-- Table structure for table `item_movement_rel_extra`
--

CREATE TABLE `item_movement_rel_extra` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `item_id` int(10) unsigned DEFAULT 0,
  `item_movement_id` int(10) unsigned DEFAULT 0,
  `item_color_id` int(10) unsigned DEFAULT 0,
  `item_status_id` int(10) unsigned DEFAULT 0,
  `item_unit_business_id` int(10) unsigned DEFAULT 0,
  `item_mold_cavities_id` int(10) unsigned DEFAULT 0,
  `item_package_measurements_id` int(10) unsigned DEFAULT 0,
  `item_units_per_package_id` int(10) unsigned DEFAULT 0,
  `item_mold_properties_id` int(10) unsigned DEFAULT 0,
  `item_product_family_id` int(10) unsigned DEFAULT 0,
  `item_size_id` int(10) unsigned DEFAULT 0,
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`),
  KEY `item_movement_rel_extra_item_movement_id_foreign` (`item_movement_id`),
  KEY `index_item_status_id` (`item_status_id`),
  KEY `index_item_unit_business_id` (`item_unit_business_id`),
  KEY `index_item_mold_cavities_id` (`item_mold_cavities_id`),
  KEY `index_item_package_measurements_id` (`item_package_measurements_id`),
  KEY `index_item_units_per_package_id` (`item_units_per_package_id`),
  KEY `index_item_mold_properties_id` (`item_mold_properties_id`),
  KEY `index_item_product_family_id` (`item_product_family_id`),
  KEY `index_item_size_id` (`item_size_id`),
  CONSTRAINT `item_movement_rel_extra_item_movement_id_foreign` FOREIGN KEY (`item_movement_id`) REFERENCES `item_movement` (`id`)
) ENGINE=InnoDB AUTO_INCREMENT=615 DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `item_movement_rel_extra`
--

SET autocommit=0;
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09:23:22'),(536,1,808,0,0,0,0,0,0,0,0,0,'2026-05-16 09:23:22','2026-05-16 09:23:22'),(537,1,809,0,0,0,0,0,0,0,0,0,'2026-05-16 14:10:48','2026-05-16 14:10:48'),(538,1,810,0,0,0,0,0,0,0,0,0,'2026-05-16 14:10:48','2026-05-16 14:10:48'),(539,293,813,0,0,0,0,0,0,0,0,0,'2026-05-17 12:17:34','2026-05-17 12:17:34'),(540,293,814,0,0,0,0,0,0,0,0,0,'2026-05-17 12:17:34','2026-05-17 12:17:34'),(541,294,824,0,0,0,0,0,0,0,0,0,'2026-05-20 13:18:20','2026-05-20 13:18:20'),(542,294,825,0,0,0,0,0,0,0,0,0,'2026-05-20 13:18:20','2026-05-20 13:18:20'),(543,1,833,0,0,0,0,0,0,0,0,0,'2026-05-20 20:33:44','2026-05-20 20:33:44'),(544,1,834,0,0,0,0,0,0,0,0,0,'2026-05-20 20:33:44','2026-05-20 20:33:44'),(545,295,839,0,0,0,0,0,0,0,0,0,'2026-05-22 19:22:03','2026-05-22 19:22:03'),(546,295,840,0,0,0,0,0,0,0,0,0,'2026-05-22 19:22:03','2026-05-22 19:22:03'),(547,296,841,0,0,0,0,0,0,0,0,0,'2026-05-23 11:16:56','2026-05-23 11:16:56'),(548,296,842,0,0,0,0,0,0,0,0,0,'2026-05-23 11:16:56','2026-05-23 11:16:56'),(549,1,845,0,0,0,0,0,0,0,0,0,'2026-05-25 10:39:38','2026-05-25 10:39:38'),(550,1,846,0,0,0,0,0,0,0,0,0,'2026-05-25 10:39:38','2026-05-25 10:39:38'),(551,297,853,0,0,0,0,0,0,0,0,0,'2026-05-26 15:02:12','2026-05-26 15:02:12'),(552,297,854,0,0,0,0,0,0,0,0,0,'2026-05-26 15:02:12','2026-05-26 15:02:12'),(553,298,857,0,0,0,0,0,0,0,0,0,'2026-05-27 13:35:31','2026-05-27 13:35:31'),(554,298,858,0,0,0,0,0,0,0,0,0,'2026-05-27 13:35:31','2026-05-27 13:35:31'),(555,299,859,0,0,0,0,0,0,0,0,0,'2026-05-27 15:07:49','2026-05-27 15:07:49'),(556,299,860,0,0,0,0,0,0,0,0,0,'2026-05-27 15:07:49','2026-05-27 15:07:49'),(557,1,876,0,0,0,0,0,0,0,0,0,'2026-05-28 16:23:07','2026-05-28 16:23:07'),(558,1,877,0,0,0,0,0,0,0,0,0,'2026-05-28 16:23:07','2026-05-28 16:23:07'),(559,1,878,0,0,0,0,0,0,0,0,0,'2026-05-30 11:45:07','2026-05-30 11:45:07'),(560,1,879,0,0,0,0,0,0,0,0,0,'2026-05-30 11:45:07','2026-05-30 11:45:07'),(561,1,884,0,0,0,0,0,0,0,0,0,'2026-05-31 10:47:15','2026-05-31 10:47:15'),(562,1,885,0,0,0,0,0,0,0,0,0,'2026-05-31 10:47:15','2026-05-31 10:47:15'),(563,63,886,0,0,0,0,0,0,0,0,0,'2026-05-31 11:21:48','2026-05-31 11:21:48'),(564,63,887,0,0,0,0,0,0,0,0,0,'2026-05-31 11:21:48','2026-05-31 11:21:48'),(565,63,888,0,0,0,0,0,0,0,0,0,'2026-05-31 11:22:28','2026-05-31 11:22:28'),(566,63,889,0,0,0,0,0,0,0,0,0,'2026-05-31 11:22:28','2026-05-31 11:22:28'),(567,63,892,0,0,0,0,0,0,0,0,0,'2026-06-01 17:40:45','2026-06-01 17:40:45'),(568,63,893,0,0,0,0,0,0,0,0,0,'2026-06-01 17:40:45','2026-06-01 17:40:45'),(569,300,894,0,0,0,0,0,0,0,0,0,'2026-06-02 16:34:11','2026-06-02 16:34:11'),(570,300,895,0,0,0,0,0,0,0,0,0,'2026-06-02 16:34:11','2026-06-02 16:34:11'),(571,301,906,0,0,0,0,0,0,0,0,0,'2026-06-06 13:35:24','2026-06-06 13:35:24'),(572,301,907,0,0,0,0,0,0,0,0,0,'2026-06-06 13:35:24','2026-06-06 13:35:24'),(573,302,910,0,0,0,0,0,0,0,0,0,'2026-06-06 15:36:27','2026-06-06 15:36:27'),(574,302,911,0,0,0,0,0,0,0,0,0,'2026-06-06 15:36:27','2026-06-06 15:36:27'),(575,303,914,0,0,0,0,0,0,0,0,0,'2026-06-09 13:33:39','2026-06-09 13:33:39'),(576,303,915,0,0,0,0,0,0,0,0,0,'2026-06-09 13:33:39','2026-06-09 13:33:39'),(577,304,920,0,0,0,0,0,0,0,0,0,'2026-06-10 14:03:15','2026-06-10 14:03:15'),(578,304,921,0,0,0,0,0,0,0,0,0,'2026-06-10 14:03:15','2026-06-10 14:03:15'),(579,1,922,0,0,0,0,0,0,0,0,0,'2026-06-10 18:13:08','2026-06-10 18:13:08'),(580,1,923,0,0,0,0,0,0,0,0,0,'2026-06-10 18:13:08','2026-06-10 18:13:08'),(581,305,926,0,0,0,0,0,0,0,0,0,'2026-06-12 17:40:52','2026-06-12 17:40:52'),(582,305,927,0,0,0,0,0,0,0,0,0,'2026-06-12 17:40:52','2026-06-12 17:40:52'),(583,306,928,0,0,0,0,0,0,0,0,0,'2026-06-12 19:33:02','2026-06-12 19:33:02'),(584,306,929,0,0,0,0,0,0,0,0,0,'2026-06-12 19:33:03','2026-06-12 19:33:03'),(585,307,936,0,0,0,0,0,0,0,0,0,'2026-06-17 14:55:04','2026-06-17 14:55:04'),(586,307,937,0,0,0,0,0,0,0,0,0,'2026-06-17 14:55:04','2026-06-17 14:55:04'),(587,308,938,0,0,0,0,0,0,0,0,0,'2026-06-17 14:56:08','2026-06-17 14:56:08'),(588,308,939,0,0,0,0,0,0,0,0,0,'2026-06-17 14:56:08','2026-06-17 14:56:08'),(589,309,940,0,0,0,0,0,0,0,0,0,'2026-06-17 18:29:15','2026-06-17 18:29:15'),(590,309,941,0,0,0,0,0,0,0,0,0,'2026-06-17 18:29:15','2026-06-17 18:29:15'),(591,310,942,0,0,0,0,0,0,0,0,0,'2026-06-18 15:09:40','2026-06-18 15:09:40'),(592,310,943,0,0,0,0,0,0,0,0,0,'2026-06-18 15:09:40','2026-06-18 15:09:40'),(593,311,946,0,0,0,0,0,0,0,0,0,'2026-06-19 14:19:52','2026-06-19 14:19:52'),(594,311,947,0,0,0,0,0,0,0,0,0,'2026-06-19 14:19:52','2026-06-19 14:19:52'),(595,312,948,0,0,0,0,0,0,0,0,0,'2026-06-19 18:20:41','2026-06-19 18:20:41'),(596,312,949,0,0,0,0,0,0,0,0,0,'2026-06-19 18:20:41','2026-06-19 18:20:41'),(597,313,950,0,0,0,0,0,0,0,0,0,'2026-06-20 14:19:37','2026-06-20 14:19:37'),(598,313,951,0,0,0,0,0,0,0,0,0,'2026-06-20 14:19:37','2026-06-20 14:19:37'),(599,131,956,0,0,0,0,0,0,0,0,0,'2026-06-22 16:23:45','2026-06-22 16:23:45'),(600,131,957,0,0,0,0,0,0,0,0,0,'2026-06-22 16:23:45','2026-06-22 16:23:45'),(601,314,960,0,0,0,0,0,0,0,0,0,'2026-06-24 12:17:33','2026-06-24 12:17:33'),(602,314,961,0,0,0,0,0,0,0,0,0,'2026-06-24 12:17:33','2026-06-24 12:17:33'),(603,315,962,0,0,0,0,0,0,0,0,0,'2026-06-24 14:04:35','2026-06-24 14:04:35'),(604,315,963,0,0,0,0,0,0,0,0,0,'2026-06-24 14:04:35','2026-06-24 14:04:35'),(605,316,970,0,0,0,0,0,0,0,0,0,'2026-06-25 17:58:35','2026-06-25 17:58:35'),(606,316,971,0,0,0,0,0,0,0,0,0,'2026-06-25 17:58:35','2026-06-25 17:58:35'),(607,317,972,0,0,0,0,0,0,0,0,0,'2026-06-26 10:00:55','2026-06-26 10:00:55'),(608,317,973,0,0,0,0,0,0,0,0,0,'2026-06-26 10:00:55','2026-06-26 10:00:55'),(609,318,976,0,0,0,0,0,0,0,0,0,'2026-06-26 17:26:33','2026-06-26 17:26:33'),(610,318,977,0,0,0,0,0,0,0,0,0,'2026-06-26 17:26:33','2026-06-26 17:26:33'),(611,319,978,0,0,0,0,0,0,0,0,0,'2026-06-27 10:02:22','2026-06-27 10:02:22'),(612,319,979,0,0,0,0,0,0,0,0,0,'2026-06-27 10:02:22','2026-06-27 10:02:22'),(613,320,980,0,0,0,0,0,0,0,0,0,'2026-06-27 10:02:22','2026-06-27 10:02:22'),(614,320,981,0,0,0,0,0,0,0,0,0,'2026-06-27 10:02:22','2026-06-27 10:02:22');
COMMIT;

-- Dumped table `item_movement_rel_extra` with 614 row(s)
--

--
-- Table structure for table `item_package_measurements`
--

CREATE TABLE `item_package_measurements` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `item_id` int(10) unsigned NOT NULL,
  `cat_item_package_measurements_id` int(10) unsigned NOT NULL,
  `active` tinyint(4) DEFAULT 1 COMMENT 'Define si se encuentra activo',
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`)
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `item_package_measurements`
--

SET autocommit=0;
COMMIT;

-- Dumped table `item_package_measurements` with 0 row(s)
--

--
-- Table structure for table `item_product_family`
--

CREATE TABLE `item_product_family` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `item_id` int(10) unsigned NOT NULL,
  `cat_item_product_family_id` int(10) unsigned NOT NULL,
  `active` tinyint(4) DEFAULT 1 COMMENT 'Define si se encuentra activo',
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`)
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `item_product_family`
--

SET autocommit=0;
COMMIT;

-- Dumped table `item_product_family` with 0 row(s)
--

--
-- Table structure for table `item_rel_suscription_plans`
--

CREATE TABLE `item_rel_suscription_plans` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `item_id` int(10) unsigned DEFAULT 0 COMMENT 'Relacion con items',
  `item` longtext CHARACTER SET utf8mb4 COLLATE utf8mb4_bin DEFAULT NULL CHECK (json_valid(`item`)),
  `suscription_plan_id` int(10) unsigned DEFAULT 0 COMMENT 'Relacion con planes de suscripcion',
  `quantity` decimal(12,2) DEFAULT 0.00,
  `unit_value` decimal(16,2) DEFAULT 0.00,
  `affectation_igv_type_id` char(255) DEFAULT NULL,
  `total_base_igv` decimal(12,2) DEFAULT 0.00,
  `percentage_igv` decimal(12,2) DEFAULT 0.00,
  `total_igv` decimal(12,2) DEFAULT 0.00,
  `system_isc_type_id` char(255) DEFAULT NULL,
  `total_base_isc` decimal(12,2) DEFAULT 0.00,
  `percentage_isc` decimal(12,2) DEFAULT 0.00,
  `total_isc` decimal(12,2) DEFAULT 0.00,
  `total_base_other_taxes` decimal(12,2) DEFAULT 0.00,
  `percentage_other_taxes` decimal(12,2) DEFAULT 0.00,
  `total_other_taxes` decimal(12,2) DEFAULT 0.00,
  `total_taxes` decimal(12,2) DEFAULT 0.00,
  `price_type_id` char(255) DEFAULT NULL,
  `unit_price` decimal(16,6) DEFAULT 0.000000,
  `total_value` decimal(12,2) DEFAULT 0.00,
  `total_charge` decimal(12,2) DEFAULT 0.00,
  `total_discount` decimal(12,2) DEFAULT 0.00,
  `total` decimal(12,2) DEFAULT 0.00,
  `attributes` longtext CHARACTER SET utf8mb4 COLLATE utf8mb4_bin DEFAULT NULL CHECK (json_valid(`attributes`)),
  `discounts` longtext CHARACTER SET utf8mb4 COLLATE utf8mb4_bin DEFAULT NULL CHECK (json_valid(`discounts`)),
  `charges` longtext CHARACTER SET utf8mb4 COLLATE utf8mb4_bin DEFAULT NULL CHECK (json_valid(`charges`)),
  `additional_information` text DEFAULT NULL,
  `warehouse_id` int(10) unsigned DEFAULT 0,
  `name_product_pdf` longtext DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`)
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `item_rel_suscription_plans`
--

SET autocommit=0;
COMMIT;

-- Dumped table `item_rel_suscription_plans` with 0 row(s)
--

--
-- Table structure for table `item_sets`
--

CREATE TABLE `item_sets` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `item_id` int(10) unsigned NOT NULL,
  `individual_item_id` int(10) unsigned NOT NULL,
  `quantity` decimal(12,4) NOT NULL DEFAULT 1.0000,
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`),
  KEY `item_sets_item_id_foreign` (`item_id`),
  KEY `item_sets_individual_item_id_foreign` (`individual_item_id`),
  CONSTRAINT `item_sets_individual_item_id_foreign` FOREIGN KEY (`individual_item_id`) REFERENCES `items` (`id`),
  CONSTRAINT `item_sets_item_id_foreign` FOREIGN KEY (`item_id`) REFERENCES `items` (`id`) ON DELETE CASCADE
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `item_sets`
--

SET autocommit=0;
COMMIT;

-- Dumped table `item_sets` with 0 row(s)
--

--
-- Table structure for table `item_size`
--

CREATE TABLE `item_size` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `item_id` int(10) unsigned NOT NULL,
  `cat_item_size_id` int(10) unsigned NOT NULL,
  `active` tinyint(4) DEFAULT 1 COMMENT 'Define si se encuentra activo',
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`)
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `item_size`
--

SET autocommit=0;
COMMIT;

-- Dumped table `item_size` with 0 row(s)
--

--
-- Table structure for table `item_status`
--

CREATE TABLE `item_status` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `item_id` int(10) unsigned NOT NULL,
  `cat_item_status_id` int(10) unsigned NOT NULL,
  `active` tinyint(4) DEFAULT 1 COMMENT 'Define si se encuentra activo',
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`)
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `item_status`
--

SET autocommit=0;
COMMIT;

-- Dumped table `item_status` with 0 row(s)
--

--
-- Table structure for table `item_supplies`
--

CREATE TABLE `item_supplies` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `item_id` int(10) unsigned NOT NULL,
  `individual_item_id` int(10) unsigned NOT NULL,
  `quantity` decimal(13,3) NOT NULL,
  `unit_price` decimal(12,2) DEFAULT 0.00,
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`),
  KEY `item_supplies_item_id_foreign` (`item_id`),
  KEY `item_supplies_individual_item_id_foreign` (`individual_item_id`),
  CONSTRAINT `item_supplies_individual_item_id_foreign` FOREIGN KEY (`individual_item_id`) REFERENCES `items` (`id`),
  CONSTRAINT `item_supplies_item_id_foreign` FOREIGN KEY (`item_id`) REFERENCES `items` (`id`) ON DELETE CASCADE
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `item_supplies`
--

SET autocommit=0;
COMMIT;

-- Dumped table `item_supplies` with 0 row(s)
--

--
-- Table structure for table `item_tags`
--

CREATE TABLE `item_tags` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `item_id` int(10) unsigned NOT NULL,
  `tag_id` int(10) unsigned NOT NULL,
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`),
  KEY `item_tags_item_id_foreign` (`item_id`),
  KEY `item_tags_tag_id_foreign` (`tag_id`),
  CONSTRAINT `item_tags_item_id_foreign` FOREIGN KEY (`item_id`) REFERENCES `items` (`id`) ON DELETE CASCADE,
  CONSTRAINT `item_tags_tag_id_foreign` FOREIGN KEY (`tag_id`) REFERENCES `tags` (`id`) ON DELETE CASCADE
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `item_tags`
--

SET autocommit=0;
COMMIT;

-- Dumped table `item_tags` with 0 row(s)
--

--
-- Table structure for table `item_types`
--

CREATE TABLE `item_types` (
  `id` char(2) NOT NULL,
  `description` varchar(255) NOT NULL,
  PRIMARY KEY (`id`)
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `item_types`
--

SET autocommit=0;
INSERT INTO `item_types` VALUES ('01','Producto'),('02','Servicio');
COMMIT;

-- Dumped table `item_types` with 2 row(s)
--

--
-- Table structure for table `item_units_per_package`
--

CREATE TABLE `item_units_per_package` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `item_id` int(10) unsigned NOT NULL,
  `cat_item_units_per_package_id` int(10) unsigned NOT NULL,
  `active` tinyint(4) DEFAULT 1 COMMENT 'Define si se encuentra activo',
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`)
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `item_units_per_package`
--

SET autocommit=0;
COMMIT;

-- Dumped table `item_units_per_package` with 0 row(s)
--

--
-- Table structure for table `item_unit_business`
--

CREATE TABLE `item_unit_business` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `item_id` int(10) unsigned NOT NULL,
  `cat_item_unit_business_id` int(10) unsigned NOT NULL,
  `active` tinyint(4) DEFAULT 1 COMMENT 'Define si se encuentra activo',
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`)
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `item_unit_business`
--

SET autocommit=0;
COMMIT;

-- Dumped table `item_unit_business` with 0 row(s)
--

--
-- Table structure for table `item_unit_types`
--

CREATE TABLE `item_unit_types` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `description` varchar(255) NOT NULL,
  `item_id` int(10) unsigned NOT NULL,
  `unit_type_id` varchar(255) NOT NULL,
  `quantity_unit` decimal(12,4) NOT NULL,
  `price1` decimal(12,4) NOT NULL,
  `price2` decimal(12,4) NOT NULL,
  `price3` decimal(12,4) NOT NULL,
  `price_default` tinyint(1) NOT NULL DEFAULT 2,
  `barcode` varchar(150) DEFAULT NULL,
  `deleted_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`),
  UNIQUE KEY `item_unit_types_barcode_unique` (`barcode`),
  KEY `item_unit_types_unit_type_id_foreign` (`unit_type_id`),
  KEY `item_unit_types_item_id_foreign` (`item_id`),
  CONSTRAINT `item_unit_types_item_id_foreign` FOREIGN KEY (`item_id`) REFERENCES `items` (`id`),
  CONSTRAINT `item_unit_types_unit_type_id_foreign` FOREIGN KEY (`unit_type_id`) REFERENCES `cat_unit_types` (`id`)
) ENGINE=InnoDB AUTO_INCREMENT=3 DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `item_unit_types`
--

SET autocommit=0;
INSERT INTO `item_unit_types` VALUES (1,'Unidad',321,'NIU',1.0000,30.0000,0.0000,0.0000,1,'1NIU1',NULL),(2,'Unidad',322,'NIU',1.0000,80.0000,0.0000,0.0000,1,'2NIU1',NULL);
COMMIT;

-- Dumped table `item_unit_types` with 2 row(s)
--

--
-- Table structure for table `item_unit_type_changes`
--

CREATE TABLE `item_unit_type_changes` (
  `id` bigint(20) unsigned NOT NULL AUTO_INCREMENT,
  `item_id` int(10) unsigned NOT NULL,
  `item_unit_type_id` int(10) unsigned NOT NULL,
  `warehouse_id` int(10) unsigned DEFAULT NULL,
  `field` varchar(32) NOT NULL,
  `old_value` decimal(12,4) DEFAULT NULL,
  `new_value` decimal(12,4) DEFAULT NULL,
  `user_id` int(10) unsigned DEFAULT NULL,
  `reason` varchar(255) DEFAULT NULL,
  `created_at` timestamp NOT NULL DEFAULT current_timestamp(),
  PRIMARY KEY (`id`),
  KEY `item_unit_type_changes_item_unit_type_id_field_index` (`item_unit_type_id`,`field`),
  KEY `item_unit_type_changes_item_id_created_at_index` (`item_id`,`created_at`),
  KEY `iutc_wh_created_idx` (`warehouse_id`,`created_at`)
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `item_unit_type_changes`
--

SET autocommit=0;
COMMIT;

-- Dumped table `item_unit_type_changes` with 0 row(s)
--

--
-- Table structure for table `item_unit_type_warehouse_price`
--

CREATE TABLE `item_unit_type_warehouse_price` (
  `id` bigint(20) unsigned NOT NULL AUTO_INCREMENT,
  `item_unit_type_id` int(10) unsigned NOT NULL,
  `warehouse_id` int(10) unsigned NOT NULL,
  `price1` decimal(12,2) DEFAULT NULL,
  `price2` decimal(12,2) DEFAULT NULL,
  `price3` decimal(12,2) DEFAULT NULL,
  `price_default` tinyint(3) unsigned DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`),
  UNIQUE KEY `iutwp_unique` (`item_unit_type_id`,`warehouse_id`),
  KEY `iutwp_wh_idx` (`warehouse_id`,`item_unit_type_id`),
  CONSTRAINT `iutwp_iut_fk` FOREIGN KEY (`item_unit_type_id`) REFERENCES `item_unit_types` (`id`) ON DELETE CASCADE,
  CONSTRAINT `iutwp_wh_fk` FOREIGN KEY (`warehouse_id`) REFERENCES `warehouses` (`id`) ON DELETE CASCADE
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `item_unit_type_warehouse_price`
--

SET autocommit=0;
COMMIT;

-- Dumped table `item_unit_type_warehouse_price` with 0 row(s)
--

--
-- Table structure for table `item_warehouse`
--

CREATE TABLE `item_warehouse` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `item_id` int(10) unsigned NOT NULL,
  `warehouse_id` int(10) unsigned NOT NULL,
  `stock` decimal(12,4) NOT NULL,
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`),
  UNIQUE KEY `idx_item_warehouse_unique` (`item_id`,`warehouse_id`),
  KEY `item_warehouse_warehouse_id_foreign` (`warehouse_id`),
  CONSTRAINT `item_warehouse_item_id_foreign` FOREIGN KEY (`item_id`) REFERENCES `items` (`id`) ON DELETE CASCADE,
  CONSTRAINT `item_warehouse_warehouse_id_foreign` FOREIGN KEY (`warehouse_id`) REFERENCES `warehouses` (`id`) ON DELETE CASCADE
) ENGINE=InnoDB AUTO_INCREMENT=323 DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `item_warehouse`
--

SET autocommit=0;
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COMMIT;

-- Dumped table `item_warehouse` with 322 row(s)
--

--
-- Table structure for table `item_warehouse_pricing_states`
--

CREATE TABLE `item_warehouse_pricing_states` (
  `id` bigint(20) unsigned NOT NULL AUTO_INCREMENT,
  `item_id` int(10) unsigned NOT NULL,
  `warehouse_id` int(10) unsigned NOT NULL,
  `initialized_at` timestamp NULL DEFAULT NULL,
  `initialized_source` varchar(32) DEFAULT NULL,
  `last_applied_at` timestamp NULL DEFAULT NULL,
  `last_applied_from_warehouse_id` int(10) unsigned DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`),
  UNIQUE KEY `iwps_item_wh_unique` (`item_id`,`warehouse_id`),
  KEY `iwps_wh_initialized_idx` (`warehouse_id`,`initialized_at`),
  KEY `iwps_last_applied_wh_fk` (`last_applied_from_warehouse_id`),
  CONSTRAINT `iwps_item_fk` FOREIGN KEY (`item_id`) REFERENCES `items` (`id`) ON DELETE CASCADE,
  CONSTRAINT `iwps_last_applied_wh_fk` FOREIGN KEY (`last_applied_from_warehouse_id`) REFERENCES `warehouses` (`id`) ON DELETE SET NULL,
  CONSTRAINT `iwps_wh_fk` FOREIGN KEY (`warehouse_id`) REFERENCES `warehouses` (`id`) ON DELETE CASCADE
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `item_warehouse_pricing_states`
--

SET autocommit=0;
COMMIT;

-- Dumped table `item_warehouse_pricing_states` with 0 row(s)
--

--
-- Table structure for table `kardex`
--

CREATE TABLE `kardex` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `date_of_issue` date NOT NULL,
  `type` enum('sale','purchase') DEFAULT NULL,
  `item_id` int(10) unsigned NOT NULL,
  `document_id` int(10) unsigned DEFAULT NULL,
  `purchase_id` int(10) unsigned DEFAULT NULL,
  `purchase_settlement_id` int(10) unsigned DEFAULT NULL,
  `sale_note_id` int(10) unsigned DEFAULT NULL,
  `quantity` decimal(12,4) NOT NULL,
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`),
  KEY `kardex_purchase_id_foreign` (`purchase_id`),
  KEY `kardex_document_id_foreign` (`document_id`),
  KEY `kardex_item_id_foreign` (`item_id`),
  KEY `kardex_sale_note_id_foreign` (`sale_note_id`),
  KEY `kardex_purchase_settlement_id_foreign` (`purchase_settlement_id`),
  CONSTRAINT `kardex_document_id_foreign` FOREIGN KEY (`document_id`) REFERENCES `documents` (`id`) ON DELETE CASCADE,
  CONSTRAINT `kardex_item_id_foreign` FOREIGN KEY (`item_id`) REFERENCES `items` (`id`),
  CONSTRAINT `kardex_purchase_id_foreign` FOREIGN KEY (`purchase_id`) REFERENCES `purchases` (`id`) ON DELETE CASCADE,
  CONSTRAINT `kardex_purchase_settlement_id_foreign` FOREIGN KEY (`purchase_settlement_id`) REFERENCES `purchase_settlements` (`id`) ON DELETE CASCADE,
  CONSTRAINT `kardex_sale_note_id_foreign` FOREIGN KEY (`sale_note_id`) REFERENCES `sale_notes` (`id`) ON DELETE CASCADE
) ENGINE=InnoDB AUTO_INCREMENT=940 DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `kardex`
--

SET autocommit=0;
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10:00:04'),(861,'2026-07-13','sale',1,NULL,NULL,NULL,519,1.0000,'2026-07-13 11:12:47','2026-07-13 11:12:47'),(862,'2026-07-14','sale',25,NULL,NULL,NULL,520,1.0000,'2026-07-14 17:02:09','2026-07-14 17:02:09'),(863,'2026-07-14','sale',63,NULL,NULL,NULL,520,1.0000,'2026-07-14 17:02:09','2026-07-14 17:02:09'),(864,'2026-07-14','sale',296,NULL,NULL,NULL,520,1.0000,'2026-07-14 17:02:09','2026-07-14 17:02:09'),(865,'2026-07-14','sale',129,NULL,NULL,NULL,520,1.0000,'2026-07-14 17:02:10','2026-07-14 17:02:10'),(866,'2026-07-14','sale',1,NULL,NULL,NULL,520,1.0000,'2026-07-14 17:02:10','2026-07-14 17:02:10'),(867,'2026-07-14','sale',5,NULL,NULL,NULL,521,1.0000,'2026-07-14 20:37:07','2026-07-14 20:37:07'),(868,'2026-07-15','sale',64,NULL,NULL,NULL,522,1.0000,'2026-07-15 16:59:45','2026-07-15 16:59:45'),(869,'2026-07-15','sale',27,NULL,NULL,NULL,523,1.0000,'2026-07-15 17:40:37','2026-07-15 17:40:37'),(870,'2026-07-16','sale',35,NULL,NULL,NULL,524,1.0000,'2026-07-16 12:39:18','2026-07-16 12:39:18'),(871,'2026-07-16','sale',42,NULL,NULL,NULL,525,1.0000,'2026-07-16 12:39:28','2026-07-16 12:39:28'),(872,'2026-07-16','sale',1,NULL,NULL,NULL,526,1.0000,'2026-07-16 13:45:52','2026-07-16 13:45:52'),(873,'2026-07-16','sale',63,NULL,NULL,NULL,527,1.0000,'2026-07-16 17:37:57','2026-07-16 17:37:57'),(874,'2026-07-16','sale',64,NULL,NULL,NULL,527,1.0000,'2026-07-16 17:37:58','2026-07-16 17:37:58'),(875,'2026-07-16','sale',43,NULL,NULL,NULL,528,1.0000,'2026-07-16 20:57:00','2026-07-16 20:57:00'),(876,'2026-07-17','sale',129,NULL,NULL,NULL,529,1.0000,'2026-07-17 14:18:35','2026-07-17 14:18:35'),(877,'2026-07-17',NULL,322,NULL,NULL,NULL,NULL,0.0000,'2026-07-17 17:51:46','2026-07-17 17:51:46'),(878,'2026-07-17','sale',322,NULL,NULL,NULL,530,1.0000,'2026-07-17 17:52:01','2026-07-17 17:52:01'),(879,'2026-07-17','sale',63,NULL,NULL,NULL,530,2.0000,'2026-07-17 17:52:01','2026-07-17 17:52:01'),(880,'2026-07-17','sale',5,NULL,NULL,NULL,530,1.0000,'2026-07-17 17:52:01','2026-07-17 17:52:01'),(881,'2026-07-17','sale',39,NULL,NULL,NULL,531,1.0000,'2026-07-17 17:56:51','2026-07-17 17:56:51'),(882,'2026-07-17','sale',129,NULL,NULL,NULL,531,1.0000,'2026-07-17 17:56:51','2026-07-17 17:56:51'),(883,'2026-07-17','sale',63,NULL,NULL,NULL,532,1.0000,'2026-07-17 17:58:39','2026-07-17 17:58:39'),(884,'2026-07-17','sale',1,NULL,NULL,NULL,532,1.0000,'2026-07-17 17:58:39','2026-07-17 17:58:39'),(885,'2026-07-18','sale',63,NULL,NULL,NULL,533,1.0000,'2026-07-18 11:48:13','2026-07-18 11:48:13'),(886,'2026-07-18','sale',1,NULL,NULL,NULL,534,1.0000,'2026-07-18 15:48:17','2026-07-18 15:48:17'),(887,'2026-07-18','sale',43,NULL,NULL,NULL,535,1.0000,'2026-07-18 17:33:54','2026-07-18 17:33:54'),(888,'2026-07-19','sale',43,NULL,NULL,NULL,536,1.0000,'2026-07-19 10:58:11','2026-07-19 10:58:11'),(889,'2026-07-20','sale',43,NULL,NULL,NULL,537,1.0000,'2026-07-20 08:39:52','2026-07-20 08:39:52'),(890,'2026-07-20','sale',1,NULL,NULL,NULL,538,1.0000,'2026-07-20 10:20:03','2026-07-20 10:20:03'),(891,'2026-07-20','sale',44,NULL,NULL,NULL,539,1.0000,'2026-07-20 11:28:25','2026-07-20 11:28:25'),(892,'2026-07-20','sale',147,NULL,NULL,NULL,539,1.0000,'2026-07-20 11:28:25','2026-07-20 11:28:25'),(893,'2026-07-20','sale',1,NULL,NULL,NULL,540,1.0000,'2026-07-20 14:03:50','2026-07-20 14:03:50'),(894,'2026-07-20','sale',63,NULL,NULL,NULL,541,1.0000,'2026-07-20 16:52:27','2026-07-20 16:52:27'),(895,'2026-07-20','sale',5,NULL,NULL,NULL,541,1.0000,'2026-07-20 16:52:27','2026-07-20 16:52:27'),(896,'2026-07-20','sale',43,NULL,NULL,NULL,542,1.0000,'2026-07-20 17:53:48','2026-07-20 17:53:48'),(897,'2026-07-20','sale',43,NULL,NULL,NULL,543,1.0000,'2026-07-20 18:10:39','2026-07-20 18:10:39'),(898,'2026-07-20','sale',63,NULL,NULL,NULL,544,1.0000,'2026-07-20 18:11:20','2026-07-20 18:11:20'),(899,'2026-07-20','sale',1,NULL,NULL,NULL,545,1.0000,'2026-07-20 18:55:11','2026-07-20 18:55:11'),(900,'2026-07-21','sale',1,NULL,NULL,NULL,546,1.0000,'2026-07-21 13:57:06','2026-07-21 13:57:06'),(901,'2026-07-21','sale',64,NULL,NULL,NULL,547,1.0000,'2026-07-21 17:13:17','2026-07-21 17:13:17'),(902,'2026-07-21','sale',43,NULL,NULL,NULL,548,1.0000,'2026-07-21 18:01:41','2026-07-21 18:01:41'),(903,'2026-07-21','sale',5,NULL,NULL,NULL,549,1.0000,'2026-07-21 19:16:08','2026-07-21 19:16:08'),(904,'2026-07-22','sale',1,NULL,NULL,NULL,550,1.0000,'2026-07-22 17:10:37','2026-07-22 17:10:37'),(905,'2026-07-22','sale',296,NULL,NULL,NULL,551,1.0000,'2026-07-22 18:07:41','2026-07-22 18:07:41'),(906,'2026-07-22','sale',1,NULL,NULL,NULL,552,1.0000,'2026-07-22 20:25:33','2026-07-22 20:25:33'),(907,'2026-07-23','sale',67,NULL,NULL,NULL,553,1.0000,'2026-07-23 13:21:20','2026-07-23 13:21:20'),(908,'2026-07-23','sale',63,NULL,NULL,NULL,553,1.0000,'2026-07-23 13:21:20','2026-07-23 13:21:20'),(909,'2026-07-23','sale',296,NULL,NULL,NULL,553,1.0000,'2026-07-23 13:21:20','2026-07-23 13:21:20'),(910,'2026-07-23','sale',1,NULL,NULL,NULL,553,1.0000,'2026-07-23 13:21:20','2026-07-23 13:21:20'),(911,'2026-07-23','sale',33,NULL,NULL,NULL,554,1.0000,'2026-07-23 17:11:10','2026-07-23 17:11:10'),(912,'2026-07-23','sale',64,NULL,NULL,NULL,555,1.0000,'2026-07-23 17:28:24','2026-07-23 17:28:24'),(913,'2026-07-23','sale',5,NULL,NULL,NULL,556,1.0000,'2026-07-23 19:07:51','2026-07-23 19:07:51'),(914,'2026-07-24','sale',43,NULL,NULL,NULL,557,1.0000,'2026-07-24 13:02:20','2026-07-24 13:02:20'),(915,'2026-07-24','sale',1,NULL,NULL,NULL,558,1.0000,'2026-07-24 16:45:04','2026-07-24 16:45:04'),(916,'2026-07-24','sale',43,NULL,NULL,NULL,559,1.0000,'2026-07-24 18:19:02','2026-07-24 18:19:02'),(917,'2026-07-24','sale',126,NULL,NULL,NULL,560,1.0000,'2026-07-24 18:20:10','2026-07-24 18:20:10'),(918,'2026-07-24','sale',43,NULL,NULL,NULL,560,1.0000,'2026-07-24 18:20:10','2026-07-24 18:20:10'),(919,'2026-07-24','sale',43,NULL,NULL,NULL,561,1.0000,'2026-07-24 19:04:53','2026-07-24 19:04:53'),(920,'2026-07-24','sale',5,NULL,NULL,NULL,562,1.0000,'2026-07-24 19:22:44','2026-07-24 19:22:44'),(921,'2026-07-25','sale',1,NULL,NULL,NULL,563,1.0000,'2026-07-25 10:31:03','2026-07-25 10:31:03'),(922,'2026-07-25','sale',1,NULL,NULL,NULL,564,1.0000,'2026-07-25 14:18:21','2026-07-25 14:18:21'),(923,'2026-07-25','sale',43,NULL,NULL,NULL,565,1.0000,'2026-07-25 17:15:31','2026-07-25 17:15:31'),(924,'2026-07-26','sale',43,NULL,NULL,NULL,566,1.0000,'2026-07-26 11:25:05','2026-07-26 11:25:05'),(925,'2026-07-27','sale',31,NULL,NULL,NULL,567,1.0000,'2026-07-27 18:11:39','2026-07-27 18:11:39'),(926,'2026-07-27','sale',43,NULL,NULL,NULL,567,1.0000,'2026-07-27 18:11:39','2026-07-27 18:11:39'),(927,'2026-07-27','sale',43,NULL,NULL,NULL,568,1.0000,'2026-07-27 18:13:24','2026-07-27 18:13:24'),(928,'2026-07-27','sale',43,NULL,NULL,NULL,569,1.0000,'2026-07-27 18:16:38','2026-07-27 18:16:38'),(929,'2026-07-27','sale',32,NULL,NULL,NULL,569,1.0000,'2026-07-27 18:16:38','2026-07-27 18:16:38'),(930,'2026-07-27','sale',1,NULL,NULL,NULL,569,1.0000,'2026-07-27 18:16:38','2026-07-27 18:16:38'),(931,'2026-07-27','sale',63,NULL,NULL,NULL,570,1.0000,'2026-07-27 18:49:55','2026-07-27 18:49:55'),(932,'2026-07-27','sale',43,NULL,NULL,NULL,570,1.0000,'2026-07-27 18:49:55','2026-07-27 18:49:55'),(933,'2026-07-28','sale',96,NULL,NULL,NULL,571,1.0000,'2026-07-28 13:09:49','2026-07-28 13:09:49'),(934,'2026-07-28','sale',1,NULL,NULL,NULL,571,1.0000,'2026-07-28 13:09:49','2026-07-28 13:09:49'),(935,'2026-07-29','sale',43,NULL,NULL,NULL,572,1.0000,'2026-07-29 10:26:36','2026-07-29 10:26:36'),(936,'2026-07-29','sale',63,NULL,NULL,NULL,573,1.0000,'2026-07-29 11:10:52','2026-07-29 11:10:52'),(937,'2026-07-29','sale',43,NULL,NULL,NULL,573,1.0000,'2026-07-29 11:10:52','2026-07-29 11:10:52'),(938,'2026-07-29','sale',43,NULL,NULL,NULL,574,1.0000,'2026-07-29 11:12:08','2026-07-29 11:12:08'),(939,'2026-07-29','sale',43,NULL,NULL,NULL,575,1.0000,'2026-07-29 11:12:47','2026-07-29 11:12:47');
COMMIT;

-- Dumped table `kardex` with 939 row(s)
--

--
-- Table structure for table `laboratory_results`
--

CREATE TABLE `laboratory_results` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `medical_laboratory_item_id` int(10) unsigned DEFAULT NULL,
  `date_result` date DEFAULT NULL,
  `file_url` varchar(255) DEFAULT NULL,
  `observations` text DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`)
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `laboratory_results`
--

SET autocommit=0;
COMMIT;

-- Dumped table `laboratory_results` with 0 row(s)
--

--
-- Table structure for table `locations`
--

CREATE TABLE `locations` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `name` varchar(255) NOT NULL,
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`)
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `locations`
--

SET autocommit=0;
COMMIT;

-- Dumped table `locations` with 0 row(s)
--

--
-- Table structure for table `machines`
--

CREATE TABLE `machines` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `machine_type_id` int(10) unsigned NOT NULL,
  `name` text DEFAULT NULL,
  `brand` text DEFAULT NULL,
  `model` text DEFAULT NULL,
  `closing_force` text DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`)
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `machines`
--

SET autocommit=0;
COMMIT;

-- Dumped table `machines` with 0 row(s)
--

--
-- Table structure for table `machine_types`
--

CREATE TABLE `machine_types` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `name` text NOT NULL,
  `description` text DEFAULT NULL,
  `active` tinyint(1) NOT NULL DEFAULT 0,
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`)
) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `machine_types`
--

SET autocommit=0;
COMMIT;

-- Dumped table `machine_types` with 0 row(s)
--

--
-- Table structure for table `medical_consultations`
--

CREATE TABLE `medical_consultations` (
  `id` int(10) unsigned NOT NULL AUTO_INCREMENT,
  `patient_id` int(10) unsigned DEFAULT NULL,
  `doctor_id` int(10) unsigned DEFAULT NULL,
  `appointment_id` int(10) unsigned DEFAULT NULL,
  `specialty_id` int(10) unsigned DEFAULT NULL,
  `treatment` text DEFAULT NULL,
  `work_plan` text DEFAULT NULL,
  `evaluation` text DEFAULT NULL,
  `patient_status` text DEFAULT NULL,
  `additional_observations` text DEFAULT NULL,
  `recital_date` date DEFAULT NULL,
  `vas_scale` int(11) DEFAULT NULL,
  `created_at` timestamp NULL DEFAULT NULL,
  `updated_at` timestamp NULL DEFAULT NULL,
  PRIMARY KEY (`id`),
  KEY `mc_patient_id` (`patient_id`),
  KEY `mc_appointment_id` (`appointment_id`)
) ENGINE=InnoDB AUTO_INCREMENT=501 DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci;

--
-- Dumping data for table `medical_consultations`
--

SET autocommit=0;
INSERT INTO `medical_consultations` VALUES (1,8,3,7,1,'Se le suministra de nuevo acido hialuronico','se le cita en 15 días','paciente con dolor de cadera derecha, refiere haber recibido infiltración de acido hialuronico, refiere además dolor de ambas rodillas','T02',NULL,NULL,8,'2026-01-05 16:17:02','2026-01-05 16:22:34'),(2,11,3,9,1,'se le realiza punción seca en ambos gemelos','cita cada 30 dias','Paciente con secuela de ruptura de tendón de Aquiles, manifiesta dolor en gemelos derecho e izquierdo','T01',NULL,NULL,4,'2026-01-05 17:03:58','2026-01-05 17:10:00'),(3,12,3,10,1,'se le recomienda ecografía de mano','cita en 6 días','Paciente refiere dolor en 4to dedo de la mano derecha presenta edema y tumefacción, dolor a la palpación',NULL,NULL,NULL,7,'2026-01-05 17:15:01','2026-01-05 17:31:15'),(4,13,3,11,1,'terapia manual\ninfiltración de plasma','03 infiltración de plasma','Paciente amputada de miembro inferior izquierdo, refiere dolor de rodilla derecha, dolor a la palpación, crujido articular y dolor a la marcha, se le sugiere ecografía de rodilla, no se encuentra derrame articular en el receso suprapatelar, se hallan signo de artrosis','T02',NULL,'2026-01-20',7,'2026-01-05 17:31:26','2026-01-05 17:35:46'),(5,9,3,8,1,'inmovilización con yeso','enyesado por 30 días','niño de 3 años de edad , refiere caída hace 9 días, fracturándose radio y cubito del brazo izquierdo, madre refiere que llevo al huesero, hace 2 días saca radiografía y encuentran fractura, en radiografía se visualiza fractura sin desplazamiento','T02',NULL,'2026-02-05',6,'2026-01-05 17:40:05','2026-01-05 17:45:31'),(6,7,3,6,1,'Terapia manual',NULL,'dolor lumbar irradiado a miembro inferior','T02',NULL,NULL,6,'2026-01-05 17:51:22','2026-01-11 19:52:21'),(7,3,3,2,1,'punción seca y terapia manual','terapia en 5 dias','Paciente refiere dolor de la mano derecha, a la evaluación dolor en la muñeca, tendinitis de quervain',NULL,NULL,NULL,7,'2026-01-05 17:53:04','2026-01-05 17:57:05'),(8,14,3,12,1,'Plasma rico en plaquetas\nArtrocentesis','Plasma 3 aplicaciones','Paciente refiere dolor de rodilla izquierda, lesión hace 4 meses, rodilla cae en rotación interna, hace 2 semana jugando pelota se recrudece lesión, a la evaluación dolor en linea articular de menisco medial, signo de cajón positivo, en ecografía se visualiza derrame articular receso suprapatelar, meniscopatia medial, hoffitis',NULL,NULL,NULL,7,'2026-01-05 18:39:07','2026-01-05 18:49:45'),(9,4,3,3,1,'infiltración de corticoide y punción seca','terapia por 4 días','paciente refiere dolor de pie izquierdo, de gemelos izquierdo y de hombro derecho, dolor a la palpación en región interdigital de 3er y 4to dedo del pie','T02',NULL,'2026-01-12',7,'2026-01-05 19:06:17','2026-01-05 19:10:42'),(10,16,3,14,1,'infiltración de acido hialuronico','cita al año','Paciente con antecedente de infección articular de rodilla, presenta artrosis marcada y deformidad en valgo de la rodilla derecha',NULL,NULL,NULL,7,'2026-01-05 20:43:33','2026-01-05 20:45:16'),(11,15,3,13,1,NULL,NULL,'paciente posqx de fractura de 5t0 dedo de la mano, presenta evolución favorable, 5t0 no completa rango articular a la flexión',NULL,NULL,NULL,4,'2026-01-05 20:45:33','2026-01-05 20:48:45'),(12,17,3,15,1,'Terapia manual y punción seca','terapia por 4 días','Dolor de cuello, hace 2 semanas, a la palpación dolor agudo en trapecio y ECOM',NULL,NULL,NULL,7,'2026-01-06 15:09:11','2026-01-06 15:21:36'),(13,18,3,16,1,'reposo',NULL,'paciente refiere dolor en dedo gordo izquierdo, por patear con punta de pie y recibir contusión directa, presenta edema y tumefacción en las articulaciones interfalángicas proximal y distal del dedo gordo',NULL,NULL,NULL,7,'2026-01-06 15:21:57','2026-01-06 15:24:10'),(14,19,3,17,1,'Terapia manual\npunción seca','terapia para 2 dias','dolor de cuello, sufre caída hace 2 meses, coloca la mano para no golpearse la cara y7 hace síndrome de latigazo, dolor en ECOM y trapecios','T02',NULL,NULL,7,'2026-01-06 16:06:49','2026-01-06 16:10:56'),(15,20,3,34,1,'terapia manual','alta','Paciente refiere mejoría  en los tres días de terapia física','T01',NULL,NULL,2,'2026-01-08 18:26:54','2026-01-08 18:29:44'),(16,18,3,33,1,'tratamiento medicamentoso','alta','refiere bastante mejoría','T01',NULL,NULL,2,'2026-01-08 18:30:07','2026-01-08 18:31:50'),(17,27,3,32,1,'Terapia manual','cita por 3 sesiones','Paciente refiere dolor de cuello, es derivado por Psicología a terapia física, lleva tratamiento medicamentoso con geriatría','T02',NULL,NULL,7,'2026-01-08 18:32:25','2026-01-08 18:36:50'),(18,26,3,31,1,'ninguno',NULL,'Paciente refiere algo prominente en su espalda dorsal lateral izquierdo, no refiere dolor ni molestia alguna, a la ecografía se visualiza lipoma','T01',NULL,NULL,2,'2026-01-08 18:37:33','2026-01-08 18:42:58'),(19,22,3,30,1,'Terapia manual','5 sesiones de terapia física','paciente con segundo día de terapia refiere mejoria','T02',NULL,NULL,6,'2026-01-08 18:43:15','2026-01-08 18:44:59'),(20,25,3,29,1,'Terapia manual','continua terapia','Paciente que viene recibiendo terapia facial en forma esporádica de meses atrás, refiere mejoría','T02',NULL,NULL,1,'2026-01-08 18:51:51','2026-01-08 18:59:56'),(21,19,3,26,1,'Terapia manual','manipulación vertebral','Paciente refiere mejoría de su dolor de cuello','T01',NULL,NULL,2,'2026-01-08 19:06:58','2026-01-08 19:08:53'),(22,24,3,28,1,'terapia manual y punción seca',NULL,'Paciente refiere dolor de cuello hace una semana, paciente de luto por muerte de esposo, presenta dolor a la palpación, fuertes contracturas musculares en cuello y espalda',NULL,NULL,NULL,7,'2026-01-08 19:09:36','2026-01-08 19:12:19'),(23,16,3,35,1,'terapia manual y ejercicios','10 sesiones de terapia física','Paciente que se le aplica acido hialuronico hace 4 días, evoluciona favorablemente, refiere poco dolor en la región posterior de la rodilla','T02',NULL,NULL,4,'2026-01-08 19:12:39','2026-01-08 19:15:05'),(24,22,3,21,1,'Terapia manual\nPunción seca','5 Sesiones de terapia','Paciente procedente de Bagua grande, refiere dolor de cuello crónico hace 4 meses, refiere haber recibido tratamiento por varios médicos, sin resultado positivos, dolor a la palpación en músculos trapecio, dorsal, y ECOM','T02',NULL,NULL,7,'2026-01-08 19:15:46','2026-01-08 20:13:12'),(25,28,3,36,1,'TYerapia manual\npunción seca','tres sesiones de terapia','Paciente procedente de Chiclayo refiere dolor cervical crónico, dolor que irradia a la cabeza, tronco y extremidades, anteriormente se le hizo tratamiento con punción seca','T02',NULL,NULL,7,'2026-01-08 20:08:19','2026-01-08 20:10:26'),(26,18,3,22,1,'Administración de medicamento',NULL,'refiere mejoría',NULL,NULL,NULL,3,'2026-01-08 20:14:14','2026-01-08 20:14:57'),(27,30,3,38,1,'Terapia manual','Terapia continua','dolor de cuello hace 4 meses con dolor de cabeza',NULL,NULL,NULL,7,'2026-01-09 14:31:01','2026-01-09 14:32:56'),(28,31,3,39,1,NULL,NULL,'Paciente que meses atrás recibió tratamiento de punción seca refiere dolor de hombro que se irradia a miembro superior izquierdo, viene para tratamiento punción seca',NULL,NULL,NULL,6,'2026-01-09 14:33:07','2026-01-09 14:34:38'),(29,21,3,40,1,'Terapia manual','Terapia continua','Paciente con secuela de fractura de codo, presenta limitación articular a la extensión en los últimos grados',NULL,NULL,NULL,2,'2026-01-09 14:35:08','2026-01-09 14:36:21'),(30,16,3,44,1,'Crioterapia, fortalecimiento muscular y terapia manual',NULL,'paciente refiere dolor en rodilla que dificulta la subida de escalera, 5 días de aplicación de acido hialuronico',NULL,NULL,NULL,4,'2026-01-10 19:28:11','2026-01-10 19:33:24'),(31,30,3,43,1,'Terapia manual',NULL,'REFIERE MEJORIA','T02',NULL,NULL,4,'2026-01-10 19:33:47','2026-01-10 19:35:12'),(32,28,3,42,1,'Terapia manual y punción seca',NULL,'Refiere mejoría',NULL,NULL,NULL,3,'2026-01-10 19:38:52','2026-01-10 19:39:47'),(33,24,3,41,1,'Terapia manual',NULL,'refiere mejoría , dolor ha disminuido','T02',NULL,NULL,3,'2026-01-10 19:40:10','2026-01-10 19:41:34'),(34,16,3,45,1,'terapia manual y fortalecimiento',NULL,'Refiere evolución estacionaria','T02',NULL,NULL,6,'2026-01-10 19:41:46','2026-01-10 19:42:47'),(35,22,3,47,1,'Terapia manual y punción seca',NULL,'paciente refiere mejoría, refiere ya no sentir mareo con maniobra d appley',NULL,NULL,NULL,3,'2026-01-11 11:41:03','2026-01-11 11:42:58'),(36,31,3,48,1,'Terapia manual y punción seca',NULL,'paciente refiere evolución favorable','T02',NULL,NULL,2,'2026-01-11 11:43:13','2026-01-11 11:45:08'),(37,32,3,46,1,'Terapia manual',NULL,'Paciente refiere desgarro muscular hace 3 meses que fue tratado con plasma rico en plaquetas, no refiere sentir dolor, a la ecografía se observa cicatriz retráctil','T02',NULL,NULL,1,'2026-01-11 11:45:32','2026-01-11 11:47:20'),(38,29,3,37,1,'Terapia manual',NULL,'dolor de cuello','T02',NULL,NULL,7,'2026-01-11 11:48:47','2026-01-11 11:49:48'),(39,21,3,19,1,'Padre del paciente refiere mejoría',NULL,'Paciente con secuela fractura de codo izquierdo','T02',NULL,NULL,2,'2026-01-11 11:50:20','2026-01-11 11:52:51'),(40,19,3,20,1,NULL,NULL,'refiere mejoría de síndrome de latigazo',NULL,NULL,NULL,3,'2026-01-11 11:53:53','2026-01-11 12:00:13'),(41,17,3,23,1,'Terapia manual y punción seca',NULL,'refiere bastante mejoría con punción seca','T02',NULL,NULL,3,'2026-01-11 12:06:50','2026-01-11 12:07:57'),(42,20,3,24,1,'Terapia manual',NULL,'paciente refiere mejoría','T02',NULL,NULL,2,'2026-01-11 12:20:06','2026-01-11 12:22:17'),(43,23,3,25,1,'Terapia manual',NULL,'refiere mejoría','T02',NULL,NULL,2,'2026-01-11 12:23:51','2026-01-11 12:24:36'),(44,20,3,18,1,'Terapia manual','5 sesiones de fisioterapia','dolor de cuello','T02',NULL,NULL,4,'2026-01-11 12:25:17','2026-01-11 12:26:06'),(45,16,3,49,1,'Terapia manual',NULL,'Paciente refiere mejoría','T02',NULL,NULL,4,'2026-01-11 19:40:33','2026-01-11 19:42:41'),(46,34,3,50,1,'tratamiento medicamentoso','aplicación de suprahyal en 1 semana','Paciente refiere dolor de rodilla hace 1 año y medio, dolor a la palpación en linea articular, dolor de sentado a bípedo, refiere recrudecer lesión hace 1 semana en lesión deportiva rodilla en rotación interna','T02',NULL,NULL,8,'2026-01-12 14:40:54','2026-01-12 14:45:07'),(47,35,3,53,1,'Aplicación de acido hialuronico en rodilla, y corticoide en ligamento lateral, uso de rodillera','Tratamiento de terapia física por un mes','paciente hace 4años sufre accidente de moto, sufre fractura de fémur y lesión de partes blanda de rodilla, es intervenido quirúrgicamente con material de osteosíntesis para fémur, presenta dificultad la marcha, atrofia muscular severa de cuádriceps, presenta dificultad para la marcha y mantener en extensión la rodilla, camina con dificultad, y pasar de sedestación a bípedo. a la evaluación presenta dolor en menisco lateral y ligamento lateral externo, que se visualiza en ecografía','T02',NULL,NULL,9,'2026-01-13 17:27:06','2026-01-13 17:36:37'),(48,21,3,54,1,'Terapia manual','Terapia continua','El paciente presenta evolución favorable, rango articular ha mejorado','T02',NULL,NULL,0,'2026-01-13 17:37:53','2026-01-13 17:40:31'),(49,24,3,55,1,NULL,NULL,'Paciente refiere bastante mejoría, dolor ha disminuido, rangos articulares normales',NULL,NULL,NULL,2,'2026-01-13 17:41:23','2026-01-13 17:43:54'),(50,25,3,56,1,'Terapia manual','Terapia continua','Paciente refiere mejoría, dolor cervical derecho ha disminuido','T02',NULL,NULL,1,'2026-01-13 17:44:27','2026-01-13 17:46:27'),(51,24,3,52,1,'Se le administra vitamina B y C','Terapia continua','Paciente refiere mejoría','T02',NULL,NULL,4,'2026-01-13 17:46:42','2026-01-13 17:49:35'),(52,25,3,51,1,'Terapia manual','Terapia continua','Refiere evolución favorable','T02',NULL,NULL,1,'2026-01-13 17:49:54','2026-01-13 17:52:37'),(53,36,3,58,1,'Infiltración acido hialuronico',NULL,'Paciente refiere dolor de rodilla izquierda, con antecedente de cirugía de menisco. presenta dolor a la palpación y a la marcha, en ecografía se visualiza derrame articular, y sigo de condromalacia.\nDolor en muñeca derecha, deslizamiento radiocubital inferior','T02',NULL,NULL,7,'2026-01-14 16:06:49','2026-01-14 16:21:44'),(54,35,3,59,1,'Terapia manual, punción seca y ejercicios',NULL,'Paciente refiere mejoría, camina un poco mejor, y pasa con mayor facilidad de sedestación a decubito',NULL,NULL,NULL,7,'2026-01-14 16:21:55','2026-01-14 16:23:38'),(55,42,3,66,1,'Aplicación de acido hialuronico',NULL,'Paciente con artrosis de rodilla, hace 1 año se coloca acido hialuronico, hoy se aplica acido hialuronico en rodilla bilateral','T01',NULL,NULL,3,'2026-01-16 17:10:50','2026-01-16 17:16:27'),(56,17,3,67,1,'Terapia manual y punción seca',NULL,'paciente que recibió tratamiento de punción seca refiere mejoria','T02',NULL,NULL,2,'2026-01-16 17:17:42','2026-01-16 18:06:05'),(57,18,3,68,1,NULL,NULL,'Paciente refiere mejoría después de tratamiento con punción seca','T02',NULL,NULL,4,'2026-01-16 18:06:18','2026-01-16 18:07:37'),(58,40,3,63,1,'inmovilización con yeso por 12 días','recita en 12 días, para retiro de yeso','paciente con osteocondrosis de calcáneo, refiere no evolucionar favorablemente con crioterapia y antiinflamatorios, refiere persistir dolor, se procede a inmovilización por 12 dias','T02',NULL,NULL,7,'2026-01-16 18:08:03','2026-01-16 18:16:11'),(59,43,3,69,1,'acido hialuronico a rodilla derecha, e infiltración corticoide a pata de ganso bilateral','Terapia continua','Paciente refiere dolor de rodillas bilateral que dificultad la marcha, refiere haber recibido tratamiento con ozono, plasma y acido hialuronico en inyecciones quincenales, a la evaluación presenta artrosis y tendinitis de la pata de ganso bilateral','T02',NULL,NULL,8,'2026-01-16 18:16:37','2026-01-16 18:20:02'),(60,37,3,64,1,'Aplicación de acido hialuronico',NULL,'paciente con dolor de rodilla, lesión de menisco, en ecografía se visualiza derrame articular','T02',NULL,NULL,7,'2026-01-16 18:28:18','2026-01-16 18:44:13'),(61,37,3,61,1,'Terapia manual',NULL,'Paciente refiere dolor en rodilla izquierda por traumatismo, dolor a la palpación en menisco lateral, en ecografía se visualiza derrame articular','T02',NULL,NULL,8,'2026-01-16 18:44:38','2026-01-16 18:48:46'),(62,16,3,57,1,'Terapia manual. ejercicios y fortalecimientos',NULL,'Paciente refiere mejoría','T02',NULL,NULL,6,'2026-01-16 18:50:15','2026-01-16 18:53:46'),(63,16,3,60,1,'Terapia manual, ejercicios y fortalecimiento',NULL,'Paciente refiere evolución favorable','T02',NULL,NULL,6,'2026-01-16 18:54:50','2026-01-16 19:02:15'),(64,16,3,65,1,'Terapia manual, ejercicios y fortalecimiento',NULL,'Paciente refiere evolución favorable','T02',NULL,NULL,4,'2026-01-16 19:02:34','2026-01-16 19:04:22'),(65,38,3,62,1,'Terapia manual','Reposo por tres meses','Paciente refiere dolor en glúteo mediano, por contusión directa, hace 1 mes, refiere haber estado con tratamiento medicamentoso y no refiere mejoría, en ecografía se visualiza desgarro muscular del glúteo mediano','T02',NULL,NULL,6,'2026-01-17 21:32:58','2026-01-17 21:42:35'),(66,44,3,72,1,'infiltración de tendón bíceps región posterior','reposo','Paciente refiere mejoría, fue infiltrado de rodilla derecha y ligamento lateral de rodilla izquierda, refiere aun dolor el la región posterior de la rodilla','T02',NULL,NULL,3,'2026-01-17 21:43:28','2026-01-17 21:46:09'),(67,45,3,73,1,'Aplicación de plasma en supraespinoso y subescapular','Terapia por 5 sesiones de fisioterapia','Paciente refiere dolor de hombro izquierdo, dolor de espalda y cuello, paciente refiere dolor a la abducción de hombro, en ecografía se visualiza desgarro longitudinal de subescapular y tendón supraespinoso','T02',NULL,NULL,7,'2026-01-17 21:46:28','2026-01-17 21:56:06'),(68,46,3,74,1,'Se le realiza terapia manual y punción seca','Sesiones de terapia continua','Paciente refiere dolor agudo de la columna lumbar, con dificultad de pasar se sentado a bípedo, dolor a la palpación y presenta cifosis marcada, se le realiza densitometría y se visualiza osteoporosis de columna lumbar (-4.6) y cadera (-3.1)','T02',NULL,NULL,8,'2026-01-17 21:58:51','2026-01-17 22:05:22'),(69,47,3,75,1,'Crioterapia','Reposo','Paciente refiere dolor de muñeca, región del pulgar, dolor a la palpación en tendón abductor y flexor del pulgar, en ecografía se visualiza tendinitis de Quervain','T02',NULL,NULL,6,'2026-01-17 22:06:53','2026-01-17 22:11:19'),(70,16,3,76,1,'Terapia manual y ejercicios de fortalecimiento','Sesiones de terapia continua','Paciente refiere mejoría','T02',NULL,NULL,3,'2026-01-17 22:12:03','2026-01-17 22:13:29'),(71,46,3,79,1,'Terapia manual y vit B y C',NULL,'Paciente refiere que dolor ha disminuido, puede realizar los cambios decúbito con menor dolor','T02',NULL,NULL,4,'2026-01-19 17:08:34','2026-01-19 17:10:35'),(72,21,3,77,1,'continua tratamiento terapéutico',NULL,'Paciente presenta mejoría en su rango articular','T02',NULL,NULL,0,'2026-01-19 17:10:59','2026-01-19 17:16:00'),(73,16,3,78,1,'Terapia manual y aplicación de plasma',NULL,'paciente refiere mejoría lenta, rodilla presenta aún dolor','T02',NULL,NULL,4,'2026-01-19 17:16:23','2026-01-19 17:17:49'),(74,15,3,80,1,'Terapia manual','terapia continua','Paciente con secuela de fractura de dedos de la mano, antecedente quirúrgico, 5to dedo inmovilizado con material de osteosíntesis, viene realizando fisioterapia hace 2 meses, refiere mejoría','T02',NULL,NULL,NULL,'2026-01-20 16:14:44','2026-01-20 16:19:21'),(75,30,3,81,1,'Terapia manual','Terapia continua','Paciente refiere sentirse mejor','T02',NULL,NULL,4,'2026-01-20 16:20:15','2026-01-20 16:21:23'),(76,48,3,82,1,'referencia a clínicas San Juan Chiclayo o Lima',NULL,'Paciente niño de 1 año y medio presenta dificultad para caminar, realiza rotación interna en rodilla y presenta cojeo. En radiografía se visualiza cabeza de humero derecha (hemicabeza) no homogénea con cabeza izquierda','T01',NULL,NULL,0,'2026-01-20 16:21:44','2026-01-20 16:28:45'),(77,50,3,83,1,'Terapia manual','Terapia continua','Paciente que recibió tratamiento de acido hialuronico en rodilla bilateral, refiere, mejoría, y que hace 4 días piso en falso y le provoco dolor en la región posterior de la rodilla','T02',NULL,NULL,4,'2026-01-20 16:29:00','2026-01-20 16:33:24'),(78,51,3,84,1,'Terapia manual','terapia continua','Paciente refiere mejoría de dolor de cuello','T02',NULL,NULL,3,'2026-01-20 16:33:30','2026-01-20 16:34:25'),(79,16,3,85,1,'Terapia manual',NULL,'paciente de evolución lenta','T02',NULL,NULL,3,'2026-01-20 21:37:51','2026-01-20 21:40:46'),(80,52,3,86,1,'Terapia manual','Terapia continua','Paciente evoluciona favorablemente','T02',NULL,NULL,1,'2026-01-21 19:06:18','2026-01-21 19:07:49'),(81,53,3,87,1,'Plasma rico en plaquetas','Terapia manual','Paciente con dolor de rodilla, refiere mejoría , recibe segunda aplicación de plasma en la rodilla derecha. rodilla izquierda aplicable en 10 días','T02',NULL,NULL,3,'2026-01-21 19:08:01','2026-01-21 19:10:38'),(82,54,3,88,1,'terapia manual y punción seca','Ejercicios','Dolor lumbar hace 1 semana','T02',NULL,NULL,4,'2026-01-22 13:15:31','2026-01-22 13:17:44'),(83,15,3,89,1,'TERAPIA MANUAL','terapia continua','Secuela de fractura de dedo de la mano, retiraron material de osteosíntesis','T02',NULL,NULL,3,'2026-01-22 13:18:40','2026-01-22 13:21:11'),(84,56,3,92,1,'aplicación de plasma rico en plaquetas y reposo','3 sesiones de PRP, cada 15 días','Paciente refiere haberse agachado y ponerse de pie, refiere un sonido como \"chucaque\" en la parte posterior de la rodilla, a la evaluación , dolor a la palpación en región de inserción del bíceps femoral, en la ecografía se observa desgarro del bíceps femoral','T02',NULL,NULL,8,'2026-01-22 15:48:35','2026-01-22 17:01:34'),(85,55,3,91,1,NULL,NULL,'Aplicación de vitamina no realizo terapia física',NULL,NULL,NULL,5,'2026-01-22 17:02:19','2026-01-22 17:03:33'),(86,21,3,90,1,'Ejercicios','Terapia continua','Paciente con secuela de fractura de codo, evolución favorable, 10 grados para completar rango total de extensión','T02',NULL,NULL,1,'2026-01-22 17:03:43','2026-01-22 17:05:30'),(87,57,3,93,1,'inmovilización con fisiotape','Reposo','dolor en zona nasal, lesión por contusión directa','T01',NULL,NULL,7,'2026-01-23 16:41:50','2026-01-23 16:44:57'),(88,59,3,94,1,'terapia manual','Terapia continua','Dolor lumbar por esfuerzo excesivo, cargar maderas, hace 4 días, dolor a la palpación y al agacharse','T02',NULL,NULL,7,'2026-01-23 16:45:18','2026-01-23 16:47:01'),(89,61,3,95,1,'Terapia física continua','Terapia continua','Paciente con antecedente de tuberculosis de columna vertebral , hace 5 meses, cumple tratamiento actualmente, presenta parálisis espástica de miembros inferiores, miembros superiores de fuerza muscular y sensibilidad normal, no bípedo, no cuadrúpedo ni marcha','T02',NULL,NULL,2,'2026-01-23 16:47:34','2026-01-23 16:56:35'),(90,15,3,96,1,'Terapia manual','Terapia continua','Paciente refiere mejoría','T02',NULL,NULL,2,'2026-01-23 20:11:29','2026-01-23 20:12:56'),(91,62,3,98,1,'Terapia manual','Terapia continua','Paciente con dolor lumbar, hace 1 semana, refiere dolor a la altura de L4 y L5, no refiere traumatismo','T02',NULL,NULL,7,'2026-01-24 20:03:51','2026-01-24 20:05:34'),(92,16,3,97,1,'Terapia manual','Ejercicios','Paciente refiere caminar mejor, pero dolor a la flexión persiste','T02',NULL,NULL,3,'2026-01-24 20:06:18','2026-01-24 20:07:56'),(93,65,3,101,1,'terapía manual, e inyección de corticoide en neuroma de Morton','Terapia continua','Paciente refiere dolor y adormecimiento del codo y dedo meñique del brazo izquierdo, dolor en region dorsal del pie izquierdo','T02',NULL,NULL,8,'2026-01-27 16:27:29','2026-01-27 16:32:30'),(94,66,3,102,1,'vitamina I,V',NULL,'Paciente con dolor de cuello e irradiado a miembro superior, refiere leve dolor','T02',NULL,NULL,3,'2026-01-27 16:32:44','2026-01-27 16:34:07'),(95,67,3,103,1,'Terapia manual e administración de plasma','Terapia continua','Paciente con dolor cronico de rodilla, dolor que incrementa a la marcha, recibe inyección de plasma','T02',NULL,NULL,7,'2026-01-27 16:34:24','2026-01-27 16:41:43'),(96,68,3,104,1,'Terapia manual y crioterapia','Terapia continua','Paciente refiere haber sufrido fractura hace 45 dias, le colocaron yeso, viene para retiro de yeso, muñeca presuntamente alineada , realiza terapia','T02',NULL,NULL,NULL,'2026-01-27 16:43:31','2026-01-27 16:46:33'),(97,69,3,105,1,NULL,NULL,'dolor en rodilla hace 3 días, refiere haber agachado en cuclillas y escuchar crujido articular, presenta dificultad para la marcha, edema y tumefacción, por ecografía se visualiza derrame articular en el receso suprapatelar',NULL,NULL,NULL,9,'2026-01-27 17:26:10','2026-01-27 17:28:29'),(98,16,3,106,1,'Terapia continua','Terapia continua','Paciente refiere dolor ha disminuido pero manifiesta dolor para subir escaleras, en radiografía se visualiza artrosis severa de rodilla y condromalacia de 4to grado','T02',NULL,NULL,6,'2026-01-27 17:28:54','2026-01-27 17:31:37'),(99,21,3,107,1,'Terapia manual','Terapia continua','Paciente con secuela de fractura de codo, manifiesta mejoría, a 10 grados para cumplir extensión total','T02',NULL,NULL,1,'2026-01-27 17:31:58','2026-01-27 17:33:36'),(100,70,3,108,1,'plasma en hombro, corticoide en muñeca y codo','Terapia continua','Paciente refiere sentir dolor agudo en hombro derecho y muñeca derecha, con parestesia nocturnas en muñeca, además refiere adormecimiento de dedos de la mano','T02',NULL,NULL,8,'2026-01-27 17:33:57','2026-01-27 17:39:58'),(101,71,3,109,1,'Plasma rico en plaquetas en recorrido de nervio ciático y terapia manual','Terapia continua','Paciente refiere dolor lumbar irradiado a miembro inferior izquierdo, que dificultad la marcha','T02',NULL,NULL,8,'2026-01-27 17:40:15','2026-01-27 17:45:57'),(102,40,3,111,1,'reposos relativo',NULL,'Paciente de 14 años con síndrome de Sever, enyesado por 12 días refiere mejoría','T01',NULL,NULL,1,'2026-01-27 20:47:25','2026-01-27 20:53:26'),(103,65,3,112,1,'Terapia manual y administración de vitamina B Y C','Terapia continua','Paciente refiere mejoría, evolución favorable','T02',NULL,NULL,4,'2026-01-27 20:54:39','2026-01-27 20:56:52'),(104,16,3,113,1,'Ejercicios terapeuticos','Terapia continua','paciente continua ejercicio de fortalecimiento, refiere mayor fuerza muscular','T02',NULL,NULL,4,'2026-01-27 20:57:07','2026-01-27 20:59:20'),(105,72,3,110,1,'Terapia manual','Terapia continua','Paciente con dolor agudo lumbar, presenta contractura muscular en el cuadrado lumbar, refiere haber sido tratada por diferentes médicos y no le pasa el dolor, a la evaluación presenta acortamiento del cuadrado lumbar derecho',NULL,NULL,NULL,7,'2026-01-27 20:59:40','2026-01-27 21:04:23'),(106,61,3,115,1,'Ejercicios','Terapia continua','Paciente parapléjico por mal de pott, presenta espasticidad severa, evolución estacionaria','T02',NULL,NULL,2,'2026-01-28 15:40:08','2026-01-28 15:45:39'),(107,73,3,114,1,'Terapia manual','Terapia continua','Paciente con dolor agudo en región lumbar, manifiesta dolor intenso que no cede al tratamiento medicamentoso, nen densitometría se determina osteopenia en extremidades, cadera y region lumbar','T02',NULL,NULL,8,'2026-01-28 15:46:29','2026-01-28 15:53:16'),(108,65,3,117,1,'terapia manual y aplicación de vitamina B y C','TERAPIA UN DIA MÁS','Paciente refiere mejoría, dolor ha disminuido de 9 a 3','T02',NULL,NULL,3,'2026-01-29 18:27:40','2026-01-29 18:30:17'),(109,74,3,118,1,'crioterapia y reposo','reposo tres meses','Paciente refiere dolor en región posterior del muslo, sufre caída hace 4 días, se dificulta la marcha, en ecografia se visualiza desgarro muscular','T02',NULL,NULL,6,'2026-01-29 19:24:20','2026-01-29 19:39:44'),(110,72,3,119,1,'Terapia manual y administración de vitaminas','Terapia por un día más','Paciente refiere mejoría, dolor ha disminuido','T02',NULL,NULL,2,'2026-01-29 19:41:13','2026-01-29 19:42:20'),(111,21,3,121,1,'Ejercicios y terapia manual','Terapia continua','Paciente refiere mejoría, falta 5 grados para la extensión','T02',NULL,NULL,0,'2026-01-31 13:08:36','2026-01-31 13:12:01'),(112,72,3,122,1,'terapia y ejercicios','alta','Paciente refiere total mejoría','T01',NULL,NULL,0,'2026-01-31 13:13:35','2026-01-31 13:15:12'),(113,75,3,123,1,'Terapia manual, ultrasonido y crioterapia','Terapia continua','Paciente refiere haber sufrido lesión en rodilla hace 1 mes, presentando fuerte edema y tumefacción, presentaba dificultad para caminar, fue evaluado y tratado por traumatólogo, ahora presenta dolor a la marcha y en resonancia magnética manifiesta quiste en menisco medial y lesión 1er grado de LCA, además de leve derrame receso suprapatelar, ahora en la ecografía se visualiza aún leve derrame en el receso suprapatelar, edema residual en región contusa','T02',NULL,NULL,1,'2026-01-31 13:15:37','2026-01-31 13:21:36'),(114,16,3,124,1,'Terapia manual y ejercicios','Terapia continua','Paciente refiere evolución estacionaria','T02',NULL,NULL,6,'2026-01-31 13:24:34','2026-01-31 13:25:59'),(115,76,3,125,1,'medicamentoso',NULL,'Paciente en presunta etapa menopaúsica, con dolor en codo y dedos de la mano refiere dedo en gatillo','T02',NULL,NULL,7,'2026-01-31 13:26:12','2026-01-31 13:27:49'),(116,16,3,120,1,'Terapia manual y ejercicios','Terapia continua','Paciente refiere evolución estacionaria, dolor de rodilla al subir escalera, fuerza muscular en flexores y extensores de rodilla ha mejorado','T02',NULL,NULL,6,'2026-01-31 13:28:11','2026-01-31 13:30:30'),(117,55,3,126,1,'Administración de vitamina B y C',NULL,'Paciente diabética con dolores articulares',NULL,NULL,NULL,4,'2026-01-31 19:52:20','2026-01-31 19:53:39'),(118,61,3,127,1,'Ejercicios terapeuticos','Terapia continua','Paciente con diplejía refiere disminuir espasticidad','T02',NULL,NULL,1,'2026-01-31 19:55:22','2026-01-31 19:58:22'),(119,21,3,129,1,'Ejercicios','terapia continua','secuela de fractura de codo','T02',NULL,NULL,NULL,'2026-02-03 19:28:07','2026-02-03 19:36:14'),(120,55,3,132,1,'administración de vitaminas',NULL,'Dolor articular',NULL,NULL,NULL,5,'2026-02-03 19:36:31','2026-02-03 19:42:02'),(121,78,3,133,1,'punción seca y ejercicios de elongación del piramidal','Recita en 15 dias','Paciente con dolor de músculos gemelos, refiere sentir dolor, calambres poco frecuentes, no cede al tratamiento medicamentoso, dolor a la palpación en región de menisco medial, en ecografía se visualiza leve derrame articular en el receso suprapatelar',NULL,NULL,NULL,7,'2026-02-03 19:42:28','2026-02-03 19:49:42'),(122,77,3,130,1,'terapia manual, colágeno y acido hialuronico',NULL,'Paciente con dolor en región lumbar, trae resonancia magnética donde se visualiza listesis anterior severa entre L5 y S1, se visualiza compromiso de medula espinal, dolor a la palpación en musculo longisimo',NULL,NULL,NULL,7,'2026-02-03 19:50:26','2026-02-03 19:54:58'),(123,69,3,131,1,'plasma rico en plaquetas, 2da dosis',NULL,'Paciente refiere bastante mejoría, administración de segunda dosis de PRP','T02',NULL,NULL,5,'2026-02-03 19:55:18','2026-02-03 19:57:46'),(124,16,3,128,1,'2da dosis de plasma','Terapia continua','Refiere mejoría','T02',NULL,NULL,NULL,'2026-02-03 19:58:08','2026-02-03 19:58:57'),(125,79,3,134,1,'Terapia manual y punción seca, vitamina c y b',NULL,'Paciente refiere dolor de espalda, no cede al tratamiento medicamentoso, refiere ser agricultor','T02',NULL,NULL,6,'2026-02-04 16:48:16','2026-02-04 16:51:41'),(126,61,3,135,1,'Ejercicios en 4 puntos y 2 puntos de rodillas',NULL,'paciente con diplejía , evolución estacionaria',NULL,NULL,NULL,3,'2026-02-04 16:51:53','2026-02-04 16:53:07'),(127,80,3,136,1,'terapia manual, infiltración corticoide pata de ganso izquierda',NULL,'Paciente con dolor de hace 1 año, refiere dolor en ambas rodillas, que dificultan la marcha, en ecografía se visualiza derrame articular receso suprapatelar leve en ambas rodillas, se visualiza sigo de meniscopatia medial, lesión de tendinitis de pata de ganso en rodilla izquierda','T02',NULL,NULL,7,'2026-02-04 16:54:14','2026-02-04 17:00:09'),(128,34,3,138,1,'administración de PRP','3 PRP','Paciente con dolor en rodilla derecha, refiere lesión en rotación interna en la rodilla, dolor a la palpación en region de menisco medial','T02',NULL,NULL,7,'2026-02-05 20:45:47','2026-02-05 20:48:00'),(129,82,3,139,1,'terapia manual',NULL,'Paciente refiere dolor de rodilla derecha, dolor a la palpación en linea articular región menisco medial','T02',NULL,NULL,7,'2026-02-05 20:48:18','2026-02-05 20:52:37'),(130,53,3,140,1,'administración de plasma rodilla derecha, 3ra dosis',NULL,'refiere mejoria','T02',NULL,NULL,3,'2026-02-05 20:56:14','2026-02-05 20:57:50'),(131,83,3,141,1,'terapia manual y elongación piramidal','4 sesiones de terapia','Paciente mototaxista con dolor en región lumbar, y región anterior de psoas, refiere dolor que dificulta la marcha','T02',NULL,NULL,6,'2026-02-06 19:40:30','2026-02-06 19:45:44'),(132,84,3,142,1,'Terapia manual y elongación piramidal','cita en 7 días','paciente mujer con dolor y hormigueo en la región lateral del muslo bilateral, con mayor dolor en lado izquierdo, refiere molestia hace 1 mes','T02',NULL,NULL,7,'2026-02-06 19:46:38','2026-02-06 19:51:14'),(133,61,3,143,1,'ejercicios terapeuticos','Terapia continua','paciente refiere soltarse después de cada terapia','T02',NULL,NULL,1,'2026-02-06 19:51:23','2026-02-06 19:52:49'),(134,21,3,145,1,'Ejercicios','Terapia continua','Secuela de fractura de codo evoluciona favorablemente','T02',NULL,NULL,1,'2026-02-09 16:52:38','2026-02-09 16:54:21'),(135,22,3,146,1,'punción seca y terapia manual y administración de vitamina B y C','Terapia continua','paciente que fue tratado el mes pasado refiere sentirse bien con primera terapia y liego en segunda terapia sentirse adolorida por lo que fue evaluado por traumatólogo, recibiendo plasma y tratamiento medicamentoso, reinicia tratamiento de terapia con nosotros','T02',NULL,NULL,7,'2026-02-09 16:55:26','2026-02-09 16:59:07'),(136,22,3,149,1,'Punción seca, terapia manual y vit B y C','Terapia continua','Paciente refiere mejoría después de recibir el día de ayer tratamiento con punción seca','T02',NULL,NULL,2,'2026-02-09 16:59:19','2026-02-09 17:00:56'),(137,61,3,148,1,'Ejercicios terapéuticos','Terapia continua','Paciente refiere dolor muscular debido al trabajo de terapia física, continua terapia hoy se trabajo posición bípeda',NULL,NULL,NULL,6,'2026-02-09 17:01:24','2026-02-09 17:03:31'),(138,85,3,147,1,'PRP, Terapia manual','terapia continua','Paciente que refiere sentir dolor hace 1 año, dolor que se intensifica en la posición de pie, dolor que se irradia por la parte posterior del miembro inferior izquierdo','T02',NULL,NULL,7,'2026-02-09 17:04:00','2026-02-09 17:07:22'),(139,16,3,150,1,'Fortalecimiento muscular','Terapia continua','Refiere mejoría','T02',NULL,NULL,2,'2026-02-10 13:52:02','2026-02-10 13:59:21'),(140,22,3,151,1,'Terapia manual, punción seca',NULL,'Paciente refiere mejoría, se le de de alta y se le sugiere retornar a terapia al aparecer de nuevo el dolor','T01',NULL,NULL,2,'2026-02-11 18:30:16','2026-02-11 18:32:11'),(141,21,3,152,1,'Terapia manual',NULL,'Paciente evoluciona favorablemente','T02',NULL,NULL,1,'2026-02-11 18:36:26','2026-02-11 18:43:21'),(142,87,3,155,1,'Terapia manual','Cita en 5 dias','Paciente con dolor en la región lateral del muslo izquierdo, en el recorrido de la fascia lata, dolor en la palpación del nervio femurocutaneo, que se incrementa de sentado a bípedo','T02',NULL,NULL,7,'2026-02-12 18:36:54','2026-02-12 18:42:24'),(143,21,3,154,1,NULL,'Terapia una vez por semana','Paciente con evolución favorable','T02',NULL,NULL,1,'2026-02-12 18:42:32','2026-02-12 18:43:33'),(144,86,3,153,1,'Punción seca, terapia manual y ejercicios','Terapia continua','Paciente con fractura de humero izquierdo con material de osteosintesis, hace 2 meses, en la radiografia se visualiza proceso consolidación normal','T02',NULL,NULL,5,'2026-02-12 18:43:55','2026-02-12 18:47:36'),(145,70,3,156,1,'PRP en hombro','PRP en 15 días','Paciente refiere mejoría, no existe dolor en muñeca derecha ni codo izquierdo, refiere dolor moderado en hombro derecho, en ecografía se visualiza lesión de tendón del bíceps, subescapular (DESGARRO LONGITUDINAL) e infraespinoso (desgarro en inserción)','T02',NULL,NULL,3,'2026-02-18 18:24:32','2026-02-18 18:34:02'),(146,87,3,157,1,'Terapia manual','Terapia continua','Paciente refiere mejoría, dolor de muslo ha disminuido, refiere dormir mejor sin dolor, leve dolor en bipedestación','T02',NULL,NULL,3,'2026-02-18 18:35:09','2026-02-18 18:47:58'),(147,88,3,158,1,'Aplicación PRP',NULL,'Paciente con dolor de rodilla cronico, se aplico PRP hace 6 meses,  se aplica PRP','T02',NULL,NULL,7,'2026-02-18 18:48:59','2026-02-18 19:07:52'),(148,89,3,159,1,'Terapia manual',NULL,'Paciente con dolor crónico de columna vertebral, realiza tratamiento de terapia física','T02',NULL,NULL,6,'2026-02-18 19:08:05','2026-02-18 19:09:25'),(149,90,3,160,1,'Zapato ortopédico',NULL,'Madre refiere que niño 1 año 2 meses, camina con pie metido hacia dentro, en evaluación se observa hipelaxitud articular','T02',NULL,NULL,0,'2026-02-18 19:10:10','2026-02-18 19:20:17'),(150,92,3,161,1,'terapia manual. punción seca',NULL,'Paciente atendido hace 3 años por la misma dolencia, refiere dolor en pierna derecha que viene irradiado de región lumbar, dolor a la palpación en nervio femorocutáneo y adormecimiento en región anterior del cuádriceps, además de dolor en gemelos','T02',NULL,NULL,6,'2026-02-18 21:35:43','2026-02-18 21:38:50'),(151,61,3,162,1,'ejercicios terapéuticos',NULL,'Paciente refiere disminuir levemente espasticidad, realiza terapia en casa','T02',NULL,NULL,1,'2026-02-18 21:39:05','2026-02-18 21:40:07'),(152,34,3,163,1,'PRP en rodilla derecha','se recomienda tercera dosis de PRP en 15 días','Paciente refiere evolución favorable','T02',NULL,NULL,4,'2026-02-18 21:40:17','2026-02-18 21:41:25'),(153,93,3,166,1,'se le recomienda inmovilización, refiere estar atendiendose por curioso en Aramango',NULL,'Paciente con dolor de pierna derecha, recibe contusión hace 7 días, presenta edema y tumefacción, dificultad para caminar, además de crujido óseo, en ecografía se visualiza solución inflamatoria y perdida de cortical ósea en humero','T01',NULL,NULL,8,'2026-02-20 19:32:01','2026-02-20 19:36:07'),(154,94,3,168,1,'terapia manual, tratamiento artrosis, punción seca','Terapia condicional al dolor, vive en bagua grande','Paciente de 72 años, manifiesta dolor en columna dorsal, dolor a la palpación presenta giba moderada, refiere recibir tratamiento para artrosis, tiene 6 hijos, se le realiza densitometría donde se manifiesta osteoporosis de columna lumbar y osteopenia marcada en cadera','T02',NULL,NULL,7,'2026-02-21 19:56:20','2026-02-21 19:59:43'),(155,16,3,169,1,'Terapia manual','Terapia continua','Paciente refiere mejoría',NULL,NULL,NULL,3,'2026-02-21 19:59:54','2026-02-21 20:00:55'),(156,75,3,167,1,'Aplicación PRP','3 dosis de PRP','Paciente que recibió contusión de rodilla hace un mes refiere mejoría, pero aun persiste leve dolor de rodilla, se le aplica PRP','T02',NULL,NULL,5,'2026-02-21 20:01:19','2026-02-21 20:07:57'),(157,96,3,171,1,'Zapato ortopédico y ejercicios para marcha','control en 6 meses','Niña de a año 5 meses, recién empezando a caminar, presenta hiperlaxitud articular, en miembros inferiores, presenta pie valgo y en radiografía de cadera normal','T02',NULL,NULL,1,'2026-02-23 14:20:40','2026-02-23 14:23:48'),(158,97,3,172,1,'Aciclovir para herpes, terapia manual','Terapia continua','Paciente con dolor lumbar hace 1 mes, dolor que se irradia a pierna izquierda, presenta una ampolla en la nalga que no cede al tratamiento ( índice de herpes), se le realiza densitometría y se visualiza disminución del espacio de conjunción entre L5 y S1','T02',NULL,NULL,6,'2026-02-23 14:24:36','2026-02-23 14:29:50'),(159,98,3,173,1,'Ejercicios y vitaminas','Terapia continua','Paciente con debilidad muscular en miembros derechos, con menor motilidad en miembros superiores','T02',NULL,NULL,1,'2026-02-23 14:30:00','2026-02-23 14:32:44'),(160,95,3,170,1,'Terapia manual, PRP','Terapia continua','Paciente refiere mejoría en parálisis facial, dificulta en oclusión de ojo, dolor en cuello',NULL,NULL,NULL,3,'2026-02-23 14:33:20','2026-02-23 14:34:52'),(161,99,3,174,1,'infiltración de corticoide','Cita para mañana para terapia','Paciente con adormecimiento de manos en forma bilateral, desde hace 2 meses, incrementa mas por las madrugadas y refiere no ceder con pastillas, en ecografía se visualiza incremento del grosor del nervio mediano bilateral','T02',NULL,NULL,7,'2026-02-23 17:02:19','2026-02-23 17:07:26'),(162,100,3,175,1,'terapia manual, punción seca y tratamiento de herpes','paciente de Sarameriza dificultad para venir','Paciente con dolor lumbar crónico, que no cede al tratamiento medicamentoso, a la evaluación se observa llagas de herpes en la zona lumbar, en densitometría se observa disminución del agujero de conjunción de las vertebras L4 y L5- L5 y S1, no osteoporosis ni osteopenia','T02',NULL,NULL,7,'2026-02-24 19:03:32','2026-02-24 19:08:52'),(163,37,3,176,1,'Terapia manual, infiltración de corticoide','terapia por 3 dias','Paciente con dolor de hombro derecho, refiere caída hace 1 mes, en ecografía se visualiza lesión del tendón del bíceps y subescapular','T02',NULL,NULL,7,'2026-02-24 19:09:27','2026-02-24 19:15:41'),(164,16,3,177,1,'Terapia manual','Terapia continua','Paciente refiere leve mejoría','T02',NULL,NULL,3,'2026-02-24 19:15:56','2026-02-24 19:23:16'),(165,101,3,178,1,'NIkzon',NULL,'Paciente refiere dolor en ano después de tomar antiparasitario y purgarse','T01',NULL,NULL,6,'2026-02-24 19:23:39','2026-02-24 19:31:06'),(166,79,3,179,1,'Terapia manual, punción seca e infiltración de acido hialñuronico en la rodilla derecha',NULL,'Paciente con dolor de rodilla , refiere haberse colocado acido hialuronico a la rodilla izquierda el año pasado, refiere bastante mejoría, en ecografía se visualiza meniscopatia bilateral, signo de artrosis sin derrame articular en el receso suprapatelar','T02',NULL,NULL,6,'2026-02-24 19:31:27','2026-02-24 20:47:05'),(167,102,3,180,1,'Terapia manual y punción seca, colágeno 250 mg',NULL,'Paciente refiere dolor lumbar después de estar cargando 30 kg de café, dolor en musculo longísimo y paravertebrales',NULL,NULL,NULL,6,'2026-02-24 20:47:36','2026-02-24 20:50:01'),(168,99,3,181,1,'terapia manual, administración de vitaminas y punción seca','Ya no puede asistir a terapia por vivir sarameriza','Paciente refiere mejoria, adormecimiento de las manos ha bajado ha bajado','T01',NULL,NULL,4,'2026-02-24 21:12:08','2026-02-24 21:14:57'),(169,100,3,182,1,'terapia manual, aciclovir','No puede asistir a terapia por vivir lejos','Paciente refiere evolución estacionaria, se detecta herpes en región lumbar','T01',NULL,NULL,7,'2026-02-24 21:16:49','2026-02-24 21:18:45'),(170,103,3,183,1,'terapia manual, punción seca, capsula de acido hialuronico',NULL,'Paciente refiere dolores articulares, movimientos involuntarios de la mano, dolores en dedos de la mano al sobreesfuerzo o al contacto con detergentes','T01',NULL,NULL,6,'2026-02-24 21:19:08','2026-02-24 21:20:51'),(171,95,3,184,1,'PRP, Terapia manual',NULL,'Paciente refiere mejoria, se le aplica plasma en cara por acne','T02',NULL,NULL,1,'2026-02-24 21:22:51','2026-02-24 21:23:40'),(172,28,3,185,1,'punción seca y terapia manual',NULL,'Paciente con cervicalgia cronica','T02',NULL,NULL,6,'2026-02-24 21:23:54','2026-02-24 21:24:49'),(173,81,3,186,1,'terapia manual y punción seca',NULL,'Paciente de Chiclayo con dolor de cuello cronico, reinicia terapia física','T02',NULL,NULL,6,'2026-02-24 21:24:58','2026-02-24 21:26:11'),(174,102,3,190,1,'Terapia manual',NULL,'Paciente refiere mejoría','T02',NULL,NULL,4,'2026-02-26 17:27:11','2026-02-26 17:28:34'),(175,97,3,191,1,'terapia manual, vitamina doble',NULL,'Paciente refiere mejoría',NULL,NULL,NULL,3,'2026-02-26 17:28:44','2026-02-26 17:29:35'),(176,97,3,187,1,'Terapia manual','Terapia continua','Dolor lumbar, paciente refiere mejoría, ampolla ha disminuido de tamaño','T02',NULL,NULL,4,'2026-02-26 17:30:51','2026-02-26 17:34:29'),(177,99,3,188,1,'terapia manual y administración de vit B y C',NULL,'Paciente refiere mejoría, dolor ha bajado hormigueo persiste moderadamente','T01',NULL,NULL,4,'2026-02-26 17:37:51','2026-02-26 17:40:55'),(178,28,3,189,1,'Terapia manual, punción seca','Terapia manual','Paciente refiere mejoría','T02',NULL,NULL,4,'2026-02-26 17:42:14','2026-02-26 17:45:38'),(179,106,3,197,1,'tracción articular, terapia manual, infiltración de acido hialuronico','terapia por 5 sesiones y control','Paciente refiere dolor en rodilla derecha, sufre lesión deportiva, con mecanismo de rodilla en rotación interna, presenta dolor a la palpación en linea rticular interna, dolor a la flexión total, dolor a la marcha, en ecografía se visualiza derrame articular receso suprapatelar','T02',NULL,NULL,9,'2026-02-28 14:55:53','2026-02-28 14:59:00'),(180,104,3,195,1,NULL,'Administración de vitaminas','administración de vitaminas',NULL,NULL,NULL,3,'2026-02-28 15:00:05','2026-02-28 15:02:24'),(181,105,3,196,1,'terapia manual, punción seca, infiltración de acido hiañluronico',NULL,'Paciente con dolor de rodilla hace 3 años, con secuela de fractura de fémur, manifiesta problemas de ligamento lateral con excesiva hinchazón por tres años, diagnosticada con artrosis grado 3 en Chiclayo, a la evaluación y en ecografía se aprecia lesión ligamento lateral interno, tendinitis pata de ganso y menisco','T02',NULL,NULL,8,'2026-02-28 15:02:55','2026-02-28 15:07:45'),(182,95,3,192,1,'Terapia manual',NULL,'Terapia continua, paciente refiere mejoría','T02',NULL,NULL,0,'2026-02-28 15:08:57','2026-02-28 15:14:34'),(183,28,3,193,1,'Terapia manual',NULL,'Paciente refiere sentirse mejor con dolor de cuello y región lumbar','T02',NULL,NULL,4,'2026-02-28 15:14:49','2026-02-28 15:15:44'),(184,81,3,194,1,'terapia manual y punción seca',NULL,'Paciente refiere mejoria','T02',NULL,NULL,7,'2026-02-28 15:16:22','2026-02-28 15:17:11'),(185,107,3,198,1,'Terapia continua',NULL,'Paciente con dolor lumbar, manifiesta realizar terapia en lima','T02',NULL,NULL,6,'2026-03-02 15:53:41','2026-03-02 16:00:56'),(186,85,3,199,1,'Se administra segunda dosis',NULL,'Paciente refiere mejoría, dolor ha disminuido y continua con segunda dosis de PRP','T02',NULL,NULL,4,'2026-03-02 16:01:37','2026-03-02 16:06:38'),(187,108,3,200,1,'Terapia manual y PRP','3 Sesiones de PRP','Paciente refiere dolor en cadera, no presenta mejoría ha sido tratado por diferentes médicos, en su radiografía se visualiza artrosis de cadera','T02',NULL,NULL,8,'2026-03-02 17:41:42','2026-03-02 17:45:13'),(188,109,3,201,1,'tratamiento para osteopenia marcada y terapia manual','Terapia continua','Paciente con dolor de columna lumbar, se visualiza osteofito incipiente lumbar, en densitometría se visualiza osteopenia marcada','T02',NULL,NULL,7,'2026-03-02 17:45:32','2026-03-02 17:47:39'),(189,106,3,202,1,'Terapia manual, crioterapia','Terapia continua','Paciente refiere bastante mejoría, dolor de rodilla ha bajado','T02',NULL,NULL,2,'2026-03-02 17:48:23','2026-03-02 17:50:12'),(190,117,3,213,1,'infiltración corticoide',NULL,'Paciente con dolor de hombro izquierdo,  dolor a la abducción en el tramo final','T02',NULL,NULL,7,'2026-03-10 21:06:41','2026-03-10 21:09:24'),(191,111,3,205,1,'Terapia manual y punción seca',NULL,'Paciente con temblor en la mano derecha, con tratamiento para parkinson hace 6 meses','T02',NULL,NULL,4,'2026-03-10 21:10:06','2026-03-10 21:13:32'),(192,112,3,206,1,'Terapia manual',NULL,'Paciente con hemiparesia derecha, temblor en las manos y movimientos involuntarios no sincronizados, hace 6 meses','T02',NULL,NULL,3,'2026-03-10 21:15:02','2026-03-10 21:23:22'),(193,113,3,207,1,'Terapia manual - PRP',NULL,'Paciente con dolor en región lateral de la columna lumbar, refiere esfuerzo brusco crujido en esa región del cuadrado lumbar, dolor a la palpación, en ecografía se visualiza desgarro muscular','T02',NULL,NULL,7,'2026-03-10 21:24:14','2026-03-10 21:28:28'),(194,114,3,208,1,'Terapia manual y punción seca','Terapia manual y punción seca','Dolor en región dorsal izquierda que irradia a miembro superior izquierdo','T02',NULL,NULL,7,'2026-03-10 21:30:04','2026-03-10 21:33:23'),(195,115,3,209,1,'terapia manual. PRP, infiltración corticoide tendinitis pata de ganso',NULL,'Dolor en rodilla derecha, que dificulta la marcha, dolor en linea articular, en ecografía se visualiza sigo de artrosis y tendinitis pata de ganso','T02',NULL,NULL,7,'2026-03-10 21:34:35','2026-03-12 18:32:58'),(196,109,3,212,1,'Terapia manual','Terapia manual','Paciente refiere mejoría en región lumbar','T02',NULL,NULL,4,'2026-03-10 21:36:49','2026-03-10 21:37:51'),(197,110,3,204,1,'administración de acido hialuronico y corticoide','terapia manual','Paciente con dolor intenso en rodilla izquierda en ecografía se visualiza artrosis y lesión ligamento lateral de la rodilla izquierda','T02',NULL,NULL,8,'2026-03-10 21:40:11','2026-03-10 21:42:18'),(198,109,3,203,1,'Terapia manual',NULL,'Paciente refiere nmejoria','T02',NULL,NULL,4,'2026-03-10 21:42:33','2026-03-10 21:43:23'),(199,110,3,211,1,'Terapia manual',NULL,'Paciente refiere mejoría',NULL,NULL,NULL,3,'2026-03-10 21:43:59','2026-03-10 21:45:12'),(200,116,3,210,1,'Terapia manual',NULL,'paciente refiere dolor lumbar agudo, toma prednisona  50mg hace 5 años, carpintero de oficio, en densitometría se determina osteoporosis','T02',NULL,NULL,7,'2026-03-12 18:33:46','2026-03-12 18:37:48'),(201,50,3,214,1,'Terapia manual y punción seca',NULL,'Paciente con dolor de rodilla y lumbar, refiere dolor , tratamiento de control',NULL,NULL,NULL,6,'2026-03-12 18:38:06','2026-03-12 18:39:32'),(202,51,3,215,1,'Terapia manual',NULL,'Paciente refiere dolor en cuello y región lumbar','T02',NULL,NULL,7,'2026-03-12 18:39:57','2026-03-12 18:41:04'),(203,116,3,216,1,'Terapia manual',NULL,'Paciente refiere evolución lenta','T02',NULL,NULL,7,'2026-03-12 18:41:22','2026-03-12 18:42:12'),(204,11,3,224,1,'terapia manual y punción seca',NULL,'Paciente refiere dolor en músculos gemelos , bilateral, secuela de ruptura de tendón de Aquiles en talón izquierdo','T02',NULL,NULL,6,'2026-03-14 19:22:49','2026-03-14 19:25:20'),(205,22,3,223,1,'Terapia manual y punción seca',NULL,'dolor de cuello y espalda que se irradia a brazos, manifiesta que punción seca le ayuda a calmar dolor','T02',NULL,NULL,6,'2026-03-14 19:25:38','2026-03-14 19:28:15'),(206,111,3,220,1,'Terapia manual',NULL,'Paciente refiere sentirse mejor','T02',NULL,NULL,1,'2026-03-14 19:28:56','2026-03-14 19:29:38'),(207,119,3,221,1,NULL,NULL,'Solo realizo densitometría',NULL,NULL,NULL,8,'2026-03-14 19:30:08','2026-03-14 19:30:57'),(208,55,3,219,1,NULL,NULL,'administración de vitamina, no realizo terapia',NULL,NULL,NULL,0,'2026-03-14 20:21:00','2026-03-14 20:21:32'),(209,115,3,218,1,'crioterapia y terapia manual',NULL,'Refiere dolor estacionario, se le realiza terapia','T02',NULL,NULL,7,'2026-03-14 20:22:02','2026-03-14 20:23:06'),(210,107,3,222,1,'Terapia manual',NULL,'refiere mejoria del dolor lumbar','T02',NULL,NULL,6,'2026-03-14 20:23:21','2026-03-14 20:23:59'),(211,118,3,217,1,'Terapia manual',NULL,'Paciente refiere dolor en articulaciones de la mano y rodillas, además dolor en región plantar del talón, y lumbalgia','T02',NULL,NULL,7,'2026-03-14 20:25:18','2026-03-14 20:29:32'),(212,120,3,225,1,'inmovilización con yeso por 12 dias',NULL,'niño de 10 años con dolor en región lateral de rodilla, por caida hace 2 dias, no cede al tratamiento medicamentoso presenta edema y tumefacción, dolor a la palpación, dolor a la flexión y extensión total de rodilla, en ecografía se visualiza lesión de tensor de la fascia lata en zona de inserción','T02',NULL,NULL,7,'2026-03-14 20:29:43','2026-03-14 20:32:32'),(213,108,3,228,1,'Segunda dosis de PRP',NULL,'Paciente refiere mejoría, dolor de cadera ha disminuido, facilita marcha','T02',NULL,NULL,4,'2026-03-16 15:40:07','2026-03-16 15:41:08'),(214,111,3,227,1,'Terapia manual y ejercicios',NULL,'Paciente con Parkinson refiere sentirse mejor','T02',NULL,NULL,0,'2026-03-16 15:41:25','2026-03-16 15:47:07'),(215,117,3,226,1,'Terapia manual',NULL,'Paciente refiere bastante mejoría, dolor ha disminuido y rango de movimiento se ampliado','T02',NULL,NULL,3,'2026-03-16 15:47:17','2026-03-16 15:48:58'),(216,122,3,229,1,'Terapia manual',NULL,'Paciente refiere dolo lumbar que se irradia a pierna izquierda hace 3 meses, refiere no ceder el dolor con terapia de masajes realizados por empíricos, dolo en región piramidal, en densitometría se observa espondilolistesis anterior de L5, y osteopenia lumbar','T02',NULL,NULL,6,'2026-03-17 19:55:57','2026-03-17 19:58:58'),(217,106,3,232,1,'crioterapia y terapia manual',NULL,'Dolor en rodilla derecha, en tuberosidad de la tibia, dolor a la palpación','T02',NULL,NULL,4,'2026-03-20 18:39:19','2026-03-20 18:41:33'),(218,123,3,230,1,'Terapia manual',NULL,'Paciente que 7 meses atrás fue atendido en nuestro consultorio refiere dolor lumbar, no de la misma intensidad de antes','T02',NULL,NULL,4,'2026-03-20 19:28:23','2026-03-20 19:31:13'),(219,95,3,231,1,'Terapia manual',NULL,'Paciente con secuela de parálisis  facial, refiere poca movilidad en la boca','T02',NULL,NULL,0,'2026-03-20 19:31:23','2026-03-20 19:33:00'),(220,22,3,233,1,'terapia manual y punción seca',NULL,'refiere mejoria',NULL,NULL,NULL,4,'2026-03-25 19:58:46','2026-03-25 20:09:10'),(221,21,3,234,1,'Ejercicios terapéuticos',NULL,'refiere mejoría pero aun no completa rango de movimiento total a la extensión','T02',NULL,NULL,2,'2026-03-25 20:09:38','2026-03-25 20:12:00'),(222,124,3,235,1,'crioterapia, inmovilización con muslera',NULL,'Paciente con dolor en muslo por contusión directa, presenta dificultad para caminar, dolor a la palpación y en ecografia se visualiza desgarro muiscular','T02',NULL,NULL,8,'2026-03-25 20:15:55','2026-03-25 21:00:15'),(223,125,3,236,1,'inmovilización y crioterapia',NULL,'Paciente con dolor de hombro derecho sufre caída golpeándose el hombro región lateral, dolor a la palpación en articulación acromioclavicular se visualiza deformidad, en la ecografía se visualiza luxación acromioclavicular','T02',NULL,NULL,8,'2026-03-25 21:01:17','2026-03-25 21:05:00'),(224,126,3,237,1,'terapia manual',NULL,'Paciente refiere dolor al movimiento brusco, que se irradia a la pierna, dolor a la palpación y dificultad para caminar','T02',NULL,NULL,8,'2026-03-25 21:05:53','2026-03-25 21:07:22'),(225,111,3,238,1,'Ejercicios y ejercicios de coordinación',NULL,'Paciente refiere mejoria','T02',NULL,NULL,1,'2026-03-25 21:08:21','2026-03-25 21:09:29'),(226,127,3,239,1,'terapia manual y ejercicios',NULL,'Paciente con dolor hace 1 mes, no cede con tratamiento medicamentoso, presenta dolor lumbar irradiado a miembro inferior derecho, manifiesta quemar las piernas, en densitometría se visualiza osteopenia marcada y escoliosis lumbar severa','T02',NULL,NULL,8,'2026-03-25 21:10:18','2026-03-25 21:12:19'),(227,128,3,240,1,'se recomienda inmovilización y crioterapia',NULL,'Paciente con dolor de rodilla izquierda, refiere contusión de rodilla, inestabilidad articular, dolor en linea articular, dolor en ligamento lateral, signo de cajón anterior positivo','T02',NULL,NULL,9,'2026-03-25 21:13:05','2026-03-25 21:15:22'),(228,126,3,241,1,NULL,NULL,'Paciente refiere mejoría, no realiza terapia',NULL,NULL,NULL,3,'2026-03-25 21:15:34','2026-03-25 21:16:06'),(229,127,3,244,1,'Terapia manual',NULL,'Paciente refiere leve mejoría',NULL,NULL,NULL,6,'2026-03-25 21:16:51','2026-03-25 21:17:34'),(230,129,3,242,1,'Manipulación coxis y crioterapia',NULL,'Paciente refiere dolor en coxis despues de caida hace 2 meses, presenta fiebre y dolor de garganta por lo que se le recomienda evaluación medica, por el problema de coxis se proceda a manipulación con consentimiento de su papá presente','T02',NULL,NULL,7,'2026-03-25 21:18:06','2026-03-25 21:20:55'),(231,130,3,243,1,'Terapia manual',NULL,'Paciente con dolor intenso lumbar, no le permite ponerse de pie , ni sentarse, dificultad para caminar, disminución de fuerza muscular en miembro inferior derecho, en densitometría se visualiza perdida del espacio de agujero de conjunción entre S1 Y L5',NULL,NULL,NULL,9,'2026-03-25 21:21:17','2026-03-25 21:23:30'),(232,131,3,245,1,'Terapia manual y ejercicios, administración de acido hialuronico',NULL,'Paciente con dolor lumbar y dolor de rodilla, en ecografía se visualiza lipoma extenso en zona del sacro, y lipomas y quiste es glúteo de imagen hiperecogénica, en rodilla dolor a la palpación en linea articular, manifiesta dolor cuando se excede de trabajo o juego, dolor que se presenta hace meses atrás','T02',NULL,NULL,6,'2026-03-26 18:32:11','2026-03-26 19:30:39'),(233,135,3,252,1,'Ejercicios',NULL,'Paciente con diagnostico de hipertensión arterial, desde hace 4 años , 2 años que no tomo pastilla, presenta cuadro de ACV flacida, en resonancia  se observa lesión en protuberancia','T02',NULL,NULL,6,'2026-03-28 15:17:11','2026-03-28 16:07:05'),(234,134,3,251,1,'Terapia manual',NULL,'paciente refiere dolor de espalda que no cede al tratamiento medicamentoso, dolor intenso a la palpación, en densitometría se determina osteopenia marcada (2.4), en radiografía de visualiza artrosis y osteofitos en región lumbar','T02',NULL,NULL,6,'2026-03-28 16:07:19','2026-03-28 16:12:06'),(235,133,3,250,1,'terapia manual y punción seca',NULL,'paciente con dolor crónico cervical','T02',NULL,NULL,6,'2026-03-28 16:12:15','2026-03-28 16:13:46'),(236,22,3,249,1,'Punción seca y terapia manual',NULL,'Paciente con dolor crónico cervical','T02',NULL,NULL,6,'2026-03-28 16:13:52','2026-03-28 16:19:05'),(237,86,3,248,1,'inyección de corticoide',NULL,'Paciente con secuela de fractura de humero, intervenido quirúrgicamente, presenta subluxación acromioclavicular en ecografía se observa lesión de ligamento acromioclavicular',NULL,NULL,NULL,4,'2026-03-28 16:19:24','2026-03-28 16:21:31'),(238,127,3,247,1,'terapia manual',NULL,'Paciente refiere mejoría, disminuye dolor lumbar','T02',NULL,NULL,NULL,'2026-03-28 16:22:04','2026-03-28 16:22:47'),(239,132,3,246,1,'Terapia manual y administración de corticoide, inmovilización con cabestrillo',NULL,'Paciente con dolor de hombro derecho , dolor a la flexión de hombro, dolor para tocarse hombro contrario. en ecografía se visualiza lesión de tendón infraespinoso y supraespinoso','T02',NULL,NULL,8,'2026-03-28 16:23:08','2026-03-28 16:25:34'),(240,127,3,253,1,'Terapia manual',NULL,'Paciente refiere mejoría','T02',NULL,NULL,2,'2026-03-29 11:37:32','2026-03-29 12:10:38'),(241,136,3,254,1,'terapia manual, punción seca y administración de vitaminas B y C',NULL,'Paciente con antecedente de parálisis facial izquierda hace un año, ahora refiere sentir hormigueo y falta de motilidad a lado derecho. a la evaluación no hay manifestación clínica','T02',NULL,NULL,1,'2026-03-29 12:10:55','2026-03-29 12:13:50'),(242,137,3,255,1,'Terapia manual',NULL,'Paciente con dolor de cuello y espalda crónico','T02',NULL,NULL,7,'2026-03-29 12:15:43','2026-03-29 12:18:15'),(243,127,3,262,1,'Terapia manual',NULL,'El paciente refiere mejoria, dolor ha disminuido en comparación al dolor inicial','T02',NULL,NULL,4,'2026-03-31 15:15:52','2026-03-31 15:18:33'),(244,140,3,261,1,'terapia manual',NULL,'Paciente con dolor lumbar, a la evaluación signo de artrosis lumbar, dolor irradiado a miembro inferior, se ayuda de un baston para caminar','T02',NULL,NULL,8,'2026-03-31 15:18:54','2026-03-31 15:21:43'),(245,136,3,256,1,'Terapia manual',NULL,'Paciente refiere acentuarse parálisis facial','T02',NULL,NULL,1,'2026-03-31 15:22:20','2026-03-31 17:57:45'),(246,108,3,259,1,'aplicación de acido hialuronico',NULL,'Dolor de cadera que no cede al tratamiento de plaquetas, aplacados 15 días atrás','T02',NULL,NULL,8,'2026-03-31 17:58:17','2026-03-31 18:00:42'),(247,136,3,263,1,'Terapia manual',NULL,'Se acentúa parálisis facial','T02',NULL,NULL,1,'2026-03-31 18:01:04','2026-03-31 18:02:47'),(248,111,3,264,1,'Terapia manual',NULL,'Paciente refiere mejoría','T02',NULL,NULL,1,'2026-03-31 18:03:02','2026-03-31 18:04:21'),(249,141,3,265,1,'Terapia manual y punción seca',NULL,'Dolor de cuello crónico , que no cede tratamient0 medicamentoso por psiquiatra','T02',NULL,NULL,7,'2026-03-31 18:04:47','2026-03-31 18:07:02'),(250,142,3,266,1,'Terapia manual y punción seca',NULL,'Dolor de cuello y espalda por uso excesivo de celular','T02',NULL,NULL,NULL,'2026-03-31 18:07:37','2026-03-31 18:09:32'),(251,143,3,267,1,'Terapia manual y punción seca',NULL,'Paciente con dolor de espalda hace 6 años , refiere no ceder dolor con tratamiento medicamentoso ni quiroprácticos, en densitometria se obtine que tiene disminución del agujero de conjunción y osteopenia columna lumbar (-1.2)','T02',NULL,NULL,7,'2026-03-31 18:09:57','2026-03-31 18:13:40'),(252,145,3,272,1,'infiltración de corticoide',NULL,'dolor en región de muñeca, presenta ganglion solidificado, dolor intenso hace un mes, en ecografía se visualiza tendinitis de quervain','T02',NULL,NULL,7,'2026-04-07 20:10:46','2026-04-07 20:13:53'),(253,132,3,273,1,'aplicación de plasma y terapia manual',NULL,'Paciente refiere bastante mejoría, moviliza su hombro en su rango total','T02',NULL,NULL,4,'2026-04-07 20:14:30','2026-04-07 20:17:06'),(254,146,3,274,1,'Terapia manual',NULL,'Paciente refiere dolor de rodilla izquierda, dolor a la palpación en linea articular, en ecografía se visualiza derrame articular receso suprapatelar y lesión de menisco medial','T02',NULL,NULL,7,'2026-04-07 20:17:18','2026-04-07 20:22:19'),(255,134,3,276,1,NULL,NULL,'Paciente refiere mejoría, dolor ha disminuido en un  90 %',NULL,NULL,NULL,2,'2026-04-07 20:22:41','2026-04-07 20:25:22'),(256,144,3,277,1,'Terapia manual y ejercicios',NULL,'Paciente refiere mejoría, dolor ha disminuido y la marcha ha mejorado','T02',NULL,NULL,3,'2026-04-07 20:25:31','2026-04-07 20:26:56'),(257,144,3,275,1,'Terapia manual y plantilla ortopédica',NULL,'Paciente refiere mejoría, mejora marcha','T02',NULL,NULL,3,'2026-04-07 20:27:09','2026-04-07 20:27:58'),(258,144,3,271,1,'Terapia manual',NULL,'Paciente con secuela de fractura de metatarsiano refiere mejoría después de retirar yeso','T02',NULL,NULL,4,'2026-04-07 20:28:24','2026-04-07 20:29:25'),(259,134,3,269,1,'terapia manual',NULL,'Paciente refiere mejoría','T02',NULL,NULL,6,'2026-04-07 20:29:55','2026-04-07 20:30:52'),(260,143,3,270,1,'Terapia manual',NULL,'Paciente refiere que dolor de cuello ha disminuido, pero refiere que dolor de espalda persiste','T02',NULL,NULL,6,'2026-04-07 20:32:01','2026-04-07 20:33:02'),(261,144,3,268,1,'Ejercicios de fortalecimiento y carga de articulaciones de miembros inferiores','10 sesiones de terapia','Paciente con secuela de fractura, manifiesta mejoría luego de retirar yeso, inicia tratamiento terapeutico','T02',NULL,NULL,6,'2026-04-07 20:33:20','2026-04-07 20:34:52'),(262,89,3,278,1,'terapia manual e infiltración de corticoide',NULL,'Paciente con dolor de pie izquierdo que se irradia de anterior a posterior ente 3er y 4to metatarsiano, neuroma de morton','T02',NULL,NULL,7,'2026-04-10 19:49:22','2026-04-10 19:52:05'),(263,88,3,279,1,'Terapia manual',NULL,'Paciente con dolor crónico de rodilla y dolor lumbar','T02',NULL,NULL,4,'2026-04-10 19:52:43','2026-04-10 20:07:08'),(264,144,3,280,1,'Terapia manual',NULL,'Paciente con secuela de fractura de pie refiere mejoría, su marcha se expresa mas natural','T02',NULL,NULL,4,'2026-04-10 20:07:54','2026-04-10 20:09:06'),(265,147,3,281,1,'Terapia manual',NULL,'Paciente con dolor crónico lumbar, con diagnostico de espondilo artrosis y escoliosis marcada','T02',NULL,NULL,7,'2026-04-10 20:09:17','2026-04-10 20:15:13'),(266,89,3,282,1,'Terapia manual',NULL,'Paciente refiere que dolor ha disminuido en su totalidad','T02',NULL,NULL,2,'2026-04-10 20:15:33','2026-04-10 20:18:41'),(267,88,3,283,1,'Terapia manual',NULL,'Paciente refiere mejoría','T02',NULL,NULL,4,'2026-04-10 20:19:04','2026-04-10 20:19:59'),(268,148,3,284,1,'Infiltración de corticoide',NULL,'Dolor en dedo anular de mano izquierda, presenta signo de resorte marcado','T02',NULL,NULL,4,'2026-04-10 20:20:20','2026-04-10 20:24:34'),(269,151,3,287,1,'Terapia manual, administración de corticoide y plasma',NULL,'Paciente dolor en rodilla hace 5 meses, dolor que no cede con tratamiento medicamentoso, en ecografía se visualiza tendinitis de para de ganso, lesión de ligamento lateral interno y sigo de artrosis','T02',NULL,NULL,6,'2026-04-16 19:56:07','2026-04-16 20:06:05'),(270,152,3,288,1,'infiltración de acido hialuronico',NULL,'dolor en tobillo hace 5 meses, en ecografía se visualiza lesión de ligamento peroneoastragalino derecho','T02',NULL,NULL,8,'2026-04-16 20:00:51','2026-04-16 20:05:07'),(271,153,3,289,1,'Terapia manual',NULL,'Dolor en región lumbar después de esfuerzo brusco, refiere crujido articular al momento se saltar','T02',NULL,NULL,7,'2026-04-16 20:07:01','2026-04-16 20:08:26'),(272,150,3,286,1,'Terapia manual',NULL,'dolor lumbar, refiere dolor al cargar peso, paciente asiste a gym','T02',NULL,NULL,7,'2026-04-16 20:08:38','2026-04-16 20:09:57'),(273,149,3,285,1,'Terapia manual',NULL,'dolor lumbar que se irradia a miembro inferior, presenta dolor en rodilla , dolor a la palpación en linea articular','T02',NULL,NULL,7,'2026-04-16 20:10:23','2026-04-16 20:12:29'),(274,154,3,290,1,'Ejercicios y zapato ortopédico',NULL,'niño de  años de edad , madre refiere que se cae constantemente, presenta a la evaluación pie plano valgo','T02',NULL,NULL,0,'2026-04-17 18:40:41','2026-04-17 18:42:25'),(275,156,3,291,1,'Terapia manual',NULL,'Paciente con dolor lumbar que se irradia a miembro inferior derecho','T02',NULL,NULL,7,'2026-04-17 18:43:17','2026-04-17 18:45:24'),(276,158,3,293,1,'Ejercicios de pie y zapato ortopédico',NULL,'Madre refiere que su hijo se cae constantemente, a la evaluación presenta pie plano y talón valgo','T02',NULL,NULL,0,'2026-04-17 18:47:45','2026-04-17 18:50:22'),(277,157,3,292,1,'Terapia manual',NULL,'Paciente refiere dolor de dedos de la mano, sobresale nodulos de heberdeng y bouchard, refiere ordeñar vaca y dedicarse a actividades de la agricultura, en la densitometria se visualiza osteofitos dorsales y lumbares, no osteopenia ni osteoporosis','T02',NULL,NULL,7,'2026-04-17 18:50:57','2026-04-17 18:54:40'),(278,150,3,294,1,'Terapia manual',NULL,'Paciente refiere bastante mejoría, evolución favorable','T02',NULL,NULL,2,'2026-04-17 18:54:51','2026-04-17 18:56:03'),(279,153,3,295,1,'Terapia manual',NULL,'paciente niño refiere bastante mejoría','T02',NULL,NULL,1,'2026-04-17 18:56:11','2026-04-17 18:57:24'),(280,159,3,296,1,NULL,NULL,'Paciente con leve retardo mental, con dolor de rodilla izquierda hace 1 año, hace 18 días fue operado de quistes sinoviales en ligamento cruzado anterior en la ciudad de Lima, presenta dolor al caminar y a la flexión de rodilla, en ecografía se visualiza derrame en el receso suprapatelar',NULL,NULL,NULL,7,'2026-04-18 20:12:54','2026-04-18 20:16:14'),(281,161,3,297,1,'Terapia manual',NULL,'Paciente con dolor lumbar, hace 5 días manifiesta dolor al agacharse refiere crujido en zona lumbar izquierda, dolor a la extensión lumbar','T02',NULL,NULL,9,'2026-04-18 20:16:30','2026-04-18 20:18:19'),(282,153,3,298,1,'Terapia manual',NULL,'Niño refiere mejoría, dolor ha disminuido en escala de EVA a 0','T01',NULL,NULL,0,'2026-04-18 20:18:26','2026-04-18 20:19:28'),(283,159,3,299,1,'Terapia manual',NULL,'Paciente refiere mejoría, camina mejor y volumen de la rodilla ha disminuido','T02',NULL,NULL,3,'2026-04-19 12:00:19','2026-04-19 12:02:02'),(284,161,3,300,1,'Terapia manual',NULL,'Paciente refiere mejoría desarrolla marcha normal, dolor ha disminuido','T02',NULL,NULL,3,'2026-04-19 12:02:10','2026-04-19 12:04:15'),(285,151,3,301,1,'Terapia manual',NULL,'paciente refiere mejoría, paciente realiza mejor marcha, dolor ha disminuido','T02',NULL,NULL,4,'2026-04-20 18:09:56','2026-04-20 18:12:46'),(286,162,3,302,1,'Terapia manual y administración de corticoide',NULL,'Paciente refiere dolor crónico de hombro derecho y codo izquierdo, en ecografía se visualiza lesión tendón subescapular y epicondilitis lateral de codo izquierdo','T02',NULL,NULL,7,'2026-04-20 18:13:17','2026-04-20 18:16:24'),(287,159,3,303,1,'Terapia manual',NULL,'Paciente con  dolor de rodilla refiere mejoría, marcha ha mejorado se inicia fortalecimiento muscular','T02',NULL,NULL,4,'2026-04-20 18:16:33','2026-04-20 18:17:58'),(288,161,3,304,1,'Terapia manual',NULL,'Paciente refiere no sentir dolor','T02',NULL,NULL,1,'2026-04-20 18:18:16','2026-04-20 18:21:29'),(289,159,3,309,1,'Ejercicios y crioterapia',NULL,'paciente refiere mejoría','T02',NULL,NULL,2,'2026-04-22 18:37:57','2026-04-22 18:39:57'),(290,159,3,307,1,'Terapia manual',NULL,'Paciente refiere mejoría','T02',NULL,NULL,2,'2026-04-22 18:40:11','2026-04-22 18:41:37'),(291,55,3,308,1,'vitaminas administración',NULL,'paciente cronica de dolor de espalda','T02',NULL,NULL,0,'2026-04-22 18:41:58','2026-04-22 18:43:17'),(292,163,3,305,1,'crioterapia y vendaje de compresión',NULL,'Paciente jugando futbol recibe fuerte puntapie en la pierna, presenta edema y tumefacción que se visualiza en ecografía','T02',NULL,NULL,7,'2026-04-22 18:43:39','2026-04-22 18:47:51'),(293,164,3,306,1,'Terapia manual e infiltración de plasma en glúteo',NULL,'Paciente con dolor lumbar irradiado a glúteo derecho, después de esfuerzo brusco, hace 4 días, refiere dolor a la palpación y dolor al caminar. en ecografía se visualiza fuerte  reacción inflamamtoria en glúteos','T02',NULL,NULL,NULL,'2026-04-22 18:48:28','2026-04-22 18:52:17'),(294,166,3,315,1,'Terapia manual',NULL,'Paciente refiere dolor lumbar que se irradia a miembro inferior izquierdo','T02',NULL,NULL,7,'2026-04-24 20:28:17','2026-04-24 20:30:24'),(295,159,3,316,1,'Terapia manual',NULL,'mama del paciente refiere que el niño presenta mejoría, ha bajado el edema y tumefacción y camina mejor','T02',NULL,NULL,3,'2026-04-24 20:30:39','2026-04-24 20:32:40'),(296,165,3,310,1,'bajar actividad física',NULL,'Paciente refiere haber sufrido accidente en moto, hace 1 año y medio, presenta dolor en tibial anterior y peroneos, en ecografía se visualiza desgarro muscular crónico','T01',NULL,NULL,3,'2026-04-24 20:33:22','2026-04-24 20:36:17'),(297,132,3,311,1,'administración de plasma en hombro',NULL,'Paciente que fue tratado con plasma hace 15 días, por desgarro de tendón subescapular supraespinoso, refiere bastante mejoría, dolor ha disminuido y movilidad ha mejorado en un 90%, viene por segunda dosis','T02',NULL,NULL,3,'2026-04-24 20:36:33','2026-04-24 20:38:58'),(298,157,3,312,1,'administración de vitamina c',NULL,'Paciente refiere mejoría, dolor en dedos de la mano ha disminuido, administración de vitaminas B y C','T02',NULL,NULL,3,'2026-04-24 20:39:37','2026-04-24 20:43:30'),(299,159,3,313,1,'Terapia manual',NULL,'Paciente refiere mejoría','T02',NULL,NULL,3,'2026-04-24 20:45:32','2026-04-24 20:46:27'),(300,139,3,314,1,'2da dosis de plasma ecoguiado',NULL,'Paciente con desgarro muscular hace 20 días, y que recibió tratamiento con plasma, refiere mejoría, se le realiza 2  da dosis de plasma','T02',NULL,NULL,4,'2026-04-24 20:47:37','2026-04-24 20:51:09'),(301,169,3,324,1,'tratamiento con plasma',NULL,'Paciente refiere dolor de hombro derecho hace 5 semanas, en ecografía se visualiza desgarro tendón sub escapular y tendinosis de supraespinoso','T02',NULL,NULL,7,'2026-04-27 18:20:53','2026-04-27 18:24:24'),(302,159,3,325,1,'Ejercicios terapéuticos',NULL,'paciente refiere mejoría, marcha ha mejorado y dolor ha disminuido','T02',NULL,NULL,2,'2026-04-27 18:24:35','2026-04-27 18:26:48'),(303,159,3,321,1,'Ejercicios terapeuticos',NULL,'Paciente refiere mejoría','T02',NULL,NULL,3,'2026-04-27 18:27:09','2026-04-27 18:28:04'),(304,166,3,322,1,'Terapia manual, elongación piramidal',NULL,'Refiere que dolor ha disminuido a grado 1','T02',NULL,NULL,1,'2026-04-27 18:28:19','2026-04-27 18:29:32'),(305,167,3,323,1,'Terapia manual',NULL,'Dolor ha disminuido','T02',NULL,NULL,2,'2026-04-27 18:29:50','2026-04-27 18:31:21'),(306,166,3,317,1,'Terapia manual y punción seca',NULL,'Paciente refiere que dolor ha disminuido en el primer día del tratamiento, al día siguiente el dolor se a intensificado','T02',NULL,NULL,6,'2026-04-27 18:32:30','2026-04-27 18:34:36'),(307,167,3,318,1,'Terapia manual',NULL,'Paciente refiere dolor lumbar que se irradia a miembro inferior','T02',NULL,NULL,7,'2026-04-27 18:34:54','2026-04-27 18:36:08'),(308,168,3,319,1,'se recomienda plasma y no realizar actividad deportiva por tres meses',NULL,'Paciente refiere dolor de tobillo por lesión deportiva hace 5 meses, en ecografia se visualiza desgarro de ligamento peroneo astragalino, dolor a la palpación','T02',NULL,NULL,7,'2026-04-27 18:36:28','2026-04-27 18:39:04'),(309,159,3,320,1,'Ejercicios terapéuticos',NULL,'Paciente con evolución favorable','T02',NULL,NULL,2,'2026-04-27 18:39:16','2026-04-27 18:40:53'),(310,156,3,327,1,'Terapia manual',NULL,'Paciente refiere dolor lumbar, realizo terapia hace 10 días, y refiere que dolor disminuyo por 4 días, reinicia terapia','T02',NULL,NULL,7,'2026-04-28 19:36:23','2026-04-28 19:44:16'),(311,170,3,328,1,'Terapia manual',NULL,'Paciente refiere dolor de espalda, presenta leve cifosis y dolor de base de cráneo','T02',NULL,NULL,6,'2026-04-28 19:44:53','2026-04-28 19:46:00'),(312,171,3,329,1,'Terapia manual y punción seca',NULL,'paciente refiere dolor de cuello y base de nuca, refiere stress','T02',NULL,NULL,4,'2026-04-28 19:46:25','2026-04-28 19:47:38'),(313,172,3,330,1,'Terapia manual y punción seca',NULL,'Paciente refiere dolor de cuello y  base de nuca','T02',NULL,NULL,4,'2026-04-28 19:47:46','2026-04-28 19:48:36'),(314,163,3,326,1,'administración de medicamento',NULL,'Paciente refiere mejoría','T01',NULL,NULL,2,'2026-04-28 19:49:06','2026-04-28 19:50:26'),(315,173,3,331,1,'administración de plasma',NULL,'Dolor en región posterior de muslo, en ecografía se visualiza desgarro muscular isquiotibiales','T02',NULL,NULL,4,'2026-04-29 19:40:38','2026-04-29 19:58:15'),(316,174,3,332,1,'terapia en essalud',NULL,'Paciente con dolor de mano derecha, sufre caída hace 2 meses, en ecografía se visualiza lesión de tendón aductor del pulgar y extensor del pulgar','T01',NULL,NULL,7,'2026-04-29 19:59:08','2026-04-29 20:36:15'),(317,175,3,333,1,'terapia manual, punción seca',NULL,'paciente con dolor crónico de codo derecho que se irradia al hombro','T02',NULL,NULL,7,'2026-04-29 20:36:41','2026-04-29 20:38:18'),(318,176,3,334,1,'terapia manual y punción seca',NULL,'Paciente con dolor crónico de cuello, viene por tratamiento de punción seca','T02',NULL,NULL,6,'2026-04-29 20:38:30','2026-04-29 20:40:05'),(319,48,3,335,1,'ferula nocturna para rodilla valga',NULL,'Paciente con deformidad en valgo de rodilla derecha','T02',NULL,NULL,0,'2026-04-29 20:40:27','2026-04-29 20:42:52'),(320,178,3,342,1,'inmovilización de muñeca',NULL,'Paciente que sufre caída , le ocasiona una fractura de muñeca, en radiografía se visualiza fractura no desplazada','T02',NULL,NULL,7,'2026-05-04 18:38:36','2026-05-04 18:41:19'),(321,177,3,341,1,'vitamina b y c',NULL,'Paciente refiere mejoria , movilidad ha mejorado y dolor ha disminuido','T02',NULL,NULL,4,'2026-05-04 18:42:12','2026-05-04 18:43:32'),(322,179,3,344,1,'limpieza de herida y se le coloca vendaje elastico',NULL,'Paciente refiere accidente de moto, presenta edema , tumefacción y deformidad articular, posible fractura , se le sugiere radiografía de tobillo','T02',NULL,NULL,8,'2026-05-04 18:44:01','2026-05-04 18:46:20'),(323,157,3,343,1,'Terapia manual, infrarrojo y ultrrasonido',NULL,'Paciente refiere mejoría','T02',NULL,NULL,3,'2026-05-04 18:48:40','2026-05-04 18:49:47'),(324,151,3,345,1,'2da dosis de plasma',NULL,'El paciente refiere sentirse mejor, dolor a la palpación ha disminuido y presenta una mejor marcha','T02',NULL,NULL,3,'2026-05-05 15:23:45','2026-05-05 15:25:29'),(325,180,3,346,1,'crioterapia y fisiotape',NULL,'Paciente de 14 años presenta dolor en rodilla bilateral, hace 1 año, en zona de la tuberosidad de la tibia, a la palpación presenta dolor y una ligera protrusión ósea','T02',NULL,NULL,6,'2026-05-05 15:25:49','2026-05-05 15:29:44'),(326,105,3,338,1,'Terapia manual',NULL,'Paciente refiere que despues de infiltración de acido hialuronico mejoró por un mes, ahora refiere dolor volver','T02',NULL,NULL,4,'2026-05-05 15:30:59','2026-05-05 15:32:47'),(327,177,3,339,1,'terapia manual',NULL,'paciente refiere dolor lumbar','T02',NULL,NULL,NULL,'2026-05-05 15:33:11','2026-05-05 15:35:18'),(328,175,3,340,1,'Terapia manual',NULL,'Paciente refiere bastante mejoría, dolor de hombro ha disminuido','T02',NULL,NULL,1,'2026-05-05 15:36:27','2026-05-05 15:38:10'),(329,175,3,337,1,'Terapia manual',NULL,'paciente refiere que dolor ha disminuido','T02',NULL,NULL,3,'2026-05-05 15:38:46','2026-05-05 15:41:04'),(330,105,3,336,1,'Terapia manual',NULL,'Paciente refiere que dolor de rodilla ha aumentado debido a la actividad física que realiza, le calmo dolor por 2 meses con ACIDO HIALURONICO','T02',NULL,NULL,6,'2026-05-05 15:41:41','2026-05-05 15:43:06'),(331,181,3,348,1,'Terapia manual',NULL,'Paciente refiere que dolor ha disminuido','T02',NULL,NULL,2,'2026-05-06 20:03:57','2026-05-06 20:05:16'),(332,182,3,349,1,'Artrocentesis y terapia manual, y PRP',NULL,'Paciente refiere que se coloco PRP en la rodilla hace 1 año, refiere mejoría durante ese tiempo, desde hace 2 días presenta dolor e incremento de volumen de rodilla derecha, ecográficamente se visualiza derrame articular en el receso suprapatelar','T02',NULL,NULL,7,'2026-05-06 20:05:24','2026-05-12 16:26:23'),(333,181,3,347,1,'Terapia m anual',NULL,'Paciente refiere mejoría','T02',NULL,NULL,2,'2026-05-12 16:24:06','2026-05-12 16:24:55'),(334,181,3,350,1,'Terapia manual',NULL,'Paciente refiere mejoría','T02',NULL,NULL,1,'2026-05-12 16:27:11','2026-05-12 16:28:12'),(335,168,3,351,1,'segunda dosis de PRP',NULL,'Paciente refiere mejoría después de aplicación de 1er plasma','T02',NULL,NULL,NULL,'2026-05-12 16:28:39','2026-05-12 16:30:10'),(336,183,3,352,1,'1ra dosis de PRP en muslo',NULL,'Paciente con dolor de muslo izquierdo después de realizar esfuerzo brusco, ecográficamente se visualiza desgarro muscular cuádriceps','T02',NULL,NULL,6,'2026-05-12 16:30:51','2026-05-12 16:34:21'),(337,184,3,353,1,'Infiltración de corticoide',NULL,'Paciente con dolor de codo, epicondilitis, refiere que hace 1 año recibió infiltración, dolor que ha incrementado hace 1 mes','T02',NULL,NULL,6,'2026-05-12 16:35:09','2026-05-12 16:37:04'),(338,180,3,354,1,'Terapia manual',NULL,'Paciente refiere bastante mejoría, dolor ha disminuido totalmente','T02',NULL,NULL,1,'2026-05-12 16:37:13','2026-05-12 16:38:26'),(339,173,3,355,1,'Aplicación de 2da dosis de PRP',NULL,'Paciente refiere que dolor ha disminuido después de infiltración de PRP','T02',NULL,NULL,3,'2026-05-12 19:18:36','2026-05-12 19:20:56'),(340,180,3,357,1,'crioterapia y terapia manual',NULL,'Paciente con síndrome Osgood schlatter, refiere mejoría','T02',NULL,NULL,1,'2026-05-14 18:13:04','2026-05-14 18:14:17'),(341,185,3,358,1,'infiltración de corticoide',NULL,'Paciente refiere dolor intenso en muñeca derecha, que dificultad actividades de la vida diaria, signo finkelstein positivo','T02',NULL,NULL,8,'2026-05-14 18:14:40','2026-05-14 18:18:23'),(342,11,3,356,1,'Terapia manual y punción seca',NULL,'Paciente con secuela de ruptura de tendón de Aquiles, presenta contractura de gemelos y soleo','T02',NULL,NULL,5,'2026-05-14 18:18:42','2026-05-14 18:20:31'),(343,186,3,359,1,'Infiltración de corticoide',NULL,'Paciente refiere dolor en region plantar de talón, que incrementa al levantarse de la cama, punzadas en talón','T02',NULL,NULL,8,'2026-05-15 18:32:40','2026-05-15 18:34:11'),(344,187,3,360,1,'Terapia manual',NULL,'Paciente con dolor de espalda en la región derecha, refiere punzada en trapecios inferiores, en densitometría se determina osteopenia lumbar (++) y osteopenia cadera derecha (+)','T02',NULL,NULL,7,'2026-05-17 11:29:43','2026-05-17 11:31:56'),(345,188,3,361,1,'aplicación de acido hialuronico, densitometría y terapia manual',NULL,'Paciente que refiere dolor que desciende por los glúteos desde la región lumbar, manifiesta además dolor en rodilla, refiere haber recibido dosis de acido hialuronico en la rodilla hace 1 año, refiere mejoría, viene por segunda aplicación de acido hialuronico, en densitometría la densidad mineral ósea normal y se observa una artrosis marcada en columna dorsolumbar acompañada de una escoliosis severa','T02',NULL,NULL,6,'2026-05-17 11:32:31','2026-05-17 11:36:14'),(346,189,3,362,1,'Terapia manual y administración de acido hialuronico y corticoide en pata de ganso y ligamento lateral',NULL,'Paciente con dolor de rodilla, manifiesta que a los 16 años sufre lesión de rodilla caracterizado por inestabilidad, aumento de volumen y dolor, refiere haber sido infiltrada en aquella época, posteriormente de adulta se infiltro por una ocasión mas corticoide , manifestando haber empeorado, en ecografía no se observa derrame articular, si lesión pata de ganso y ligamento lateral ,se observa lesión de menisco lateral, en densitometría normal, solo pinzamiento lumbar','T02',NULL,NULL,7,'2026-05-17 11:36:49','2026-05-17 11:44:20'),(347,190,3,363,1,'infiltración de corticoide en ligamento lateral y terapia manual',NULL,'Dolor de rodilla izquierda, con antecedente de lesión de menisco externo, dolor en rodilla derecha refiere caída de moto lesión de ligamento lateral externo','T02',NULL,NULL,6,'2026-05-17 13:30:48','2026-05-17 13:33:25'),(348,2,3,1,1,NULL,NULL,NULL,NULL,NULL,NULL,8,'2026-05-20 11:05:16','2026-05-20 11:05:41'),(349,7,3,365,1,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2026-05-20 13:21:43','2026-05-20 13:21:43'),(350,151,3,366,1,'gfhgfhghf','ghgfghf','rrrgfgfhg','T01','hgghgh','2026-05-21',5,'2026-05-20 15:21:41','2026-05-20 15:26:43'),(351,192,3,369,1,'infiltración de acido hialuronico bilateral, terapia manual y punción seca','cita en 9 días','Paciente de 70 años con dolor de rodilla hace 7 años presenta dolor en rodilla derecha(+++) con deformidad en flexión y dolor rodilla izquierda(+). presenta dificultad para caminar y estar en bipedestación, camina con bastón, en ecograf+ia no se visualiza derrame articular, presencia de osteofitos','T02',NULL,NULL,8,'2026-05-20 16:07:22','2026-05-20 16:10:59'),(352,182,3,367,1,'PRP en rodilla derecha e izquierda, terapia manual',NULL,'Paciente refiere mejoría, dolores ha disminuido en rodilla derecha, ha iniciado dolor en rodilla izquierda por lo que se le administra PRP','T02',NULL,NULL,4,'2026-05-20 16:12:24','2026-05-20 16:14:43'),(353,194,3,371,1,'Terapia manual y bajar de peso',NULL,'Paciente refiere dolor de espalda y lumbar , aparentemente obesa, con fosa en lordosis  lumbar acentuada, refiere que dolor no cede con tratamiento medicamentoso','T02',NULL,NULL,6,'2026-05-22 14:06:33','2026-05-22 14:08:28'),(354,195,3,372,1,'Ejercicios terapéuticos',NULL,'Paciente que sufre caída de escalera hace 1 mes, se fractura cráneo parietal derecho, es operada hace 15 días, fragmento óseo ubicado en cadera para posterior reemplazo, presenta hemiplejia derecha','T02',NULL,NULL,2,'2026-05-22 20:09:31','2026-05-22 20:12:32'),(355,173,3,373,1,'PRP tercera dosis',NULL,'Paciente refiere total mejoría, no hay dolor, en ecografía se visualiza tejido cicatrizal de isquiotibiales','T02',NULL,NULL,1,'2026-05-22 20:13:25','2026-05-22 20:15:15'),(356,193,3,370,1,'infiltración de corticoide y terapia manual',NULL,'Paciente con dolor en 5to dedo de la mano, tenosinovitis, en ecografía se visualiza tendinitis del flexor del 5to dedo','T02',NULL,NULL,6,'2026-05-22 20:16:48','2026-05-22 20:21:37'),(357,130,6,375,1,NULL,NULL,NULL,NULL,NULL,NULL,3,'2026-05-23 19:42:27','2026-05-23 19:42:40'),(358,198,3,376,1,'infiltración corticoide bilateral',NULL,'Paciente refiere dolor de ambos talones  por la mañanas, dolor persistente hace 1 mes no cede al tratamiento medicamentoso, en ecografía se puede visualizar fascitis plantar','T02',NULL,NULL,7,'2026-05-25 20:10:16','2026-05-25 20:14:53'),(359,196,3,374,1,'aplicación de PRP',NULL,'Paciente con dolor de tobillo sufrió torcedura hace tres meses, refiere hinchazón y edema los 2 primeros meses  en ecografía hecha en Jaen expresa lesión de ligamento peroneo astragalino y peroneo calcáneo, refiere persistir dolor a pesar del tratamiento medicamentoso','T02',NULL,NULL,7,'2026-05-25 20:15:13','2026-05-25 20:20:32'),(360,199,3,377,1,'aplicación de PRP y terapia manual',NULL,'Paciente que presenta hormigueo en miembro inferior derecho hace 1 año, es intervenido quirúrgicamente por HNP lumbar diagnosticado por RM, refiere no presentar mejoría, ha recibido tratamientos medicamentoso y terapéutico con evolución estacionaría','T02',NULL,NULL,7,'2026-05-26 20:10:14','2026-05-26 20:15:39'),(361,200,3,378,1,'Terapia manual',NULL,'Paciente con dolor lumbar fue infiltrado por neurólogo en región lumbar, en RM se visualiza protuberancias en vertebras lumbares, le recomiendan 10 sesiones de terapia por neurólogo','T02',NULL,NULL,7,'2026-05-26 20:16:13','2026-05-26 20:18:26'),(362,201,3,379,1,'Terapia manual y punción seca',NULL,'paciente con marcha steppage en pie derecho hace 1 año, refiere hormigueo y debilidad muscular en dorsiflexores de pie, presenta dolor a nivel de la parte posterior de la cabeza del peroné, presenta atrapamiento del nervio ciático poplíteo externo','T02',NULL,NULL,6,'2026-05-26 20:18:36','2026-05-26 20:27:13'),(363,192,3,381,1,'Terapia manual y rodillera',NULL,'Paciente refiere mejoría, dolor y volumen inflamatoria ha bajado, mejora marcha','T02',NULL,NULL,2,'2026-05-27 21:01:48','2026-05-27 21:03:32'),(364,200,3,382,1,'Terapia manual',NULL,'Paciente refiere mejoría después de primera sesión de terapia, el mismo día ha presentado dolor por manipulación pero para hoy dolor ha disminuido','T02',NULL,NULL,3,'2026-05-27 21:03:59','2026-05-27 21:06:12'),(365,202,3,380,1,'crioterapia y terapia manual, además de tobillera',NULL,'Paciente con dolor de tobillo intenso en tobillo derecho(+++) e izquierdo(++) presenta aumento de volumen, dolor a la palpación en ligamento tibioperoneos, presenta talones valgos bilateral','T02',NULL,NULL,7,'2026-05-27 21:07:01','2026-05-27 21:12:02'),(366,203,6,383,1,'GHHGF','HGFHHGGF','VBHGBG',NULL,NULL,NULL,NULL,'2026-05-28 10:02:33','2026-05-28 10:03:58'),(367,146,6,384,1,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2026-05-28 10:24:57','2026-05-28 10:24:57'),(368,207,3,392,1,'administración medicamento',NULL,'Paciente con antecedente de lupus eritemaso, refiere dolor de moderado a intenso en región cervical, presenta marca de haberse realizado ventosas','T02',NULL,NULL,8,'2026-06-01 18:05:46','2026-06-01 18:10:46'),(369,137,3,393,1,'aplicación de medicamento',NULL,'Paciente refiere mejoría, dolor ha disminuido','T02',NULL,NULL,8,'2026-06-01 18:11:31','2026-06-01 18:15:02'),(370,137,3,389,1,'Terapia manual, crioterapia, inmovilización',NULL,'Paciente refiere dolor costal derecho, sufre caída golpeándose en la vereda hace 3 días','T02',NULL,NULL,8,'2026-06-01 18:15:56','2026-06-01 18:20:45'),(371,206,3,390,1,'crioterapia',NULL,'Paciente refiere mejoría, edema ha disminuido y temperatura local es menor','T02',NULL,NULL,6,'2026-06-01 18:22:17','2026-06-01 18:23:48'),(372,205,3,391,1,'Terapia manual',NULL,'Paciente refiere mejoría, aun persiste molestia de pie a sedestación, y de sedestación a decubito','T02',NULL,NULL,6,'2026-06-01 18:25:46','2026-06-01 18:29:17'),(373,205,3,386,1,'crioterapia y  faja lumbar',NULL,'Paciente refiere caída en vereda, presenta dolor en región lumbar y cadera, en ecografía se visualiza desgarro muscular glúteo mediano y oblicuo','T02',NULL,NULL,NULL,'2026-06-01 18:29:57','2026-06-01 18:33:22'),(374,40,3,387,1,'Terapia manual',NULL,'paciente con dolor de planta de pie , en ecografía se visualiza engrosamiento de fascia plantar','T02',NULL,NULL,6,'2026-06-01 18:33:51','2026-06-01 18:38:52'),(375,206,3,388,1,'Terapia manual y artrocentesis',NULL,'Paciente refiere contusión con  un palo en la pierna, presenta edema, tumefacción y alza de temperatura local, en ecografía se visualiza colección liquida, refiere realizar tratamiento medicamentoso y no mejorar','T02',NULL,NULL,7,'2026-06-01 18:39:22','2026-06-01 18:46:41'),(376,204,3,385,1,'Terapia manual',NULL,'Paciente con dolor lumbar, refiere dolor al alzar moto lineal un día atrás, refiere dificultad para agacharse y mantenerse sentada','T02',NULL,NULL,7,'2026-06-01 18:47:42','2026-06-01 18:49:01'),(377,205,3,394,1,'REPOSO Y PRP',NULL,'Paciente refiere disminuir dolor con medicamentos, no guarda reposo y dolor aumenta','T02',NULL,NULL,7,'2026-06-02 20:38:41','2026-06-02 20:40:40'),(378,209,3,396,1,'infiltración bilateral de corticoide, terapia manual',NULL,'Paciente con dolor de rodilla izquierda, presenta aumento de volumen en rodilla izquierda, refiere que le atendí hace 10 años, a la evaluacion presenta dolor en linea articular, ecograficamente presenta derrame articular en el receso prepatelar de ambas rodillas, meniscopatia bilateral, dolor en rodilla izquierda (+++) rodilla derecha(+)','T02',NULL,NULL,7,'2026-06-05 17:45:16','2026-06-05 17:55:47'),(379,210,3,397,1,'Terapia manual, manipulación coxis, almohadilla de silicona',NULL,'Paciente refiere caída hace 2 semanas, presenta dolor lumbar y de coxis, en ecografía se puede visualizar reacción inflamatoria','T02',NULL,NULL,8,'2026-06-05 17:57:35','2026-06-05 18:03:48'),(380,211,3,398,1,'Terapia manual',NULL,'Paciente con dolor en la rodilla izquierda, refiere caída hace meses, presenta dolor en la linea articular, región de menisco medial','T02',NULL,NULL,7,'2026-06-05 18:06:48','2026-06-05 18:09:07'),(381,182,3,400,1,'PRP BILATERAL , EN DERECHA (3) EN IZQUIERDA (2)',NULL,'Paciente refiere mejoría, dolor ha disminuido en ambas rodillas','T02',NULL,NULL,2,'2026-06-06 21:00:21','2026-06-06 21:03:04'),(382,214,3,402,1,'PRP en rodilla derecha',NULL,'Paciente con dolor de rodilla, sufre caída en rotación externa, refiere dolor en linea articular en menisco externo','T02',NULL,NULL,8,'2026-06-06 21:03:56','2026-06-06 21:09:09'),(383,213,3,401,1,'punción seca, terapia  manual y elongación piramidal',NULL,'dolor lumbar irradiado a miembro inferior derecho, dolor extensión de columna que se irradia miembro inferior derecho, dolor en glúteo mediano','T02',NULL,NULL,8,'2026-06-06 21:09:36','2026-06-06 21:18:31'),(384,212,3,399,1,'manipulación articular con técnica cóncavo convexo, después de manipulación el paciente refiere mucha mejoría',NULL,'Dolor en muñeca por caída hace 2 semanas, dolor a la rotación externa de mano, dolor intenso',NULL,NULL,NULL,8,'2026-06-06 21:21:45','2026-06-06 21:27:52'),(385,215,3,404,1,'Terapia manual y PRP',NULL,'Paciente con desgarro del cuadrado lumbar,  refiere mejoría en la región del cuadrado lumbar','T02',NULL,NULL,6,'2026-06-09 14:37:17','2026-06-09 19:43:34'),(386,215,3,403,1,'PRP Y terapia manual',NULL,'Paciente refiere dolor hace 1 día en la región lumbar derecho, después de cargar una caja, dolor en cuadrado lumbar, en ecografía se puede visualizar desgarro cuadrado lumbar',NULL,NULL,NULL,8,'2026-06-09 14:39:14','2026-06-09 19:43:04'),(387,216,3,405,1,'PRP y Terapia manual',NULL,'Paciente con dolor de tobillo izquierdo, refiere lesión de tobillo hace 1 mes, refiere dolor al caminar, flexión dorsal limitada, dolor a la palpación en ligamento peroneo astragalino y tibioastragalino en ecografía se visualiza lesión de estos','T02',NULL,NULL,NULL,'2026-06-09 19:44:04','2026-06-09 19:46:56'),(388,217,3,406,1,'Inicia tratamiento para osteoporosis',NULL,'Paciente con dolor costal izquierdo y dolor lumbar, presenta cifosis marcada, refiere recibir golpe con un palo en columna lumbar hace años, ha recibido terapia en otros centros y manifiesta no enconbtrar mejoría, en densitometría se visualiza marcada osteoporosis de -4.6 lumbar, -2.7 en extremidades','T02',NULL,NULL,7,'2026-06-10 18:05:57','2026-06-10 18:14:58'),(389,215,3,407,1,'Terapia manual',NULL,'Paciente refiere 70% de mejoría',NULL,NULL,NULL,2,'2026-06-10 20:15:34','2026-06-10 20:16:53'),(390,218,3,408,1,'PRP en 4 tendones y terapia manual',NULL,'Paciente refiere dolor de hombro bilateral, derecho (++) izquierdo (+++), hace meses atrás que se ha intensificado estos días, no cumple rango articular total en flexión de hombro, dolor en abducción de hombro izquierdo, en ecografía se visualiza tendinitis bicipital y supraespinoso izquierdo y tendinosis subescapular e infraespinoso derecho','T02',NULL,NULL,NULL,'2026-06-10 20:17:04','2026-06-10 20:21:16'),(391,220,3,412,1,'Terapia manual\nArtrocentesis\nInfiltración de plasma y acido hialuronico',NULL,'Paciente con dolor de rodilla, por lesión de ligamento cruzado anterior, manifiesta colocarse acido hialuronico hace 1 año y le fue bastante bien, tiene accidente de moto hace 6 meses y manifiesta molestias que han empeorado en estas dos semanas, en ecografía se visualiza derrame articular, prueba de cajón anterior positiva','T01',NULL,NULL,7,'2026-06-15 18:39:26','2026-06-15 18:44:27'),(392,219,3,409,1,NULL,NULL,'Paciente joven refiere caída, en radiografía se visualiza fractura de diáfisis de humero y luxación de hombro, se recomienda evaluación y tratamiento por traumatología','T01',NULL,NULL,7,'2026-06-15 18:45:43','2026-06-15 18:57:45'),(393,23,3,410,1,'infiltración de corticoide',NULL,'Paciente refiere caída de hombro, dolor en articulación acromioclavicular a la palpación, 24 horas de caída','T02',NULL,NULL,8,'2026-06-15 18:58:09','2026-06-15 20:13:03'),(394,218,3,411,1,'terapia manual',NULL,'Paciente refiere mejoría, refiere ahora adormecimiento de manos y dolor de espalda y cuello','T02',NULL,NULL,4,'2026-06-15 20:13:17','2026-06-15 20:14:41'),(395,221,3,413,1,'Terapia manual',NULL,'paciente con cesárea hace 1 mes presenta dolor de espalda y lumbar','T02',NULL,NULL,6,'2026-06-16 20:03:29','2026-06-16 20:17:48'),(396,224,3,424,1,'Terapia manual y ejercicios, plantilla ortopédica',NULL,'Paciente con dolor de ambas rodillas derecha(+) e izquierda(++), refiere dolor después de ir al gym y después de hacer ejercicios, dolor a la palpación en linea articular , región menisco interno, rodilla derecha, signo condromalacia positivo en ambas rodillas','T02',NULL,NULL,7,'2026-06-24 12:00:49','2026-06-24 12:14:56'),(397,215,3,425,1,'Terapia manual, PRP 2',NULL,'Paciente refiere que dolor ha disminuido, casi no tiene dolor en el lado del cuadrado lumbar, ahora refiere dolor en glúteos (+)que viene de región lumbar','T02',NULL,NULL,2,'2026-06-24 12:18:24','2026-06-24 12:22:06'),(398,223,3,422,1,'terapia manual e infiltración de corticoide',NULL,'Paciente refiere dolor, hormigueo y disminución de fuerza muscular en dedo pulgar e índice de la mano derecha, disminución de la fuerza muscular, dificultad para hacer pinzamiento, en ecografía se visualiza diámetro de nervio mediano aumentado','T02',NULL,NULL,7,'2026-06-24 12:22:25','2026-06-24 12:26:50'),(399,188,3,421,1,'PRP en glúteos y terapia manual',NULL,'Paciente refiere mejoría de las rodillas, ahora refiere dolor en glúteos que se irradia desde región lumbar, dolor a la palpación y delimita la deambulación','T02',NULL,NULL,NULL,'2026-06-24 12:28:07','2026-06-24 12:38:38'),(400,222,3,417,1,'Terapia manual y PRP en hombro bilateral',NULL,'Paciente refiere dolor de hombro, en ecografía se visualiza tendinosis en hombro derecho del supraespinoso y del bíceps y tendinitis subescapular','T02',NULL,NULL,6,'2026-06-24 12:39:25','2026-06-24 12:41:50'),(401,214,3,419,1,'PRP 2da dosis',NULL,'Paciente refiere mejoría de dolor de rodilla, se le realiza 2da dosis de PRP','T02',NULL,NULL,3,'2026-06-24 12:45:41','2026-06-24 12:49:24'),(402,200,3,418,1,'Terapia manual',NULL,'Paciente refiere dolor lumbar, ha mejorado con las sesiones de terapia','T02',NULL,NULL,2,'2026-06-24 12:50:25','2026-06-24 12:52:42'),(403,200,3,416,1,'Terapia manual',NULL,'Paciente con diagnostico de discopatía refiere mejoría con terapia manual','T02',NULL,NULL,4,'2026-06-24 12:53:02','2026-06-24 12:54:45'),(404,200,3,414,1,'Terapia manual',NULL,'Paciente refiere mejoría, antecedente de HNP','T02',NULL,NULL,4,'2026-06-24 12:55:43','2026-06-24 12:56:56'),(405,139,3,415,1,'PRP 3ra dosis',NULL,'Paciente refiere mejoría, dolor de muslo ha bajado y en ecografía se visualiza proceso de cicatrizacion muscular','T02',NULL,NULL,2,'2026-06-24 12:57:07','2026-06-24 12:58:26'),(406,225,3,427,1,'PRP en glúteos y terapia manual, vit By C',NULL,'Paciente con dolor lumbar irradiado a miembro inferior izquierdo hasta las pantorrillas, manifiesta dolor hace 1 semana que dificultad la marcha y sedestación, refiere que hace 10 años le atendí por el mismo problema y se mejoró, en densitometría se visualiza escoliosis leve, osteofitos incipientes y pinzamiento L5 y S1','T02',NULL,NULL,8,'2026-06-25 18:42:37','2026-06-25 18:46:14'),(407,226,3,428,1,'PRP 1ra dosis y terapia manual',NULL,'Paciente con dolor de rodilla derecha, en ecografía se visualiza derrame articular en el receso suprapatelar, protrusión meniscal y signo de artrosis','T02',NULL,NULL,6,'2026-06-25 18:46:49','2026-06-25 18:52:32'),(408,227,3,429,1,'Terapia manual y vitamina B y C',NULL,'Paciente d e90 años, en radiografía se visualiza espondilos artrosis severa y escoliosis severa e inestabilidad columna lumbar, dificultad para caminar, sentarse y acostarse','T02',NULL,NULL,8,'2026-06-25 18:52:58','2026-06-25 18:54:47'),(409,228,3,430,1,'Terapia manual y control de presión arterial',NULL,'Paciente con parálisis facial derecha hace 1 mes, refiere mejoría, recibe terapia con colega, musculos de la boca (0) de los ojos (3)','T02',NULL,NULL,2,'2026-06-25 18:56:24','2026-06-25 18:58:43'),(410,200,3,426,1,'Terapia manual',NULL,'Paciente evoluciona favorablemente y dolor ha disminuido en un 90%','T02',NULL,NULL,2,'2026-06-25 19:00:08','2026-06-25 19:02:10'),(411,225,3,431,1,'Terapia manual',NULL,'Paciente refiere mucha mejoría','T02',NULL,NULL,3,'2026-06-27 17:23:57','2026-06-27 17:34:58'),(412,227,3,432,1,'administración de vitaminas',NULL,'Paciente con espondilo artrosis severa recibe administración de vitamina B y C en domicilio','T02',NULL,NULL,7,'2026-06-27 17:35:40','2026-06-27 17:38:10'),(413,228,3,433,1,'Terapia manual - Infrarrojo',NULL,'Paciente con parálisis facial continua terapia física','T02',NULL,NULL,1,'2026-06-27 17:38:24','2026-06-27 17:39:37'),(414,225,3,434,1,'Terapia manual y administración de vitaminas B y C',NULL,'Paciente refiere mejoría dolor ha disminuido','T02',NULL,NULL,2,'2026-06-27 17:41:03','2026-06-27 17:44:44'),(415,229,3,435,1,'manipulación coxis y terapia manual',NULL,'Paciente refiere dolor en región sacrocococcigea, cae sentada hace 3 semanas, dolor para sentarse y dolor en región lumbar y glútea, en ecografía se visualiza coccigodinea','T02',NULL,NULL,7,'2026-06-27 17:45:09','2026-06-27 18:01:41'),(416,227,3,436,1,'administración de vitaminas',NULL,'dolor controlado','T02',NULL,NULL,6,'2026-06-27 18:01:51','2026-06-27 18:03:14'),(417,182,3,437,1,'PRP 3ra dosis en rodilla izquierda',NULL,'Paciente con gonartrosis bilateral, recibe ultima dosis de PRP en rodilla izquierda','T02',NULL,NULL,2,'2026-06-27 18:03:41','2026-06-27 18:05:12'),(418,6,3,5,1,NULL,NULL,NULL,NULL,NULL,NULL,NULL,'2026-06-29 02:32:51','2026-06-29 02:32:51'),(419,230,3,438,1,'Terapia manual',NULL,'Paciente refiere dolor persistente de región lumbar que no cede al tratamiento medicamentoso','T02',NULL,NULL,7,'2026-06-29 20:43:17','2026-07-08 19:11:14'),(420,232,3,441,1,'Terapia manual y PRP ciático',NULL,'Paciente refiere dolor intenso lumbar que se irradia a miembro inferior izquierdo (***) y a derecho (*) que incrementa a la marcha, y no le deja dormir, en ecografía se visualiza reacción inflamatoria en el recorrido del nervio ciático bilateral','T02',NULL,NULL,8,'2026-07-05 19:57:22','2026-07-05 20:03:47'),(421,232,3,445,1,'Terapia manual y Vitamina B y C',NULL,'Paciente refiere mejoria, dolor ha disminuido','T02',NULL,NULL,3,'2026-07-05 20:04:36','2026-07-05 20:08:33'),(422,232,3,452,1,'Terapia manual y Vitamina B y C',NULL,'Paciente refiere mejoría, dolor ha disminuido notablemente','T02',NULL,NULL,1,'2026-07-05 20:09:38','2026-07-05 20:19:25'),(423,236,3,451,1,'Terapia manual y PRP ciático',NULL,'Paciente embarazada, refiere dolor lumbar que se irradia a glúteos, en ecografía se visualiza reacción inflamatoria en ambos recorridos del nervio ciático','T02',NULL,NULL,6,'2026-07-05 20:20:37','2026-07-05 20:24:23'),(424,233,3,442,1,'Terapia manual y punción seca',NULL,'Paciente de nieva, su madre manifiesta haber estado hospitalizado en nieva por dolor lumbar, debido a caída, en radiografía no se visualiza fractura y en ecografía reacción inflamatoria lumbar','T02',NULL,NULL,7,'2026-07-05 20:24:56','2026-07-05 20:28:43'),(425,233,3,449,1,'Terapia manual',NULL,'Paciente refiere dolor ha disminuido bastante','T02',NULL,NULL,2,'2026-07-05 20:29:09','2026-07-05 20:30:07'),(426,234,3,443,1,'Terapia manual y PRP en cuadrado lumbar',NULL,'Paciente refiere dolor lumbar y dolor en cuadrado lumbar izquierdo hace años, dolor en brazo por esfuerzo brusco en región del tríceps, en ecografía se visualiza desgarro en cuadrado lumbar','T02',NULL,NULL,6,'2026-07-05 20:30:37','2026-07-05 20:33:09'),(427,234,3,450,1,'Terapia manual',NULL,'Paciente refiere mejoría','T02',NULL,NULL,2,'2026-07-05 20:35:23','2026-07-05 20:40:37'),(428,222,3,444,1,'Recibe 2da dosis de PRP en hombro bilateral',NULL,'Paciente refiere mejoría, dolor de hombro derecho ha disminuido , en hombro izquierdo dolor persiste','T02',NULL,NULL,5,'2026-07-05 20:40:55','2026-07-05 20:42:49'),(429,188,3,447,1,'Recibe segunda dosis de PRP',NULL,'Paciente refiere mejoría en dolopr de rodilla, refiere dolor lumbar ha mejorado levemente, adormecimiento de piernas presentes','T02',NULL,NULL,4,'2026-07-05 20:43:21','2026-07-05 20:47:37'),(430,235,3,448,1,'Crioterapia y enyesado',NULL,'Paciente refiere accidente de moto hace 15 dais, presenta dificultad para mover la mano, presenta quemazón en el recorrido del nervio radial, presenta mano en gota (**), y equimosis amplia en región del musculo tríceps, lesión del nervio radial neuropraxia marcada y desgarro tendón tríceps izquierdo',NULL,NULL,NULL,6,'2026-07-05 20:48:09','2026-07-05 20:51:42'),(431,231,3,440,1,'Inmovilización con yeso',NULL,'Paciente niño, madre refiere dolor en muñeca por caída , a la evaluación dolor en muñeca no sigo de fractura, esguince de muñeca','T02',NULL,NULL,7,'2026-07-05 20:52:54','2026-07-05 20:55:19'),(432,234,3,454,1,'Terapia manual',NULL,'Paciente refiere mejoría','T02',NULL,NULL,2,'2026-07-06 16:59:54','2026-07-06 17:00:58'),(433,233,3,453,1,'Terapia manual',NULL,'Mama del niño refiere que niño ha mejorado','T02',NULL,NULL,1,'2026-07-06 17:01:31','2026-07-06 17:02:30'),(434,236,3,455,1,'Terapia manual',NULL,'Dolor lumbar ha mejorado','T02',NULL,NULL,2,'2026-07-06 18:03:06','2026-07-06 18:04:13'),(435,238,3,457,1,'Férula nocturna',NULL,'Paciente de 8 meses con torsión tibial bilateral por uso de andador, presenta deformidad leve, 2do dedo se monta sobre 3ero bilateral se acentúa mas en el pie izquierdo','T02',NULL,NULL,0,'2026-07-06 18:04:30','2026-07-06 18:06:53'),(436,237,3,456,1,'Terapia manual',NULL,'Paciente con dolor lumbar agudo, refiere dolor hace 2 semanas, dolor intenso a la palpación 2q1ue se intensifica de sedestación a bípedo, en densitometría se visualiza rectificación lumbar, calcio normal, paciente con dolor en cicatriz por corte de cesárea','T02',NULL,NULL,8,'2026-07-06 18:07:11','2026-07-06 18:09:44'),(437,239,3,459,1,'terapia manual, infiltración de corticoide de neuroma Morton',NULL,'Paciente con secuela de fractura de 5to metatarsiano de pie derecho, fractura hace 4 meses, dolor entre 3er y 4to dedo del pie, neuroma de Morton, paciente fu evaluado por traumatología e indico 20 sesiones de terapia','T02',NULL,NULL,5,'2026-07-08 01:27:19','2026-07-08 18:54:51'),(438,240,3,460,1,'Terapia manual, artrocentesis, PRP bilateral',NULL,'Paciente refiere dolor de rodilla bilateral, derecha (**) izquierda(*), dolor de hace meses, en ecografía se visualiza derrame articular bilateral y signo de artrosis','T02',NULL,NULL,6,'2026-07-08 18:43:12','2026-07-08 18:47:52'),(439,232,3,458,1,'Terapia manual',NULL,'Paciente refiere mucha mejoría','T02',NULL,NULL,1,'2026-07-08 18:55:25','2026-07-08 18:57:27'),(440,225,3,446,1,'Terapia manual',NULL,'Paciente refiere mejoría','T02',NULL,NULL,2,'2026-07-08 18:57:39','2026-07-08 18:59:36'),(441,188,3,423,1,'2da dosis de PRP',NULL,'Paciente con dolor lumbar refiere evolución estacionaria, adormecimiento de pie y pierna persiste, dolor lumbar ha disminuido','T02',NULL,NULL,5,'2026-07-08 19:06:39','2026-07-08 19:09:06'),(442,200,3,420,1,'Paciente refiere evolución favorable',NULL,'evolución favorable','T02',NULL,NULL,3,'2026-07-08 19:11:49','2026-07-08 19:15:23'),(443,245,3,472,1,'Terapia manual',NULL,'Paciente con dolor de rodilla bilateral, dolor en rodilla derecha (***) e izquierda(**), en ecografía presenta tendinitis de pata de ganso y lesión ligamento lateral interno rodilla  derecha, presenta leve derrame articular en rodilla derecha, en rodilla izquierda presenta dolor ligamento lateral interno, no derrame articular receso suprapatelar','T02',NULL,NULL,7,'2026-07-13 15:29:42','2026-07-13 15:35:29'),(444,244,3,471,1,'terapia manual y punción seca',NULL,'Paciente con dolor de hombro, presenta dolor en trapecio y romboides','T02',NULL,NULL,4,'2026-07-13 15:35:48','2026-07-13 15:41:06'),(445,226,3,470,1,'PRP 2dadosis, e infiltración de tendinitis pata de ganso',NULL,'Paciente recibe 2da dosis de plasma, refiere mejoría, pero estos 2 últimos días refiere sentir molestias, a la evaluación presenta tendinitis de la pata de ganso','T02',NULL,NULL,3,'2026-07-13 15:41:34','2026-07-13 15:46:33'),(446,242,3,465,1,'PRP en rodilla derecha 1ra dosis',NULL,'Paciente con dolor de rodilla derecha, refiere lesión hace 3 meses, dolor en linea articular menisco externo, refiere dolor a subir escalera e inestabilidad articular, en ecografía se visualiza leve derrame articular y lesión de menisco externo','T02',NULL,NULL,6,'2026-07-13 15:46:59','2026-07-13 15:49:44'),(447,242,3,469,1,'Terapia manual',NULL,'Paciente con dolor de ambas rodillas refiere mejoría después de plasma bilateral','T02',NULL,NULL,3,'2026-07-13 15:55:26','2026-07-13 15:56:44'),(448,239,3,462,1,'Terapia manual',NULL,'Paciente refiere mejoría , dolor ha disminuido en 70 %','T02',NULL,NULL,3,'2026-07-13 16:01:23','2026-07-13 16:02:26'),(449,214,3,467,1,'Terapia manual y PRP 3ra dosis',NULL,'Paciente recibe 3ra dosis de plasma , refiere bastante mejoría','T02',NULL,NULL,2,'2026-07-13 16:02:40','2026-07-13 16:09:08'),(450,225,3,461,1,'Terapia manual',NULL,'Paciente evoluciona favorablemente','T02',NULL,NULL,3,'2026-07-13 16:10:43','2026-07-13 16:16:04'),(451,232,3,463,1,'Terapia manual',NULL,'Paciente refiere mejoría, dolor ha disminuido','T02',NULL,NULL,2,'2026-07-13 16:19:05','2026-07-13 16:21:07'),(452,241,3,464,1,'terapia manual y PRP ciático',NULL,'Paciente mecánico, con dolor lumbar que se irradia a miembro inferior derecha hace un mes, que no cede al tratamiento medicamentoso, en ecografías se visualiza inflamación del nervio ciático','T02',NULL,NULL,6,'2026-07-13 16:21:28','2026-07-13 16:26:12'),(453,243,3,466,1,'Terapia manual y PRP 1era Dosis',NULL,'Paciente refiere dolor lumbar irradiado a miembro inferior derecho, refiere estar con dolor hace un mes y que ha incrementado los últimos días, dolor que dificultad la sedestación y marcha','T02',NULL,NULL,8,'2026-07-13 16:26:56','2026-07-13 16:30:29'),(454,243,3,468,1,'Terapia manual',NULL,'Paciente refiere mejoría luego de 1ra dosis de plasma','T02',NULL,NULL,3,'2026-07-13 16:30:37','2026-07-13 16:31:34'),(455,246,3,473,1,'terapia manual\nPRP Ciático 1RA Dosis',NULL,'Paciente con dolor intenso de región lumbar que se irradia a miembro inferior izquierdo hace 1 mes que se ha incrementado esta ultima semana, refiere haber sido evaluado por médicos y no cede el dolor al tratamiento medicamentoso, signo lasegue positivo','T02',NULL,NULL,9,'2026-07-14 20:43:23','2026-07-14 20:47:10'),(456,81,3,474,1,'Terapia manual',NULL,'Paciente con cervicalgia crónica, realiza terapia física y punción seca',NULL,NULL,NULL,6,'2026-07-14 20:48:07','2026-07-14 20:49:11'),(457,247,3,476,1,'Terapia manual',NULL,'Paciente refiere dolor intenso lumbar que se irradia al miembro inferior izquierdo, hace 2 semanas, dolor que llega al borde lateral del píe, refiere realizar tratamiento medicamentoso y no ceder','T02',NULL,NULL,7,'2026-07-16 18:44:46','2026-07-16 18:51:55'),(458,246,3,475,1,'Terapia manual',NULL,'Paciente a un día de recibir su tratamiento refiere mejoría, dolor en región glútea ha disminuido, adormecimiento en dorso de pie persiste','T02',NULL,NULL,7,'2026-07-16 18:52:31','2026-07-16 18:56:47'),(459,246,3,477,1,'Terapia manual',NULL,'Paciente refiere mejoría en comparación al día de ayer','T02',NULL,NULL,5,'2026-07-16 18:57:02','2026-07-16 19:01:36'),(460,247,3,479,1,'PRP 1ra dosis - Terapia manual',NULL,'Paciente refiere leve mejoría y se le aplica su plasma, en densitometría se visualiza disminución del diámetro de agujero de conjunción de las vertebras L5 y S1','T02',NULL,NULL,7,'2026-07-17 19:47:11','2026-07-17 19:56:02'),(461,194,3,480,1,'punción seca y manipulación coxis',NULL,'Paciente que fue atendida hace 3 meses, por cervicalgia y coxis, ahora viene por dolor coxis y manipulación','T02',NULL,NULL,6,'2026-07-17 20:05:47','2026-07-17 20:12:06'),(462,232,3,478,1,'PRP 2da dosis',NULL,'Paciente refiere bastante mejoría, recibe 2da dosis de plasma','T02',NULL,NULL,3,'2026-07-17 20:12:16','2026-07-17 20:16:31'),(463,248,3,481,1,'infiltración de corticoide en codo',NULL,'paciente con adormecimiento de 4to y 5to dedo de la mano izquierda por atrapamiento del nervio cubital en el codo, en densitometría se determina osteopenia en columna lumbar y cadera, se logra visualizar quiste óseo en zona metafisaria del fémur izquierdo','T02',NULL,NULL,7,'2026-07-17 20:17:02','2026-07-17 20:21:22'),(464,52,3,482,1,'Terapia manual y punción seca',NULL,'Paciente con antecedente de parálisis facial hace 3 meses, presenta aun secuelas, con presión arterial elevada, no controla presion para ser determinado como hipertenso, en la actualidad presenta dolor intenso en trapecios','T02',NULL,NULL,6,'2026-07-17 20:21:30','2026-07-17 20:25:48'),(465,247,3,483,1,'hoy no recibió terapia física, solo inyección intramuscular',NULL,'Paciente refiere mejoría , dolor de región glútea ha disminuido','T02',NULL,NULL,4,'2026-07-18 21:26:57','2026-07-18 21:31:21'),(466,36,3,484,1,'Terapia manual e infiltración corticoide',NULL,'Paciente refiere dolor en región plantar del pie, en región de espolón de calcáneo y en base de metatarso, en ecografía se visualiza fascitis plantar y espolón de calcáneo','T02',NULL,NULL,7,'2026-07-18 21:31:31','2026-07-18 21:35:05'),(467,246,3,485,1,'Terapia manual',NULL,'Paciente refiere mejoría a un 50%, dolor ha disminuido pero persiste a la marcha, continua tratamiento medicamentos indicado por su medico','T02',NULL,NULL,5,'2026-07-18 21:35:29','2026-07-18 21:37:29'),(468,240,3,489,1,'Acido hialuronico en la rodilla derecha y plasma en la rodilla izquierda, terapia manual',NULL,'Paciente que recibió tratamiento de PRP en rodillas bilateral, manifiesta que el dolor ha disminuido, pero aun manifiesta dolor en la derecha (++) e izquierda(+). opta por tratamiento de acido hialuronico en la derecha y continua plasma en la rodilla izquierda','T02',NULL,NULL,4,'2026-07-20 18:38:24','2026-07-20 18:42:08'),(469,250,3,490,1,'PRP en tendón de Aquiles y punción seca',NULL,'Paciente con dolor en región de tendón de Aquiles, manifiesta dolor después de hacer deporte, refiere sentir un puntapié en zona de lesión, síntoma típico de desgarro de tendón de Aquiles, lesión sufrida hace un año, paciente presenta dolor leve a la palpación y en ecografias se observa desgarro antiguo del tendón de aquiles','T02',NULL,NULL,4,'2026-07-20 18:42:57','2026-07-20 18:50:39'),(470,246,3,486,1,'Crioterapia y terapia manual',NULL,'Paciente refiere mejoría lenta, quemazón y hormigueo presente en la pantorrilla y tobillo izquierdo','T02',NULL,NULL,5,'2026-07-20 18:51:09','2026-07-20 18:56:09'),(471,246,3,492,1,'crioterapia y terapia manual',NULL,'Paciente refiere sentirse mejor, adormecimiento ha disminuido con  crioterapia','T02',NULL,NULL,4,'2026-07-20 18:56:21','2026-07-20 18:57:41'),(472,252,3,494,1,'Pañal abductor',NULL,'Paciente varón evaluado por pediatra, viene con ecografía del Dr. Pacheco con diagnostico de displasia de cadera. viene para elaboración de pañal abductor.\nNo solicita mi consulta, para a la evaluación paciente normal, solo presencia de pliegue cutáneo en muslo','T02',NULL,NULL,0,'2026-07-20 18:58:26','2026-07-20 19:03:09'),(473,245,3,487,1,'Terapia manual y continua tratamiento medicamentoso y colageno',NULL,'Paciente refiere mucha mejoría, dolor edema y tumefacción han disminuido','T02',NULL,NULL,2,'2026-07-20 19:03:32','2026-07-20 19:11:07'),(474,249,3,488,1,'Terapia manual',NULL,'Paciente con antecedente de hipertensión arterial medicada, refiere dolor intenso en rodillas, con deformidad en flexión en rodilla derecha, dolor intenso en rodilla izquierda, en radiografía traída por el paciente se visualiza perdida del espacio articula en ambas rodillas, osteofitos y signo marcados de artrosis severa','T02',NULL,NULL,8,'2026-07-20 19:12:12','2026-07-20 19:15:51'),(475,251,3,491,1,'Terapia manual y punción seca',NULL,'Paciente con dolor de hombro, y región de espalda','T02',NULL,NULL,4,'2026-07-20 19:16:28','2026-07-20 19:19:46'),(476,52,3,493,1,'Terapia manual y punción seca',NULL,'Paciente con dolor de espalda crónico, refiere fallecimiento de esposa y problemas de salud en la familia, refiere subirse la presión en forma esporádica, a la evaluación fuerte contractura muscular de trapecios y romboides','T02',NULL,NULL,4,'2026-07-20 19:20:20','2026-07-20 19:24:17'),(477,246,3,496,1,'Terapia manual',NULL,'El paciente refiere persistir hormigueo en pierna izquierda, dolor en región glútea ha disminuido','T02',NULL,NULL,4,'2026-07-21 18:38:33','2026-07-21 18:45:19'),(478,253,3,495,1,'Terapia manual',NULL,'Paciente con secuela de fractura de fémur hace 3 años, no recibió terapia física, presenta dificultad para caminar y dolor en cadera derecha','T02',NULL,NULL,5,'2026-07-21 18:45:30','2026-07-21 18:57:29'),(479,254,3,497,1,'Terapia manual',NULL,'Paciente con dolor de cuello crónico de 25 años de edad, refiere aumentar dolor con el stress','T02',NULL,NULL,4,'2026-07-21 18:58:18','2026-07-21 19:02:15'),(480,251,3,498,1,'Terapia manual y punción seca',NULL,'Paciente refiere mejoría, dolor ha diminuido','T02',NULL,NULL,2,'2026-07-21 19:16:25','2026-07-21 19:18:16'),(481,257,3,502,1,'PRP en nervio ciático y terapia manual',NULL,'Paciente con dolor lumbar que irradia a glúteo derecho, tiempo de evolución 1 día, refiere recibir tratamiento medicamentoso con otros especialistas y no refiere mejoría','T02',NULL,NULL,7,'2026-07-23 19:18:30','2026-07-23 19:23:45'),(482,255,3,499,1,'terapia manual, infiltración de acido hialuronico bilateral',NULL,'Paciente refiere dolor de rodilla bilateral en rodilla derecha (++) e izquierda(+), dolor que incrementa a las sentadillas y a la flexión total, en ecografía se visualiza derrame articular en la rodilla derecha y lesión ligamento lateral externo, en rodilla izquierda se visualiza tendinitis de pata de ganso, dolor a la palpación en linea articular externa bilateral','T02',NULL,NULL,7,'2026-07-23 19:23:58','2026-07-23 19:30:04'),(483,246,3,500,1,'PRP 2da dosis',NULL,'Paciente refiere dolor ha disminuido, pero persiste adormecimiento en la pierna, se le coloca PRP','T02',NULL,NULL,4,'2026-07-23 19:30:31','2026-07-23 19:48:04'),(484,246,3,503,1,'Terapia manual',NULL,'Paciente refiere mejoría el adormecimiento ha disminuido , refiere ahora adormecimiento se ha trasladado al pie','T02',NULL,NULL,3,'2026-07-23 19:57:07','2026-07-23 20:00:41'),(485,256,3,501,1,'Terapia manual',NULL,'Paciente con dolor lumbar, con antecedente de osteopenia marcada del cual hizo tratamiento por tres meses, refiere que hace meses corriendo sintió dolor en la ingle, a la palpación presenta dolor en nervio femorocutáneo derecho, en ecografía se visualiza recciones inflamatorias','T02',NULL,NULL,5,'2026-07-23 20:01:58','2026-07-23 20:08:02'),(486,81,3,504,1,'Terapia manual',NULL,'Paciente refiere dolor crónico de cuello','T02',NULL,NULL,7,'2026-07-23 20:08:17','2026-07-23 20:13:10'),(487,253,3,505,1,'Infiltración de acido Hialuronico en cadera derecha y terapia manual',NULL,'Paciente refiere mejoría después de 1ra terapia, refiere sentirse mejor con mejor deambulación','T02',NULL,NULL,7,'2026-07-24 19:48:20','2026-07-24 19:50:45'),(488,258,3,506,1,'Se recomienda crioterapia, reposo e inmovilización, no adquirió faja',NULL,'Paciente que refiere dolor costal derecho por contusión directa con una baranda hace 4 días, refiere dolor a pesar de tratamiento medicamentoso, en ecografía se visualiza fisura costal','T02',NULL,NULL,8,'2026-07-24 19:51:11','2026-07-24 19:54:12'),(489,257,3,507,1,'Terapia manual',NULL,'Paciente después de 1ra PRP refiere bastante mejoría, dolor ha disminuido casi al 100%','T02',NULL,NULL,2,'2026-07-24 19:54:22','2026-07-24 19:56:33'),(490,246,3,508,1,'Terapia manual y vitamina B y C',NULL,'Paciente refiere mejoría, pero aun continua adormecimiento en pie','T02',NULL,NULL,3,'2026-07-24 19:58:32','2026-07-24 20:01:19'),(491,256,3,509,1,'Terapia manual',NULL,'Paciente refiere mejoría después de primera sesión de terapia, leve dolor lumbar','T02',NULL,NULL,2,'2026-07-24 20:01:47','2026-07-24 20:03:50'),(492,207,3,510,1,'Terapia manual y punción seca',NULL,'Paciente con dolor crónico de cuello','T02',NULL,NULL,7,'2026-07-24 20:07:38','2026-07-24 20:11:27'),(493,257,3,514,1,'Terapia manual',NULL,'Paciente refiere que dolor ha disminuido en comparación a la primera vez, pero de ayer para hoy incremento un poco','T02',NULL,NULL,5,'2026-07-26 12:28:08','2026-07-26 12:29:14'),(494,246,3,513,1,'Terapia manual',NULL,'Paciente refiere mejoría , dolor ha disminuido en comparación al día de ayer','T02',NULL,NULL,3,'2026-07-26 12:29:37','2026-07-26 12:30:44'),(495,259,3,511,1,'PRP 1ra dosis bilateral y terapia manual',NULL,'Paciente con dolor lumbar irradiado a miembro inferior izquierdo y derecho hacia ambos glúteos, dolor hace 1 mes','T02',NULL,NULL,7,'2026-07-26 12:31:16','2026-07-26 12:45:13'),(496,151,3,512,1,'Terapia manual y PRP 1ra dosis',NULL,'Paciente con antecedente de lesión de rodilla y con tratamiento con nosotros, ahora viene por dolor ciático irradiado a miembro inferior izquierdo, Lasegue (++)','T02',NULL,NULL,7,'2026-07-26 12:38:02','2026-07-26 12:47:51'),(497,246,3,518,1,'Terapia manual',NULL,'Paciente después de 2  semanas de terapia , 2 PRP y punción seca refiere bastante mejoría a un 80 %','T02','Terapia dejando un día',NULL,3,'2026-07-27 19:59:18','2026-07-27 20:01:06'),(498,261,3,517,1,'Terapia manual',NULL,'Paciente niño con secuela de fractura de codo izquierdo intervenido quirúrgicamente hace 4 meses, presenta limitación articular hacia la flexión y extensión de codo, postura intermedia flexo extensión de codo','T02',NULL,NULL,4,'2026-07-27 20:01:30','2026-07-27 20:05:48'),(499,253,3,516,1,'Terapia manual',NULL,'Paciente refiere mejoría, dolor ha disminuido y mejorado la marcha','T02',NULL,NULL,3,'2026-07-27 20:07:38','2026-07-27 20:08:48'),(500,260,3,515,1,'Terapia manual',NULL,'Paciente intervenido quirúrgicamente por hernia del núcleo pulposo hace 50 días, refiere sentir mejoría dolor ha disminuido , dolor de la pierna izquierda ha mejorado, aunque siente algo de hormigueo y quemazón en la planta del pie','T02',NULL,NULL,6,'2026-07-27 20:09:17','2026-07-27 20:12:31');
COMMIT;

-- Dumped table `medical_consultations` with 500 row(s)
--

--
