e-revistas (Universidad de Los Andes)
Not a member yet
17192 research outputs found
Sort by
Multifocalidad y multicentricidad del cáncer de mama detectada por mamoresonancia en pacientes que acuden a un centro de salud, 2022 Multifocality and multicentricity of breast cancer detected by mammoresonance in patients attending a health center, 2022
Get PDFObjective: to determine multicentricity and multifocality by magnetic resonance imaging in patients with breast cancer who attended the Imaging Service of the Center for Medical Specialties (CEDEM), during the year 2022. Materials and methods: Observational correlational, non-experimental, retrospective cross-sectional design, in patients recently diagnosed with breast CA who came to undergo breast MRI. The images were analyzed together with the histopathological and immunohistochemical diagnosis obtained from the medical history of each patient. Results: A total of 75 patients who underwent breast MRI were analyzed; 40% had multifocality and 23.3% had multicentricity, with 20% of the sample having MF/MC CA, this relationship being statistically significant (p <.001). In the post-contrast dynamic study of the magnetic resonance imaging, a predominance of the type II curve was evident in 94%. The majority corresponded to infiltrating ductal carcinomas, Luminal B. Conclusions: Breast magnetic resonance imaging allows determining the presence of multifocality and multicentricity in breast cancer; essential and determining in the decision of the treatment to follow, so it should be included as a preoperative assessment in patients.Objetivo: determinar la multicentricidad y multifocalidad por resonancia magnética en pacientes con cáncer de mama que asistieron al Servicio de Imagenología del Centro de Especialidades Médicas (CEDEM), durante el año 2022. Materiales y métodos: observacional correlacional, diseño no experimental, retrospectivo transversal, en pacientes recientemente diagnosticadas de CA de mama que acudieron a realizarse Resonancia Magnética de mama. Se analizaron las imágenes en conjunto con el diagnóstico histopatológico e inmunohistoquímico obtenido de la historia clínica de cada paciente. Resultados: Se analizó un total de 75 pacientes a quienes se les realizó resonancia magnética de mama; 40% resultó con presencia de multifocalidad y 23,3% de multicentricidad, coincidiendo un 20% de la muestra con presencia de CA MF/MC, siendo esta relación estadísticamente significativa (p<.001). En el estudio dinámico postcontraste de la resonancia magnética se evidenció predominio de la curva tipo II en un 94%. La mayoría correspondió a Carcinomas ductales infiltrantes, Luminales B. Conclusiones: La resonancia Magnética de mama permite determinar la presencia de multifocalidad y multicentricidad en el CA de Mama; esencial y determinante en la decisión del tratamiento a seguir, por lo que debe incluirse como valoración preoperatoria en las pacientes.Objective: to determine multicentricity and multifocality by magnetic resonance imaging in patients with breast cancer who attended the Imaging Service of the Center for Medical Specialties (CEDEM), during the year 2022. Materials and methods: Observational correlational, non-experimental, retrospective cross-sectional design, in patients recently diagnosed with breast CA who came to undergo breast MRI. The images were analyzed together with the histopathological and immunohistochemical diagnosis obtained from the medical history of each patient. Results: A total of 75 patients who underwent breast MRI were analyzed; 40% had multifocality and 23.3% had multicentricity, with 20% of the sample having MF/MC CA, this relationship being statistically significant (p <.001). In the post-contrast dynamic study of the magnetic resonance imaging, a predominance of the type II curve was evident in 94%. The majority corresponded to infiltrating ductal carcinomas, Luminal B. Conclusions: Breast magnetic resonance imaging allows determining the presence of multifocality and multicentricity in breast cancer; essential and determining in the decision of the treatment to follow, so it should be included as a preoperative assessment in patients.Recibido: 03-09-2024Aceptado: 11-10-2024Publicado: 01-11-202
Estrategia de diagnóstico para trastornos de comportamiento en infantes de ocho a once años Diagnostic strategy for behavioral disorders in infants aged eight to eleven years old
Get PDFThe article presents a study on the diagnosis of behavioral disorders in children aged eight to eleven years using linear regression models and artificial neural networks. The study was conducted on a sample of 176 children from an educational unit in the province of Cotopaxi, Ecuador, using the ESPERI project instrument to collect data. The study focused on four main factors: inattention/impulsivity/hyperactivity, oppositional-defiant, predispositional and dissocial. The data were preprocessed, cleaned, and normalized using Microsoft Excel, and descriptive analysis and statistical tests were performed to determine the significance of the relationships between the independent variables and the dependent variable. Four variables were selected for the linear regression model: inattention/impulsivity/hyperactivity, dissocial factor, predisocial factor, and oppositional-defiant factor. The model was created using Python and Google Colaboratory, and different metrics were used to evaluate its performance. The model was validated using an independent dataset, and the results were interpreted to determine the variables that have the greatest influence on the diagnosis of behavioral disorders. The results of the study showed that the prevalence of behavioral disorders in children was 4.8% to 7.4% in boys and 2.1% to 3.2% in girls. The linear regression model had a good fit to the data and was able to explain the variability in the dependent variable with low prediction error on the test set. The article also provides the complete code of the model to be tested in a production environment.DOI: https://doi.org/10.53766/GICOS/2024.09.02.08ResumenEstudio sobre el diagnóstico de trastornos de comportamiento en niños de ocho a once años utilizando modelos de regresión lineal y redes neuronales artificiales. El estudio se llevó a cabo en una muestra de 176 niños de una unidad educativa en la provincia de Cotopaxi, Ecuador, utilizando el instrumento del proyecto ESPERI para recopilar datos. El estudio se centró en cuatro factores principales: inatención/impulsividad/hiperactividad, oposicional-desafiante, predisocial y disocial. Los datos fueron preprocesados, limpiados y normalizados utilizando Microsoft Excel, y se realizaron análisis descriptivos y pruebas estadísticas para determinar la significancia de las relaciones entre las variables independientes y la variable dependiente. Se seleccionaron cuatro variables para el modelo de regresión lineal: inatención/impulsividad/hiperactividad, factor disocial, factor predisocial y factor oposicional-desafiante. El modelo fue creado utilizando Python y Google Colaboratory, y se utilizaron diferentes métricas para evaluar su rendimiento. El modelo fue validado utilizando un conjunto de datos independiente y los resultados se interpretaron para determinar las variables que tienen la mayor influencia en el diagnóstico de trastornos de comportamiento. Los resultados del estudio mostraron que la prevalencia de trastornos de comportamiento en niños era del 4,8% al 7,4% en niños y del 2,1% al 3,2% en niñas. El modelo de regresión lineal tuvo un buen ajuste a los datos y fue capaz de explicar la variabilidad en la variable dependiente con un bajo error de predicción en el conjunto de prueba. En el artículo también se proporciona el código completo del modelo para ser probado en un entorno de producción.ABSTRACTThe article presents a study on the diagnosis of behavioral disorders in children aged eight to eleven years using linear regression models and artificial neural networks. The study was conducted on a sample of 176 children from an educational unit in the province of Cotopaxi, Ecuador, using the ESPERI project instrument to collect data. The study focused on four main factors: inattention/impulsivity/hyperactivity, oppositional-defiant, predispositional and dissocial. The data were preprocessed, cleaned, and normalized using Microsoft Excel, and descriptive analysis and statistical tests were performed to determine the significance of the relationships between the independent variables and the dependent variable. Four variables were selected for the linear regression model: inattention/impulsivity/hyperactivity, dissocial factor, predisocial factor, and oppositional-defiant factor. The model was created using Python and Google Colaboratory, and different metrics were used to evaluate its performance. The model was validated using an independent dataset, and the results were interpreted to determine the variables that have the greatest influence on the diagnosis of behavioral disorders. The results of the study showed that the prevalence of behavioral disorders in children was 4.8% to 7.4% in boys and 2.1% to 3.2% in girls. The linear regression model had a good fit to the data and was able to explain the variability in the dependent variable with low prediction error on the test set. The article also provides the complete code of the model to be tested in a production environment.Recibido: 10-03-2024Aceptado: 17-04-2024Publicado: 25-05-202
Tumor en ángulo pontocerebeloso izquierdo: paraganglioma gigante de fosa craneal posterior con extensión a región cervical: reporte de un caso Left cerebellopontine angle tumor: giant paraganglioma of the posterior cranial fossa with extension to the cervical region: a case report
Get PDFParagangliomas are rare benign neuroendocrine tumors that arise from sympathetic or parasympathetic ganglia, with an incidence of 0.3 to 1 per 100,000 population. They can be the result of alterations in more than 15 different genes. We analyze the case of a 35-year-old male patient who presented with paresthesia in the upper limbs. He had a history of severe holocranial headache. Physical examination revealed left peripheral facial paralysis, discharge through the left ear, and a stony consistency swelling in the left neck region. A magnetic resonance imaging (MRI) scan of the skull was performed, showing a diffuse heterogeneous image with areas of necrosis compressing the left cerebellopontine angle and extending to the left petrous apex, with obliteration of grooves and convolutions in the left cerebellar hemisphere. A sagittal section revealed an extended hyperintense image at the bulboprotuberantial level. The patient was prescribed analgesic and neuromodulator medications, as well as measures to reduce cerebral edema and a steroid-based pyramidal scheme. Under a preoperative diagnosis of posterior fossa brain neoplasia, the patient underwent suboccipital craniectomy, during which the tumor was partially resected and a sample was taken for histopathological analysis. Paragangliomas are already rare tumors, and the cranio-cervical presentation, along with the extent found in this case, is exceptional as it involves multiple neurological, vascular, and visceral structures, posing a high-risk life-threatening situation for the patient.DOI:https://doi.org/10.53766/GICOS/2024.09.02.17RESUMENLos paragangliomas son tumores neuroendocrinos benignos infrecuentes que surgen en los ganglios simpáticos o parasimpáticos, teniendo una incidencia de 0.3 a 1 por cada 100.000 habitantes, pueden ser el resultado de alteraciones en más de 15 genes diferentes. Se analiza el caso de un paciente masculino de 35 años de edad, quien presentó parestesia en miembros superiores. Con antecedente de cefalea holocraneana de fuerte intensidad. Al examen físico se evidenció parálisis facial periférica izquierda, salida de secreción a través de oído izquierdo y aumento de volumen en región de cuello izquierdo de consistencia pétrea. Se realizó estudio de imagen tipo resonancia magnética de cráneo donde se evidenció imagen heterogénea difusa, con áreas de necrosis que comprimían ángulo pontocerebeloso del lado izquierdo con extensión a ápex petroso izquierdo, surcos y circunvoluciones borradas en hemisferio cerebeloso izquierdo. En un corte sagital se evidenció imagen hiperintensa extendida a nivel bulboprotuberancial. Se indicó tratamiento médico analgésico, neuromodulador, medidas antiedema cerebral y esquema piramidal con esteroides. Bajo diagnóstico preoperatorio de neoplasia cerebral de fosa posterior fue llevado a mesa quirúrgica para realizar craniectomía suboccipital en la cual el tumor fue resecado parcialmente y se tomó muestra para análisis histopatológico. Los paragangliomas son tumores poco frecuentes de por sí y la presentación cráneo-cervical además de la extensión hallada en este caso es excepcional, pues toma múltiples estructuras neurológicas, vasculares y viscerales que ocasionan la clínica particular presentada y que comprometen con alto riesgo la vida del paciente.ABSTRACT Paragangliomas are rare benign neuroendocrine tumors that arise from sympathetic or parasympathetic ganglia, with an incidence of 0.3 to 1 per 100,000 population. They can be the result of alterations in more than 15 different genes. We analyze the case of a 35-year-old male patient who presented with paresthesia in the upper limbs. He had a history of severe holocranial headache. Physical examination revealed left peripheral facial paralysis, discharge through the left ear, and a stony consistency swelling in the left neck region. A magnetic resonance imaging (MRI) scan of the skull was performed, showing a diffuse heterogeneous image with areas of necrosis compressing the left cerebellopontine angle and extending to the left petrous apex, with obliteration of grooves and convolutions in the left cerebellar hemisphere. A sagittal section revealed an extended hyperintense image at the bulboprotuberantial level. The patient was prescribed analgesic and neuromodulator medications, as well as measures to reduce cerebral edema and a steroid-based pyramidal scheme. Under a preoperative diagnosis of posterior fossa brain neoplasia, the patient underwent suboccipital craniectomy, during which the tumor was partially resected and a sample was taken for histopathological analysis. Paragangliomas are already rare tumors, and the cranio-cervical presentation, along with the extent found in this case, is exceptional as it involves multiple neurological, vascular, and visceral structures, posing a high-risk life-threatening situation for the patient.Recibido: 31-03-2024Aceptado: 02-05-2024Publicado: 25-05-202
Plasma rich in platelets versus prolotherapy for the treatment of pain in osteoarthrosis of the knee
Get PDFDOI: https://doi.org/10.53766/GICOS/2024.01.09.03RESUMEN La investigación planteó como objetivo determinar la efectividad entre las infiltraciones articulares con plasma rico en plaquetas vs proloterapia con solución hipertónica de dextrosa al 50% + anestésico local: lidocaína al 1%, como estrategia para el manejo del dolor en pacientes con Osteoartrosis de rodilla, Instituto Autónomo Hospital Universitario de Los Andes, enero 2022 a marzo 2023. Método: estudio clínico experimental tipo ensayo terapéutico con dos grupos de estudio. Muestra de 74 casos que cumplieron con los criterios de inclusión, divididos en dos grupos, PRP (30 casos) y PRL (44 casos). Resultados: femenino (67,7%), edad (62,03 ± 11,016 años), IMC normal (43,5%), sobrepeso (37,1%) y obesidad (19,4%). 67,7% indicó alguna comorbilidad, siendo las más frecuentes HTA (50,0%). 77,9% asistieron a fisioterapia. 87,8% se encontraron según la escala de Kellgren y Lawrence en artrosis grado I a III y 12,2% grado IV. Se determinó p<0,05 entre el antes y después de cada tratamiento, específicamente entre la valoración del dolor según la Escala Analógica Visual (EVA) y la evaluación de la capacidad funcional según el cuestionario del Western Ontario Mc Master Universities Osteoarthritis Index (WOMAC) entre los resultados del ingreso y del egreso. No se obtuvieron diferencias estadísticas entre los resultados de ambos grupos de tratamientos. Conclusiones: se determinó que ambos tratamientos fueron efectivos en el manejo del dolor en la artrosis de rodilla, encontrándose un promedio tres veces menos en el grado de dolor según EVA y mejoría del WOMAC en comparación con la evaluación inicial.ABSTRACTThe objective of the research was to determine the effectiveness between joint infiltrations with platelet-rich plasma vs. prolotherapy with hypertonic 50% dextrose solution + local anesthetic: 1% lidocaine, as a strategy for pain management in patients with knee osteoarthritis, Instituto Autónomo Hospital Universitario de Los Andes, January 2022 to March 2023. Method: experimental clinical study type therapeutic trial with two study groups. Sample of 74 cases that met the inclusion criteria, divided into two groups, PRP (30 cases) and PRL (44 cases). Results: female (67.7%), age (62.03 ± 11,016 years), normal BMI (43.5%), overweight (37.1%) and obesity (19.4%). 67.7% indicated some comorbidity, the most frequent being HTN (50.0%). 77.9% attended physical therapy. According to the Kellgren and Lawrence scale, 87.8% were found to have grade I to III osteoarthritis and 12.2% were grade IV. P<0.05 are considered between before and after each treatment, specifically between the assessment of pain according to the Visual Analogue Scale (VAS) and the evaluation of functional capacity according to the Western Ontario Mc Master Universities Osteoarthritis Index (WOMAC) questionnaire between the income and discharge results. No statistical differences were obtained between the results of both treatment groups. Conclusions: it was determined that both treatments were effective in managing pain in knee osteoarthritis, finding an average three times less in the degree of pain according to VAS and improvement in the WOMAC compared to the initial evaluation.Recibido: 03-10-2023. Aceptado: 15-01-2024. Publicado: 01-03-2024The objective of the research was to determine the effectiveness between joint infiltrations with platelet-rich plasma vs. prolotherapy with hypertonic 50% dextrose solution + local anesthetic: 1% lidocaine, as a strategy for pain management in patients with knee osteoarthritis, Instituto Autónomo Hospital Universitario de Los Andes, January 2022 to March 2023. Method: experimental clinical study type therapeutic trial with two study groups. Sample of 74 cases that met the inclusion criteria, divided into two groups, PRP (30 cases) and PRL (44 cases). Results: female (67.7%), age (62.03 ± 11,016 years), normal BMI (43.5%), overweight (37.1%) and obesity (19.4%). 67.7% indicated some comorbidity, the most frequent being HTN (50.0%). 77.9% attended physical therapy. According to the Kellgren and Lawrence scale, 87.8% were found to have grade I to III osteoarthritis and 12.2% were grade IV. P<0.05 are considered between before and after each treatment, specifically between the assessment of pain according to the Visual Analogue Scale (VAS) and the evaluation of functional capacity according to the Western Ontario Mc Master Universities Osteoarthritis Index (WOMAC) questionnaire between the income and discharge results. No statistical differences were obtained between the results of both treatment groups. Conclusions: it was determined that both treatments were effective in managing pain in knee osteoarthritis, finding an average three times less in the degree of pain according to VAS and improvement in the WOMAC compared to the initial evaluation
Estado nutricional y estilo de vida del adulto mayor. Ambulatorio Belén. Municipio Libertador del Estado Mérida. Octubre - diciembre de 2022 Nutritional status and lifestyles of older adults who attend the Belén outpatient of the Libertador municipality of the Mérida state, october - december 2022
Get PDFThis research sought to determine the relationship between nutritional status and lifestyle in the case of older adults. It was carried out with a quantitative, analytical and field approach in 149 individuals. A matrix was designed to record sociodemographic characteristics. The instruments were applied: nutritional screening Mini Nutritional Assessment (MNA), lifestyle scale. Factors associated with malnutrition and morbidities were evaluated. Results: age 67.4 ± 8.36 years; female (62.4%), married or in a stable union (36.2%) and educational level, secondary school (54.4%). According to the Mini Nutritional Assessment (MNA) test, normal nutritional status predominated in 53% and the anthropometric parameters explored were weight 64.70 ± 10.99, height 1.58 ± 0.07, Body Mass Index normal to female sex prevalence, calf circumference 25.87 ± 1.82 and calf circumference 33.02 ± 1.65. However, 46% of older adults are at risk of malnutrition. The 89% reported an unhealthy lifestyle. The main associated factors that influenced were economic and sociocultural. The 40.3% of patients suffer from HTA. There was a statistically significant relationship between nutritional status and lifestyle with a p-value of 0.01, as well as between lifestyle and diabetes mellitus 2. It is important to apply evaluation scales in primary care that allow identifying the nutritional status and lifestyle of the elderly, because there is a relationship between both variables.DOI: https://doi.org/ 10.53766/GICOS/2024.09.02.03RESUMENEn esta investigación se buscó determinar la relación entre el estado nutricional y el estilo de vida del adulto mayor. Fue una investigación con un enfoque cuantitativo, analítico y de campo en 149 individuos. Se diseñó una matriz para el registro de las características sociodemográficas. Se aplicaron los instrumentos: cribado nutricional Mini Nutritional Assessment (MNA), escala de estilo de vida. Los factores asociados a la malnutrición y las morbilidades también fueron evaluados. Resultados: edad 67,4 ± 8,36 años; sexo femenino (62,4%), casados o unión estable (36,2 %) y nivel educativo, secundaria (54,4%). Según el test Mini Nutritional Assessment, (MNA) el estado nutricional normal predominó en el 53 % y los parámetros antropométricos explorados fueron el peso 64,70 ± 10,99, la talla 1,58 ± 0,07, el Índice de Masa Corporal normal prevalencia en el sexo femenino, circunferencia branquial 25,87 ± 1,82 y perímetro de pantorrilla 33,02 ± 1.65. No obstante, el 46 % de los adultos mayores tuvieron riesgo de malnutrición. El 89% manifestaron estilo de vida no saludable. Los principales factores asociados que influyeron fueron el económico y el sociocultural. El 40,3% de los pacientes presentaron HTA. Hubo una relación estadísticamente significativa entre estado nutricional y estilo de vida con p-valor de 0,01, así como también entre estilo de vida y la diabetes mellitus tipo 2. Es importante aplicar escalas de evaluación en la atención primaria que permitan identificar el estado nutricional y el estilo de vida del adulto mayor, debido a que existe relación entre ambas variables.ABSTRACTThis research sought to determine the relationship between nutritional status and lifestyle in the case of older adults. It was carried out with a quantitative, analytical and field approach in 149 individuals. A matrix was designed to record sociodemographic characteristics. The instruments were applied: nutritional screening Mini Nutritional Assessment (MNA), lifestyle scale. Factors associated with malnutrition and morbidities were evaluated. Results: age 67.4 ± 8.36 years; female (62.4%), married or in a stable union (36.2%) and educational level, secondary school (54.4%). According to the Mini Nutritional Assessment (MNA) test, normal nutritional status predominated in 53% and the anthropometric parameters explored were weight 64.70 ± 10.99, height 1.58 ± 0.07, Body Mass Index normal to female sex prevalence, calf circumference 25.87 ± 1.82 and calf circumference 33.02 ± 1.65. However, 46% of older adults are at risk of malnutrition. The 89% reported an unhealthy lifestyle. The main associated factors that influenced were economic and sociocultural. The 40.3% of patients suffer from HTA. There was a statistically significant relationship between nutritional status and lifestyle with a p-value of 0.01, as well as between lifestyle and diabetes mellitus 2. It is important to apply evaluation scales in primary care that allow identifying the nutritional status and lifestyle of the elderly, because there is a relationship between both variables.Recibido: 26-02-2024Aprobado: 09-04-2024Publicado: 25-05-202
Riesgo cardiovascular en docentes de una institución de educación superior en la ciudad de Ambato Cardiovascular risk in teachers at an institution of higher education in the city of Ambato
Get PDFThe research was carried out on teachers of a Higher Education entity in the Province of Tungurahua whose purpose was to characterize the cardiovascular risk profile, through a cross-sectional observational study with 79 teachers, the following were carried out: anthropometry, lipid profile, identifying the cardiovascular risk with the Framingham scale, an instrument that measures the probability of suffering cardiac arrest in the next 10 years, in people over 20. Low cardiovascular risk was evident in 65.8% of the teachers. The average BMI value was 23.4 Kg/cm2±2.5 Kg/cm2. The heart age resulting from the calculation of the different parameters was 42 years compared to the average age of the participants of 40 years. Using the tool taken from the Mexican Social Security Institute, an average cardiovascular risk of 3.1% was obtained of the total population investigated. Among the activities most practiced by the population was walking. Thanks to the intervention, the institution met the institutional requirements of carrying out occupational checkups in accordance with those of the public system that had not been carried out until the time of the investigation. With these results, the entity will be able to implement healthy lifestyle and cardiovascular disease prevention programs.La investigación se efectuó sobre los docentes de una entidad de Educación Superior de la Provincia de Tungurahua cuya finalidad fue caracterizar el perfil de riesgo cardiovascular, mediante un estudio de tipo observacional transversal con 79 docentes, se realizó: antropometría, perfil lipídico, identificando el riesgo cardiovascular con la escala de Framingham instrumento que mide las probabilidades de sufrir un paro cardíaco en los próximos 10 años, en personas mayores de 20. Se evidenció que un 65,8% de los docentes tiene un bajo riesgo cardiovascular. El valor promedio del IMC fue 23,4 Kg/cm2±2,5 Kg/cm2. La edad del corazón producto del cálculo de los diferentes parámetros fue de 42 años comparado con la edad promedio de los participantes de 40 años. Mediante la herramienta tomada del Instituto Mexicano del Seguro Social en promedio se obtuvo un riesgo cardiovascular del 3,1%. del total de la población investigada. Entre las actividades de mayor práctica de la población fue la caminata. Gracias a la intervención la institución cumplió con los requisitos institucionales de realizar chequeos ocupacionales en concordancia con los del sistema público que no se habían realizado hasta el momento de la investigación. Con estos resultados la entidad podrá implementar programas de estilos de vida saludable y prevención de enfermedad cardiovascular.The research was carried out on teachers of a Higher Education entity in the Province of Tungurahua whose purpose was to characterize the cardiovascular risk profile, through a cross-sectional observational study with 79 teachers, the following were carried out: anthropometry, lipid profile, identifying the cardiovascular risk with the Framingham scale, an instrument that measures the probability of suffering cardiac arrest in the next 10 years, in people over 20. Low cardiovascular risk was evident in 65.8% of the teachers. The average BMI value was 23.4 Kg/cm2±2.5 Kg/cm2. The heart age resulting from the calculation of the different parameters was 42 years compared to the average age of the participants of 40 years. Using the tool taken from the Mexican Social Security Institute, an average cardiovascular risk of 3.1% was obtained of the total population investigated. Among the activities most practiced by the population was walking. Thanks to the intervention, the institution met the institutional requirements of carrying out occupational checkups in accordance with those of the public system that had not been carried out until the time of the investigation. With these results, the entity will be able to implement healthy lifestyle and cardiovascular disease prevention programs.Recibido: 20-07-2024Aceptado: 29-08-2029Publicado: 01-11-202
Anaplasmosis simulando enfermedad linfoproliferativa: A propósito de un caso Anaplasmosis simulating lymphoproliferative disease: A case report
Get PDFEhrlichiosis and Anaplasmosis are bacterial infections transmitted by ticks, currently considered an emerging problem. Among species, Anaplasma phagocytophilum is responsible for human infection. This is a 55-year-old male patient who was admitted due to fever and weakness. He reports grade III prostatic hyperplasia, treated for 2 years, requiring use of a urinary catheter, while awaiting prostatectomy. He lives in a rural home, with an epidemiological history of employment as a dog trainer. On examination, the patient had a temperature of 39°C, large lymphadenopathy in the neck, axillae, epitrochlear and inguinal areas, generalized petechiae and grade III hard splenomegaly (Boyd). The analysis highlights leukocytes 2.100/mm3, Hemoglobin 4,5 g/dL, platelets 75.000/mm3, C-reactive protein 5.66 mg/L. Urine culture reports Escherichia coli and Candida sp. During his first hospital stay, he received a presumptive diagnosis of lymphoproliferative syndrome and urinary tract infection, treated with antibiotic therapy. Without improvement in symptoms, he was discharged against medical advice. Later he went to a private center due to an exacerbation of the clinical condition. The diagnosis was based on the epidemiological history, clinical manifestations and confirmation of active infection by determination of positive IgM antibodies. The lymph node biopsy reports reactive lymph node hyperplasia. Excellent response to treatment with Doxycycline, resolution of general symptoms, disappearance of adenosplenomegaly and hematological compromise. The literature reports that this type of bacteria has a special affinity for blood cells and is responsible for the cytopenias observed, causing significant degrees of immunosuppression, a fact that facilitates the appearance of opportunistic infections which, together with the use of a urinary catheter, was the case of urinary infection.DOI: https://doi.org/10.53766/GICOS/2024.09.02.19RESUMENEhrlichiosis y Anaplasmosis, son infecciones bacterianas transmitidas por garrapatas, actualmente consideradas como problema emergente. Entre especies, Anaplasma phagocytophilum es la responsable de la infección humana. Se trata de paciente masculino de 55 años, que ingresa por fiebre y debilidad. Refiere hiperplasia prostática grado III, tratada desde hace 2 años, requiriendo uso de sonda vesical, a la espera de prostatectomía. Habita en vivienda rural, con antecedente epidemiológico de ocupación como entrenador de perros. A la exploración presentaba temperatura de 39°C, adenopatías de gran tamaño en cuello, axilas, epitrocleares e inguinales, petequias generalizadas y esplenomegalia dura grado III (Boyd). En la analítica destaca leucocitos 2.100/mm3, Hemoglobina 4,5 g/dL, plaquetas 75.000/mm3, proteína C reactiva 5,66 mg/L. El urocultivo reporta Escherichia coli y Cándida sp. En su primera estadía hospitalaria recibe diagnóstico presuntivo de síndrome linfoproliferativo e infección urinaria, tratada con antibioticoterapia. Sin mejoría de los síntomas egresa contra opinión médica. Posteriormente acude a centro privado por exacerbación del cuadro clínico. El diagnóstico se basó en los antecedentes epidemiológicos, manifestaciones clínicas y confirmación de infección activa mediante determinación de anticuerpos IgM positivas. La biopsia ganglionar reporta hiperplasia ganglionar reactiva. Excelente respuesta al tratamiento con Doxiciclina, resolución de síntomas generales, desaparición de adenoesplenomegalia y compromiso hematológico. La literatura reporta que este tipo de bacterias tiene especial afinidad por las células sanguíneas y son responsables de las citopenias observadas, provocando grados importantes de inmunodepresión, hecho que facilita la aparición de infecciones oportunistas que, aunado al uso de sonda vesical, fue el caso de la infección urinaria.ABSTRACTEhrlichiosis and Anaplasmosis are bacterial infections transmitted by ticks, currently considered an emerging problem. Among species, Anaplasma phagocytophilum is responsible for human infection. This is a 55-year-old male patient who was admitted due to fever and weakness. He reports grade III prostatic hyperplasia, treated for 2 years, requiring use of a urinary catheter, while awaiting prostatectomy. He lives in a rural home, with an epidemiological history of employment as a dog trainer. On examination, the patient had a temperature of 39°C, large lymphadenopathy in the neck, axillae, epitrochlear and inguinal areas, generalized petechiae and grade III hard splenomegaly (Boyd). The analysis highlights leukocytes 2.100/mm3, Hemoglobin 4,5 g/dL, platelets 75.000/mm3, C-reactive protein 5.66 mg/L. Urine culture reports Escherichia coli and Candida sp. During his first hospital stay, he received a presumptive diagnosis of lymphoproliferative syndrome and urinary tract infection, treated with antibiotic therapy. Without improvement in symptoms, he was discharged against medical advice. Later he went to a private center due to an exacerbation of the clinical condition. The diagnosis was based on the epidemiological history, clinical manifestations and confirmation of active infection by determination of positive IgM antibodies. The lymph node biopsy reports reactive lymph node hyperplasia. Excellent response to treatment with Doxycycline, resolution of general symptoms, disappearance of adenosplenomegaly and hematological compromise. The literature reports that this type of bacteria has a special affinity for blood cells and is responsible for the cytopenias observed, causing significant degrees of immunosuppression, a fact that facilitates the appearance of opportunistic infections which, together with the use of a urinary catheter, was the case of urinary infection.Recibido: 09-04-2024Aceptado: 18-05-2024Publicado: 25-05-202
La Participación Política de los Pueblos y Comunidades Indígenas: Estrategias para Potenciar el Reconocimiento del Derecho a la Identidad Cultural y Protección del Territorio Ancestral en Ecuador
Get PDFThe article addresses the interaction between the recognition of the plurinational state, governance, and community participation in territorial subscriptions of indigenous peoples and nationalities in the Ecuadorian context. It is clarified that the State is defined as the recognition of several nationalities with their own and different cultural identity; and participation, as the system of processes and structures that organize the administration and interactions between the State and society that plays a crucial role in sustainable development and social inclusion. The Constitution (2008), the COTAD and the LOPC are examples of laws that recognize the plurinational State, promote participation and decentralization. The study uses a qualitative-comparative approach and a bibliographic review. The results highlight the importance of citizen participation in respect for cultural identity and ancestral heritage, as well as the challenges and opportunities in rural development driven by governance.El presente artículo aborda la interacción entre el reconocimiento del Estado plurinacional, la gobernanza, la participación comunitaria en suscripciones territoriales de pueblos y nacionalidades indígenas en el contexto ecuatoriano. Se matiza que el Estado, se define como el reconocimiento de varias nacionalidades con identidad cultural propia y diferente; y la participación, como el sistema de procesos y estructuras que organizan la administración y las interacciones entre el Estado y la sociedad que juega un papel crucial en el desarrollo sostenible y la inclusión social. La Constitución (2008), el COTAD y la LOPC son ejemplos de leyes que reconocen al Estado plurinacional, promueven la participación y la descentralización. El estudio utiliza un enfoque cualitativo-comparativo y una revisión bibliográfica. Los resultados resaltan la importancia de la participación ciudadana en el respeto a la identidad cultural y patrimonio ancestral, como los desafíos y oportunidades en el desarrollo rural impulsado por la gobernanza. Recibido: 10-12-2023Aceptado: 30-03-202
Acceso a la atención médica en el iahula relacionado con los derechos constitucionales en venezuela-2020
Get PDFIntroduction: health is conceived as a human, social and fundamental right of human beings, the State must guarantee the population free access to health services with equal opportunities. However, the situation in our country in relation to health coverage is critical, due to various problems among which stand out; the acquisition of supplies and inputs, unfavorable conditions of public institutions, deterioration of nutrition services, among other triggering factors. Objective: to analyze the access to health services in a group of patients and health personnel working at the “Instituto Autónomo Hospital Universitario de los Andes” (IAHULA) in relation to the provisions of articles 83, 84 and 85 of the Constitution of the Bolivarian Republic of Venezuela. Materials and Methods: the study was analytical with a field design, the sample consisted of 14 participants, distributed among health personnel working at IAHULA and patients attending different clinical areas of the institution. Results: Participants reported that they received adequate care, obtaining availability of some studies, medical exams, and basic supplies. However, they expressed economic limitations, deficiency of services in the institution, labor desertion, among other determining factors. Conclusions: access to medical care at IAHULA was affected by the economic, political and social inequalities present in the country, triggering unfavorable conditions, leading to the loss of guarantees in the health sectorIntroducción: la salud es concebida como un derecho humano, social y fundamental de los seres humanos, el Estado debe garantizar a la población el acceso gratuito a los servicios de salud en igualdad de oportunidades. Sin embargo, la situación que se presenta en nuestro país en relación con la cobertura en salud es crítica, debido a los diversos problemas entre los que se destacan; condiciones desfavorables de las instituciones públicas, pérdida del poder adquisitivo de la población, entre otros factores desencadenantes. Objetivo: analizar el acceso a los servicios de salud en un grupo de pacientes y personal de salud que labora en el Instituto Autónomo Hospital Universitario de Los Andes con relación a lo establecido en los artículos 83, 84 y 85 de la Constitución de la República Bolivariana de Venezuela. Metodología: el tipo de investigación fue analítica con un diseño de campo, la muestra estuvo conformada por 14 participantes,distribuidas entre el personal de salud que labora en el IAHULA y pacientes que asistieron a distintas áreas clínicas de la institución. Resultados: los participantes manifestaron haber recibido una atención médica adecuada, y acceso a estudios, exámenes médicos, insumos y suministros básicos. Sin embargo, expresaron limitaciones económicas, deficiencia de los servicios en la institución, deserción laboral, entre otros factores. Conclusiones: el acceso a la atención médica en el IAHULA se vio afectada por las desigualdades económicas, políticas y sociales presentadas en el país, desencadenando condiciones desfavorables, conllevando a la perdida de garantías constitucionales en el sector salud.Recibido: 26-6-23 Aceptado: 31-8-2
The oppression of critical thinking. A rereading from the conception of Paulo Freire
Get PDFSe presenta un ensayo que aborda la opresión del pensamiento crítico como práctica educativa, a la luz de las ideas que Paulo Freire consideróen su obra Pedagogía del Oprimido. Se interpretan aspectos vinculados con la educación alienante, en la cual el pensar crítico se ha sustituidopor la enseñanza pasiva que no fomenta la transformación individual y social del individuo. Con base en la interpretación de citas de la obra de Freire, se contextualiza el problema de la existencia de educadores centrados en la memorización y repetición de ideas, que Freire estableció como educación bancaria. En el ensayo se busca la comprensión de la importancia de fortalecer la autonomía de pensamiento en el educando.Recepción/Received: 20/11/2022Arbitraje/Sent to peers: 22/11/2022Aprobación/Approved: 07/12/2022Publicado/Published: 01/07/2023An essay is presented that addresses the oppression of critical thinking as an educational practice, in light of the ideas that Paulo Freire consideredin his work Pedagogy of the Oppressed. Aspects related to alienating education are interpreted, in which critical thinking has been replaced by passive teaching that does not encourage the individual and social transformation of the individual. Based on the interpretation of quotes from Freire’s work, the problem of the existence of educators focused on memorizing and repeating ideas, which Freire established as banking education, is contextualized. The essay seeks to understand the importance of strengthening the autonomy of thought in the student