergency. Accurate assessment of disease severity is crucial for its management. In this context, prognostic scales such as the National Early Warning Score 2 (NEWS-2) and the COVID-19 Severity Index (CSI) have emerged as significant tools. This study aims to evaluate the effectiveness of the NEWS-2 and CSI scales as mortality predictors in individuals infected with SARS-CoV-2. For this purpose, a literature review of research on prognostic scales in COVID-19 patients was conducted, selecting relevant articles published up to January 2023. The results were analyzed to determine the accuracy of NEWS-2 and CSI in predicting mortality. Evidencing that, roth NEWS-2 and CSI were shown to be effective tools for predicting mortality in individuals with COVID-19. However, CSI demonstrated higher sensitivity and specificity, especially when supplemented with additional parameters such as biomarkers and risk factors. It is concluded that, NEWS-2 and CSI are useful for predicting mortality in COVID-19, with CSI being more precise. The inclusion of biomarkers and risk factors improves their predictive capacity. Further research is needed to validate and enhance these tools in the clinical management of the disease.Item Pronóstico e índice de mortalidad en pacientes VIH positivos infectados por SARS-COV-2(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Carrera de Medicina, 2022-10-13) Silva Dávalos, Mauro José; Palacios Vargas, Doris VanesaIntroduction: Currently mortality is linked to diseases caused by COVID-19, so it would be expected to show a high percentage of infections in people with HIV and therefore a high mortality, however, it has been possible to establish through of the information collected, that this population does not have lower levels of contagion, and in case of contagion its mortality rate is equal to that of the population that does not present this disease, for which it is sought to collect current data on the index of mortality and complications of HIV positive patients infected with COVID 19 to try to show if the figures are similar, lower or higher than that of the population without HIV infection. Objective: To determine the degree of severity and mortality rate of HIV patients infected by SARS-COV-2, studying the current scientific evidence on the epidemiology of COVID 19 in the HIV population, analyzing the correlation between the development of severe symptoms of COVID 19 in HIV positive and negative patients. Methodology: This scientific article was carried out based on the scientific literature published in scientific medical databases that have information on the proposed topic, in the Intra Med, PubMed, The Cochrane, SciELO, Elsevier, New England Journal of Medicine databases. , ScienceDirect. 13 scientific articles were used, and 8 systematic reviews published within a range of two years old. Development: Due to the high efficacy of current antiretroviral therapies, most people living with HIV are virologically suppressed and often have normal or slightly decreased CD4 cell counts. Mortality in patients with COVID-19 does not depend solely on their comorbidities, since the presence of complications has been established in terms of clinical manifestations and the management of patients with this disease. Mortality in patients diagnosed with COVID-19 and HIV positive has been able to carry out a series of investigations that allow determining a relationship between the information collected. Discussion: The main relationship between COVID-19 disease and HIV patients is based on the fact that the presentation of clinical manifestations and complications in the analyzed studies do not vary from HIV positive or HIV negative people, despite this it has been possible to establish certain characteristics that can determine slight changes in this presentation due to the belief that patients with HIV generally have a higher risk of serious illness or death, despite this it has not been possible to determine the existence of characteristics directly related to mortality in patients with these two diseases. Conclusion: Mortality in patients diagnosed with COVID-19 and HIV is a subject of study, which has not been able to establish a clear relationship between mortality due to COVID 19 disease in HIV-positive patients and negative patients.Item “Embarazo ectópico cornual”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2018-10-01) Salinas Velastegui, Verónica Gabriela; Belalcázar Sánchez Dra. Esp., Yajaira MonserrathEctopic pregnancy is considered one of the main causes of maternal mortality, and one of the most frequent problems in Obstetrics services, both public and private, is for this reason that it is decided to present this case of rare incidence worldwide, with in order to know the causes, diagnosis, risk factors and proper management of this pathology. The case analysis to be presented corresponds to a 34 year old female patient, resident in Ambato, higher education, mestizo, without significant personal pathological history, with gynecological and obstetric history: date of last menstruation April 3, 2017, gestational age 9.2 weeks of gestation, gestations: 2, deliveries: 0, abortions: 1, live children: 0, dead children: 0, pregnancy 1: spontaneous abortion at 5 weeks of gestation, pregnancy 2: current. Patient who enters the gynecological emergency service of the Ambato General Hospital (IESS) due to scarce vaginal bleeding of chocolate color of 15 days of evolution, at the physical examination: normal vital signs, abdomen: slightly distended, depressible not painful on palpation, region inguinogenital; presence of little chocolate secretion, tests are requested which report: positive BHCG in blood, progesterone 8.18 ng/ml, EMO: infectious, transvaginal ultrasound: complex left adnexal mass, empty uterine cavity, reason for which laparoscopy is performed exploratory study in which there is a non-injured left cornual ectopic pregnancy, subserous uterine myoma and conversion to laparotomy is decided for ectopic pregnancy removal and incidental myomectomy; postsurgical with satisfactory evolution, high in good conditions.Item “Factores asociados a la Morbimortalidad en prematuros nacidos en el Hospital Provincial Docente Ambato período Enero 2010- Septiembre 2011”.(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2012-04-01) Morales Cisneros, Diego Alejandro; Paredes Lazcano, Patricia Dra.Item Síndrome de Embolia Grasa Secundaria a Fractura de Fémur(2016-10-01) Moreira Granda, Edison Javier; Guerrero Sierra, Alfonso Bolívar Dr. Esp.For those who manage major trauma victims, the topic of fat embolism weighs heavily on the mind. The incidence of this problem can approach 90% in patients who have sustained major injuries. If it progresses to the rare clinical entity known as fat embolism syndrome (FES), a systemic inflammatory cascade affecting multiple organ systems, morbidity and mortality are high. Accordingly, swift diagnosis and treatment of fat embolism are paramount for ensuring the survival of this patient population. (1) Here, we present a case of a 25-year-old previously healthy who was admitted to our hospital after suffering a traffic accident with front right latero impaction against a trailer to go as copilot. The patient's injuries include a fractured right femur subtrochanteric fracture and contusions. The patient went on to develop fat embolism syndrome twelve hours after the accident. Its symptoms include poor respiratory mechanics with desaturation, tachycardia, tachypnea, irritability disorientation. Based on the clinical presentation and imaging support, the patient was transferred to the intensive care unit for hospital management. During the development of this clinical case we specify in detail the clinical, diagnostic methods, treatment and evolution that had the patient during their hospital stay.Item “Evaluación de los cuidados obstétricos de emergencia en relación a las complicaciones obstétricas en el hospital regional docente Ambato del 2008-2011”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2012-12-01) Ramos Salinas, Irene Sofía; Dra. Aguilar Salazar, Aida FabiolaEmergency Obstetric Care (COEs) are performed in pregnant and postpartum women with complications, its purpose is to prevent maternal deaths. Establishments with COEs must provide adequate coverage for obstetric complications exceeded 15% and case fatality rate of less than 1% The Plan for Accelerated Reduction of Maternal Mortality in hospitals implemented the COEs since 2007, so this work is carried out to assess the management of direct and indirect complications in Ambato Provincial Teaching Hospital (HPDA) from 2008 to 2011. MATERIALS AND METHODS: We performed a retrospective study documentary, reviewed the record books of Gynecology and Obstetrics, and analyze a sample of 363 randomly selected medical records. We also analyze the medical records of all maternal deaths in the indicated period. RESULTS: During the study period care coverage for obstetric complications ranged from 25 to 28% and the case fatality rate was less than 0.5%. 99% were direct obstetric complications: prolonged labor/obstructed abortion complications, hemorrhage antepartum / postpartum average of 39%, 32.3% and 18.2% respectively. There were 31 deaths: five indirect complications, 13 associated with eclampsia/severe preeclampsia, 10 obstetric sepsis (6 complications of abortion, postpartum endometritis two stillbirths and 2), there were 3 cases of hypovolemic shock (ectopic pregnancy, placental retention and uterine atony). Twenty patients died within 48 hours of hospitalization. Diagnosis was based on the average of 2 hours and treatment was initiated in 1H30. The performances surgical/drug were effective and applied according to protocols. CONCLUSIONS: The COEs for HPDA CO coverages are adequate to rising above 25% with less than 0.5% TL, with rapid and effective implementation of protocols, but constant evaluation is essential to improve the service.