Browsing by Autor "Yenifer Zelaya-Espinoza"

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Bilateral Subdural Empyema, secondary to odontogenic infectious process. Case Report
(2024) Edwin Cruz Choquetopa; Jhossmar Cristians Auza-Santiváñez; Mildred Ericka Kubatz La Madrid; Blas Apaza-Huanca; Yenifer Zelaya-Espinoza; Maribel Zambrana-Mejia; F Salazar; Osman Arteaga Iriarte
Introduction: Subdural empyema (ESD) is a collection of pus between the dura mater and arachnoid, and constitutes a medical emergency due to its rapid progression and high mortality rate. Although ENT infections are the main causes, odontogenic infections can also lead to ESD. Early diagnosis, intravenous antibiotic therapy and surgical intervention are essential to reduce mortality.Clinical case: A 32-year-old male patient presented with a month-long picture of swelling and pain on the left side of the face, recently aggravated by fever, headache, vomiting and generalised tonic-clonic convulsions. He had a history of alcoholism and recurrent dental infections. Imaging revealed a bilateral subdural empyema with left-sided predominance. Urgent antibiotic treatment was initiated, followed by bilateral craniotomy and drainage of purulent material. In addition, a brain abscess and a subgaleal haematoma were managed. Cultures identified Streptococcus viridans and coagulase-negative Staphylococcus, with good response to targeted therapy. The patient progressed favourably and was discharged in good condition.Conclusions: In regions like Bolivia, the prevalence of odontogenic infections due to cultural and economic factors increases the risk of severe complications such as SDE. A multidisciplinary approach, including early diagnosis, broad-spectrum antibiotics, and surgical intervention, is essential to improve outcomes and reduce mortality in these patients
Challenges in the epidemiological surveillance of maternal mortality in Bolivia: a retrospective analysis
(2023) Blas Apaza-Huanca; Jhossmar Cristians Auza-Santiváñez; José José Corini-Mamani; Amira Guisel Lopez-Quispe; Yenifer Zelaya-Espinoza; Olvis Scharbel Valdivia-Tola; M Sanchez
Objective: To address the challenges in epidemiological surveillance of maternal mortality in Bolivia, highlighting the importance of improving this process and highlighting the lack of updated data. Methods: This is a descriptive, retrospective study using data from the National Health Information and Epidemiological Surveillance System (SNIS-VE) of the Bolivian Ministry of Health and Sports. Two periods were examined: 2001-2014 and 2015-2022, with an emphasis on changes introduced in the SNIS-VE, such as the categorisation of reported and confirmed maternal deaths. Results: A deterioration in epidemiological surveillance was observed in 2020 and 2021 due to the COVID-19 pandemic. The situation varied between departments and levels of care, highlighting regional differences and differences in the quality of registration systems. These findings underline the complexity of epidemiological surveillance of maternal mortality in Bolivia. Conclusions: This study highlights the urgent need to improve the epidemiological surveillance of maternal mortality in Bolivia, improve the registration by the statistics department to avoid under-registration and strengthen the organization and operation of the Technical Committees for Maternal Mortality Surveillance, to in order to improve the Epidemiological Surveillance process in its different stages. These efforts are essential to move towards safer and more effective maternal care in Bolivia.
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.
Overweight, Obesity and High Blood Pressure: Early Atherogenic Signs in Children Aged 3 to 7 Years
(2025) Jhossmar Cristians Auza-Santiváñez; Freddy Ednildon Bautista-Vanegas; Ingrid Neysa Cabezas-Soliz; Henrry Temis Quisbert Vasquez; Yenifer Zelaya-Espinoza; Jorge Márquez-Molina; Delly Espejo-Alanoca; Paola Kattya Barrientos Lujan; Isaura Oberson Santander
Introduction: Human atherosclerosis has been considered for centuries as one of the greatest predators of health, its distribution on the planet is so wide that it overwhelmingly surpasses any other pathological process and reaches epidemic proportions, both in economically developed populations and in the process of becoming so.Objective: To identify the presence of overweight, obesity and arterial hypertension as early signs of atherosclerosis in children aged 3-7 years.Methods: A descriptive-analytical cross-sectional epidemiological study was carried out in 5 clinics of the "19 de abril" University Polyclinic, in the Plaza de la Revolución municipality, Havana City, during the period 2022-2023. The sample consisted of 152 children aged 3 to 7 years who met the inclusion criteria. The data were collected using the new model (AtecomR) and stored in an automated database in Microsoft Access. Statistical processing was performed using the SPSS statistical package, through a Toshiba Intel (R) Pentium IV microprocessor.Conclusion: This study constitutes a preamble for other investigations that address the problem of cardiovascular disease from the perspective of intrauterine life. The results have provided certain evidence, which, together with a review of the literature, has allowed us to propose the following conclusions. A high frequency of obesity, overweight and high blood pressure levels was identified in the study population. It was observed that in the obese and overweight group they had a tendency to increase with age, being higher their frequency between five and six years respectively. It was shown that overweight and obesity in children were factors for the presence of alterations in blood pressure.
Relevance of ultrasound detection and assessment of vascular calcifications in chronic kidney disease
(2024) Jhossmar Cristians Auza-Santiváñez; Blas Apaza-Huanca; Jose Luis Diaz-Guerrero; Daniel Ramiro Elías Vallejos-Rejas; Yenifer Zelaya-Espinoza; Ismael Vargas Gallego; Ariel Sosa Remón
Introduction: Chronic kidney disease (CKD) affects approximately 10% of the Spanish population and constitutes an independent cardiovascular risk factor. Vascular calcifications, especially in the abdominal aorta, are significantly associated with increased cardiovascular mortality in patients with CKD. This systematic review evaluates the evidence on the usefulness of ultrasound to detect and assess vascular calcifications in patients with CKD, and its relevance as a cardiovascular risk factor.Methods: A systematic search of multiple electronic databases was conducted until July 2024. Original studies published between 2000 and 2024 evaluating the use of ultrasound to detect vascular calcifications in adult patients with CKD at any stage were included. Reviews, letters, editorials, animal studies and those not published in English or Spanish were excluded. Methodological quality was assessed using the Newcastle-Ottawa scale for observational studies and the Cochrane tool for clinical trials.Results: Twenty-eight studies were included with a total of 50 to 3,000 participants per study. Most were observational studies, with 3 randomised clinical trials. Ultrasound showed good correlation with computed tomography (r=0.65-0.82) to quantify aortic and femoral calcifications. The presence of aortic calcifications was associated with increased risk of cardiovascular mortality (HR 1.8-3.2) in patients with advanced CKD and on haemodialysis. Iliac/femoral calcifications were associated with increased risk of cardiovascular events (RR 1.6-2.4) in patients with stage 3-5 CKD. Incorporation of ultrasound assessment of calcifications into CKD-specific risk algorithms significantly improved their predictive performance.Discussion: Ultrasonography emerges as a valuable tool for the detection of vascular calcifications due to its non-invasive nature, low cost and ability to perform repeated assessments. However, limitations such as heterogeneity in assessment methods, variable sample sizes and lack of long-term follow-up in some studies were identified. Further research is needed to standardise protocols and assess the long-term impact of interventions based on ultrasound detection of calcifications.Conclusions: Ultrasonography is an effective and accessible tool for detecting and assessing vascular calcifications in patients with CKD, providing relevant prognostic information for cardiovascular risk stratification. Its consideration as a first-line tool in nephrological practice is recommended. However, large-scale prospective studies are needed to definitively validate its prognostic value in different stages of CKD and to evaluate the efficacy of early interventions based on these findings.