Ciencias de la Salud
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Item “Dependencia funcional del paciente con glioma del tronco encefálico y su relación con las oportunidades de mejora”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Enfermeria, 2017-06-01) Chiliquinga Sigcho, Betty Natali; Salguero Fiallos, Carmen Marlene Lcda.Introduction: The purpose of this clinical case study was to examine the evolution of the patient with glioma of the brainstem by collecting data with structured instruments. Objetive; identify the main critical points and thus establish opportunities for improvement through the use of the guide Directed to the caregiver of the patient with Glioma. In this work, the patient's parents report that 8 days ago she suffered a swing fall (1 meter), presenting a blow in the occipital region, without loss. Of consciousness; 48 hours ago presents a deviation of the gaze for what goes to the pediatric emergency service and an interconsulta with the ICU and is sent to perform diagnostic studies. Methodology; In the case study the descriptive method was used to describe each of the stages in which the pathology evolved, the Documentary-Bibliographic method to detect and deepen different aspects related to it. Result; Through the survey conducted the patient obtains data about the patient's exposure to risk factors such as; The age, sex, falls the same ones that when related them with the bibliography could be the triggers of the pathology. Conclusion; Gliomas within the brainstem comprise 10-20% of all pediatric CNS tumors. Brainstem gliomas can occur at any age, although they generally present in childhood, with the mean age of diagnosis at 7 to 9 years.Item Enfermedad Renal Crónica Secundaria A Glomeruloesclerosis Focal y Segmentaria(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Gavilánez Guerrero, Silvia Janeth; Lituma Jumbo, Rosalina de Lourdes Dra.Patient , 28 , male , without relevant history , reports that approximately 1 year actual date makes presents lower limb edema lasting 2 weeks and subsides spontaneously , then it becomes intermittent with an appearance of 1 once a month and duration of 2 weeks.- 3 days unexplained presents facial edema and palpebral morning , extends to the lower limbs , is symmetrical , cold, painless , soft consistency , inelastic leaves fovea difficult ambulation , accompanied by generalized asthenia, pain the knee joints , not self-medicating patient reports , is referred to internal medicine , where they perform laboratory tests and impaired renal function evidence. Physical examination shows blood pressure of 140/90 mmHg, facial edema is evident, and lower extremity edema soft , inelastic , not painful on palpation, Godet sign +++ / ++++ consistency. The cause of impaired renal function is investigated , performing exams evidenced proteinuria in the nephrotic range , hypoalbuminemia and hypoproteinemia, features of nephrotic syndrome; tests requested to determine its etiology including: renal Eco , eco doopler renal artery , renal biopsy and antibodies to rule autoimmune diseases. Is able to determine focal segmental glomerulosclerosis on biopsy primary etiology because immunological tests were negative , treatment is initiated with corticoid to reverse proteinuria and prevent progression of kidney damage, it is administered for 16 weeks but proteinuria remains in nephrotic range , without changes in renal function , the same as was altered from the beginning , being in chronic kidney disease 3b , due to the lack of response to corticosteroid resistance is considered the same . In an attempt to reduce proteinuria and lack of medication you decide to start with a cycle of methylprednisolone to prevent progression of kidney damage, but despite treatment continues with proteinuria, treatment is suggested with other immunosuppressive so it is transferred to a tertiary hospital where tests performed value note the chronic kidney disease, proteinuria, and anti- refer to this nursing home with no indication of treatment to follow. Given the refusal of tertiary hospital with other immunosuppressants support is decided to administer intravenous pulse cyclophosphamide is administered three times with an interval of 15 days, showing partial reduction of proteinuria levels.