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Cardiovascular disease constitutes a group of clinical entities that in the transplant patient is the main cause of morbidity and mortality. Around cardiovascular disease, multiple risk factors are recognized that determine its development. In this context, the objective of this research work was to describe these pathologies encompassed within cardiovascular disease with a focus on their diagnosis and treatment. For this, the bibliographic search and review was carried out, which included 25 articles, published between the years 2012 and 2022, which were retrieved from the PubMed database. The results obtained were the description of the five main pathologies that include cardiovascular disease in renal transplantation: heart failure, pulmonary hypertension, arrhythmias, valve disease, and coronary atherosclerotic disease. Within this group, heart failure was the most prevalent. Likewise, some risk factors were identified, such as arterial hypertension, whose prevalence exceeds 90%, and others specific to the transplant, such as immunosuppression, which was associated with the development of dyslipidemia, hypertension, and atherosclerosis. It is concluded that in the context of a renal transplant patient with cardiovascular disease it implies: heart failure, pulmonary hypertension, cardiac arrhythmias, atherosclerotic coronary disease and heart valve disease.

Type 2 diabetes mellitus (DM2) and nonalcoholic fatty liver disease (NAFLD) have a high prevalence worldwide and frequently coexist, so that DM2 is an important risk factor for the more rapid progression of NAFLD, in turn NAFLD is an independent risk factor for the development of DM2, so knowing the bidirectional pathophysiology between these two clinical entities allows having a broader knowledge of the subject to improve the management of this type of patients. Therefore, the aim of this review was to describe the pathophysiological interrelationship between DM2 and NASH. To this end, a search was carried out in PubMed and 714 articles were found, with the subsequent application of inclusion and exclusion criteria. The articles included in this bibliographic review were 33, including systematic and literature reviews, meta-analyses, clinical trials and observational studies corresponding to the last 10 years. It was concluded that the mechanisms described, such as insulin resistance in different tissues and the role of lipotoxicity in the previous mechanism, have updated evidence in favor of them, despite the low degree of evidence. On the other hand, mechanisms such as the role of lipotoxicity in NASH progression and the role of cytokines in insulin resistance still need the contribution of more studies to find firm support for these theories in humans.

Background: Life expectancy has increased in the population, as the number of patients with chronic kidney disease. Kidney transplantation has become an option for those patients who require renal replacement therapy. This procedure can be performed using living or deceased donors; therefore, it is crucial to analyze the benefits and risks associated with each type of transplantation. Objective: To carry out an exhaustive synthesis of the updated scientific literature on the risks and benefits present in kidney transplantation from a living donor versus a deceased donor. Methods: Twenty scientific articles were included in this bibliographic review, obtained mainly from Pubmed, Elsevier and Scielo, in English and Spanish. The PICO strategy was used to obtain the keywords and MeSH terms in order to elaborate the search equation. Expected results: In this bibliographical review, the differences, similarities, risks and benefits were found by comparing living-donor and deceased-donor kidney transplants in order to determine the best therapeutic option for patients in need of kidney transplantation.

Background: SARS-CoV-2 causing COVID-19 disease, appears at the end of 2019, its acute effects have been well studied and characterized, but its cardiovascular sequelae have not yet been comprehensively described, so the present review is performed. Aim: To determine the post-COVID 19 cardiovascular sequelae through a review of the literature. Methods: Methodological bibliographic review carried out through the medical search engine Pubmed, whose publication date corresponds to the period between 2020 and 2022, in Spanish and English language and the results were structured and summarized in a data matrix. Results: A total of 32 publications were analyzed, which found that cardiovascular sequelae are a common affectation of post COVID 19 syndrome, demonstrating cardiac abnormalities in MRI measurements and presenting elevated troponin levels in their samples. Sequelae include myocarditis, pericarditis, new-onset hypertension, pulmonary hypertension, heart failure, myocardial infarction, thromboembolism, post-COVID 19 tachycardia syndrome, ischemic stroke, arrhythmias, and syncope. Conclusions: The research indicates that post-COVID 19 cardiovascular sequelae may represent an essential clinical manifestation, and that the long-term effects of this infection will be a challenge for the future. This becomes representative as their chronicity may generate long-lasting consequences for patients and health systems with wide implications on the economy and life expectancy of the population

COVID-19 does not have a predilection for specific population groups, however, there are certain predisposing factors that increase the likelihood of developing severe clinical symptoms. These factors include people over 60 years old and those who have underlying medical conditions such as high blood pressure, heart or lung problems, diabetes, obesity, cancer, and immunosuppression. Patients who have received a kidney transplant are in this last group and have a higher mortality rate and more complications compared to the rest of the population due to their compromised immune system. The objective of this review is to describe the complications generated by COVID-19 in kidney transplant recipients by conducting a bibliographic review of COVID-19 complications in kidney transplant recipients through PubMed and ScienceDirect databases, establishing quality criteria based on SCImago Journal. In total, 351 articles were found between systematic reviews and meta-analyses between 2020 and 2022, and after applying inclusion and exclusion criteria, 12 articles were selected for inclusion in this research work. After an exhaustive review of the articles and the respective analysis of each one, we concluded that the complications of kidney transplant recipients infected with COVID-19 include ARDS (acute respiratory distress syndrome), AKI (acute kidney injury), coinfections, graft rejection, and cardiovascular complications, which considerably increase the mortality rate in this population group

Background: Surgical site infection (SSI) is a public health problem by increasing the length of stay, costs and re-admissions, and therefore affecting the patient's working status; In this research, the frequency of SSI in appendectomized patients was established. Objective: to determine the frequency of infections of the surgical site and its characteristics in appendectomized patients in the José Carrasco Arteaga Hospital. Basin. 2017 Methodology: the study was descriptive, transversal, documentary, in the period between January and December of 2017; We worked with the universe of study. A data collection form was used as an instrument. The technique was the observation of clinical histories of the computerized system of the Ecuadorian Institute of Social Security AS400. Subsequently, the data entry was made in Excel 2016 and the analysis in SPSS v 25. Results: the frequent age range was 31 to 40 years, male (54.95%), urban residence (71.61%) and mestizos (99.45%). The frequency of SSI was 4.95%, having an ASA I classification of 74.1%, the duration of surgery was 1 to 2 hours (77.8%), the technique applied was laparoscopic (96.7%). %), the frequency of SSI was higher in the conventional one (11.1%); the patients apparently did not have comorbidity in their majority, the mean hospital stay was 1.56 days and they did not need re-entry for the treatment of SSI (92.6%). Conclusion: a low frequency of patients with SSI was found, which could be due to the implementation of better biosecurity and antibiotic prophylaxis schemes.

INTRODUCTION: The incorrect and inadequate use of antibiotics these have been a growing problem in recent years, because they endanger the lives of millions of patients each year, and contribute to the increase in resistance to them. GENERAL OBJECTIVE: to determine the prescription characteristics of antibiotics in appendicitis in the area of surgery of the Hospital Jose Carrasco year 2017 MATERIAL AND METHODS: Descriptive with a sample of 496 patients, who were admitted to the surgery in the 2017 period, of which by means of a form and access to the database was obtained information on the prescription characteristics in acute appendicitis. The results were grouped, tabulated with the program SPSS version 25 and analyzed by percentages, frequencies and measures of central tendency. RESULTS: The men with 53% of cases, the average age was 38.5 years. There was a prophylaxis compliance of 85.9%, with Ampicillin plus Sulbactam being the most used with 49,2%, followed by Ciprofloxacin plus metronidazole (17.4%) and Ceftriaxone plus metronidazole (9.2%). an average of 5.09 days of hospital stay in complicated appendicitis, and of 1.63 days in uncomplicated, with respect to time of administration of antibiotics the average was 6.44 days in complicated appendicitis, and 1.8 days in uncomplicated appendicitis. CONCLUSIONS: the prescription of antibiotics in appendectomized patients of the Jose Carrrasco Arteaga hospital is in accordance whit the current guidelines and protocols established worldwide.

Introduction: Laparoscopic cholecystectomy is the procedure of choice for symptomatic cholecystolithiasis because it reduces hospital stay and patient recovery; however, it is not exempt from complications. Objectives: To determine the prevalence of trans and immediate post surgical complications of laparoscopic cholecystectomy and associated factors, performed in the emergency service of the Hospital Vicente Corral Moscoso. Cuenca. 2017 Methodology: Analytical cross-sectional study, with patients who underwent laparoscopic cholecystectomy who met the inclusion criteria; with a sample of 164 patients by simple random probability sampling, with a 95% confidence interval. To determine if the factors are of risk, odds ratio was used. Results: 64.6% were female. 92.1% of the patients were between 20 and 64 years old, 7.9% were over 64 years old. 41.4% of patients presented normal nutritional status and 17.7% had obesity. 71.3% presented acute cholecystitis. 77.4% of patients did not present associated co-morbidity. There were no patients with ASA IV and 3.7% had ASA III. The prevalence of complications was 5.5%; 88.9% presented bleeding and 11.1% bile duct injury. Acute inflammation is associated with complications but is not a risk or protection factor. (OR 8.31, 95% CI 0.47-145.85, p = 0.04)

Objective: To determine which diagnostic scale between RIPASA and modified Alvarado is more effective in the diagnosis of acute appendicitis. Method and materials: A validation study of diagnostic tests was carried out that compared the scales of RIPASA and Modified Alvarado, with the histopathological result as a gold test. The sample consisted of 201 patients who attended the emergency service of surgery of the Hospitals José Carrasco Arteaga and Vicente Corral Moscoso with a diagnosis of acute appendicitis and who underwent surgery. The analysis was performed using Excel software, R program for Windows version 1.0.3 and the SPSS program version 25 Results: The RIPASA scale obtained a sensitivity and specificity of 98.34% and 75%, respectively, compared to 93.92% and 85% for the Modified Alvarado scale. The diagnostic accuracy was 96.02% for RIPASA and 93.03% for the Modified Alvarado score, showing a difference of 2.99% statistically significant (p 0.006). However, the areas under the curve of the two tests are similar (RIPASA 0.963, Alvarado modified 0.964). Conclusions: The scales of RIPASA and Alvarado Modified have a high sensitivity, specificity and diagnostic precision for acute appendicitis and could be a useful tool, decreasing the use of complementary tests and facilitating decision making in our population

Background. Bile pancreatitis, cholangitis and choledocholithiasis are entities mainly caused by a lithiasic obstructive process, if the blockage is locating in the distal bile duct will interrupt the output of pancreatic and bile liquid, triggering an inflammatory process such as pancreatitis or may have generating an infectious bacterial colonization (cholangitis). These diseases of the biliary tract are highly prevalent in the population as part of the 10 leading causes of morbidity in 2013 in the country with 2.96% according to the National Institute of Statistics and Censuses, being served an important number of patients in the Hospital Jose Carrasco Arteaga using methods and techniques such as: endoscopic retrograde cholangiopancreatography, interventional method; laparoscopic cholecystectomy, surgical method, some degree of complication being subject during said processes. General purpose. Determine the post therapeutic complications: in interventional and surgical treatments in patients with biliary pancreatitis, cholangitis and choledocholithaisis in the “hospital Jose Carrasco Arteaga” in January 2010 to December 2014. Methodological design. A retrospective quantitative descriptive study which included 456 patients hospitalized with a diagnosis of choledocholithiasis, cholangitis and biliary pancreatitis in the area of Emergency Surgery An Internal Medicine Hospital Jose Carrasco Arteaga. Data were obtained from medical records were the same as those analyzed in the SPSS 20.0 program and EXEL. Results. Of the total cases the filed 15.79% presented post therapeutic interventional and surgical complication; 12.94% corresponded to the complications of ERCP and 2.85% of the complications of laparoscopic cholecystectomy