4to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica

Este volumen acoge la memoria académica de la Cuarta edición del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2017, desarrollado entre el 29 de noviembre y el 1 de diciembre de 2017 y organizado por la Universidad Politécnica Salesiana (UPS) en su sede de Guayaquil. El Congreso ofreció un espacio para la presentación, difusión e intercambio de importantes investigaciones nacionales e internacionales ante la comunidad universitaria que se dio cita en el encuentro. El uso de herramientas tecnológicas para la gestión de los trabajos de investigación como la plataforma Open Conference Systems y la web de presentación del Congreso http://citis.blog.ups.edu.ec/, hicieron de CITIS 2017 un verdadero referente entre los congresos que se desarrollaron en el país. La preocupación de nuestra Universidad, de presentar espacios que ayuden a generar nuevos y mejores cambios en la dimensión humana y social de nuestro entorno, hace que se persiga en cada edición del evento la presentación de trabajos con calidad creciente en cuanto a su producción científica. Quienes estuvimos al frente de la organización, dejamos plasmado en estas memorias académicas el intenso y prolífico trabajo de los días de realización del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad al alcance de todos y todas

HIV with initial ocular Kaposi sarcoma

ABSTRACT We present an interesting case of a 62-year-old black female, presented to the ophthalmological hospital with a little "nevus" on the left eye previously visualized at the mirror, with one month of development. Physical examination with slit lamp (biomicroscopy) showed a group of painless veins, with vascular redness, and a mass nodular aspect in the mid temporal bulbar conjunctiva, of approximately 2mmx4mm

Endoftalmitis endógena con evolución hacia panoftalmitis

Introducción: La endoftalmitis endógena representa ella sóla el 15 % del total de casos de endoftalmitis. Son los tejidos de vítreo, retina, tracto uveal, esclera y órbita los involucrados en su mayoría, que alcanza así la panoftalmía. Objetivo: Describir la evolución clínica de un caso infrecuente de endoftalmitis endógena, en los servicios de emergencias oftalmológicas en Cuba.Caso clínico: Una mujer de de 54 años de edad se presentó al Servicio de Oftalmología del Hospital "Dr. Enrique Cabrera", en el área del Cuerpo de Guardia. El motivo de su consulta fue dolor ocular del ojo izquierdo, disminución brusca de la agudeza visual, ojo rojo y secreción de siete días de evolución. Conclusiones: La solución del caso fue satisfactoria, con una resolución visual favorable para la paciente, como resultado de la aplicación de antibioticoterapia temprana y alta sospecha para ello, por lo que se hace imprescindible documentar las manifestaciones infrecuentes de esta enfermedad. El desconocimiento constituye un factor directo para su desenlace, ya que es una emergencia médica oftalmológica. El retraso del diagnóstico, así como el desconocimiento de los factores de riesgo, aunado al uso inadecuado de antibioticoterapia, constituyen la instauración de la panoftalmitis, que condiciona así un desenlace clínico fatal de evisceración o enucleación, hasta el 30 % del total de pacientes

Indicadores epidemiológicos, sociales y clínicos del glaucoma en el Hospital "Enrique Cabrera"

Introducción: La incidencia de glaucoma es un problema actual de salud que compromete la calidad de vida de las personas. El género femenino representa la mayor prevalencia de ceguera en el mundo, por encima de los cuarenta años de edad. El glaucoma es la causa número uno de ceguera irreversible.Objetivo: Identificar los indicadores epidemiológicos, sociales y clínicos del glaucoma.Métodos: Estudio transversal, descriptivo, desarrollado de enero 2021 a enero 2022, mediante la Encuesta 473, de 16 variables epidemiológicas, validada por el Departamento de Glaucoma del Hospital General Docente "Enrique Cabrera".Resultados: Se incluyeron 50 pacientes, 50 % varones y resto mujeres. La evolución promedio fue 13 años del glaucoma, en control 86 %, con monoterapia de Timolol (colirio al 0,5 %) (56 %). Estuvo prevalente, en su mayoría, el glaucoma primario de ángulo abierto con 62 %. La comorbilidad más frecuente fue la hipertensión arterial sistémica 53 %. Hubo presencia de catarata en el 56 % de los casos.Conclusiones: Se recaban como indicadores epidemiológicos, sociales y clínicos en el glaucoma, el número de fármacos empleados, la relación de familiares de primer nivel, la excavación evaluada y el color de la piel en los pacientes estudiados

Correlación clinicopatológica de enfermedades en la piel con patrón liquenoide / Clinicopathological correlation of skin diseases with a lichenoid pattern

Introducción: El patrón de reacción liquenoide es común a disímiles enfermedades, de ahí la importancia del empleo de criterios histopatológicos precisos en el diagnóstico diferencial y una adecuada correlación clínico-patológica.Objetivo: Correlacionar los planteamientos clínicos con el diagnóstico histopatológico de las enfermedades en piel con patrón liquenoide en el Hospital “Enrique Cabrera”, durante el año 2016.Métodos: Se realizó un estudio transversal que incluyó 93 biopsias. Se exploraron variables demográficas, clínicas e histopatológicas. Se emplearon porcentajes y se evaluó la concordancia entre el diagnóstico clínico e histológico mediante el índice Kappa.Resultados: Se obtuvo que el 62,3 % de los casos eran mujeres y la edad media fue de 48,8 años. Las lesiones fueron localizadas en un 63,4 % y de tipo placa en un 33,3 %. La dermatitis liquenoide superficial se presentó en el 49,4 % de los pacientes y predominó el diagnóstico de lupus con 19 casos. En el 72,1 % de los diagnósticos se encontró concordancia mejor en el lupus con un kappa de 0,77.Conclusiones: Se concluye que en el periodo estudiado la reacción liquenoide se caracterizó por aparecer con mayor frecuencia en pacientes femeninas, blancas y entre la cuarta y quinta década de la vida, correspondiente a las grandes series presentadas. Además, de la correcta caracterización clínico-patológica es importante destacar la compleja asociación que presentan con respecto a otras entidades y su importancia para el correcto diagnóstico y tratamiento del patrón liquenoide

Resultados Semilleros de investigación 2011

Aproximaciones al sector minero no energético en colombia (2009-2010) / Discursos y contradiscursos en la construcción e inter-vención de las sujetas desplazadas desde una perspectiva interseccional de género / El rol de los actores en el entramado institucional de los partidos políticos y sistemas electorales en colombia en el final de la primera década del Siglo XXI / Administración de justicia en los pueblos indígenas de Arauca. Pueblos Sikuani (165), Uwa (222), Hitnu (266), Inga (291), Caño Mochuelo (317), Pueblo Betoye (343) / De la violencia a la democracia: hacia la construcción de un modelo justicia comunitaria en tres corregimientos de Simití, sur de Bolívar / Ética, política y mundo común / Multiculturalismo y plurinacionalidad. Análisis comparado de las Constituciones Boliviana y Colombiana en perspectiva intercultural / La reconstitución del patrimonio del deudor / Consecuencias políticas, económicas, y sociales de la implementación de programas hacia la juventud y contribuciones analíticas para el logro de buenos resul-tados desde la administración distrital en políticas para jóvenes de Bogotá / El “allemansrätten” o el derecho público de acceso al pai-saje en la planeación urbana y ambiental de la ciudad de Bogotá D.C. / Penas alternativas a la prisión en Colombia / Políticas públicas en seguridad desde un nuevo paradigma socia

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research