Medicina
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Item “Calidad en el manejo para el diagnóstico de un caso con Mixoma Atrial Cardíaco”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2017-01-01) Salinas Escobar, Christian Germán; Dr. Jácome López, Fredy MarceloThe cardiac tumors constitute a rare condition, can occur at any age, may be primary (originating from heart tissue) or secondary (caused by metastases), most cardiac tumors are benign especially in the adult population, being myxoma that tops the list of these and in childhood rhabdomyomas, but a small percentage especially the secundary are malignant, they can occupy any of the heart chambers, the risk factors to consider the clinical suspicion correlate with factors associated neoplasms of different types, in addition to involve certain hereditary load there in, their symptoms start to grow these tumors and lead to hemodynamic alterations whose presentation may be confused in other non cardiac pathologies, including valvular diseases, electrical conduction pathology or autoimmune, it is effective for diagnosis always consider the possibility of their presence and also keep handy complementary tests that can help us discern all hypotheses, especifics imaging test; transesophageal and the transthoracic ultrasound, computed tomography and magnetic resonance imaging, that contribute significantly for the diagnosis of tumors of the heart. The initial treatment has a base clinical, curative treatment is based on the surgical resolution, which has shown good results, with few cases that have presented recurrences, so the prognosis of patients diagnosed in time is good.Item Complicaciones Postquirúrgicas por Tumor Carcinoide de Intestino Delgado(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Silva Bermeo, Verónica Daniela; López Terán, Gloria Paulina Dra. Esp.Small bowel tumors are rare and usually give vague and nonspecific symptoms that limit their diagnostic and therapeutic measures with a forecast incierto.1 Its annual rate of around 8.4 / 100,000 population, 14 constitute about 2% of all malignancies tube digestive and represent the third cause of small bowel obstruction. 13-14 new estimates in the United States per year is 5,300 cases and the estimated mortality is 1,210, respectively, while in Europe it is 3,500 and the estimated mortality is 1.100.6 The incidence of cancer of the small intestine increases with age, with peak onset between the sixth and seventh decade of life, 26 being greater in men than in women.15 the risk factors for this condition may include eating habits (high consumption of fat, protein animal foods smoked, etc.), smoking, alcohol consumption, biliary surgery (previous cholecystectomy), some occupations; prior radiotherapy, genetic diseases, among others. 12,15 The most common clinical symptoms are abdominal pain and intermittent colic usually type, weight loss and anorexia, 1 however, some may be asymptomatic until they reach an advanced stage. 5 More than 40 histopathologic types of tumors occur in the small intestine, of which 95% are carcinoid tumors malignos.6 tumors vary in appearance, from small to large intraluminal submucosal lesions ulcerated injury so its diagnosis is made on the basis of clinical manifestations and tests complementarios.8 differential diagnoses should include many causes of abdominal pain from irritable bowel syndrome to a endometriosis.20 the main management approach in these cases is surgical resection of the primary lesion, as the only option curativa.8 the presence of postoperative complications depend on several factors, including the extent of disease, clinical presentation, nutritional status, age and comorbidities of the patient. 9 During the course of this work a clinical case of a patient of 65 years of age, personal medical history of hypothyroidism and family history of cancer important risk factors for contracting the disease risk is analyzed, in addition, detailed specific clinical outcome, diagnostic methods, surgical treatment to which she was subjected during their hospital stay to allow us to confirm the importance of a complete medical history.Item Calidad de Diagnóstico de un Seudoquiste Pancreático(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Sánchez Centeno, Edgar Israel; Atiaja Arias, Jeanet Verónica Dra. Esp.The Pancreatic pseudocyst is a collection of fluid encapsulated with an inflammatory wall defined usually outside the pancreas with minimal or no necrosis. Rich in amylase and other pancreatic enzymes without communication with the main conduit. They occur after 4 weeks after the onset of acute pancreatitis, and develops as a postsurgical complication. The case of a female patient of 22 years with a clinical picture of 15 days of evolution is presented. Physical examination unquantified characterized by abdominal pain and asthenia, nausea, vomiting, mild headache holocraneana, thermal rise. The Eco and Computed Tomography (CT) Abdominal concluded with the diagnosis of pancreatic pseudocysts so he was made a cistoyeyunoanastomosis splenectomy and distal pancreatectomy more. After two weeks the patient comes predominance presenting abdominal pain at the site of surgical intervention, so he entered. He underwent an ECO and an abdominal CT scan which concludes with ileus Intestinal hospitalized for 6 days, receiving good response after treatment and discharge decide on favorable terms. At three weeks after discharge the patient comes presenting moderate abdominal pain accompanied by nausea, vomiting, malaise and signs of dehydration. It is assessed by the Internal Medicine concluded as a diagnostic electrolyte imbalance and dehydration. Receive analgesia and hydration treatment, no complications so it is given a medical discharge. Next control is indicated but no go.Item Hematuria como Debut de Hipernefroma(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Poma Macías, Jairo José; Guacho Guacho, Juan Sebastián. Dr. Esp.The Hypernephroma also called renal tubular cell carcinoma, tumor Internist, gray tumor cells, renal cell carcinoma, clear cell tumor or tumor Grawitz, is the most common adult renal tumor. It represents 2.3% of all malignant tumors and is more common in men than in women 3: 1 and between 50 and 70 years. (17). There are symptoms for neoplastic within which we name: fever, weight loss, anemia. (18) (19) (20) As for what the risk factors for both development refers has been linked with diets high in fat and cholesterol, as well as environmental carcinogens and snuff without the availability of clear evidence of the existence of an etiologic factor clearly demonstrated. They described genetic alterations 97% of patients showed allelic loss suppressor gene family and the Von Hippel-Lindau disease that is given by: renal carcinoma, retinal hemangioma, hemangioblastomas spinal cord and cerebellum, and pheochromocytomas. The treatment of kidney cancer can divide it into surgical and conservative: Nephrectomy is used in the tumor located having two partial nephrectomy and radical nephrectomy pathways which in turn can be performed by laparoscopic or open surgery. Conservative treatment and surveillance masses reserves that are less than 4cm, as they usually have a relatively low mortality using cytokines and cytoreductive nephrectomy prior systemic therapy has been shown to provide a survival benefit in patients with good prognosis. With regard to targeted therapies cytoreductive nephrectomy is no evidence retrospective can be beneficial in patients with intermediate or risk for patients with symptomatic primary lesion, although prospective trials are ongoing. Hematuria affects about 16% of the adult population and this may serve as a marker of infection, cancer and others. (1). The origin of it can be: kidneys, ureters, bladder, prostate and ureters, must be distinguished from bleeding of these places and relate with urination, which we call urethral bleeding, and whose origin would be located somewhere below the external sphincter the urethra (2), including the risk factors of microscopic hematuria most cases is benign (1) it is why we must take into account the characteristics of the same in the study of this as a symptom of Hypernephroma with two other features are: abdominal mass and flank pain which make up the triad of this disease.