REVISTA DE LA FACULTAD DE CIENCIAS MÉDICAS
Revista sobre ciencia de la salud de carácter científico de acceso abierto; cuya finalidad es difundir informacion científica en salud y resultados de investigacones para contribuir a la formacion científica del lector. Dirigido a estudiantes de pregrado, profesionales e investigadores de la salud. Actualmente se encuentra indexada en las Base de datos: Latindex Catalogo 2.0
La preparación de un cirujano cardiotorácico: Un camino de excelencia y precisión La cirugía cardiotorácica es una de las ramas más exigentes y especializadas de la medicina, ya que se encarga de tratar enfermedades del corazón, los pulmones, el esófago y otros órganos dentro del tórax. Para llegar a convertirse en un cirujano cardiotorácico, se requiere una extensa preparación académica y práctica, comenzando con la formación en cirugía general y posteriormente completando una subespecialización altamente rigurosa. La complejidad de las intervenciones que realiza este especialista, como los trasplantes de corazón, las cirugías de revascularización coronaria y las reparaciones de aneurismas aórticos, exige una destreza técnica impecable y una gran capacidad para tomar decisiones críticas en situaciones de alta presión.
Copyright (c) 2025 REVISTA DE LA FACULTAD DE CIENCIAS MÉDICAS
COLGAJO FRONTOPARIETAL PARA LA RECONSTRUCCIÓN DE COMPLEJO TRAUMATISMO NASAL
Introducción: las mordeduras de perro pueden causar lesiones faciales que resultan en pérdida de tejido y deformidades. La reconstrucción de estas lesiones es un desafío debido a la complejidad de la anatomía facial y la necesidad de restaurar la función y la apariencia natural. Este trabajo se elaboró para mostrar la tecnica de reconstruccion de lesiones en cara usando el colgajo frontal paramedial de acuerdo a las caracteristicas de las lesiones por mordedura de perro. Caso y metodos: se trata de una paciente, una paciente femenina de 47 años de edad la cual presentaba una herida en la nariz con pérdida de tejido nasal debido a una mordedura de perro. en las cuales se realizó un colgajo frontal paramedial para procurar restaurar funciones y apariencia a la estructura lesionada. Discusión: La reconstrucción tisular mediante colgajos es efectiva para restaurar la apariencia y función después de mordeduras de perro en la nariz. El colgajo frontal paramedial es una técnica confiable y ampliamente utilizada con resultados estéticos satisfactorios. Conclusiones: La reconstrucción tisular mediante colgajos es efectiva en lesiones traumáticas. El colgajo frontal paramedial es uno de los mas adecuados para mordeduras de perro en la nariz, es importante la evaluación temprana y la selección cuidadosa de la técnica de reconstrucción.
COMPLICACIONES DE LA PRECLAMPSIA EN ADOLESCENTES
La preeclampsia es un síndrome multisistémico de origen incierto que se encuentra en un espectro de alteraciones hipertensivas durante el embarazo, y se considera una causa importante de mortalidad materna en adolescentes en América Latina. Esta condición suele perjudicar las gestaciones nulíparas y se manifiesta en más del 10% de todas las gestaciones a término. El objetivo de esta investigación fue establecer los factores de riesgo y las complicaciones vinculadas a la preeclamsia en adolescentes embarazadas que se presentaron al hospital Gineco-Obstétrico Matilde Hidalgo de Procel de Guayaquil durante el lapso de enero a junio de 2018. Estudio descriptivo y retrospectivo en 181 jóvenes embarazadas con preeclamsia que fueron internadas en hospital para manejar su gestación y el parto. Todas las pacientes eran nulíparas, un 26% contaba con menos de 16 años y un 10% experimentó problemas graves durante el parto como hemorragia uterina y síndrome de HELLP. Estas complicaciones se registraron con los cambios significativos en este grupo, corroborando la hipótesis que los factores de riesgo más severos para causar hipertensión gestacional son la adolescencia y la nuliparidad.
DIVERTÍCULO DE KOMMERELL: A PROPÓSITO DE UN CASO
Kommerell diverticulum is a rare congenital anomaly of the aortic arch. It is characterized by the presence of one or several diverticula in the thoracic aorta, usually ascending and arch, from which aberrant arteries such as the subclavian arteries or aortic arches can emerge. It presents asymptomatically with an incidental imaging finding or in patients with symptoms such as dysphagia, cough or chest pain. Treatment is surgical in most cases, although a few patients benefit from endovascular procedures. The clinical case of an asymptomatic 45-year-old female patient is presented, who presents with refractory hypertension that is difficult to control, with a pressure difference between upper and lower limbs, in which a tomographic discovery of several Kommerell diverticula is made (in number). of 5) in ascending aorta and arch without vascular aberration, added to aortic coarctation, which is unusual. Due to the unusual imaging finding at the presentation of this rare congenital anomaly, the clinical case is presented.
Alteraciones Electrocardiográficas en Pacientes Ambulatorios: Estudio Descriptivo en el Hospital Guayaquil Abel Gilbert Pontón.
Background: The electrocardiogram is a fundamental tool in the evaluation of cardiac function, being very useful to identify cardiac alterations in various populations. Its application is not only limited to hospitalized patients, but is also crucial in outpatient care, where it can detect subclinical or previously undiagnosed alterations. Objective: Determine the prevalence and the most common electrocardiographic alterations in outpatients treated at the Guayaquil Abel Gilbert Pontón Hospital during the first quarter of 2024. Material and Methods: Descriptive study that included 1000 outpatients treated in the first quarter of 2024. Variables such as age, gender, personal history and electrocardiographic diagnosis were analyzed; these were performed with a 12-lead device and reviewed by cardiologists. Descriptive statistics were used with Microsoft Excel 2010. Results: Of the 1000 electrocardiograms performed, 52% corresponded to women and 48% to men. The highest frequency of alterations was found in patients aged 60 to 79 years. The prevalence of electrocardiographic alterations was 55%. The most common abnormalities were sinus bradycardia (31%) and right bundle branch block (22%). Conclusion: The prevalence of electrocardiographic alterations in outpatients of the Guayaquil Hospital is significant, highlighting sinus bradycardia and right bundle branch block. These results underline the importance of implementing preventive strategies for the early identification of cardiac disorders.
POEMS SYNDROME AND PULMONARY HYPERTENSION. A CASE REPORT AND LITERATURE REVIEW
síndrome de POEMS es una patología paraneoplásica de muy baja incidencia, debido a las múltiples manifestaciones que posee, su diagnóstico y tratamiento pueden retrasarse, conllevando a la aparición de múltiples complicaciones. La publicación del presente caso resulta importante ante el subdiagnóstico de la patología, la mejoría clínica de la hipertensión pulmonar tras la administración de sildenafil y la poca información que se encuentra respecto al uso de vasodilatadores pulmonares en pacientes con Síndrome de POEMS e hipertensión pulmonar. Presentamos el caso de una paciente de 60 años de edad en quien tras un exhaustivo seguimiento se detecta síndrome de POEMS asociado a enfermedad de Castleman y en consecuencia hipertensión pulmonar. Se recomienda la administración temprana de sildenafil en pacientes que sean diagnosticados con hipertensión pulmonar asociado a síndrome de POEMS en quienes se haya descartado patología pulmonar restrictiva e hipertensión pulmonar secundaria a cardiopatía izquierda.
Síndrome, POEMS, Castleman, Sildenafil, Hipertensión pulmonar
"DESPEJANDO CAMINOS: EXPLORANDO LOS BENEFICIOS REVOLUCIONARIOS DE LA TROMBECTOMÍA MECÁNICA PERCUTÁNEA EN EL TRATAMIENTO DEL TROMBOEMBOLISMO PULMONAR"
Introducción. El tromboembolismo pulmonar agudo de alto riesgo se define al paciente que cursa con inestabilidad hemodinámica o shock por esta causa, siendo la fibrinólisis sistémica el tratamiento de elección sin embargo su tasa de éxito es discutible, así como sus efectos adversos. La trombectomía quirúrgica y percutánea son opciones a recomendadas dentro del tratamiento del tromboembolismo pulmonar agudo de alto riesgo cuando la fibrinolisis falla o está contraindicada. Objetivo. Describir un caso clínico de insuficiencia cardiaca derecha por tromboembolismo pulmonar agudo de alto riesgo tratado con trombectomía percutánea. Materiales y Métodos. Paciente de 78 años, con antecedentes de hipertensión arterial sistémica. Ingresó por cuadro de disnea y dolor precordial de horas de evolución. Resultados. Electrocardiograma con taquicardia sinusal y signo de Mac-GinWhite. El ecocardiograma transtorácico evidenció masa filamentosa móvil en cavidades derechas, signo de McConnell positivo, dilatación y disfunción del ventrículo derecho. Angiotomografía confirmó tromboembolismo pulmonar de alto riesgo de arteria pulmonar izquierda + infarto en lóbulo superior izquierdo. Se realizó fibrinolisis sistémica siendo esta fallida por lo que se procedió a angiografía pulmonar + tromboaspiración + angioplastia pulmonar izquierda con éxito. Discusión. Es escasa la evidencia, sin embargo, diversos reportes de casos y ensayos clínicos obtuvieron que la terapia dirigida por catéter es no inferior e inclusive superior a la fibrinolisis sistémica disminuyendo la morbi-mortalidad a corto y largo plazo, así como los eventos hemorrágicos asociados. Conclusión. La terapia dirigida por catéter en el tromboembolismo pulmonar agudo de alto riesgo es un procedimiento seguro y eficaz, que podría considerarse de forma primaria y no sólo cuando la fibrinolisis sistémica falle o existan contraindicaciones para su uso.
pulmonary thromboembolism, percutaneous thrombectomy, catheter-directed thrombolysis, acute heart failure, shock
ANEMIA HEMOLÍTICA AUTOINMUNE SECUNDARIA A INFECCIÓN POR CITOMEGALOVIRUS A PROPÓSITO DE UN CASO
La anemia hemolítica autoinmune (AHAI) por infección a CMV es un proceso raro en la infancia y más aún en los primeros meses, aunque se han descrito algunos casos en el primer mes de vida. La AHAI presenta un cuadro clínico heterogéneo caracterizado por presencia de autoanticuerpos contra antígenos que se encuentran en la membrana de los glóbulos rojos del paciente que inducen el acortamiento de su vida media. La hemólisis puede presentarse en el curso o inmediatamente después de la infección por CMV, clínicamente con anemia grave, esferocitosis, y reticulocitosis. El tratamiento de elección consiste en prednisona o su equivalente en dosis de 2 mg/kg/día. La respuesta es muy buena en la mayoría de los casos, y la enfermedad remite en semanas o meses. La dosis se reduce paulatinamente hasta aquélla en que se consiga mantener una cifra de hemoglobina aceptable para la edad del paciente y los efectos secundarios sean mínimos o nulos. La prueba de Coombs directo puede mantenerse positiva durante muchos meses. Dentro de la participación del médico pediatra, hay que recalcar la importancia de establecer un diagnóstico diferencial cuando tenemos un paciente pediátrico que está cursando con un proceso infeccioso y que secundariamente está produciendo una anemia de tipo hemolítica para poder plantear el tratamiento más adecuado.
Anemia hemolítica autoinmune, Citomegalovirus, Anemia grave, Coombs directo
Autoimmune hemolytic anemia, Cytomegalovirus, Severe anemia
Ethics in the practice of the Health professional
We can define as ethics to the part of the philosophy constituted by a set of norms that are present and direct human behavior. In the concept of integral training that professionals should receive during higher education, ethics constitutes the cornerstone in which no commitment, clarity of ethical concepts and a high level of personal and social responsibility should not miss. Establish ethical foundations in the practice of health professionals in order to provide a support tool in decision -making before ethical dilemmas, analyze ethics in the health field and know the role of ethics in the training of Health professionals. Every professional should know that their service dimension must always be to see academic and technical competences.
Copyright (c) 2024 REVISTA DE LA FACULTAD DE CIENCIAS MÉDICAS
In the span of seven years, in the Hospital "Abel Gilbert Ponton" was operated an average of 6825 patients, of these 2.6% were complicated patients (184 patients) and the main complication was the entero-cutaneous fistula 164 patients is say 2.4%, which would be within the margin percentage international fistula production. (thesis Dr. Fernando Moncayo A.) The co-morbidity factors (62% of the patients in this study had more than 3 factors) influenced the evolution of the patient who underwent surgery, but also the appearance of fistula was observed in patients without them. The patient's age, nutritional status, comorbid states (cancers, diabetes, inmundeprimido), septic or inflammatory processes that currently owns the patient are gravitating factors (risks) in the occurrence of fistulas. In our study 62% had more than 3 factors. Besides the human factor as the ability to solve problems encountered in surgery, physical and mental fatigue (Burnaut syndrome) are also factors influencing post-surgical complications. Overall mortality was 13.3%, were re-operated for 8.7% of patients and were not re-operated 4.3%.
Intestinal Obstruction Due to Gallstone: Gallstone Ileus (A Case)
It is considered a complication of cholelithiasis with duodenal cholecyst fistula and rarely colonic cholecyst. It occurs when there is a bile-enteric fistula as a consequence of recurrent acute cholecystitis where the gallbladder adheres to the duodenum or colon, causing necrosis and perforation of these two organs that are in contact. Gallstone ileus is a condition of elderly patients and therefore often with comorbidity factors, which is why the immediate resolution of the obstructive condition is the best way to reduce the rate of complications in these patients, that is, early resolution. The case of a male patient, 68 years old, diabetic, who presented with abdominal pain, nausea, vomiting, and intermittent abdominal distension, was presented topographically as gallstone ileus due to the presence of an intraluminal stone in the ileus whose surgical resolution was in a single stage.
Lingual trauma as a complication of macroglossia of covid-19: clinical case
Macroglossia in hypertrophy of the organ (tongue) generally without deformation, although on some occasions it may present some alteration in its shape. The different pathologists agree that not all the elements that make up the tongue hypertrophy but it is done at the expense of two tissues: the lymphatic and the muscular with sclerosis of the connective tissue. The appearance of covid-19 has led us to find uncommon symptoms in certain types of patients, such as the one we will show below, a patient in whom macroglossia can be described not so much as a symptom but as a complication, even more so when the patient presents a trauma to the tongue due to placement in the prone position.
Ocular and brain metastasis from a differentiated thyroid carcinoma, two rare cases
Differentiated thyroid carcinoma (papillary and follicular) is the most frequent endocrine neoplasia, but it only occupies 1% of all cancers and of this small percentage only present atypical distant metastases in approximately 5 to 10%. It is an impressive manifestation of cancer in general, especially in an advanced stage and long evolution, aggressive histological variety, which implies a worse prognosis, the diagnosis is based on the images obtained (gold standard) by magnetic resonance or computed tomography Two cases of advanced or vultuous thyroid carcinoma that presented ocular and cerebral metastases respectively, their clinical presentation, diagnosis and treatment are presented. Being an infrequent or rare manifestation of papillary thyroid carcinoma, which makes the cases interesting.
This is a 61-year-old male patient who was admitted through the emergency service. In the anamnesis he presents a sedentary lifestyle and overweight as the only risk factors and no previous cardiovascular history. He is admitted with a history of typical angina lasting two days. The first electrocardiogram recorded shows negative, deep and symmetrical T waves in the precordial leads. This condition meets the clinical and electrocardiographic criteria of Wellens syndrome, whose recognition and appropriate intervention would prevent a potential extensive anterior myocardial infarction.
Efficacy of cabergoline in the management of prolactinoma
Prolactinomas are first-line drug treatment, which in most cases is required in optimal doses to achieve treatment goals, and this dose has also been shown to be safe; however, in patients in whom no response is evidenced, raising the dose may be considered for the drug to be effective and this population will probably be more prone to developing adverse effects. Objective: To determine the efficacy of cabergoline in the management of prolactinoma. Materials and methods: retrospective, descriptive, comparative, observational, longitudinal study, of 42 patients with prolactinomas treated at the "Hospital de Especialidades Guayaquil, Doctor Abel Gilbert Pontón", in the period January to September 2020, data management was performed in sheets Microsoft Excel 2010 calculation program, where data processing was performed and the SPSS version 23 program was used for statistical analysis. Results: 100% received cabergoline, 19% required doses greater than 2mg / week, demonstrating clinical benefit, especially with cabergoline alone and in low doses except for visual field alterations, the normalization of prolactin was achieved in 81%, the majority with low doses, the reduction of tumor size occurred in 100% of the patients, being effective all the schemes of Treatment studied, 17% presented adverse effects and most were resolved, no valvular disease was evident. Conclusions: Cabergoline therapy in the management of prolactinomas is effective and safe in low doses.
Cytology as a predictor of response to treatment in differentiated thyroid cancer
Introduction: Differentiated thyroid carcinoma (DTC) are neoplasms derived from follicular cells, representing more than 90.6% of thyroid neoplasms. Thyroid puncture cytology is a procedure for diagnosis and treatment decision; however, little information in known in relation to the initial response to treatment. Objective: To demonstrate the relationship between thyroid fine needle aspiration cytology and the response to treatment in differentiated thyroid cancer. Methodology: this is a descriptive, relational, non-experimental cross-sectional study; with DTC patients from the Guayaquil Specialty Hospital “Dr. Abel Gilbert Ponton” in 2018 and 2019. Results: 163 patients were evaluated, the most frequent age group was 40 to 49 years (28.8%), women reached 91.4%, the Bethesda VI category a 52.8%, papillary carcinoma 95.1%; the intermediate recurrence risk 41.1%, and the excellent response 46.6%. When comparing the risk of recurrence and the response to treatment, the low risk had an excellent response in 58.5%, and the high risk had an incomplete structural response in 45.2%. Furthermore, when associating the Bethesda II category with an excellent response, this association was present in 88.2%, with statistical significance. Conclusion: Thyroid is related to the initial response to treatment, where Bethesda II is directly associated with an excellent response, with high intensity and a moderate level of prediction.
Comparative effectiveness of the FINDRISC and ADA scores to predict diabetes mellitus in the presence of predisposing factors
Background: Type 2 diabetes mellitus (DM2) is a chronic endocrine-metabolic disorder (Gagliardinoa, et al., 2016), characterized by hyperglycemia secondary to the combination of decreased insulin secretion and increased tissue resistance to the action of the same. General Objective: To establish the efficacy of the FINDRISC and ADA scores to predict diabetes mellitus in patients with predisposing factors. Methodology: The study is quantitative approach, non-experimental design, cross-sectional, observational and analytical method. Results: The FINDRISC score classified 70.3% of the participants as having a high risk of diabetes mellitus, the variables with the greatest significance were age, first-degree family history, BMI, AC, arterial hypertension and glucose > 100mg/dl. The ADA test applied to the same individuals classified 64.2% as high risk, all of its variables with statistical significance except for the antecedent of gestational diabetes; good correlation with laboratory tests. Conclusion: Easy-to-apply ADA test, in addition to predicting risk of diabetes mellitus 2, also allows establishing the diagnosis unlike the FINDRISC.
Metastasis to the breast from thyroid cancer
There are very few cases described in the literature on thyroid metastasis to other organs, but it is even rarer to find metastasis of thyroid cancer to the breast, 0.5% to 1%. Breast metastases can simulate primary tumors both clinically and radiologically, requiring an accurate histological diagnosis for the correct therapeutic approach and given the prognostic implications they entail. The neoplasms that do so most frequently are in descending order of frequency: lymphomas (17%), melanomas (15%), rhabdomyosarcomas (12%), and lung carcinomas (8%), among others. The case is of a 79-year-old woman, with a history of radical thyroidectomy for 25 years, who attended due to an increase in volume, tumor mass, in the left cervical region (locoregional) and tumor mass in the lower quadrant left mammary region. internal, not painful without inflammatory manifestations.
Correlation between cytological and histopathological study in the diagnosis of differentiated thyroid carcinoma
Differentiated thyroid carcinoma (CDT) comprises 1% of all carcinomas and is the most common endocrine malignant neoplasia. The gold standard in thyroid nodule diagnosis, in addition to ultrasound, is histopathological study, but fine needle aspiration (FNA) is simple, safe and has high rates of specificity and sensitivity. It is important to establish the degree of concordance between the two methods to make appropriate therapeutic decisions. Objective: To determine the correlation between the cytological and histopathological study in CDT Diagnostics. Methodology: The study is descriptive, correlational, non-experimental and cross-sectional; included 237 patients with suspected thyroid cancer (CT) external endocrinology consultation of the hospital “Teodoro Maldonado Carbo” in Guayaquil period January 2016 to December 2017. Results: The diagnosis with FNA, according to the Bethesda (SB) System found 144 patients with CDT, corresponding to category IV 14.8%, V 13.5% and VI 32.5% of the total. Papillary carcinoma represented 96% of total and follicular carcinoma only 4%. The histopathological examination reported 204 patients (86.1%) with CDT. The evaluation of the diagnostic methods showed a sensitivity of 67.2%, specificity 78.8%, reliability 69%. VPP 95%, VPN 27%. Conclusion: Cytologic study with SB is the acceptable method of predicting that a patient has CT, but is questionable to predict that he does not have it. The cytologic study, through FNA, if it has diagnostic concordance with histopathological study in the CDT.
Total heterotopic ossification of the thyroid
Heterotopic ossification, that is, calcifications in tissues that do not normally calcify or ossify; it occurs in previously altered or pathological tissues such as ganglia, nodules, scars, etc., with normal serum calcium levels. Some ossifications or calcifications do not cause symptoms, and their clinical manifestation is usually more aesthetic because it is a chronic problem. They are detected in a first instance by radiography where some radiopaque image is detected on soft tissue, the contracted tomography is the exam of choice (dense radio image). The present case is about a 58-year-old female patient, who presents with a hard mass that covers the entire neck contour that limits movement and causes slight pain to flexion and laterality.
Intestinal obstruction due to intestinal intussusception (Intestinal Intussusception)
An intestinal invagination is produced when a portion of the digestive tract is introduced inside an immediately adjacent segment. Intussusception (invagination) is a rare cause of abdominal pain in adults; is uncommon. It occurs in less than 1% of all cases of adults small bowel obstruction; when it occurs, it is related up to 80% with gastrointestinal tumours. Idiopathic intussusception are an extremely rare occurrence in adults, 10%. The ileocolonic variety predominates in adults. Two cases of intestinal invagination of idiopathic etiology at a non pediatric age are presented.
Intestinal obstruction due to giant gastric trichobezoar
The tricobezoar is a rare gastric tumor formation is composed of hair and affects females at a greater rate. This rare condition is associated with psychological disorders such as trichotillomania and causing intestinal obstruction. The diagnosis is based on data from the history and physical examination to find epigastric tumor mass without morbid history. Treatment is determined by the size of the mass and thus present complications surgical removal was choice in this case. Psychological assessment in this patient needed to avoid recurrences by trichophagia they present.
Factors associated with surgical reinterventions in abdominal surgery admitted through the emergency service of the Abel Gilbert Pontón specialty hospital from January 2020-December 2020.
Background: Re-performing an emergency operation after a surgical time is something that not only shows a type of failure of the first surgery but also gives high anxiety in patients who are reoperated (Dillstro, Bjersa, & My, 2016). The reason for these reoperations are seen due to multiple factors that occur during and after the laparoscopic surgeries performed (Tae Kwan, et al., 2019). Its early identification is imperatively necessary since this would prevent multiple complications, high hospital costs and a possible increase in deaths in the operating room (Xiao, Wang, Quan, & Ouyang, 2018). Objective: To identify the most significant risk factors that precede surgical reoperations in abdominal surgery. Materials and methods: Statistical data was collected from the Abel Gilbert Ponton Hospital patients. The Excel program was used to carry out the statistics and obtain “P” plus “OR” and corroborate statistical significance between the risk factors investigated. Results: Two groups with different populations were taken (Group A: 860 and Group B: 109) which were subdivided into female and male (Group A: male: 501; female: 359; Group B: male: 61; female : 48). It was evidenced that the male gender had a higher prevalence of emergency abdominal reoperations in 58.3% and 56.0% respectively. The main postoperative complications that existed in reintevered patients were surgical site infections (46.8%), intra-abdominal collection (26.6%) and septic shock (24.8%). There were also significant statistical figures in comorbidities (glycemia and arterial hypertension), surgical time and values in blood chemistry. Conclusions: more studies are needed in Ecuador that reveal more kinds of risks presented by suddenly reoperated patients in order to make them known and therefore reduce their incidence.
Factors associated with complications in patients with Intestinal ostomy in the emergency area in 2019, at the Abel Gilbert Pontón hospital
Stoma formation is a procedure commonly performed in colorectal surgery as part of operations performed for inflammatory and malignant bowel disease. Stoma formation is a simple but not trivial task. When done poorly, it can leave patients with a legacy of complications such as leakage, prolapse, parastomal hernia, and retraction. Objective: To determine the factors associated with complications in patients with intestinal ostomies in the emergency area of the "Abel Gilbert Pontón" Hospital during 2019. Methodology: Study of a non-experimental, observational, analytical, retrospective and cross-sectional type, which analyzed patients with intestinal ostomies who presented postoperative complications at the Abel Gilbert Pontón Hospital. Results: The frequency of postoperative complications was 42.5% (n = 20), the female gender predominated in the group with complications, without statistical significance (Group A: 59.3% vs. Group B: 65%). The most frequent age group between the two groups was 56 to 75 years. The greater etiology of both groups was due to acute absences not related to trauma (Group A 96% vs. Group B 90%) and the colon was the most affected organ in the surgeries performed with a greater presentation in Group B without statistical significance ( Group A 52% vs. Group B 70%).
Evaluation of the absence of recurrence of abdominal incisional hernia with propylene mesh
The use of synthetic surgical mesh has become the standard of the hernia repair, but so far the implementation of mesh does not seem to have reduced the risk of recurrence while it is believed that it would only delay it. Objective: determine the efficiency to long term (5 years) of the hernioplasty with polypropylene mesh in patients with incisional hernia intervened in the "Abel Gilbert Pontón" Hospital. Methodology: is carried out a study quantitative, observational longitudinal, retrospective, not experimental in which is included consecutive patients with incisional hernia in who was made hernioplasty with polypropylene mesh: 45 cases without recurrence and 34 with recurrence, treated in Abel Gilbert hospital from Guayaquil - Ecuador, between 2005 and 2015. The analysis statistical is carried out with tables actuarial and of mortality. Results: the first year, the rate of no recurrence is of the 100%, to the third year is of 98% and the fifth year is of the 65%. The cumulative 5-year rate is 40% at 5 years. The complications are produced with greater frequency in patients that recurred (23,5% vs. 2,2%; P 0,06). The presence of factors of risk are associated significantly with the presence of recurrence (70,6% vs. 37,8%;) (P 0,021) Conclusions: the rate of no recurrence at 5 years in patients with incisional hernia and hernioplasty with polypropylene mesh, is low.
Acute post-surgical abdomen due to oblitoma (one case)
The postoperative acute abdomen is a plurisintomatica whose main causes lie in complications that can occur in a surgery performed. In the postoperative patient, peritonitis secondary to a complication occupies 20 to 45% of international statistics, within these, 70% may develop sepsis, which when it is not controlled it can cause a syndrome of multiple organic dysfunction with a high mortality; national and local complications vary between 10 to 20 per cent of statistics carried out in hospital units. Evaluate the postoperative acute abdomen is not an easy task since the postoperative pain, the normal adynamic ileus of a patient underwent surgery may mask the table clinical and more even if the patient is with ventilation and unstable hemodinamicamente. This clínico-quirúrgica entity currently occurs frequently, that is why it is necessary to the health professional is pending on the evolution of the patient to identify and diagnose these complications early that will be caused a postoperative acute abdomen, an essential condition to ensure even the same life of the patient.
Right hemicolectomy and its relationship with complicated appendicitis
The present research work is qualitative, retrospective, cross-sectional, which seeks to associate complicated acute appendicitis with right hemicolectomy as an implemented surgical technique. The universe was a group of 973 patients with acute appendicitis from which a population of 113 who had complicated acute appendicitis according to medical criteria was selected. As a conclusion, it was possible to define that the right hemicolectomy surgical technique is little used in complicated appendicitis, it is reserved for critical cases; it has a higher incidence in males between 46 and 55 years of age; it is associated with acute appendicitis complicated by abdominal sepsis and colon cancer.
Infection of abdominal surgical wounds: Assessment of advanced healing results in the hospitalization area
The development of surgical wound infection is related to the degree of bacterial contamination before and during surgery, the virulence of the infecting organism, and the host's defenses. It is the most frequent cause of nosocomial infections among hospitalized patients and represents 40% of the causes of nosocomial infection in surgical patients. Objectives proposed were: Define the prevalence of the most frequent microorganisms in abdominal surgical wound infection, identify the influence of hospital stay with the risk of presenting abdominal surgical wound infection. Know the prevalence of abdominal surgical wound infection according to age ranges and determine the prevalence of abdominal surgical wound infection according to gender. It was a descriptive, retrospective, non-experimental cross-sectional investigation. It corresponded to an investigation carried out during the period January-December 2019 at Abel Gilbert Pontón Specialty Hospital, Guayaquil, Ecuador, a total of [n = 157 (100%)] samples were taken that met the criteria to be included in this study , of which (83.4%) were colonized by Gram negative bacteria and (16.6%) by Gram positive bacteria, leading the microbiological profile Escherichia coli [n = 55 (35%)] with a prevalence of 25% , patients that stay in the hospital within the first 34 days presented a greater probability of abdominal surgical wound infection and in relation to the age range and gender, the age group of 41 to 63 years had a prevalence of 41.2%, and the female gender of 37%.
Craniocerebral trauma caused by motorcycle traffic accidents between the ages of 18 and 30 who were admitted to the Abel Gilbert Pontón hospital 2017-2019
Craniocerebral trauma represents a big problem in our environment, that has infinite causes, but the one that occurs in a greater proportion is that caused by traffic accidents, that is why the present investigation is carried out with the objective of determining the epidemiological characteristics and the main consequence of the cranioencephalic trauma caused in traffic accidents by motorcycles in the ages of 18 to 30 years. This research is quantitative in approach, descriptive, cross and for its realization, data is taken from medical records provided by the Abel Gilbert Pontón hospital with a sample of 148 patients who presented traumatic brain injury of which 88 patients presented traumatic brain injury due to motorcycle accident.
Main complications of diabetic patients May-December 2020 IESS Guaranda hospital
The patent ductus arteriosus (DAP) is the congenital heart disease that occurs most frequently in newborns, generating a significant short circuit that generally needs its interruption by drug administration; in the country it is estimated that about 2,500 children are born each year with congenital heart defects. General purpose: To determine the efficacy of pharmacological closure of persistent ductus arteriosus in neonates at the Francisco Icaza Bustamante Hospital between 2016-2019. Materials and methods: This are a descriptive, quantitative and descriptive investigation of retrospective analytical cross-section. Results: Of 199 neonatal patients taken with a diagnosis of DAP, 82% (163 patients) were successful in closing the ductus with drugs vs. 18% (36 patients) without success in pharmacological closure; 169 neonates (84%) were treated with paracetamol versus 30 patients (15%) who were treated with ibuprofen; Drug-associated complications occurred in 18% (36 patients). Conclusions: Having carried out and completed this investigation, it is shown that the pharmacological treatment for persistent ductus arteriosus is highly effective, with paracetamol being the most widely used drug at present and with a minimal rate of complications.