Ciencias de la Salud
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Item ACETATO DE ULIPRISTAL EN EL MANEJO DE LA MIOMATOSIS UTERINA SINTOMÁTICA. UNA REVISIÓN BIBLIOGRÁFICA(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-06-07) Aleaga Gavilánez, Jorge David; Belalcázar Sánchez, Yajaira MonserrathObjective. To perform a literature review on the use of ulipristal acetate (UPA) in the management of symptomatic uterine myomatosis. To evaluate the efficacy and safety of the drug, in order to avoid serious adverse effects such as liver failure. Methods. We collected scientific articles performed in symptomatic women with uterine myomatosis undergoing management with UPA. The search was carried out in high impact databases such as PubMed, Taylor&Francis, Springer, Elsevier, etc. At the conclusion of the search and based on the eligibility criteria, only 39 articles met the inclusion criteria and were selected. Results. According to the studies analyzed, the 14 articles present favorable results in relation to the improvement of symptoms and quality of life of the patients, since it was possible to control uterine bleeding, raise hemoglobin levels, reduce the size and volume of the fibroids, without presenting any serious effect that would lead to the interruption of the treatment. Only one study identified nine cases of severe liver damage, of which five cases ended in liver transplantation and the others reported resolution of the liver injury after discontinuation of treatment. Conclusion. The use of UPA is considered an effective treatment in this pathology. The serious adverse effects shown in the studies proved to be inconclusive because the presence of liver injury or elevation of transaminases prior to treatment was demonstrated. However, new recommendations for the use of the drug were published.Item Embarazo Ectópico Abdominal y Shock Hipovolémico(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-11-01) Aucapiña Rodríguez, Luz Cecilia; Gavilanes Sáenz, Víctor Patricio Dr.The abdominal ectopic pregnancy is an exceptional anomaly that represents 1% of ectopic pregnancies; it is associated with high morbidity and mortality, maternal and fetal. The risk of maternal mortality is 7 to 8 times greater than a tubal pregnancy and it is 90 ectopic times greater than an intrauterine pregnancy. This is a pathology of difficult diagnosis that, in many cases, belatedly established and it is considered an obstetric emergency. Female patient of 23 years old who presents an abdominal pain of 2 months evolution and amenorrhea of approximately 17 weeks, she is admitted to Hospital General Puyo by abdominal pain in study and hypovolemic shock, βHCG is performed with positive result and eco FAST showing free liquid in abdominal cavity and an appearance of embryo outside the uterine cavity with movement, so it is considered a probable accident ectopic pregnancy. On physical examination is hypotensive, tachycardic with generalized pallor, Algic facies, oral mucosal semihumid. An Emergency exploratory laparotomy with identification of abdominal ectopic pregnancy, salpingectomy, right oophorectomy, partial omentectomy is performed. Also, compensation with blood products for trans-surgical cardiovascular instability is indicated. The patient is transferred to intensive therapy to control and manage cardiovascular. Presenting a satisfactory evolution and at 17 hours of admission she is discharged to continue handling by gynecology and obstetrics where she remains hospitalized 2 days and sent homeItem Hematocolpos Secundario a Tabique(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Alajo Hinojosa, José Ricardo; Salazar Faz, Fernando Abel Dr.The vaginal tranverse septum is an extremely rare malformation. It is due to an embryonic defect that can stay hidden if the septum is incomplete and requires surgical intervention if it is complete.It exposed the clinical case of a child with this anomaly that presented acute abdominal pain due to hematocolpos that septum had produced, as a result of the obstruction of menstrual flow. It is about a girl of 13 years old without menarche, with a suspected background of Urinary tract infection, who came to the emergency service with a severe abdominal pain it has 72 hours of evolution, colicky, located in the lower abdomen. No fever, vomiting or urinary symptoms. The dietary habit was normal as the depositions. On the examination it was detected a good general and nutritional state. It showed breast development and pubic hair in stage II of Tanner. The abdomen was soft and depressible, without visceromegalies. She had a slight pain on deep palpation at the umbilicus and the suprapubic region, without palpable masses. Appendiceal points were negative and there were no signs of peritoneal irritation. The external genitals were normal. Analytical tests performed in the emergency room, that include hemo, biochemistry, coagulation and simple urine were normal. This patient was hospitalized with a suspected diagnostic of acute abdomen. It was requested an abdominal CT scan, where it was detected an homogeneous and well-defined image, so it as done an abdominal ultrasound, where was found an hematic content image of 11 cm x 9.7 cm x 7.8 cm in diamete localized inside the vagina, possibility of hematocolpos due to another malformation, the patient is hospitalized for study and treatment. Chest radiography and cardiology study were normal and sterile urine cultures. Under aseptic and antiseptic rules draining 400 mL of hematic content it was performed and a complete transverse vaginal septum in the bottom-half of the vagina of about 1.5 cm thick third visualized. Septum resection was performed and subsequently appeared menstrual cycles. The presentation of this case has an objective to consider the presence of this embryonic defect faced with an acute hypogastric abdominal pain in a girl with hematocolpos and also in a girl with pubertal development, primary amenorrhea, and suspected background in mild urinary symptoms.Item Amenorrea primaria debido a Hipotiroidismo Prepuberal(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Pacheco Vaca, María Belén; Narváez Rosero, Ramiro Oswaldo Dr.Patient 26-year-old female referred that never presented her menstrual cycle and are accompanied by some breast development, reason which comes to outpatient general medicine and is referred to the department of gynecology Base Hospital IESS Latacunga which is valued. Where they give an initial diagnosis and treatment for primary amenorrhea due to prepubertal hypothyroidism. Primary amenorrhea is the absence of menstruation at age 14, with absence of secondary sexual characteristics (breast development, axillary and pubic hair) or absence of menstruation at age 16 or older with normal development of secondary sexual characteristics, can be it caused by a variety of disorders including mullerian gonadal abnormalities, pituitary gland, hypothalamus, adrenal and thyroid or hormonal dysfunction is these different levels; these abnormalities may be congenital chromosomal or genetic defects, or acquired, so it is important to make a correct diagnosis of this condition to carry out an appropriate therapeutic approach in order to reduce all the consequences that the disease can cause. Finally we know for a diagnosis and perform the exact treatment of primary amenorrhea is required to perform a thorough history and physical examination also a suitable complementary tests.