Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

The rupture of the Achilles tendon has gradually increased in its frequency in the world. The etiology is multifactorial, although there are reports of previous histopathological changes in the anatomy of the tendon that predispose it to rupture. It presents with pain and a sudden and intense snapping sensation, frequently during sports practice. Diagnosis is clinical by finding a groove in the posterior part of the tendon. Some cabinet studies are useful. The treatment depends on the patient's conditions, although it is predominantly surgical, performing end-to-end tenodesis supported with tendon reinforcements. The incidence of acute and chronic ruptures of the Achilles tendon was determined and postoperative evolution and complications were evaluated, the risk factors that condition it were correlated, and the postoperative functional results of Achilles tendon surgery were assessed. The present work is observational, descriptive, which includes 72 patients with Achilles tendon rupture at the IESS Teodoro Maldonado Carbo Hospital captured from March 1, 2011 to June 30, 2013. It is concluded that early initiation of physical rehabilitation after surgery improves the functional outcome of the ankle and joint balance.

Depression is a highly prevalent mental disorder with various degrees of severity, which generate a chronic problem; currently with the greatest impact on mental health. Symptoms such as sadness, guilt, among others are common and can also be accompanied by anxiety; There is a wide group of risk factors identified in depression such as personal, cognitive, social, family and genetic; the presence of these increases the risk of suffering from depression. Basically, the patient can enter into a dynamic of drug use as a way of trying to alleviate the symptoms. These practices imply an increase in the use of other substances, including psychotropic substances. The interrelationship between depression, anxiety and addictive behavior is well known, a depressed individual may resort to substance use as a palliative means, or vice versa; Teens with depression often use alcohol or drugs to soothe their painful feelings, which may initially soothe, but over time the abuse makes the depression worse. The objective of this review is to update the theoretical references on depression, its risk factors and its relationship with substance abuse. A documentary review of recent research was carried out in Elsevier, Pubmed and Scopus databases, Scielo Google academic articles published between 2016 and 2021, in English and Spanish. Depression is a disorder of increasing spread during the recent pandemic, and can affect people's daily activities, including the relationship with consumption, substance abuse and clear risk of suicide; The effect of drugs on the central nervous system and its repercussions on a cognitive level is well known, which is why various researchers have studied the impact on the emotional sphere.

Brucellosis is a zoonotic infection with a worldwide distribution that is acquired especially by direct contact or with fluids derived from domestic and wild animals, mainly depending on its virulence factors. It manifests itself in various ways, sometimes it is asymptomatic and chronic, which generates focused presentations with multisystemic complications that can be recurrent. The objective of this study is to update the theoretical references on the diagnostic and therapeutic methods of brucellosis. A systematic search of recent research was carried out in Elsevier, Pubmed and Scopus databases, Science direct, academic Google of articles published between 2016 and 2021, in English and Spanish. Clinical trials, meta- analyses, case reports, and data analysis studies were excluded. Serological and culture methods are the ideal combination. Therapy is based on antibiotics, especially dicloxacillin and, in more severe cases, streptomycin; according to mild or prolonged severity, the cardinal symptom being acute onset fever, and it is one of the causes of febrile neutropenia in endemic areas.

Nephrotic syndrome is one of the kidney diseases that deteriorate and increase the permeability of the glomerular filtration barrier, some authors report not being able to identify, stratify and predict the risk in children from the beginning, it is defined with proteinuria, this being a cardinal symptom and hypoalbuminemia below 30 g/l is always secondary to glomerular disease. One of the pathophysiological mechanisms of edema is that the kidney is intrinsically unable to excrete salt and is not related to factors. Although the initial events leading to the onset of proteinuria are not yet well defined, it has become increasingly clear that many glomerular diseases can be classified as podocytopathies, in which podocyte injury plays an important role in development and progression. of the illness. In this sense, a documentary or bibliographic review was carried out in PubMed and Scielo, Scopus, academic Google, among others, of the last 5 years prior to this publication. Narrative and field review studies on the epidemiology and pathophysiology of nephrotic syndrome in childhood were included and offer clinicians up-to-date information and guidance, above all, it will help to focus on some risk and pathophysiological factors for decision-making regarding close follow-up. the treatment of NS.

Achalasia is a rare esophageal motility disorder that is usually idiopathic in origin. It is characterized by dysphagia, and patients often have chest pain, regurgitation, weight loss, and an abnormal barium radiograph showing esophageal dilation with narrowing at the gastroesophageal junction. Abnormal or absent esophageal peristalsis and impaired relaxation of the lower esophageal sphincter (LES) are typically seen on esophageal manometry. The advent of high-resolution manometry (HRM) has allowed more accurate diagnosis of achalasia, subtype designation, and differentiation from other esophageal motor disorders. Potential treatments include medications, endoscopic injection of botulinum toxin, balloon dilation, traditional surgery (usually laparoscopic Heller myotomy), and a novel, less invasive natural orifice transluminal endoscopic surgery (CETON or NOTES) approach. for Heller's myotomy called peroral endoscopic myotomy (POEM). This review discusses the diagnosis and treatment of achalasia with particular emphasis on recent developments in HRM and POEM, which arguably represent the most important advances in the field since the advent of laparoscopic Heller myotomy in the 1990s.

The human being, in his experience in time and his daily environment, must face different situations, and has learned to know what are those facts that can cause him harm. In order to analyze the aspects associated with human error in nursing professionals, identify the causes of human errors and establish the degree of application of safety and hygiene standards in the nursing professional of a public hospital institution, in order to investigate the mental representations of the personnel who work in these institutions around the risks and deviations from safety and hygiene standards, since it turns out to be a source of privileged information since they are the ones who are confronted daily with the demands of work hospital where many times, they put their own physical and emotional integrity at stake. A descriptive cross-sectional study was carried out whose population census was made up of all the professional nursing staff who work in a public hospital in Machala in the ICU area, the data collection instrument was a structured survey designed by Carrasquero. Statistical analysis of the data was performed by applying descriptive statistics. There is a low opinion dispersion in reference to assessing whether errors in the institution do not have any consequence or loss of economic time, 78.85% weighed in the category frequently, followed by 21.15% who valued always. In the same way, when analyzing the behavior of the role of motivation in human factors and in work performance, 100% of the nurses surveyed value that motivation frequently plays an important role in the performance of their work functions performed in the intensive care and emergency unit of the aforementioned hospital institution; committing an error or failure is an attribute of the environmental conditions and not of the nurse, 90.38% stated that this is always the case, while 9.62% believe that this may sometimes be the "exogenous" cause of the failure ; 69.23% in the category of sometimes some reliability technique is applied, while 21.15% express always apply some technique, and 9.62% the rest; It was evidenced that there is a lack of knowledge of security techniques for the management of human error, which can influence that they are not used as constant practices.

Premature rupture of the membranes is a common condition in both developed and developing countries and poses a serious threat to maternal and fetal well-being if not managed properly. The objective of the study was to analyze the maternal-fetal complications in pregnant women with premature rupture of membranes according to risk factors. It is an investigation of quantitative approach, of analytical, transversal and retrospective type. A sample of 446 pregnant women with premature rupture of membranes from the Guasmo Sur general hospital was analyzed during the period from January 1 to December 31, 2019. The sample was divided into 2 groups depending on whether or not they presented maternal-fetal complications. The average age was 24.81 ± 4,860, the group of 20-34 years was the most frequent. The mixed race (48%) and white (36%) predominated and the amount of income < 400 dollars (53%) was presented in more than half of the people analyzed 9% had a history of previous abortions, being 79% of spontaneous type. Only 2% reported inadequate obstetric control, while 85% presented between 1-3 controls during the entire pregnancy. The rate of maternal complications was 13%, the most common being chorioamnionitis (63%), postpartum infection (36%) and placental abruption (20%). The rate of fetal complications was 16%, the most common being: prematurity (61%), neonatal sepsis (32%), deformities (25%), pulmonary hypoplasia (17%) and contractures (4%). 64% (284) presented associated risk factors. Maternal-fetal complications were significantly associated with prolonged latency time, urinary tract infection, bacterial vaginosis, prolonged labor, inadequate obstetric control, oligohydramnios, and cigarette smoking.

Symptomatic tibial nonunion results in significant disability and loss of function, as well as psychosocial, family, and occupational limitations that impede recovery. The objective of the study is to analyze the advantages and disadvantages of bone transport in tibial diaphysis pseudarthrosis in patients of the “Alcívar” hospital during the period 2012-2017. It is a non-experimental, correlational, retrospective and cross-sectional study, which included 48 patients with nonunion of the tibia, divided into 35 patients who received surgical treatment with bone transport and 13 patients who did not receive bone transport at the "Alcívar" hospital on January 1 from 2012 to December 31, 2017. The male sex with 85% (41) and the age group over 60 years (52%) were predominant. Hypertrophic pseudoarthrosis was found in 44% (21) and atrophic 56% (27). 23% of the total presented an associated infectious process. Advantages of bone transport: better degrees of bone healing (29% grade III and 51% grade IV), 89% (31) completed bone healing in less than 20 weeks, hospital stay less than 8 weeks in 77%. The main disadvantage was the complications derived from bone transport. Lack of consolidation (25%), pin infection (25%), loss of range of motion (25%) and 1 case of fracture after removal of the external guide (25%) were observed. Bone transport offers good functional results in 29% (10) and excellent in 66% (23) and it was observed that 80% (28) returned to their work activities. Bone transport for the treatment of tibial diaphysis pseudarthrosis is an effective method that provides excellent functional results, bone consolidation and a higher rate of return to work. The advantages of bone transport are a better degree of bone consolidation, shortening of bone healing time and hospital stay.

Lipodystrophy is a heterogeneous group of rare diseases characterized by various degrees of fat loss leading to severe morbidity due to metabolic abnormalities associated with insulin resistance and subtype-specific clinical features associated with an underlying molecular etiology. It represents the most common skin-related complication associated with insulin therapy. The prevalence of lipodystrophy in adults with type 1 diabetes mellitus was determined. It is a quantitative, observational, analytical, retrospective and cross-sectional study. The sample included 36 patients with lipodystrophy from the Luis Vernaza hospital treated from January 1, 2018 to December 31, 2019. The Luis Vernaza hospital treated a total of 593 adult patients diagnosed with type 1 diabetes mellitus in 2018 and 2019, with the prevalence of lipodystrophy being 8.43%. 42% of the patients with lipodystrophy had type 1 diabetes mellitus between 10-15 years. 46% were patients with grade 1 lipodystrophy. A 46% non-adherence to the treatment of the underlying disease is reported and the The most frequent injection site was the abdomen. 76% received insulin doses > 0.7 U/kg. 76% of those analyzed reported that they did not rotate the injection site and 62% reused the same needle several times. A statistically significant association (p < 0.05) was found between the presence of lipodystrophy and the following risk factors: obesity (p=0.0001), duration of type 1 DM greater than 15 years (p=0.02), no rotation of the injection site (p=0.01) and lack of adherence to treatment (p=0.0001). The prevalence of lipodystrophy in adult patients with type 1 diabetes mellitus at the Luis Vernaza hospital during the period 2018 to 2019 is low. The main contributing risk factors for lipodystrophy were obesity, disease progression time > 15 years, reuse of needles and lack of adherence to treatment.

Garengeot's hernia is a rare entity in which the appendix is ??within a femoral hernia and is almost always found incarcerated in an emergency setting with concomitant appendicitis. In the literature, there are mostly single case reports. The objective of the present study was to conduct a review of the literature to study the incidence, pathogenesis, demographics, clinical presentation, laboratory and radiological investigations, differential diagnosis, delay in diagnosis and treatment, operative findings, surgical technique, histological findings, postoperative course, use of antibiotics, and complications related to Garengeot's hernia. Methods: A bibliographic search was carried out through PubMed, Scielo and Scopus with the following search terms, alone or combined: Garengeot, femoral hernia and appendicitis. Review articles, meta-analyses and clinical case reports were chosen. Conclusions: Garengeot's hernia is rare, being indistinguishable from an incarcerated femoral hernia in general. A delay in surgery should be avoided, but if necessary, a CT scan can be used for differential diagnosis. Although there is no standard treatment, mesh material does not seem advisable in the presence of a perforation, and it is beneficial for surgeons to perform their routine method rather than a specific technique.