Browsing by Autor "Benito Aguirre-Cruz"

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Asymptomatic multiorgan cysticercosis. A case report from Bolivia
(2025) Mildred Ericka Kubatz La Madrid; Jennifer Collazo Cruz; Yamila Cruz Cruz; Jhossmar Cristians Auza-Santiváñez; Freddy Ednildon Bautista-Vanegas; Benito Aguirre-Cruz; Ingrid Neysa Cabezas-Soliz; Carmen Julia Salvatierra-Rocha
Introduction: Cysticercosis is an infectious disease caused by Taenia solium, endemic to Latin America, Asia, and Africa. It is acquired by consuming Taenia eggs in contaminated water and food, or undercooked pork. It generally causes mild or asymptomatic disease, except for neurocysticercosis, which can be severe and potentially fatal. Symptoms depend on the number of parasites, their location, and the host's immune response. Diagnosis is based on epidemiological data, clinical presentation, and imaging studies, primarily computed tomography. Objective: To use computed tomographic images to identify the degree of tissue damage caused by Taenia solium in an asymptomatic Bolivian adult. Clinical case: A 52-year-old Bolivian female patient from a rural area, with a wooden house, dirt floor, no sewage or drinking water, a housewife, who practices open defecation and raises pigs to support her household. She had a personal health history, but an inadequate diet. She was taken to the Roberto Galindo Hospital due to a traffic accident, where an emergency CT scan of the head and abdomen was performed due to direct trauma to those areas. The studies revealed calcifications in multiple organs, findings suggestive of massive cysticercosis. Conclusions: Cysticercosis is a parasitic disease transmitted fecal-orally, preventable but highly contagious from country to country due to social migration. It constitutes a serious health problem due to the biological, economic, and social damage it entails, making increased epidemiological surveillance essential.
Endobronchial tumor, diagnosis and clinical and imaging evolution. A case report
(2025) Yamila Cruz Cruz; Mildred Ericka Kubatz La Madrid; Orlian Moreno Perera; Jennifer Collazo Cruz; Jhossmar Cristians Auza-Santiváñez; Benito Aguirre-Cruz; Yenifer Zelaya-Espinoza; Grobert Condori-Galindo
Introduction: Lung cancer has been known since the 19th century, and to date has experienced multiple advances in diagnosis and treatment, which imply a favorable prognosis for the patient. However, worldwide it exhibits high morbidity and mortality rates, it occurs mainly in males, with an average age of 65 years, is closely related to smoking and is notable for its low survival rates, particularly when diagnosed in advanced stages, as often occurs in endobronchial presentation. Objective: To describe the diagnosis and clinical imaging evolution of a patient with an endobronchial tumor. Case presentation: A 56-year-old male patient, a smoker and a carpenter by profession, who began to present chest pain and a dry, irritating cough and went to the family doctor. A series of complementary tests were prescribed, which yielded pathological results, including a chest X-ray, which supported the initial diagnosis, and a computed axial tomography (CT) scan, which confirmed the presence of an endobronchial tumor. Oncological staging and follow-up were performed, and despite complications that arose due to the patient's withdrawal from the consultation, the patient progressed well. Conclusions: Early diagnosis of lung cancer based on clinical methods and imaging studies is essential. This can improve survival and reduce the physical, emotional, and social impact on the patient and their family, as demonstrated in our clinical case. A multidisciplinary approach is essential, combining technology, clinical knowledge, and human sensitivity to provide comprehensive care and improve the patient's quality of life.
Impact of Altitude on Cardiovascular Physiology: Literature Review and Update
(2025) Jhossmar Cristians Auza-Santiváñez; Henrry Temis Quisbert Vasquez; Freddy Ednildon Bautista-Vanegas; Delly Espejo-Alanoca; Ponciano Chiri-Chambi; Victor Hugo Mamani Huarachi; Benito Aguirre-Cruz; Katrin Daniela Sivila-Marquez; Jose Luis Diaz-Guerrero
Introduction: More than 140 million people in the world live at high altitudes, above 2,500 meters (m) above sea level. Oxygen is vital for cellular metabolism; therefore, hypoxic conditions found at high altitude affect all physiological functions. Metods: A search for information was carried out in the SciELO, Scopus, PubMed/MedLine databases, the Google Scholar search engine, as well as in the ClinicalKeys services. Advanced search strategies were used to retrieve the information, by structuring search formulas using the terms "Cardiovascular Physiology", "Cardiovascular Physiology at Altitude", as well as their translations into Spanish " Fisiología Cardiovascular " and " Fisiología Cardiovascular en la altitud ". Results discussion: The heart is composed of three main types of cardiac muscle: atrial muscle, ventricular muscle, and specialized excitatory and conductive muscle fibers. The efficiency and work of the heart as a pump is often measured in terms of cardiac output, or the amount of blood the heart pumps per minute. Cardiac output is the product of stroke volume and heart rate Cardiovascular Changes at Altitude It is possible to think of the goal of acclimatization as maintaining oxygen delivery to the tissues as close to normal as possible. The cardiovascular system is central to this. Acute exposure to high altitude produces an increase in heart rate and cardiac output both at rest and for a given amount of work compared with sea level. In general, the normal heart tolerates even severe hypoxia very well. The heart, as a hemodynamic pump, has two mechanisms at its disposal to enhance its performance: heart rate and stroke volume, which together constitute cardiac output. The altitude electrocardiogram shows a variably increased amplitude of the P wave, deviation of the QRS axis to the right, and signs of right ventricular overload and hypertrophy. Conclusions: Advances in high-altitude research have shown that the cardiovascular system deploys some efficient mechanisms of acclimatization to oxygen deprivation, and the healthy heart adapts to hypoxia, even when severe, with preservation of systolic function and only minor impairment of LV and RV diastolic function. With acclimatization, desensitization of the adrenergic system, together with increased parasympathetic influence, leads to a decrease in maximum heart rate and protection of the myocardium against potentially damaging energy imbalances. Acute exposure to high altitude stimulates the adrenergic system, increasing heart rate and cardiac output; although arterial pressure remains stable, pulmonary artery pressure increases due to hypoxic pulmonary vasoconstriction. Our improved understanding of the effect of altitude hypoxia on the cardiovascular system will allow better-informed, evidence-based advice for patients with pre-existing cardiovascular disease
Knowledge, attitudes and behaviors regarding nutrition among students of the School of Public Health - Tekove Katu in Bolivia
(2025) Paola Kattya Barrientos Lujan; Blas Apaza-Huanca; Iris Ingrid Carrillo-Campos; Benito Aguirre-Cruz; Delly Espejo-Alanoca; Rodolfo R. Rosales; Lisbet Carolay Cordova Mamani; Jhossmar Cristians Auza-Santiváñez
Introduction: Food is an essential component in the socio-cultural and economic context of communities. In Bolivia, malnutrition and food security problems are prevalent, especially in indigenous communities. The "Tekove Katu" Health School is an ideal setting for the implementation of nutritional education programs, given its intercultural approach and the potential impact on the food practices of students and their communities.Methods: Study design: Descriptive, cross-sectional observational study in students from indigenous communities during the month of February - December 2023. Universe and sample: 100% of students enrolled in 2023 were included. Exclusion criteria: Not wanting to participate in the research Not attending during the days in which the questionnaire was applied. Procedure: The data were collected through a self-administered questionnaire.Results and discussion: The results indicated that 82.55% of the participants expressed an appropriate conceptualization of healthy eating; However, a significant dissonance was evident between theoretical understanding and eating behaviors. Consumption patterns characterized by a dichotomy between the recognition of nutritional principles (91.86% expressed interest in healthy eating) and suboptimal eating practices (95.38% consumption of sweets, 83.07% consumption of hamburgers).Conclusions: At the "TEKOVE KATU" Health School, there is a predominance of the female gender and a higher concentration of students in the age range of 17 to 19 years. The parents of the students have a low educational level, and most of the students live with more than four people. A positive attitude towards the interest in eating healthily is highlighted, although a preference for foods rich in fats, refined sugars and sodium is also observed, despite recognizing that these are unhealthy. A large majority of students receive limited and unreliable information on food and nutrition, which highlights the need for a more solid nutritional education. It is clear that, in the absence of nutritional education and healthy eating programs, students do not have a solid foundation to consolidate healthy eating habits, which constitutes a public health problem with implications for morbidity and mortality, quality of life, health expenditure and an increase in chronic non-communicable diseases
Morbidity at discharge in the Urology Department of the Peltier University Hospital Center in Djibouti
(2025) Dulvis Lianet Acosta Herrería; Jorge Luis Santana Pérez; Ariel Sosa Remón; Jhossmar Cristians Auza-Santiváñez; Ana Esperanza Jeréz Álvarez; Jorge Luis Santana León; Benito Aguirre-Cruz; Sara Milca Robles-Nina
Introduction: Morbidity at discharge after admission for urological diseases has been scarcely described in the literature. Methodology: A quantitative, observational, descriptive, longitudinal study was conducted at the Peltier University Hospital Center in Djibouti, from January to July 2024. The population was 131 patients hospitalized in the urology service and the sample was 129 discharged patients. Objective: to describe morbidity at discharge from the Urology service. Results: The largest number of patients admitted were patients diagnosed with prostatic hypertrophy and hydronephrosis. Adenomectomy and minimal access surgeries were performed relatively frequently and the predominant complication was infection of the surgical wound. Conclusions: The patients who were admitted and treated had diagnoses that reveal the impact of sociodemographic factors on the population of Djibouti, advanced age and desert climate
Neurobioethics and bioethics in the severe oncology patient with neurological complications
(2023) Ariel Sosa Remón; Ana Esperanza Jeréz Álvarez; Arian Jesús Cuba Naranjo; Jhossmar Cristians Auza-Santiváñez; Luis Mariano Tecuatl Gómez; Benito Aguirre-Cruz
Introduction: Clinical outcomes after a neurological emergency result worse for cancer patients and may result in critical illness requiring admission to the Intensive Care Unit. Neurobioethics and bioethics are effective tools to understand and provide the best care for this type of patient.Objective: to reflect on elements of interest related to bioethics and neurobioethics in the oncological patient with neurological complications.Development: neurobioethics is a scientific discipline derived from a multidisciplinary approach based on bioethics, which is applied to ethical questions regarding its ontology and its teleological organicity for human life. In the severe neuro-oncological patient, devoid of any integral neurological function due to central nervous system involvement, neurobioethics applies scientific knowledge and ethical behavior to medical care, responding to the neurocritical patient.Conclusions: comprehensive care of patients with cancer and severe neurological involvement requires scientific, ethical and moral knowledge that allows the application of the best therapeutic strategy, human and family care, and short- and long-term prognosis. Neurobioethics promises these tools while providing these patients with respect, compassion, care and empathy. However, it still needs further studies involving this discipline in neuro-oncologic intensive care.
Neurobioética y bioética en el paciente oncológico grave con complicaciones neurológicas
(2023) Ariel Sosa Remón; Ana Esperanza Jeréz Álvarez; Arian Jesús Cuba Naranjo; Jhossmar Cristians Auza-Santiváñez; Luis Mariano Tecuatl Gómez; Benito Aguirre-Cruz
Introducción: Los resultados clínicos tras una emergencia neurológica resultan peores para los pacientes con cáncer y pueden dar lugar a una enfermedad crítica que requiera ingreso a la Unidad de Cuidados Intensivos. La neurobioética y bioética la resultan herramientas eficaces para comprender y ofrecer el mejor cuidado a este tipo de paciente.Objetivo: reflexionar sobre elementos de interés relacionados con la bioética y la neurobioética en el paciente oncológico con complicaciones neurológicas.Desarrollo: la neurobioética es una disciplina científica derivada del abordaje multidisciplinar partiendo de la bioética, que se aplica en cuestionamientos éticos en torno a su ontología y en su organicidad teleológica para la vida humana. En el paciente neurooncológico grave, desprovisto de toda función neurológica integral por afectación del sistema nervioso central, la neurobioética aplica el conocimiento científico y el comportamiento ético a la asistencia médica, dando respuesta al paciente neurocrítico. Conclusiones: la atención integral al paciente con cáncer y afectación neurológica grave, exige conocimientos científicos, éticos y morales que permitan aplicar la mejor estrategia terapéutica, el cuidado humano, familiar y el pronóstico a corto y largo plazo. La neurobioética promete estas herramientas a la vez que brinda a estos pacientes respeto, compasión, cuidado y empatía. Sin embargo, aún necesita mayores estudios que impliquen esta disciplina al cuidado intensivo neurooncológico.
Pentalogy of Cantrell: A challenge in prenatal diagnosis. A case report in Bolivia
(2025) Benito Aguirre-Cruz; Jhossmar Cristians Auza-Santiváñez; Elizeth Mendoza-Contreras; R. Sarmiento; A. Léon; Delly Espejo-Alanoca; Blas Apaza-Huanca; Dilma Villca-Villca
Introduction. Pentalogy of Cantrell is a rare congenital anomaly with an incidence of less than one in 100,000 pregnancies. It is characterized by a defect in the abdominal wall at the level of the supraumbilical midline, the lower segment of the sternum, the anterior diaphragm, the diaphragmatic pericardium, and cardiac abnormalities such as ectopia cordis. Few cases of this entity have been reported in the literature in Bolivia. It is a constellation of congenital defects that pose a unique challenge, hence the importance of diagnosis in the prenatal stage. Clinical Case and Discussion. An 18-year-old pregnant woman came to our hospital, was consulted by Gynecology and Obstetrics, and an ultrasound was performed which revealed a defect in the anterior abdominal wall with viscera outside the fetal cavity (liver, heart, stomach and intestinal loops, 24.3 weeks of pregnancy and multiple fetal malformations. A discussion of the case was held with specialists in Gynecology and Obstetrics, Pediatrics, Genetics, Family Physician, Imaging and Psychology. Taking into account the poor prognosis and the complexity of the anomalies, the patient was told that this could represent a threat and risk for her. At the request of the parents and with prior informed consent, the patient was admitted to the gynecology service, prepared and admitted to the operating room for cesarean section. A female product was obtained, with multiple malformations, a large defect in the anterior thoracoabdominal wall from the navel to the upper third of the body of the sternum, omphalocele. Part of the heart outside the thoracic cavity, presence of a uterine cavity, and a large thoracic cavity. of defects in the diaphragm, liver and intestinal loops outside the abdominal cavity. Conclusions. The case highlights the importance of early prenatal diagnosis, even in settings with limited resources. Despite the lack of access to more complex studies, the appropriate use of ultrasound, combined with the expertise of the operator, allowed this complex congenital malformation to be identified at an early stage. The timely identification of these conditions not only facilitates multidisciplinary counseling for the pregnant woman and her family, but also opens the possibility of making informed decisions, including the option of terminating the pregnancy before the period of viability, if the parents so consider. In severe cases, such as ours, where the prognosis is generally unfavorable, an early diagnosis can better prepare families emotionally and psychologically, as well as allowing them to consider all possible options with due ethical and medical guidance.
Prenatal diagnosis of Fetal Cardiac Rhabdomyomaassociated with Familial Tuberous Sclerosis
(2024) A. Léon; Benito Aguirre-Cruz; Miguel Octavio Sosa-Palaviccini; Jhossmar Cristians Auza-Santiváñez; Blas Apaza-Huanca; Jorge Márquez-Molina; Yanin Díaz Lara
Introduction: Of the fetal heart tumors, the most common are rhabdomyomas. Its prevalence is based on 11,000 autopsies performed on children and is 0.027%.1 Its diagnosis in the prenatal stage is a challenge, however, it has been reported in the second and third trimesters of gestation.Clinical case: 19-year-old female patient with a history of presenting with lipothymia at 2 years of age. Given these manifestations, she underwent different studies, including Cranial Magnetic Resonance (MRI), which concluded as a diagnosis of Tuberous Sclerosis. In its current state of gestation, at week 33, a finding is seen that corresponds to unilateral pulmonary agenesis; at 35 weeks, liver and kidney ultrasounds are performed on the mother and fetal ultrasound. Serial ultrasound findings revealed maternal hepatic and renal hemangiolipoma. Fetal biventicular rhabdomyoma with probable transposition of the great vessels and pulmonary artery stenosis.Discussion: Rhabdomyomas are the most common fetal cardiac tumors. In our clinical case, the pregnant woman had a history of Bourneville Tuberous Sclerosis. The definitive diagnosis of maternal pathologies was made in the 3rd trimester. It was complicated to manage due to suspicion of additional heart disease of the Classical Transposition of the Great Vessels type, evidenced by imaging studies. He was subsequently referred to a more complex center for better follow-up and definitive treatment.Conclusions: Fetal rhabdomyoma diagnosed prenatally is complex, requiring serial imaging studies and multidisciplinary follow-up. It is important to monitor the hemodynamic status and any cardiovascular repercussions of the pregnant woman. In addition, fetal structures including the central nervous system, heart and renal parenchyma must be carefully evaluated to avoid significant sequelae in those affected
Ramsay Hunt Syndrome in a Pediatric Patient with Atypical Presentation: Case Report
(2025) C. Roman; Paola Nielsen Fuentes Luzcuber; Jhossmar Cristians Auza-Santiváñez; Carmen Julia Salvatierra Rocha; Edson Grover Sañez Liendo; Henrry Temis Quisbert Vasquez; Mildred Ericka Kubatz La Madrid; Benito Aguirre-Cruz; Delly Espejo-Alanoca
The case of a preschooler with Ramsay Hunt Syndrome (RHS) is reported, an infrequent pediatric neurological condition caused by the reactivation of the varicella-zoster virus, whose atypical manifestation represented a diagnostic challenge. The patient, a 3-year and 4-month-old male, presented with vesicular lesions on the forehead and periorbital region, without the classic auricular rash, which led to a delayed diagnosis. Once RHS with bacterial superinfection was confirmed, acyclovir, prednisone, and antibiotics were administered, achieving a favorable evolution. The atypical presentation highlights the diagnostic challenges in children and the risk of delayed management. Therefore, it is crucial to maintain a high index of suspicion for RHS in pediatrics, even with unusual presentations, to ensure early treatment and prevent severe long-term complications.
Usefulness of Ultrasound in the diagnosis of Septic Arthritis: about a case
(2024) Benito Aguirre-Cruz; Jhossmar Cristians Auza-Santiváñez; Daniel Ramiro Elías Vallejos-Rejas; Elizeth Mendoza-Contreras; Verónica Quispe-Medrano; B. Ortega; R. Sarmiento; Giovanni Callizaya Macedo
Introduction. Septic arthritis in the pediatric age group is a medical emergency with serious consequences if not treated early. Early diagnosis is essential to initiate appropriate treatment and prevent permanent joint damage. Ultrasound has emerged as an essential tool for the early and accurate detection of septic arthritis, allowing for a rapid and detailed evaluation of the affected joint, especially in cases where clinical findings are subtle.Clinical Case. A 1-month-old male infant was brought by his mother to the emergency service of our hospital due to irritability and crying when changing his diaper, significant increase in the volume of the right thigh, and pain during movement. An initial ultrasound was performed, which reported signs of superficial cellulitis, and a second ultrasound was performed, which revealed thickening of the synovium, a fluid collection in the joint capsule with echoes inside it, which concluded with the diagnosis of septic arthritis of the right hip.Discussion. Ultrasound not only allowed the identification of joint effusion and synovial thickening, but was also crucial in differentiating between superficial infection (cellulitis) and deeper septic arthritis.Conclusions. The importance of our clinical case lies in the use of ultrasound as a diagnostic method to detect joint involvement early. In combination with the clinical method and microbiological studies, it becomes an important component of the diagnostic approach and timely management of septic arthritis, thus reducing associated complications.