Browsing by Autor "R. Sarmiento"

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Detection and evaluation of vascular calcifications using Duplex Doppler ultrasound, in patients with Chronic Kidney Disease at the Centro Integral Hemodialisis y Trasplantes S.R.L. in Tarija Bolivia
(2024) Jhossmar Cristians Auza-Santiváñez; Jose Luis Diaz-Guerrero; Blas Apaza-Huanca; Elier Carrera González; Jorge Márquez-Molina; R. Sarmiento; Edwin Cruz Choquetopa
Introduction: Chronic Kidney Disease represents a systemic pathology with important consequences on patient survival, mainly through the development of vascular calcifications. Early detection of these calcifications is crucial for the assessment of cardiovascular risk and timely therapeutic management. The present study aims to evaluate the usefulness of Duplex Doppler ultrasound in the detection and evaluation of vascular calcifications in patients with CKD.Methods: Study design. Descriptive observational, which was carried out at the Centro Integral Hemodialisis y Trasplantes S.R.L. in Tarija, Bolivia. The research universe was 60 patients with Chronic Kidney Disease, who undergo hemodialysis at the Center, the sample was 32 patients, selected according to inclusion and exclusion criteria. Exclusion Criteria: Any patient who does not meet the inclusion criteria. Inclusion Criteria: Patients with CKD who undergo Hemodialysis at Centro Integral Hemodialisis y Trasplantes S.R.L.Results: Table 1 shows that, of 32 patients, the predominant age group is 61 to 70 years. The presence of chronic diseases is evident in patients with CKD, with arterial hypertension and type II diabetes mellitus being the most frequent. Table 3 shows that of the total number of patients in the study population, 75% had a mild vascular calcification score (0-25 points), 21.87% had a moderate vascular calcification score (26-39 points), and only 3.12% had a severe score (40-63 points).Conclusions: Duplex Doppler ultrasound is a noninvasive, safe and effective technique for the evaluation of vascular calcifications in patients with chronic kidney disease. Its ability to detect subtle changes in arterial morphology allows for early diagnosis and better management of cardiovascular risk. The presence of vascular calcifications in patients with CKD increases cardiovascular risk
Giant multiloculated omental cyst in a pediatric patient. Case report and literature review
(2024) Giovanni Callizaya Macedo; Jhossmar Cristians Auza-Santiváñez; Daniel Ramiro Elías Vallejos-Rejas; R. Sarmiento; Jhaleny Jael Flores Canaviri; Liliana Heydi Suarez Laime
Introduction: Omental cysts are rare intra-abdominal lesions, with a frequency of 1:250,000, which often present asymptomatically. However, they can cause abdominal distension, or even surgical abdominal symptoms. Case report: A 3-year-old female patient presents with a clinical picture of 2 years of evolution, reporting progressive abdominal distention since she was one year old and abdominal pain for 2 weeks. Physical findings show an abdomen with great abdominal distention, tense and painful on superficial and deep palpation. A contrast-enhanced CT scan of the abdomen and pelvis revealed abdominopelvic cystic lesions. Exploratory laparotomy revealed a giant multilocular cystic mass dependent on the greater omentum. The pathological report revealed a giant omentum cyst. A successful surgical resection of the cystic lesions was performed and a favorable post-surgical evolution was performed. Conclusions: Omentum cysts are rare in paediatrics. Diagnosis is based on imaging studies and is confirmed during surgery. Surgical treatment is effective and with few complications
Mountain sickness: physiological challenges, diagnosis and treatment
(2025) Jhossmar Cristians Auza-Santiváñez; P. Ussetti Gil; Mildred Ericka Kubatz La Madrid; Ingrid Neysa Cabezas-Soliz; Jorge Márquez-Molina; Yamila Cruz Cruz; Dilma Villca-Villca; R. Sarmiento
INTRODUCTION. The first descriptions of altitude sickness were made in (1540-1600). Nowadays, different cities in the world are at high altitude, for example Qinghai-Tibetan Plateau in China occupies an area of almost 2.5 million inhabitants km2, with an average elevation of over 4,500 m. Altitude sickness should be a major concern for anyone who normally resides at sea level. METHOD. A search for information was carried out in the period August-December 2024 in the SciELO, LILACS, Scopus, PubMed-MedLine databases, the Google Scholar search engine, as well as in the ClinicalKeys services. RESULTS AND DISCUSSION. The partial pressure of arterial oxygen (PaO2 ) decreases with altitude, which produces progressive tissue hypoxia. The normal compensatory response to hypobaric hypoxia is called acclimatization. Its main characteristic is increased ventilation. The ability to acclimatize varies widely among individuals and depends on many factors, including the degree of hypoxic stress (rate of ascent, altitude reached), the intrinsic ability of the individual to compensate for the decrease in PaO2, and extrinsic factors. Progressive ascent produces greater hypoxic stress, requiring greater degrees of physiological and behavioral adaptations to preserve function. The more rapid the ascent and the higher the altitude, the greater the stress. Below 1500 m, symptoms of high altitude illness are generally not manifest. From approximately 1500 to 2500 m, symptoms are generally mild, if experienced at all. From approximately 2500 m, mild to moderate symptoms become quite common among unacclimatized visitors after a rapid ascent. As a general rule, people who normally reside below 1500 m should avoid an abrupt ascent to altitudes above 2800 m for sleeping. Sedative-hypnotics should be avoided during acclimatization. Abstinence from alcohol is safest
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.
Usefulness of ultrasound in the diagnosis of lumbricoid ascaris. Case Report and Literature Review
(2024) Ismael Vargas Gallego; Jhossmar Cristians Auza-Santiváñez; Ariel Sosa Remón; Eloy Paycho Anagua; Marco Antonio Gumucio Villarroel; R. Sarmiento; Mildred Ericka Kubatz La Madrid
Introduction. The World Health Organization (WHO) points out that more than a third of the world's population is infected by one or more parasites. Ascariasis is the most prevalent parasitic disease in the world, with approximately 664 million people infested. Clinical case. A 22-year-old female patient enters the emergency department with general malaise, with worsening symptoms in recent days, intense abdominal pain, associated with nausea and uncontrollable vomiting. She also reports non-elimination of gas and absence of bowel movements. . An emergency ultrasound is requested, it reports the stomach with the presence of a linear, tubular echogenic image that moves in different directions. Discussion. The widespread use of ultrasound in Emergency Departments for the diagnosis of acute abdomen, as well as in the laboratory, allowed us to reach the presumptive diagnosis of temporary biliary obstruction due to A. lumbricoides, in addition, the presence of jaundice, direct hyperbilirubinemia and discrete elevation gamma-glutamyltransferase (GGT); findings that could direct the exploration of the bile duct during the surgical procedure. Conclusions. The importance of the clinical case lies in the use of abdominal ultrasound as a diagnostic method for Ascaris Lumbricoides. The use of ultrasound in emergency services is essential in the presence of an acute abdomen, and in any patient who presents acute biliary symptoms, always think about this pathology
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.