Ciencias de la Salud

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    La muerte cómo proceso natural en fase terminal
    (Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Carrera de Enfermería, 2022-10-20) Vilca Ruiz, Anthony Steeven; López Pérez, Grace Pamela
    Introduction: Nursing staff must acquire experience and knowledge about the physical and psychological management of cancer patients, considering death as the end of life, the management and acceptance of grief must be a priority, taking into account that death of patients indirectly affects health personnel on a psychological level. Objective: To identify the acceptance of death as a natural process in terminally ill patients, by Nursing staff. Methodology: The research was quantitative, field and descriptive, whose population was 24 nurses who work at the Hospital Solca Núcleo de Tungurahua, the survey was applied based on the questionnaire of attitudes towards death that addressed 6 dimensions. Results: 83.33% have thought of death as a possible fact, 66% are afraid of dying young and find it difficult to face death, 62% report that when they attend a terminal patient they have thought about the possibility of his death and it moves him to face his family, 29% see death as a passage to eternity and think that there is life after death and 33% show that death can be an exit to the load of the life. Conclusion: The death of a patient in the terminal phase is a scene that the nursing staff faces daily, accepting it provides an adequate management of grief and allows to provide care with empathy directed to the patient.
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    “Mielinolisis pontina secundaria a traumatismo craneoencefálico severo
    (Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2018-05-01) Gavilanes Acosta, Daisy Maribel; López Ulloa, Mario Orlando Dr. Esp.
    Deaths to traumatic brain injury are still among the main causes of mortality and disability, with the affections of the nervous system and hemorrhagic shock becoming its main contributors. The patient with traumatic brain injury (TCE) is forming a complicated group of patients that can present different types of brain injury, as a result of a closed lesion or an open lesion. TCEs are more frequent in males in all age groups. The causes of the TCE are related to the age of the subjects who suffer them, thus, falls are the most frequent etiology and traffic accidents correspond to the second cause in frequency. The central pontine myelinolysis is a rare pathology, characterized by a neurological alteration of undetermined etiology linked to various conditions such as serious diseases, in more than 50% of cases manifested in patients with chronic diseases with malnutrition or hydroelectrolytic disorders, being frequent, when Sodium levels rise too fast. The damage basically consists of the destruction of the myelin sheaths, leaving the cylinders undamaged, affecting part or the entire base of the protuberance symmetrically. There are a variable percentage of patients in brain death situations who have developed diabetes insipidus. To continue the clinical case is about a male patient of 14 years of age, who while doing extreme sports (Downhill), without a helmet, he suffers a fall of his bicycle in motion, with displacement of approximately 2 meters and frontal impact of his skull against a rocky surface (stones), then ECU 911 transfers him to the Pediatric Emergency Service of the IESS Ambato General Hospital. On physical examination, the positive: the patient with a tendency to sleep, disoriented, with pain, Glasgow Scale: 13/15 (O: 3, V: 4, M: 6). Head: evident hematoma in the frontal region, with left palpebral edema, localized ecchymosis, palpable bone crax in the frontal region, pupils: mydriatic, hyporeactive. CT was performed immediately, showing a fracture line at the level of the frontal bone, extending from the frontoparietal suture to the left orbit, with signs of an epidural hematoma, deciding to admit it for hospital management because he has a severe traumatic brain injury. Neurosurgery is consulted, they indicate that at the moment he does not require surgical resolution, so he decides clinical management, with advanced airway management, sedoanalgesia and later is admitted to the Intensive Care Unit Evolution in the ICU: Hemodynamically unstable, brain MRI is performed where it is evident: signs of pontine myelinolysis, results of examinations are obtained revealing the following: hypernatremia + low density + low urinary sodium + urinary hypoosmolarity + plasma hyperosmolarity related to Diabetes Insipid Central, with poor clinical evolution, he does not respond to treatment and he dies.
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    Mortalidad temprana por cáncer de cuello uterino, Provincia Tungurahua, 2010 - 2013
    (Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Dirección de Posgrado, 2016-11-01) Raza López, Elisa Aidé Md,; Scull Molina, Dra. Esp.,Martha María
    Introduction: Cervical cancer is a health problem that causes considerable morbidity and mortality, as it tends to occur in middle age. Most cases occur in women under 50 years and this implies that there years lost for each one of the women who die from the disease potential life. Objective: To determine early mortality from cervical cancer in the province Tungurahua, 2010 - 2013. Materials and Methods: A descriptive cross-sectional observational study, the study population is presented, it consisted of the total dead in 2010 to 2013, whose underlying cause of death was cervical cancer, coded according to the International Classification of Diseases as C53. Results: the level of primary education predominated in the dead with 54.2%, followed by 33.3% who had no education level, marital status married prevails with 45.8%, ethnicity I predominance was observed was mixed with 76.4% and 11.1% indigenous, 58.3% reside in urban areas. 50.0% of Deaths from cervical cancer belong to the group of middle age adult, ages comprising productive and reproductive stages, the Canton Ambato brings the largest number of deaths from cervical cancer, however, presents Mocha the greatest risk of dying from this disease. The greatest risk of losing years of life in the Tungurahua province from cervical cancer was higher in 2010 and 2013 with the rate of years of potential life lost 1.2 years per 1,000 women respectively, however in 2011 the canton Patate per 1,000 women lost 4.9 years and in 2013, Mocha 7.3 years, with the cantons risk exhibit lose years of life in women for this type of cancer and is also higher in urban areas in both the 2010 and 2013, the rate being 1.6 years respectively for 1,000 women.
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    Óbito Fetal y Shock Hipovolémico Secundario a Desprendimiento Normoplacentario
    (Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Barragán Quishpe, Fanny Gabriela; Mera Ramos, Gerardo Vinicio Dr.
    Placental abruption or placental abruption refers to bleeding in the decidual-placental interface that causes the release of partial or total placental, the main clinical findings are bleeding associated with abdominal pain or severe and persistent dorsal, sustained uterine contraction and signs of suffering fetal.6 In many cases the source of bleeding is a small blood vessel or feto-placental vessel breaks, where the result is that the decidual progressively dissected hematoma formed, leaving a thin layer in contact with the maternal face the placenta and the rest remains attached to the myometrium, the detached part of the placenta is unable to exchange gases and nutrients, when the remaining fetoplacental unit is not able to compensate for this loss, is compromised. In 5% of pregnancies occur bleeding before delivery and 1.2% are abruption.6-8 The placental abruption is an important cause of morbidity and mortality maternal and perinatal. The perinatal mortality rate is approximately 20%. In Ecuador according to the Ecuadorian Institute of Statistics and Censuses in 2013 3.23% of maternal deaths was caused by the placental abruption.12 The main risk factors are a history of abruption, hypertensive disorders of pregnancy, advanced maternal age, multiparity, premature labor and premature rupture of membranes due to inflammation or sudden decompression of the uterus, alcohol, snuff and cocaine among otros.15 The following case describes a female patient 25 years old with surgical history, two previous cesareans with no medical history of importance and gynecological and obstetrical history: menarche at age 11, regular menstrual cycles for 5 days, beginning the sexual life 15, pregnang: 3 (with the current) vaginal: 0 cesareans: 2 abortions: 0, course with urinary tract infection in pregnancy, with last menstrual period (LMP): 05 / Aug / 2015. Current Gestation: Pregnancy 39.2 weeks LMP, the patient comes aforementioned Health Center La Mana by dark red vaginal bleeding present in moderate amount, no odor, no apparent cause of approximately 12 hours of evolution followed by abdominal pain contraction type, progressive intensity that radiates lumbar region of about 3 hours of evolution, along with signs and symptoms of hypovolemic shock due to haemorrhage (tachycardia, hypotension and generalized pallor), with this clinical picture is received in gynecologic Emergencies Provincial General Hospital in Latacunga, he decided to send him to proceed with cesarean surgery is performed showing dead male product and complete abruption. The blood loss is offset by the administration of crystalloid, colloid, packed red blood cells and plasma. As a complication of surgery presents difficult control of hemostasis upper right pedicle, difficult removal of the cervix, friable tissue, uterine atony, subtotal hysterectomy is performed. In its evolution at 24 hours post-surgery blood count which draws attention hemoglobin 7.4 mg / dl and hematocrit of 23.2%, which is why they decide to spend two more packed red blood cells is performed. The patient remained hospitalized for seven days, recovering their hemoglobin which reached the fourth day, hemodynamically stable without symptoms or signs of possible complications are decided high. So we can say that the patient predisposing risk factors that could cause abruption being multiparity, smoking and alcoholism and the failure in planning and antenatal care unit primary care found. Within the management of hemorrhagic shock we can say that was indicated to restore blood volume to the patient agrees to set standards.
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    Temor a la muerte y espiritualidad en el grupo alcohólicos anónimos 24 horas Sede Ambato
    (Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Psicología Clínica, 2016-09-01) Cobo Poveda, María Cristina; López Castro, Walter Javier Ps. Cl.
    The fear of death is generated from a basic emotion, as is the fear of an inevitable death is, for many people this fear becomes a director thought of his life, which leads to taking refuge in camps as spirituality is to lower the level of anxiety that this thought causes. Given that spirituality are the values that life is governed and behavior of each of the individuals, besides establishing their belief in a higher being jointly being controller internal influences and external help redirect their way of life by making positive interaction with their surroundings. This is the case of members of Alcoholics Anonymous Group, who base their recovery on their level of spirituality and will that gives them a Higher Being.