Ciencias de la Salud
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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 Proyecto de intervención al uso de antibióticos en pacientes adultos del servicio de hospitalización del Hospital Básico el Puyo.(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de Posgrado, 2022-09-01) Défaz Miranda, Silvana Marisol, Lcda.; Inca Torres, Alberto Renato, BqF. PhDThe inappropriate and indiscriminate use of antimicrobials, the poor control of nosocomial infections increases the development of resistance mechanisms, reducing therapeutic possibilities and increasing hospital stay. Infections caused by resistant bacteria are associated with increased morbidity, mortality and cost of treatment, triggering the appearance of outbreaks at the hospital level. Due to this, in the present study it was proposed to rationalize the adequate use of antibiotics in the Puyo Basic Hospital in adult patients. This was done using a scientific methodology with a quantitative and quasi- experimental approach, through which the database was reviewed in the SPSS program and the entire population of hospitalized patients aged between 20 and 40 years was studied in a period of January until June 2021. It was obtained that Staphylococcus presents resistance against the antibiotic oxacillin with 76.2%. 100% of Gram-negative microorganisms are resistant to ampicillin, 88.8% are resistant to ampicillin sulbactam, 77.8% are resistant to cephalothin and 61.1% are resistant to sulfatrimetropim. Escherichia coli 27.7% are ESBL-producing bacteria. Finally, the factors that predispose to the inappropriate use of antibiotics were evaluated, it was proposed to adopt timely corrective measures, especially in those antibiotics that exceed 30% in relation to resistance.Item Complicaciones en pacientes diabéticos con covid-19(2021-03-01) Barrionuevo Mejía, Jenny Alicia; López Pérez, Grace PamelaIntroduction: During the COVID-19 pandemic, the diabetic population has been considered vulnerable and at high risk as they are more prone to acquiring respiratory infections due to deterioration of the immune system and alteration of glucose levels. Objective: To describe the complications in diabetic patients with COVID-19. Methodology: meta-analysis of articles published until September 14, 2020 in databases such as: Medline, PubMed, Lilacs, Scielo, Redalyc, Elsiever, BVS and academic Google. The search was carried out in 4 phases; the first for search, the second for selection, the third for information extraction and the fourth for analysis. Results: The main complications of diabetic patients with COVID-19 are: severe respiratory distress syndromes and extrapulmonary systemic hyperinflammation syndrome, shock, vasoplegia, respiratory failure, cardiopulmonary collapse, severe pneumonia, myocarditis, acute kidney injury, pancreatic damage, this due to immunological and hypoglycemic mechanisms that lead to an increased risk of death. Conclusion: Patients with diabetes do present greater complications in COVID-19 pictures, since when there is inadequate glycemic control, there is a greater susceptibility to developing a severe septic picture due to a failure in the body's response to pathogens.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 Mortalidad por Cáncer Experiencia Previa y referencia futura, Provincia de Tungurahua 2000 – 2013(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Dirección de Posgrado, 2016-11-01) Gissela Beatriz .Dra., Martínez Paredes; Carmen Cecilia , Pacheco QuintanaDra. Esp.Cancer is a chronic- degenerative disease that shows a long and progressive development and it is the cause why people die so early. Current statistical data are very important to have proper, efficient and timely planning during the diagnosis and treatment of cancer. An observational, descriptive, cross-sectional study was done in order to describe the cancer mortality pattern in the province of Tungurahua during 2000 and 2014, according to socio-demographic characteristics to determine the developments that have been around in cancer mortality as well as the number potential years of life lost. The population included the number of death people who were registered between 2000 and 2014 in the General Register of Deaths at the National Institute of Statistics and Census in Ecuador, whose main cause of death was cancer. The most important gross cancer mortality rate was in Mocha in 2000 with 120.77 per 100.000 inhabitants while in Cevallos was 165.87 in 2014. During these two years, females have a greater contribution to mortality with 59.18 % and 54.96 %, and digestive organs were the most affected with 39.40 % and 40.00 %. A greater number of years of potential life lost (YPLL) were provided by the hematological malignancies in the stomach. The most representative YPLL rates in males were taken from a group aged between 55 and 59 years, with 17.85 and 20.79 per one thousands inhabitants over the years that were analyzed. A group of females aged 55 to 59 years in 2000, amounted to 44.49 YPLL and the group aged between 60 and 64 amounted to 40.86 for 2014. The standard rate for mortality showed an increase of the risk of dying from cancer from 1.2 between 2000 and 2014. It is recommended to develop research to deepen the rates that are related to mortality of cancer and implement the proposed strategy.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.Item Análisis de caso en Paciente Pediátrico con Quemadura de 2do Grado Enfocado en los cuidados de Enfermería(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Enfermería, 2016-06-01) Tixilema Matiag, Jenny Maribel; Landázuri Troya, Teresa de Jesús Lic. Mg.In the present study the analysis of case of a pediatric patient who suffered second-degree burns on side of the face, neck, forearm, hand and left thigh, which has a focus on nursing care that will improve their quality of life is done, in this way it is intended to highlight the importance of pediatric care in these lesions as it aims to prioritize the necessary care for the child to meet their basic needs and develop optimally. This type of injury is the third leading cause of mortality worldwide although may be preventable, making it a public health problem that requires immediate attention; equally to be one of vulnerable populations lifestyle and risk factors for which he produced and thus strengthen their health status is investigated, besides evolution analyzes identifying critical points and opportunities to improve the health status boy. Similarly an alternative is created improvement in the quality of life by providing a universal physical, mental, spiritual and social care. For the execution of this case different research methods such as were used: descriptive and that through a series of systematic analysis information through medical records and direct contact with reality field is collected to study with data collected directly from reality and observation which is valued and evaluates the patient's condition through home visits.