Eficacia del bloqueo del plexo interescalénico guiado por ecografía en traumatismo de miembro superior en adulto mayor. A propósito de un caso.

The objective of this research is to expose the effectiveness of ultrasound-guided interscalene plexus block in upper limb trauma in an older adult regarding a case, as well as the evolution of the patient after surgery, allowing us to show the risks, benefits and advantages of this anesthetic technique. Through an observational and descriptive study with a qualitative approach, this research was carried out in the City of Portoviejo, province of Manabí, Ecuador, in a case of an older adult with trauma to the upper limb, previously subjected to an unsuccessful surgical procedure. Therefore, it was decided to correct and replace incorrect osteosynthesis material previously placed through interscalene plexus block, as an anesthetic technique. Thanks to the evolution of ultrasound, it has been possible to advance and improve nerve block techniques through regional anesthesia, and based on the case presented in this research, it can be mentioned that the patient's surgery was successful, with evolution and satisfactory recovery, considering that for these procedures it is important to carefully evaluate the patient's symptoms to know their comorbidities and avoid possible complications during or after the surgical procedure. Keywords: anesthesia, block, surgery, ultrasound, trauma.El objetivo de esta investigación es exponer la eficacia del bloqueo de plexo interescalénico guiado por ecografía en traumatismo de miembro superior en un adulto mayor a propósito de un caso, así como la evolución del paciente posterior a la cirugía, permitiendo mostrar los riesgos, beneficios y ventajas de esta técnica anestésica. A través de un estudio observacional, y descriptivo con un enfoque cualitativo se realizó esta investigación en la Ciudad de Portoviejo, provincia de Manabí, Ecuador, en un caso de adulto mayor con un traumatismo en miembro superior, sometido previamente a procedimiento quirúrgico no exitoso, por lo que se decide corregir y sustituir material de osteosíntesis incorrecto previamente colocado a través de bloqueo de plexo interescalénico, como técnica anestésica. Gracias a la evolución de la ecografía se ha podido avanzar y mejorar las técnicas de bloqueo de nervios por medio de la anestesia regional, y con base en el caso presentado en esta investigación, se puede mencionar que la cirugía del paciente fue exitosa, con evolución y recuperación satisfactoria, considerando que para estos procedimientos es importante evaluar con detenimiento, la clínica del paciente, para conocer sus comorbilidades y evitar posibles complicaciones durante o posterior al procedimiento quirúrgico. Palabras claves: anestesia, bloqueo, cirugía, ecografía, traumatismo. Abstract The objective of this research is to expose the effectiveness of ultrasound-guided interscalene plexus block in upper limb trauma in an older adult regarding a case, as well as the evolution of the patient after surgery, allowing us to show the risks, benefits and advantages of this anesthetic technique. Through an observational and descriptive study with a qualitative approach, this research was carried out in the City of Portoviejo, province of Manabí, Ecuador, in a case of an older adult with trauma to the upper limb, previously subjected to an unsuccessful surgical procedure. Therefore, it was decided to correct and replace incorrect osteosynthesis material previously placed through interscalene plexus block, as an anesthetic technique. Thanks to the evolution of ultrasound, it has been possible to advance and improve nerve block techniques through regional anesthesia, and based on the case presented in this research, it can be mentioned that the patient's surgery was successful, with evolution and satisfactory recovery, considering that for these procedures it is important to carefully evaluate the patient's symptoms to know their comorbidities and avoid possible complications during or after the surgical procedure. Keywords: anesthesia, block, surgery, ultrasound, trauma. Información del manuscrito:Fecha de recepción: 05 de octubre de 2023.Fecha de aceptación: 18 de diciembre de 2023.Fecha de publicación: 10 de enero de 2024

Prácticas de enfermería como estrategia para mejorar la fototerapia en el tratamiento de ictericia neonatal

Introduction: Neonatal jaundice is a common condition that affects a large number of newborns, with phototherapy being the treatment of choice. Nursing practices play a crucial role in the effectiveness of this treatment. Objective: Determine the impact of nursing practices on the effectiveness of phototherapy for the treatment of neonatal jaundice. Methods: A systematic review of the literature was carried out using the PRISMA method. Articles published between 2019 and 2024 in English, Spanish and Portuguese, related to nursing practices in neonatal phototherapy, were included. The search was carried out in databases such as Google Scholar, PubMed, Scielo and Dialnet. Results: The studies analyzed revealed that transcutaneous bilirubinometry is a useful tool for non-invasive monitoring, although it must be complemented with laboratory measurements in complex cases. The combination of techniques such as massage and position changes with phototherapy improves the effectiveness of the treatment. Education and support for parents are essential to reduce stress and improve treatment adherence. Home phototherapy, with adequate supervision, is presented as a safe and effective alternative to hospital treatment. Conclusion: Well-implemented, evidence-based nursing practices have a significant positive impact on the effectiveness of phototherapy, improving clinical outcomes and the overall experience of patients and their families in the treatment of neonatal jaundice. Keywords: Jaundice, Neonatal, Phototherapy, Nursing Care, Bilirubin, Infant, Newborn.Introducción: La ictericia neonatal es una condición común que afecta a un gran número de recién nacidos, siendo la fototerapia el tratamiento de elección. Las prácticas de enfermería juegan un papel crucial en la efectividad de este tratamiento. Objetivo: Determinar el impacto de las prácticas de enfermería sobre la efectividad de la fototerapia para el tratamiento de la ictericia neonatal. Métodos: Se realizó una revisión sistemática de la literatura utilizando el método PRISMA. Se incluyeron artículos publicados entre 2019 y 2024 en inglés, español y portugués, relacionados con prácticas de enfermería en fototerapia neonatal. La búsqueda se realizó en bases de datos como Google Académico, PubMed, Scielo y Dialnet. Resultados: Los estudios analizados revelaron que la bilirrubinometría transcutánea es una herramienta útil para el monitoreo no invasivo, aunque debe complementarse con mediciones de laboratorio en casos complejos. La combinación de técnicas como el masaje y los cambios de posición con la fototerapia mejora la eficacia del tratamiento. La educación y el apoyo a los padres son fundamentales para reducir el estrés y mejorar la adherencia al tratamiento. La fototerapia domiciliaria, con supervisión adecuada, se presenta como una alternativa segura y efectiva al tratamiento hospitalario. Conclusión: Las prácticas de enfermería bien implementadas y basadas en evidencia tienen un impacto positivo significativo en la efectividad de la fototerapia, mejorando los resultados clínicos y la experiencia general de los pacientes y sus familias en el tratamiento de la ictericia neonatal. Palabras claves: Ictericia Neonatal, Fototerapia, Atención de Enfermería, Bilirrubina, Recién Nacido. Abstract Introduction: Neonatal jaundice is a common condition that affects a large number of newborns, with phototherapy being the treatment of choice. Nursing practices play a crucial role in the effectiveness of this treatment. Objective: Determine the impact of nursing practices on the effectiveness of phototherapy for the treatment of neonatal jaundice. Methods: A systematic review of the literature was carried out using the PRISMA method. Articles published between 2019 and 2024 in English, Spanish and Portuguese, related to nursing practices in neonatal phototherapy, were included. The search was carried out in databases such as Google Scholar, PubMed, Scielo and Dialnet. Results: The studies analyzed revealed that transcutaneous bilirubinometry is a useful tool for non-invasive monitoring, although it must be complemented with laboratory measurements in complex cases. The combination of techniques such as massage and position changes with phototherapy improves the effectiveness of the treatment. Education and support for parents are essential to reduce stress and improve treatment adherence. Home phototherapy, with adequate supervision, is presented as a safe and effective alternative to hospital treatment. Conclusion: Well-implemented, evidence-based nursing practices have a significant positive impact on the effectiveness of phototherapy, improving clinical outcomes and the overall experience of patients and their families in the treatment of neonatal jaundice. Keywords: Jaundice, Neonatal, Phototherapy, Nursing Care, Bilirubin, Infant, Newborn. Información del manuscrito:Fecha de recepción: 10 de abril de 2024.Fecha de aceptación: 25 de junio de 2024.Fecha de publicación: 10 de julio de 2024

Apendicitis Aguda en paciente femenina de 20 años. Reporte de Caso

Introduction: abdominal pain is the most frequent reason for medical consultation in emergency departments. Among the possible causes of abdominal pain, acute appendicitis is the most common cause of acute abdomen with an estimated lifetime prevalence of 7-8%. Acute appendicitis is the leading cause of acute abdomen and can be resolved with surgery. Most studies agree that the most affected age group is 10-19 years. The diagnosis was essentially clinical and included abdominal pain eventually located in the right iliac fossa, which worsened on palpation of McBurney's point and was associated with local muscle resistance. Objective: to know the surgical resolution of acute appendicitis. Clinical case: 20-year-old patient presented with abdominal pain localized in the right iliac fossa radiating to the epigastrium for 48 hours. Conclusion: Appendicitis is the most common cause of acute surgical abdomen. The diagnosis is clinical and can be supported by imaging techniques. Imaging techniques in the preoperative evaluation are considered factors to reduce the percentage of empty appendectomy. Surgical treatment is the treatment of choice by open appendectomy or laparoscopic techniques. Keywords: Acute abdomen, Epigastralgia, Peritonitis, Laparoscopy.Introducción: el dolor abdominal es el motivo más frecuente de consulta médica en los servicios de urgencias. Entre las posibles causas de dolor abdominal, la apendicitis aguda es la causa más común de abdomen agudo con una prevalencia estimada a lo largo de la vida del 7-8%. La apendicitis aguda es la principal causa de abdomen agudo y puede resolverse con cirugía. La mayoría de los estudios coinciden en que el grupo de edad más afectado es el de 10 a 19 años. El diagnóstico fue esencialmente clínico e incluyó dolor abdominal eventualmente localizado en la fosa ilíaca derecha, que empeoraba a la palpación del punto de McBurney y se asociaba con resistencia muscular local. Objetivo: conocer la resolución quirúrgica de la apendicitis aguda. Caso clínico: paciente de 20 años de edad acude por presentar desde hace 48 horas dolor abdominal localizado en fosa iliaca derecha que se irradia a epigastrio. Conclusión: La apendicitis es la causa más común de abdomen agudo quirúrgico. El diagnóstico es clínico y puede apoyarse en técnicas de imagen. Las técnicas de imagen en la evaluación preoperatoria se consideran factores para reducir el porcentaje de apendicectomía vacía. El tratamiento quirúrgico es el tratamiento de elección mediante apendicectomía abierta o técnicas laparoscópicas. Palabras claves: Abdomen agudo, epigastralgia, Peritonitis, Laparoscopia. Abstract Introduction: abdominal pain is the most frequent reason for medical consultation in emergency departments. Among the possible causes of abdominal pain, acute appendicitis is the most common cause of acute abdomen with an estimated lifetime prevalence of 7-8%. Acute appendicitis is the leading cause of acute abdomen and can be resolved with surgery. Most studies agree that the most affected age group is 10-19 years. The diagnosis was essentially clinical and included abdominal pain eventually located in the right iliac fossa, which worsened on palpation of McBurney's point and was associated with local muscle resistance. Objective: to know the surgical resolution of acute appendicitis. Clinical case: 20-year-old patient presented with abdominal pain localized in the right iliac fossa radiating to the epigastrium for 48 hours. Conclusion: Appendicitis is the most common cause of acute surgical abdomen. The diagnosis is clinical and can be supported by imaging techniques. Imaging techniques in the preoperative evaluation are considered factors to reduce the percentage of empty appendectomy. Surgical treatment is the treatment of choice by open appendectomy or laparoscopic techniques. Keywords: Acute abdomen, Epigastralgia, Peritonitis, Laparoscopy. Información del manuscrito:Fecha de recepción: 10 de abril de 2024.Fecha de aceptación: 25 de junio de 2024.Fecha de publicación: 10 de julio de 2024

Medicina familiar, comunidad y cuidados paliativos en pacientes crónicos

This paper explores the role of family medicine in the management of patients with chronic diseases, the integration of the community in palliative care, and the challenges and strategies in palliative care for this group of patients. Family medicine, with its comprehensive and continuous approach, excels in coordinating the care of chronic patients, addressing not only medical aspects, but also psychological and social factors, which is essential to improve quality of life and prevent complications. The importance of community participation in palliative care is underlined, highlighting how social support and local resource mobilization can complement formal care and ease the burden on health systems. In addition, the challenges facing palliative care are discussed, including the management of complex symptoms, multidisciplinary coordination, and communication with patients and their families. It is proposed that overcoming these challenges requires strategies that include ongoing training of health professionals, the development of appropriate public policies, and a flexible and personalized approach to care. Ultimately, the need for a patient-centred approach that integrates family medicine, community support and palliative care is highlighted to provide high-quality care to patients with chronic diseases, ensuring their well-being at all stages of their illness. Keywords: Family medicine, Chronic diseases, Palliative care.Este documento explora el papel de la medicina familiar en el manejo de pacientes con enfermedades crónicas, la integración de la comunidad en los cuidados paliativos, y los desafíos y estrategias en la atención paliativa para este grupo de pacientes. La medicina familiar, con su enfoque integral y continuo, se destaca en la coordinación del cuidado de pacientes crónicos, abordando no solo aspectos médicos, sino también factores psicológicos y sociales, lo que es esencial para mejorar la calidad de vida y prevenir complicaciones. Se subraya la importancia de la participación comunitaria en los cuidados paliativos, destacando cómo el apoyo social y la movilización de recursos locales pueden complementar la atención formal y aliviar la carga sobre los sistemas de salud. En ese sentido, se analizan los desafíos que enfrenta la atención paliativa, incluyendo la gestión de síntomas complejos, la coordinación multidisciplinaria y la comunicación con los pacientes y sus familias. Se propone que superar estos desafíos requiere estrategias que incluyan la capacitación continua de los profesionales de la salud, el desarrollo de políticas públicas adecuadas, y un enfoque flexible y personalizado en el cuidado. En última instancia, se resalta la necesidad de un enfoque centrado en el paciente que integre la medicina familiar, el apoyo comunitario y la atención paliativa para proporcionar un cuidado de alta calidad a los pacientes con enfermedades crónicas, asegurando su bienestar en todas las etapas de su enfermedad. Palabras claves: Medicina familiar, Enfermedades crónicas, Cuidados paliativos. Abstract This paper explores the role of family medicine in the management of patients with chronic diseases, the integration of the community in palliative care, and the challenges and strategies in palliative care for this group of patients. Family medicine, with its comprehensive and continuous approach, excels in coordinating the care of chronic patients, addressing not only medical aspects, but also psychological and social factors, which is essential to improve quality of life and prevent complications. The importance of community participation in palliative care is underlined, highlighting how social support and local resource mobilization can complement formal care and ease the burden on health systems. In addition, the challenges facing palliative care are discussed, including the management of complex symptoms, multidisciplinary coordination, and communication with patients and their families. It is proposed that overcoming these challenges requires strategies that include ongoing training of health professionals, the development of appropriate public policies, and a flexible and personalized approach to care. Ultimately, the need for a patient-centred approach that integrates family medicine, community support and palliative care is highlighted to provide high-quality care to patients with chronic diseases, ensuring their well-being at all stages of their illness. Keywords: Family medicine, Chronic diseases, Palliative care. Información del manuscrito:Fecha de recepción: 10 de abril de 2024.Fecha de aceptación: 25 de junio de 2024.Fecha de publicación: 10 de julio de 2024

Atención Oncológica y Cuidados Paliativos en Manabí. Un Enfoque Psicosocial y Salud

Cancer is a major health problem worldwide. This disease is accompanied by a significant emotional burden for those who suffer from it due to the uncertainty of its evolution, the side effects of the treatment, the change in daily life and the symptoms themselves. For these reasons, cancer patients often feel a perception of vulnerability and loss of control that increases their level of distress and makes them need special care. Hence, the importance of palliative care, as it seeks to alleviate the suffering of patients with serious diseases such as cancer, providing care to improve quality of life and the primary objective is to avoid or treat the symptoms and side effects of the disease and of treatment as soon as possible, in addition to treating any psychological, social and spiritual problems related to the disease. Therefore, this article aims to present relevant and updated theoretical aspects on the subject, where the importance of psychosocial factors is highlighted, since they provide patients with mechanisms that allow them to assume the disease and control their emotional state. Keywords: Cancer care, palliative care, psychosocial approach.El cáncer es un problema sanitario de primera magnitud a escala mundial. Esta enfermedad viene acompañada de una carga emocional importante para quien la padece por la incertidumbre de su evolución, los efectos secundarios del tratamiento, el cambio en la vida cotidiana y los síntomas propiamente dichos de la misma. Por estas razones, el paciente oncológico suele sentir una percepción de vulnerabilidad y de pérdida de control que aumentan el nivel de angustia y que le hace necesitar unos cuidados especiales. De allí, la importancia de los cuidados paliativos, pues estos buscan aliviar el sufrimiento de pacientes con enfermedades graves como el cáncer, dando atención para mejorar la calidad de vida y el objetivo primordial es evitar o tratar los síntomas y efectos secundarios de la enfermedad y del tratamiento lo antes posible, además de tratar cualquier problema psicológico, social y espiritual relacionado con la enfermedad. Por ello, el presente artículo pretende exponer aspectos teóricos relevantes y actualizados sobre el tema, donde se resalta la importancia de los factores psicosociales, ya que dotan a los pacientes de mecanismos que le permiten asumir la enfermedad y controlar su estado emocional. Palabras claves: Atención oncológica, cuidados paliativos, enfoque psicosocial. Abstract Cancer is a major health problem worldwide. This disease is accompanied by a significant emotional burden for those who suffer from it due to the uncertainty of its evolution, the side effects of the treatment, the change in daily life and the symptoms themselves. For these reasons, cancer patients often feel a perception of vulnerability and loss of control that increases their level of distress and makes them need special care. Hence, the importance of palliative care, as it seeks to alleviate the suffering of patients with serious diseases such as cancer, providing care to improve quality of life and the primary objective is to avoid or treat the symptoms and side effects of the disease and of treatment as soon as possible, in addition to treating any psychological, social and spiritual problems related to the disease. Therefore, this article aims to present relevant and updated theoretical aspects on the subject, where the importance of psychosocial factors is highlighted, since they provide patients with mechanisms that allow them to assume the disease and control their emotional state. Keywords: Cancer care, palliative care, psychosocial approach. Información del manuscrito:Fecha de recepción: 05 de octubre de 2023.Fecha de aceptación: 18 de diciembre de 2023.Fecha de publicación: 10 de enero de 2024

Métodos de evaluación en simulación clínica: Revisión sistemática

Introduction: Clinical simulation is considered as an effective and interesting learning and teaching method that includes technology and scenarios similar to the real world. The clinical practice is guided by a professional or teacher who facilitates adequate learning and standardized learning evaluation methods in the skills and knowledge that each student has, thus making it a more interactive method that facilitates adequate learning, that is why the objective is to analyze the evaluation methods in clinical simulation. Methodology: proposal with narrative methodology of descriptive type, proposed as a bibliographic review. Information was collected from high impact databases such as Scielo, Dialnet, Pubmed and Google Scholar and with the help of the PRISMA method for data collection and its adequate classification. Results: different evaluation methods were found to be applied in clinical simulation, involving summative and formative evaluations, surveys, the Objective Structured Clinical Examination, the Kirkpatrick evaluation method, Miller's pyramid and the Debrifing and brifing. Discussion: after confirming the application of evaluative methods, several authors determine that each of the methods used are essential to obtain and provide knowledge and at the same time establish feedback according to the student's needs. Conclusion: The most reliable evaluative methods that were used are Miller's pyramid as an essential method to obtain knowledge and use feedback and debriefing that helps to give instructions and recommendations at the time of being in the clinical simulation. Keywords: Clinical practice, Health assessment, Nursing assessment, Formative feedback, Health system learning.Introducción: La simulación clínica es considerada como un método de aprendizaje y enseñanzas efectivas e interesantes que incluye tecnología y escenarios parecidos al mundo real. La práctica clínica es guiada por un profesional o docente que facilita un aprendizaje adecuado y métodos de evaluación de aprendizaje estandarizadas en las habilidades y conocimientos que tiene cada estudiante, haciendo de esta manera un método más interactivo que facilita un aprendizaje adecuado, es por eso que tiene como objetivo Analizar los métodos de evaluación en simulación clínica. Metodología: propuesta con metodología narrativa de tipo descriptiva, planteada como revisión bibliográfica. Se recolecto la información de bases de datos de alto impacto como Scielo, Dialnet, Pubmed y Google académico y con la ayuda del método PRISMA para la recolección de datos y su adecuada clasificación. Resultados: se encontraron diferentes métodos de evaluación que son aplicados en la simulación clínica, de los cuales involucran evaluaciones sumativas y formativas encuestas, el examen Clinico Objetivo Estructurado, el método de evaluación Kirkpatrick, la pirámide de Miller y el Debrifing y brifing. Discusión: tras la confirmación de la aplicación de métodos evaluativos, varios autores determinan que cada uno de los métodos empleados son esenciales para obtener y aportar conocimientos y a la vez establecer una retroalimentación según las necesidades del estudiante. Conclusión: Los métodos evaluativos más confiables que fueron utilizados son la pirámide de Miller como un método esencial para obtener conocimientos y emplear una retroalimentación y el debrifing que ayuda a dar instrucciones y recomendaciones al momento de estar en la simulación clínica. Palabras claves: Practicas clínicas, Evaluación en salud, Evaluación en enfermería, Retroalimentación formativa, Aprendizaje del sistema de salud. Abstract Introduction: Clinical simulation is considered as an effective and interesting learning and teaching method that includes technology and scenarios similar to the real world. The clinical practice is guided by a professional or teacher who facilitates adequate learning and standardized learning evaluation methods in the skills and knowledge that each student has, thus making it a more interactive method that facilitates adequate learning, that is why the objective is to analyze the evaluation methods in clinical simulation. Methodology: proposal with narrative methodology of descriptive type, proposed as a bibliographic review. Information was collected from high impact databases such as Scielo, Dialnet, Pubmed and Google Scholar and with the help of the PRISMA method for data collection and its adequate classification. Results: different evaluation methods were found to be applied in clinical simulation, involving summative and formative evaluations, surveys, the Objective Structured Clinical Examination, the Kirkpatrick evaluation method, Miller's pyramid and the Debrifing and brifing. Discussion: after confirming the application of evaluative methods, several authors determine that each of the methods used are essential to obtain and provide knowledge and at the same time establish feedback according to the student's needs. Conclusion: The most reliable evaluative methods that were used are Miller's pyramid as an essential method to obtain knowledge and use feedback and debriefing that helps to give instructions and recommendations at the time of being in the clinical simulation. Keywords: Clinical practice, Health assessment, Nursing assessment, Formative feedback, Health system learning. Información del manuscrito:Fecha de recepción: 10 de abril de 2024.Fecha de aceptación: 25 de junio de 2024.Fecha de publicación: 10 de julio de 2024

Presentación clínica de leishmaniasis cutánea diseminada en paciente masculino. Reporte de caso

Leishmaniasis is defined as an infectious disease resulting from parasitism of the cells of the mononuclear phagocytic system by flagellated protozoa belonging to the genus Leishmania. This pathology is transmitted to humans by insects of the order Diptera, specifically those belonging to the genus Phlebotomus in Old World regions, while, in the New World, transmission is carried out by insects of the genus Lutzomyia. In humans, the clinical manifestations of the disease evolve in three distinct ways: at the visceral level, affecting the internal organs; at the cutaneous level, involving the skin; and at the mucocutaneous level, affecting both mucous membranes and skin. The aforementioned conditions are globally distributed, encompassing various regions and countries around the world. People from the Old World, in the vast majority of situations, present with conditions that are primarily characterized by the skin. Often, these conditions tend to resolve spontaneously over a period ranging from a few weeks to a few months. People living in the New World, because of the presence of various Leishmania species complexes, have been shown to have a significantly higher risk of developing a secondary form of the disease affecting the mucous membranes. A clinical case has been documented involving a male patient who is only one year old and has no relevant or significant medical history. This patient also presents ulcerative lesions that are specifically located in the area of the right upper limb in the dorsal area of the wrist, as well as in the arm of the left upper limb, manifestations that are typical of a Leishmania infection. Keywords: Leishmania, arm, wrist ulcer.La leishmaniasis se define como una enfermedad infecciosa que resulta del parasitismo de las células del sistema fagocitario mononuclear por protozoos flagelados que pertenecen al género Leishmania. Esta patología es transmitida a los seres humanos por insectos del orden Díptera, específicamente aquellos que pertenecen al género Phlebotomus en regiones del Viejo Mundo, mientras que, en el Nuevo Mundo, la transmisión se lleva a cabo por los insectos del género Lutzomyia. En los seres humanos, las manifestaciones clínicas de la enfermedad evolucionan de tres maneras distintas: a nivel visceral, que afecta los órganos internos; a nivel cutáneo, que involucra la piel; y a nivel mucocutáneo, que afecta tanto las mucosas como la piel. Las condiciones mencionadas se encuentran distribuidas de manera global, abarcando diversas regiones y países alrededor del mundo. Las personas que provienen del Viejo Mundo, en la gran mayoría de las situaciones, presentan condiciones que se caracterizan principalmente por la piel. A menudo, estas condiciones tienden a resolver de manera espontánea en un período que oscila desde unas pocas semanas hasta algunos meses. Las personas que habitan en el Nuevo Mundo, a causa de la presencia de diversos complejos de la especie Leishmania, han mostrado tener un riesgo significativamente más alto de sufrir el desarrollo de una forma secundaria de la enfermedad que afecta las mucosas. Se ha documentado un caso clínico que involucra a un paciente masculino que tiene solamente un año de vida y que no presenta antecedentes médicos relevantes o significativos. Este paciente presenta, además, lesiones ulcerosas que están localizadas específicamente en el área del miembro superior derecho en la zona dorsal de la muñeca, así como en el brazo del miembro superior izquierdo, manifestaciones que son típicas de una infección por Leishmania. Palabras claves: Leishmania, brazo, muñeca ulcera. Abstract Leishmaniasis is defined as an infectious disease resulting from parasitism of the cells of the mononuclear phagocytic system by flagellated protozoa belonging to the genus Leishmania. This pathology is transmitted to humans by insects of the order Diptera, specifically those belonging to the genus Phlebotomus in Old World regions, while, in the New World, transmission is carried out by insects of the genus Lutzomyia. In humans, the clinical manifestations of the disease evolve in three distinct ways: at the visceral level, affecting the internal organs; at the cutaneous level, involving the skin; and at the mucocutaneous level, affecting both mucous membranes and skin. The aforementioned conditions are globally distributed, encompassing various regions and countries around the world. People from the Old World, in the vast majority of situations, present with conditions that are primarily characterized by the skin. Often, these conditions tend to resolve spontaneously over a period ranging from a few weeks to a few months. People living in the New World, because of the presence of various Leishmania species complexes, have been shown to have a significantly higher risk of developing a secondary form of the disease affecting the mucous membranes. A clinical case has been documented involving a male patient who is only one year old and has no relevant or significant medical history. This patient also presents ulcerative lesions that are specifically located in the area of the right upper limb in the dorsal area of the wrist, as well as in the arm of the left upper limb, manifestations that are typical of a Leishmania infection. Keywords: Leishmania, arm, wrist ulcer. Información del manuscrito:Fecha de recepción: 10 de abril de 2024.Fecha de aceptación: 25 de junio de 2024.Fecha de publicación: 10 de julio de 2024

Factores de riesgo asociados con la parvovirosis canina en diferentes regiones climáticas de Ecuador

Canine Parvovirus is a highly contagious viral disease that affects dogs, causing severe symptoms such as bloody diarrhea and vomiting. A historical and bibliographic search was conducted to learn about canine parvovirus, gathering data from various studies carried out in Ecuador that addressed the local epidemiology, the genetic diversity of canine parvovirus, and the risk factors associated with the disease. In a recent investigation, the presence of canine parvovirus variants was determined in different regions of the country through the collection of rectal swab samples and genetic analyses. The results of these studies revealed a high genetic diversity of the virus, emphasizing the importance of understanding this variability for the development of effective diagnostic tools and vaccines. Risk factors such as climate, sex, and certain clinical signs were identified, and statistical analysis helped identify potential predictors of the disease's presence. In conclusion, early detection, accurate diagnosis, and effective prevention are crucial for managing canine parvovirus in Ecuador, highlighting the importance of the virus's genetic diversity and preventive measures to improve the health and well-being of the canine population. Keywords: Glycine max, Phaseolus vulgaris, Vigna unguiculata.La parvovirosis canina es una enfermedad viral altamente contagiosa que afecta a los perros, causando síntomas graves como diarrea sanguinolenta y vómitos. Se realizó una búsqueda historia y bibliográfica para conocer sobre el parvovirus canino, obteniendo datos de diversos estudios realizados en Ecuador que han abordado la epidemiología local, la diversidad genética del parvovirus canino y los factores de riesgo asociados con la enfermedad. En una investigación reciente, se determinó la presencia de variantes del parvovirus canino en diferentes regiones del país mediante la recolección de muestras de hisopos rectales y análisis genéticos. Los resultados de estas investigaciones revelaron una alta diversidad genética del virus, resaltando la importancia de comprender esta variabilidad para el desarrollo de herramientas de diagnóstico y vacunas efectivas. Se identificaron factores de riesgo como el clima, el sexo y ciertos signos clínicos, y el análisis estadístico permitió identificar posibles predictores de la presencia de la enfermedad. En conclusión, la detección temprana, el diagnóstico preciso y la prevención efectiva son cruciales para el manejo de la parvovirosis canina en Ecuador, destacando la importancia de la diversidad genética del virus y las medidas preventivas para mejorar la salud y el bienestar de la población canina. Palabras claves: diarrea, virus, contagio, población canina. Abstract Canine Parvovirus is a highly contagious viral disease that affects dogs, causing severe symptoms such as bloody diarrhea and vomiting. A historical and bibliographic search was conducted to learn about canine parvovirus, gathering data from various studies carried out in Ecuador that addressed the local epidemiology, the genetic diversity of canine parvovirus, and the risk factors associated with the disease. In a recent investigation, the presence of canine parvovirus variants was determined in different regions of the country through the collection of rectal swab samples and genetic analyses. The results of these studies revealed a high genetic diversity of the virus, emphasizing the importance of understanding this variability for the development of effective diagnostic tools and vaccines. Risk factors such as climate, sex, and certain clinical signs were identified, and statistical analysis helped identify potential predictors of the disease's presence. In conclusion, early detection, accurate diagnosis, and effective prevention are crucial for managing canine parvovirus in Ecuador, highlighting the importance of the virus's genetic diversity and preventive measures to improve the health and well-being of the canine population. Keywords: Glycine max, Phaseolus vulgaris, Vigna unguiculata. Información del manuscrito:Fecha de recepción: 10 de abril de 2024.Fecha de aceptación: 25 de junio de 2024.Fecha de publicación: 10 de julio de 2024

Eritrodermia Secundaria a Escabiosis reportada en la Amazonia Ecuatoriana

Introduction: Erythroderma is a dermatological condition characterized by the presence of redness and scaling over a large area, covering more than 80-90% of the skin of the body, with consequences that can have a fatal outcome. There are several reasons why this may occur, such as different skin diseases that cause inflammation, negative responses to certain medications and, less frequently, possible causes such as tumors or infections. The latter include scabies, a skin condition caused by parasites that causes intense itching and skin lesions. Objective: to know the clinical presentation of erythroderma caused by a parasitic pathology such as scabies. Clinical case: 45-year-old patient presents with intense itching and skin lesions for three months, erythema and skin desquamation can be observed on most of his body surface. Conclusion: Erythroderma is a medical condition characterized by the presence of redness on more than 90% of the skin of the body. The most common reasons for erythroderma include conditions such as eczema, psoriasis, toxicity skin reactions and malignant blood diseases such as mycosis fungoides. In unusual situations, scabies can cause a generalized reddening of the skin known as erythroderma. Keywords: erythema, desquamation, pruritus.Introducción: la eritrodermia es una condición dermatológica que se caracteriza por la presencia de enrojecimiento y descamación en una gran extensión, que abarca más del 80-90% de la piel del cuerpo, con consecuencias que pueden tener un desenlace fatal. Hay varias razones por las que puede ocurrir esto, como diferentes enfermedades de la piel que causan inflamación, respuestas negativas a ciertos medicamentos y, con menos frecuencia, posibles causas como tumores o infecciones. Dentro de estas últimas, se incluye la escabiosis, una afección en la piel causada por parásitos que provoca picazón intensa y lesiones en la piel. Objetivo: conocer la presentación clínica de eritrodermia que es causada por una patología parasitaria como es la escabiosis. Caso clínico: paciente de 45 años de edad acude por presentar desde hace tres meses intenso prurito y lesiones cutáneas, se puede observar eritema y descamación cutánea en la mayor parte de su superficie corporal. Conclusión: la eritrodermia es una condición médica que se caracteriza por la presencia de enrojecimiento en más del 90% de la piel del cuerpo. Las razones que con mayor frecuencia provocan eritrodermia incluyen afecciones como eccemas, psoriasis, reacciones cutáneas por toxicidad y enfermedades sanguíneas malignas, como por ejemplo la micosis fungoide. En situaciones inusuales, la sarna puede provocar un enrojecimiento generalizado de la piel conocido como eritrodermia. Palabras claves: escabiosis, eritema, descamación, prurito. Abstract Introduction: Erythroderma is a dermatological condition characterized by the presence of redness and scaling over a large area, covering more than 80-90% of the skin of the body, with consequences that can have a fatal outcome. There are several reasons why this may occur, such as different skin diseases that cause inflammation, negative responses to certain medications and, less frequently, possible causes such as tumors or infections. The latter include scabies, a skin condition caused by parasites that causes intense itching and skin lesions. Objective: to know the clinical presentation of erythroderma caused by a parasitic pathology such as scabies. Clinical case: 45-year-old patient presents with intense itching and skin lesions for three months, erythema and skin desquamation can be observed on most of his body surface. Conclusion: Erythroderma is a medical condition characterized by the presence of redness on more than 90% of the skin of the body. The most common reasons for erythroderma include conditions such as eczema, psoriasis, toxicity skin reactions and malignant blood diseases such as mycosis fungoides. In unusual situations, scabies can cause a generalized reddening of the skin known as erythroderma. Keywords: erythema, desquamation, pruritus. Información del manuscrito:Fecha de recepción: 10 de abril de 2024.Fecha de aceptación: 25 de junio de 2024.Fecha de publicación: 10 de julio de 2024

Omisión del cuidado de Enfermería y la teoría de Jean Watson: Una revisión sistemática

This study examines the interaction between high workload and neglect in nursing and its impact on the application of Jane Watson's humanistic theory of nursing. The aim: to examine how the work intensity of nursing professionals and the incidence of neglect in nursing care interacts with the fundamental concepts suggested by Jean Watson, influencing nursing practice. Methodology: A systematic literature review was carried out, analysing scientific articles available in the following databases: Scopus, PubMed and Web of Science. Following the PRISMA guidelines, applying inclusion and exclusion criteria, with research published between 2018 and 2023 in Spanish, English, German, French and Chinese. Results: The study found a significant correlation between: overwork and neglect of nursing care. Influenced by the factors: physical and mental fatigue, understaffing and time constraints. Conclusions: The findings confirm that Watson's theory can decrease omission in care, but the present working conditions limit its implementation. The importance of training nursing staff is framed, along with the improvement of working conditions and psychological well-being of these professionals. Keywords: Quality of health care, humanized care, omission of care, work overload, Jean Watson theory.Este estudio examina la interacción entre la alta carga de trabajo, la omisión del cuidado de Enfermería y el impacto de la aplicación de la teoría humanista de Jean Watson. El Objetivo: Examinar cómo la intensidad del trabajo de los profesionales de Enfermería y la incidencia de descuidos en la atención interactúa con los conceptos fundamentales sugeridos por Jean Watson, influenciando la praxis de Enfermería. Metodología: Se llevó a cabo una revisión sistemática de literatura, analizando artículos científicos disponibles en las bases de datos: Scopus, PubMed y Web of Science, siguiendo las pautas PRISMA, aplicando criterios de inclusión y exclusión, con investigaciones publicadas en el período 2018 y 2023 en idiomas español, inglés, alemán, francés y chino. Resultados: El estudio encontró una correlación significativa entre: exceso de trabajo y abandono de los cuidados de Enfermería, influenciado por los factores: fatiga física y mental, falta de personal y limitaciones de tiempo. Conclusiones: Los hallazgos confirman que la teoría de Watson puede disminuir la omisión en el cuidado, pero las condiciones laborales presentes limitan su implementación. Se enmarca la importancia de capacitar al personal de Enfermería, junto con la mejora de las condiciones laborales y bienestar psicológico de estos profesionales. Palabras claves: Calidad del cuidado en salud, cuidado humanizado, omisión del cuidado, sobrecarga laboral, teoría de Jean Watson. Abstract This study examines the interaction between high workload and neglect in nursing and its impact on the application of Jane Watson's humanistic theory of nursing. The aim: to examine how the work intensity of nursing professionals and the incidence of neglect in nursing care interacts with the fundamental concepts suggested by Jean Watson, influencing nursing practice. Methodology: A systematic literature review was carried out, analysing scientific articles available in the following databases: Scopus, PubMed and Web of Science. Following the PRISMA guidelines, applying inclusion and exclusion criteria, with research published between 2018 and 2023 in Spanish, English, German, French and Chinese. Results: The study found a significant correlation between: overwork and neglect of nursing care. Influenced by the factors: physical and mental fatigue, understaffing and time constraints. Conclusions: The findings confirm that Watson's theory can decrease omission in care, but the present working conditions limit its implementation. The importance of training nursing staff is framed, along with the improvement of working conditions and psychological well-being of these professionals. Keywords: Quality of health care, humanized care, omission of care, work overload, Jean Watson theory. Información del manuscrito:Fecha de recepción: 10 de abril de 2024.Fecha de aceptación: 25 de junio de 2024.Fecha de publicación: 10 de julio de 2024