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- ÍtemAcceso AbiertoAbordaje sobre migraña. Revisión sistemática(Universidad Católica de Cuenca., 2023) Alvarez Naspud, Nathaly Mariana; Torres Criollo, Larry Miguel; 0302198957; ., .Introduction: Migraine is part of the primary headaches; it is a disease that causes functional limitations. Due to the pain caused by the crisis, the diagnosis is only clinical, determined by the physician through clinical history; the treatment should be individualized, which means it differs from one patient to another. Objective: To analyze the information on migraines via a systematic review, considering diagnostic criteria, treatment, and complications. Method: A systematic review was conducted using the PRISMA 2020 guide; information was obtained from PubMed, Scopus, Science Direct, SciELO, and Redalyc databases; articles were selected based on the application of inclusion and exclusion criteria, considering Q1 - Q4 quartiles, in addition to Oxford evidence levels and according to methodological quality using the PEDro scale. Results: Once analyzing the scientific articles, it is established that palpitations occur in 56.6%, being the primary extracranial autonomic symptom that precedes migraine patients. Triptans are the preferred treatment choice, with sumatriptan estimated as the first-line drug. Migraine with aura exposes patients to migrainous infarction, the most frequent complication of this condition.
- ÍtemAcceso AbiertoAcrodermatitis enteropática: Diagnóstico y tratamiento(Universidad Católica de Cuenca., 2024) Castillo Hurtado, Junior Bryan; Espinoza Días, Cristobal Ignacio; 0850601154INTRODUCTION: Acrodermatitis enteropathica is an autosomal recessive disorder due to zinc deficiency due to an alteration in one of the zinc transporter families (ZnT and ZIP) responsible for its regulation. It presents a triad characterized by periorificial dermatitis, diarrhea, and alopecia in 20% of patients. The diagnosis is made by measuring plasma zinc levels with average values between 70 and 110 ug/dL. Values <50 ug/dL suggest suspicion of acrodermatitis enteropathica. Treatment is based on zinc supplementation at 10-15 mg/kg/day doses. OBJECTIVE: To develop a clear and structured bibliographic review to provide the tools for the opportune disease’s identification, correct diagnosis, and adequate treatment. METHODOLOGY: A literature review was conducted employing PubMed, SciELO, Elsevier, Redalyc, and Ebsco databases. RESULTS: The mean age of symptom onset was six months. For all cases, the male sex is the most affected (53%). In 100% of the cases, the patients presented periorificial and acral skin lesions; diarrhea was present at 44% and alopecia at43%. On the other hand, family history of acrodermatitis enteropathica and consanguinity were reported principally in Middle Eastern countries (22% and 40%). In 100% of the cases, zinc levels were determined below the reference values, and in 32% of the cases alkaline phosphatase was determined. Genetic studies confirm the SLC39A4 gene alteration (19%). Keywords: Acrodermatitis enteropathica, zinc, skin, zinc deficiency, intestinal absorption
- ÍtemAcceso AbiertoActualización en el tratamiento de hipoglucemiantes orales en pacientes con diabetes mellitus tipo II.(Universidad Católica de Cuenca., 2024) Aportela Tárano, Claudia María; Vásquez Calle, María Alicia; 0959506049Abstract: A wide variety of oral hypoglycemic agents are available for treating Type 2 diabetes mellitus (T2DM). Conventional options include Biguanides, sulfonylureas, meglitinides, and thiazolidinediones, while newer ones like dipeptidyl peptidase four inhibitors, Sodium/Glucose transporter two inhibitors, among others, not only control T2DM but also manage associated pathologies of renal and cardiac origin. However, these medications are not included in Ecuador's basic drug regimen due to the high costs involved. Objective: To update knowledge on treating Type 2 diabetes mellitus, focusing on oral hypoglycemic agents. Methodology: A qualitative systematic review was conducted, and a non-experimental documentary outline was developed at a descriptive level following PRISMA guidelines. Results: For this review, 45 articles from Elsevier (2), PubMed (6), NIH (3), Google (11), SciELO (5), and Cochrane (1) databases were examined. Fourteen articles did not meet the established timeframe for publication. Conclusions: Although metformin remains the first-line oral medication for T2DM, other therapeutic options can be considered, considering each patient's comorbidities. Choosing the optimal option based on their condition can decrease complications, improve their lifestyle, and reduce cardiovascular risk. Keywords: Oral hypoglycemic agents, Type 2 Diabetes Mellitus, Ecuador
- ÍtemAcceso AbiertoActualización acerca de la orientación terapéutica de la alopecia areata. Revisión bibliográfica(Universidad Católica de Cuenca., 2023) Chavarrea Orellana, María del Cisne; Peláez Vélez, Luzmila Carolina; 0302562376Introduction.- Alopecia areata is a non-scarring autoimmune condition characterized by hair loss in single patches, clumps, or total loss affecting the beard, axillary hair, pubic hair, or any other hairy area. Different studies indicate that there is no one therapeutic better than another, nor solid data capable of suggesting that drug-induced remissions or treatments alter the course of the disease. Objective.- To describe the different therapeutic plans showing the best evidence in treating alopecia areata. Methodology.- It was descriptive research based on the PRISMA 2020 method; information was gathered from scientific databases such as PubMed, SciELO, and Scopus, which were guided by inclusion and exclusion criteria, using articles from the last five years on therapeutic plans for alopecia areata. Results.- As a result, 87 articles were obtained from the scientific databases, and 54 were excluded. Finally, 35 met the inclusion criteria, and 15 articles were employed to develop the discussion, aiming to clarify which type of treatment is more effective according to medical and scientific knowledge.
- ÍtemAcceso AbiertoActualización científica obstrucción de la vía aérea por cuerpo extraño - OVACE. Revisión Sistemática(Universidad Católica de Cuenca., 2023) Urgilés Rodríguez, Rafael Leonardo; Barzallo Ochoa, Tania Pamela; 0302617121; ., .Foreign Body Airway Obstruction (FBAO) is a pediatric emergency characterized by the accidental penetration of an organic or inorganic object into the tracheobronchial tree, which can cause dyspnea, severe hypoxia, cardiorespiratory arrest, and death. Objective: To provide a scientific update on FB airway obstruction through a systematic review with high statistical power. Method: An exhaustive exploration of the plasma systematic review was performed, which is a descriptive, explanatory, and longitudinal research, based on the PRISMA statement, to identify several academic articles of scientific importance. Results: It is a childhood emergency, mainly in boys, with a percentage of 61.97, and 69.02% in children under five. The focused therapeutic management was the use of Magill clamp or intubation (74.64%-53 cases), bronchoscopy (14.1%-10 cases), laparoscopic surgery (1.41%-1 cases), and expectant management (9.85%-7 cases). These figures come from 71 cases that capture 100% of pediatric patients with FBAO who attended this center between 2017 and 2021. Conclusion: Aspiration of foreign bodies has been cataloged as one of the leading causes of morbidity and mortality in pediatric patients. Among the most common foreign bodies in bronchoaspiration, are fruits, grains, candy, meat, and bones. In terms of diagnosis, the first choice is a chest X-ray to determine the type and location of the foreign body, and based on this, the appropriate treatment is determined.
- ÍtemAcceso AbiertoActualización Científica sobre la Displasia Broncopulmonar Neonatal. Revisión sistemática(Universidad Católica de Cuenca., 2024) Lalama Cruz, Miriam Coralia; Alomia Castro, Paúl; 0924337942Bronchopulmonary dysplasia (BPD) is one of the most significant and common complications of prematurity, and its frequency has been increasing in recent years. It has high cardiopulmonary morbidity and mortality in premature infants. It is characterized by lung injury and abnormal development of the neonate's lungs because of mechanical ventilation implementation and prolonged use of supplemental oxygen. Objective: To conduct an updated literature review on the primary aspects of interest regarding neonatal bronchopulmonary dysplasia. Methodology: A qualitative, descriptive, and documentary-structured systematic review was performed based on PRISMA guidelines. Results: Fifteen articles were discarded because they did not meet the established timeframe for publication, and two were duplicated. Information from 28 articles published on PubMed (6), SciELO (4), Elsevier (2), Google Scholar (8), and NIH (8) databases was used for this review. Conclusions: Prematurity is the most determinant risk factor in bronchopulmonary dysplasia (BPD). Some factors can act as protective, such as using exogenous pulmonary surfactant and caffeine. The primary complications related to BPD are late-onset neonatal sepsis, necrotizing enterocolitis, and intraventricular hemorrhage. The use of inhaled corticosteroids and salbutamol is widely used in the outpatient treatment of BPD. Keywords: bronchopulmonary dysplasia, oxygen therapy, prematurity, immature lung, mechanical ventilation
- ÍtemAcceso AbiertoActualización clínica del manejo de Taquipnea Transitoria en el recién nacido. Revisión sistemática(Universidad Católica de Cuenca., 2023) Vázquez Lituma, Sofía Belén; Barzallo Ochoa, Tania Pamela; 0106466972Introduction: Transient Tachypnea of the Newborn (TTN) results from the neonate's inability to reabsorb fetal lung fluid after birth. It is multifactorial, with an incidence of approximately 3.6-5.7 per 1000 term neonates, being self-limiting and benign. Objective: To conduct a systematic review to outline the clinical update on managing transient tachypnea of the newborn, employing scientifically significant articles. Methodology: A systematic review with a descriptive, observational, and explanatory approach was conducted based on the PRISMA 2020 method, using information published in the last five years. Results: Seventy-five articles were obtained from the database, 43 were excluded, and 31 met the inclusion criteria., eight of them were used in the discussion, indicating that TTN is a self-limiting condition with a worldwide incidence ranging from 4.0 to 5.7 per 1000-term newborns. At the same time, this condition presents multiple risk factors, such as infants of diabetic mothers, cesarean delivery, and perinatal asphyxia, among others. Diagnosis is primarily clinical, but imaging studies like pulmonary ultrasound can also be used. Treatment in neonates mainly consists of oxygen therapy, although medications such as salbutamol have been investigated, showing improvement in symptoms and reduced oxygen therapy usage, advanced life support, and hospital stay, leading to early and appropriate feeding initiation, likewise, it is not evidenced whether the early fluid restriction in neonates is safe for treating transient tachypnea in the newborn.
- ÍtemAcceso AbiertoActualización de complicaciones postquirúrgicas de colecistectomía laparoscópica(Universidad Católica de Cuenca., 2023) Vicuña Palomeque, Sazkya Andrea; Torres Maldonado, Xavier Eduardo; 0302634902Laparoscopic cholecystectomy (LC) is a surgical procedure that involves the removal of the gallbladder. It is commonly used as the standard treatment for various diseases related to the biliary tract, being cholelithiasis or gallstones the main and most frequent ones; other indications for this procedure are also: cholecystitis, biliary pancreatitis, tumors, and others. There is a low risk of post-surgical complications when using this approach compared to conventional cholecystectomy; despite this, it is not exempt from causing adverse effects. This is the case with post-surgical complications, in which various risk factors such as patient comorbidities, age, sex, and the evolution time of the pathology intervene. The adverse events after surgery are established as 1) Immediate: we will find mild ones, such as infection of the operative site and seromas; moderate: hemorrhage, fistula, and hernia; and severe ones, such as bile duct injury, vascular injury, hollow viscus injury and fistulas, and the complications 2) Mediates that refer to postcholecystectomy syndromes. It is necessary to be aware of all these unwanted effects that could arise to have early detection and adequate treatment.
- ÍtemAcceso AbiertoActualización de complicaciones quirúrgicas de Apendicectomía abierta(Universidad Católica de Cuenca., 2024) Lara Castro, Luis Israel; Torres Maldonado, Xavir Eduardo; 1600564098Appendectomy is the surgical procedure that consists of resecting the appendix when it shows signs of inflammation and induces symptomatology in the patient; in emergency services, the lifetime risk of developing appendicitis is estimated to be approximately 9%. Like any other surgical pathology, it is not exempt from complications, which are any alteration concerning the expected process in the local or systemic response of surgical patient; their cause is very often collateral to the primary disease, secondary to the surgical procedure, or unrelated causes. It is relevant to mention that conventional or laparoscopic appendectomy is performed according to the surgeon's criteria, and complications are related to the surgeon's experience, the patient, and the type of surgery. The complications that can occur are surgical site infection, intra-abdominal abscess, sepsis, wound dehiscence, sinus of suture lines, cecal fistula, evisceration, intestinal obstruction, incisional hernias, neoplasms, and pyliphlebitis. Keywords: appendicitis, intraoperative complications, focal infection
- ÍtemAcceso Abierto“ACTUALIZACIÓN DE LAS COMPLICACIONES POSTQUIRÚRGICAS EN CIRUGÍA MÍNIMAMENTE INVASIVA EN GINECOLOGÍA. REVISIÓN BIBLIOGRÁFICA”(Universidad Católica de Cuenca., 2023) Rentería Rengel, Kevin Ricardo; Gallegos Vintimilla, Santiago Homero; 1104223001; ., .Introduction: Over the years, new surgical techniques have been developed to reduce mortality and complications, which are related to the complexity of the surgery to be performed; for this circumstance, laparoscopic surgery was designed since it does not have a significant rate of complications it does not have the importance at the time of diagnosis and postoperative treatment. Objective: To analyze postoperative complications in minimally invasive surgery in gynecology through a bibliographic review. Methodology: A bibliographic review of scientific information published in the last five years was conducted. This research included scientific articles published in English and Spanish, degree works, clinical trials, and systematic and bibliographic reviews. Documents were selected from reliable sources related to the proposed topic. Results: Thirty- five scientific articles were reviewed from the following databases: Web of Science, Scopus, Google Scholar, Elsevier, SciELO, and PubMed; nine articles were excluded, one for having incomplete information, two repeated articles, and six articles that were published more than five years ago.
- ÍtemAcceso AbiertoActualización de neumonía adquirida en la comunidad en pacientes pediátricos. Revisión sistemática(Universidad Católica de Cuenca., 2023) Pinargote Santana, Pamela Lissette; Pérez Ramírez, Jacinto Eugenio; 1316178159Abstract: Respiratory diseases such as community-acquired pneumonia (CAP) in children account for 14% of all deaths worldwide in minors under five years of age. In Ecuador, the National Statistics and Census Institute (INEC by its Spanish acronym) reported in the 2018 Census that this pathology was the third cause of death in children under 11 years of age due to different risk factors that include low birth weight, poor nutrition, absent or insufficient breastfeeding, and immature immune system. Objective: To conduct a systematic review on community-acquired pneumonia in pediatric patients. Methodology: This research was a systematic review with PRISMA 2020 methodology; 26 articles from different websites related to medicine were analyzed. Results: Fifty scientific articles were identified, and 26 were included. It was determined that overcrowding, absent or insufficient breastfeeding, and an incomplete vaccination schedule are the main risk factors for acquiring this disease in children under three years of age. Conclusions: Using zinc sulfate in CAP significantly decreases hospital stays, and consuming vitamin C reduces incidence rates of respiratory diseases; complications are more predominant in children under one year, representing 51.51% of cases.
- ÍtemAcceso AbiertoActualización de neuralgia del trigémino. Revisión sistemática(Universidad Católica de Cuenca., 2023) Jimmy Javier, Molina Verdugo; Torres Criollo, Larry Miguel; 0302893086; ., .Introduction: Trigeminal neuralgia (TN) is a pathology characterized by intense unilateral facial pain and commonly affecting the maxillary and mandibular branches of the trigeminal nerve. Its multifactorial etiology makes identifying more current and effective diagnostic and therapeutic methods essential. Objective: To identify trigeminal neuralgia's updated clinical, diagnostic, and therapeutic characteristics. Methodology: A systematic review was conducted according to the recommendations of the PRISMA 2020 declaration, based on the literature available in data portals "PubMed, Science Direct, SciELO, Elsevier, and Google Scholar" from the last five years, including a bibliography between the Q1-Q4 quartiles reflecting the impact index of each journal and evidence levels classified by the Oxford scale. Results: A database was generated by searching and screening the scientific bibliography to provide quality information and thus achieve a proper identification and treatment of the disease. Conclusions: After reviewing the articles, it was concluded that the primary etiology is idiopathic. The diagnosis is clinical according to Headache Disorders Classification criteria in its third edition and three-dimensional T2-weighted magnetic resonance imaging for the assessment of nerve structures; some therapeutic options exist, the carbamazepine considered the first-line pharmacological treatment and the microvascular decompression surgical therapy as an option in cases of low tolerance.
- ÍtemAcceso AbiertoActualización del diagnóstico y manejo de la rinitis alérgica en pacientes pediátricos(Universidad Católica de Cuenca., 2023) Molina Cevallos, Erika Gabriela; Quevedo Crespo, María José; 0921698254; ., .Allergic rhinitis is a common disease in children and adolescents. It presents a prevalence of 8% to 15% in the child population worldwide (1) Objective. This work aims to inform about the different diagnostic methods and therapeutics used in this pathology in pediatric patients. Method. It is a bibliographic review of non-experimental documentary design based on PRISMA guidelines. For this research, a compilation of different scientific articles and systematic reviews was conducted, consulting high-impact databases, such as PubMed and SciELO. The search was limited to articles published in the last five years in Spanish and English. Results: Thirty-one articles were reviewed, and 26 were selected for relevance. Five articles were excluded, as four had a publication date older than five years, and one had incomplete information. The key elements for diagnosing allergic rhinitis include an adequate anamnesis and a proper physical examination. The treatment of allergic rhinitis is pharmacological (antihistamines, intranasal corticosteroids, among others) and non-pharmacological (avoiding contact with allergens). Conclusions. Allergic rhinitis involves inflammation of the nasal mucosa. It is essential for medical professionals to diagnose, treat, and follow up ith patients appropriately to improve their quality of life and those around them.
- ÍtemAcceso AbiertoActualización del diagnóstico y manejo del embarazo ectópico(Universidad Católica de Cuenca., 2023) Matute Tituana, Deybin Dubal; Espinoza Diaz, Cristóbal Ignacio; 1400878573Introduction: Ectopic pregnancy, also known as extrauterine, means a significant risk to maternal health and can lead to life-threatening complications if not diagnosed and managed promptly. A worldwide prevalence of ectopic pregnancy has been reported to be 2%. Objective: This paper aims to describe potential mechanisms underlying ectopic pregnancy, along with its diagnosis and treatment. Methodology: A literature review was performed on PubMed, Medline, and SciELO databases. It included cross-sectional, observational, and randomized controlled trials published in English and Spanish from January 2018 to July 2023. Results: The review comprises seven randomized controlled clinical trials (70%) and three retrospective observational studies (30%). In 100% of the articles, the diagnosis of ectopic pregnancy is detailed by transvaginal ultrasound and β-hCG levels > 1500. Surgical treatment (salpingectomy, salpingostomy, ultrasound-guided curettage, laparoscopic salpingectomy) is specified in 40% of the articles, 50% corresponds to pharmacological management with methotrexate 50mg intramuscular at one or two doses, expectant management is mentioned in 10% of the articles. Conclusions: A prompt diagnosis by ultrasound, blood biochemistry, and an adequate clinical record and early intervention with methotrexate at two doses (0 and 4 days) reduces the risk of morbidity and improves the chances of future pregnancy without complications.
- ÍtemAcceso AbiertoActualización del diagnóstico y manejo del síndrome compartimental abdominal. Revisión sistemática(Universidad Católica de Cuenca., 2023) Saldarriaga Basurto, Bryan Stalin; Rodas Andrade, Jorge Roberto; 1314637297; ., .Abdominal Compartment Syndrome (ACS) is defined as when two or more anatomical segments exhibit persistent intra-abdominal pressures (IAP) >20mmHg, associated with organ failure. Intra-abdominal hypertension (IAH) and ACS occur more frequently in patients with high morbidity and mortality rates. Continuous monitoring of critically ill patients, both medical and surgical, facilitates early diagnosis and appropriate ACS treatment. The detection of ACS involves measuring IAP, which can be done indirectly or directly, and the choice of medical or surgical treatment is based on each patient's needs. Objective: To describe the updated diagnosis and management of Abdominal Compartment Syndrome. Methodology: A review of the diagnosis and management of ACS was conducted through a descriptive, retrospective, qualitative approach based on scientific articles published in the last five years in Spanish, Portuguese, and English in databases such as SciELO, Science, PubMed, Taylor & Francis, Scopus, ProQuest. Results: After analyzing articles on the topic, 45 studies were obtained, followed by exclusion and inclusion methods, resulting in 30 papers for this systematization. Conclusion: The diagnosis of ACS requires the measurement of IAP, with the intravesical catheter being the gold standard. The management of ACS should be stepwise, ranging from conservative medical treatment to a surgical procedure, without needing to be mutually exclusive.
- ÍtemAcceso AbiertoActualización del diagnóstico y tratamiento clínico-quirúrgico de los abscesos hepáticos producidos por infecciones bacterianas(Universidad Católica de Cuenca., 2023) Nivelo Vásquez, Samantha Mishel; Crespo Vintimilla, Edgar Adriano; 0350105474Background: Pyogenic hepatic abscess is an encapsulated intraparenchymal pus collection of variable size, most commonly located in the right lobe, mainly originating from direct spread from the biliary tract. The primary causative microorganism is E. coli, followed by Klebsiella pneumoniae. It is a complex clinical condition that requires prompt intervention to prevent potentially life-threatening complications, such as sepsis. Objective: To analyze the various diagnostic strategies and the current clinical-surgical treatment for hepatic abscesses caused by bacterial infections. Methodology: A systematic review of primary and secondary articles with updated information on the diagnosis and treatment of bacterial hepatic abscesses was conducted, following the guidelines in the PRISMA 2020 declaration. The search was performed using digital databases like PubMed, Science Direct, and Cochrane Library, using the DeCS/MeSH descriptors in combination. Results: Initially, 2490 documents were obtained; 2470 articles were excluded based on the four established filters since they did not meet the inclusion criteria; 20 studies were included in the qualitative analysis. Conclusions: Imaging techniques have higher diagnostic accuracy than laboratory parameters, with computed tomography showing greater sensitivity. Therapeutically, antibiotic therapy, percutaneous drainage, and surgical approach depend on a series of factors, including the infection’s size and location and the general condition of the patient.
- ÍtemAcceso AbiertoActualización del diagnóstico y tratamiento de Tenosinovitis de Quervain. Revisión bibliográfica(Universidad Católica de Cuenca., 2023) Rivas Palacios , Jhosue Israel; Capote Llanares, Miguel Angel; 0350061206Quervain's tenosynovitis is defined as stenosis of the tendons of the abductor pollicis longus and extensor pollicis brevis, caused by inflammation in the tendon sheath that occupies the first extensor compartment of the wrist. It mainly affects women between 30 and 50 years of age in a ratio of 10 women to every man worldwide. Objective: To identify the current methods of diagnosis and treatment of de Quervain's tenosynovitis. Methodology: This was a non-experimental bibliographic analysis, following PRISMA guidelines, which compiled scientific articles and systematic reviews from prestigious sources such as PubMed, academic Google, and SciELO, limiting the search to the last five years in Spanish and English. Results: From the databases mentioned above, initially, 40 articles were selected, but only 25 met all the established inclusion criteria. Of the 40 original articles, ten were over five years old, and 5 lacked complete information. In summary, 15 articles were excluded, leaving 25 for inclusion in developing the theoretical framework. Conclusions: Radial styloid tenosynovitis is more common in occupational diseases. The diagnosis is clinical, with tests like ultrasound and MRI if it is severe. Non-surgical treatment includes thumb immobilization, anti-inflammatory medications, physiotherapy, and corticosteroids. It combines pharmacological and physiotherapeutic treatment to relieve symptoms and restore mobility.
- ÍtemAcceso AbiertoActualización del diagnóstico y tratamiento del Síndrome Coqueluchoide. Revisión sistemática(Universidad Católica de Cuenca., 2023) Jaigua Guallpa, Jenny Patricia; Quevedo Guallpa, Jenny Patricia; 0302393962Abstract: Coqueluchoide Syndrome (CS) or Pertussis-like Syndrome refers to a pathology exclusively at the pediatric population level, especially in children under six months. It is characterized by a clinical picture of various infectious and non-infectious etiologies. It causes pediatric health status instability, causing paroxysmal cough attacks, differentiating it from other respiratory infections. It is accompanied by inspiratory stridor or whooping cough. It has been evidenced that the clinic is mandatory, so it is effective when reaching the diagnosis and treating such pathology. General Objective: To determine the most updated diagnosis and treatment of Coqueluchoid Syndrome in pediatric patients between 1 month and five years old through a systematic review. Methodology: This review was conducted in scientific databases employing the most outstanding explanatory and descriptive articles of the last five years, focusing on the diagnosis and treatment of CS according to the PRISMA method in 2020. Results: It is evidenced that the diagnosis of CS is purely clinical, although it can be corroborated with Polymerase Chain Reaction (PCR) since it has shown a high degree of effectiveness; as for the treatment, macrolides are considered the first-line therapy, as supported by most scientific articles. After administering an antibiotic scheme and general measures according to the specific clinical condition, beneficial results have been observed.
- ÍtemAcceso AbiertoActualización del manejo clínico- terapéutico según la clasificación de Hinchey modificada de la enfermedad diverticular. Revisión Sistemática(Universidad Católica de Cuenca., 2024) Lalvay Zambrano, Dalila Steffania; Crespo Vintimilla, Edgar Adriano; 0106106826According to the modified Hinchey classification, diverticular disease is classified into uncomplicated and complicated diverticulitis (stenosis, perforation, abscess, or fistula), which can range from mild clinical symptoms to peritonitis and hemodynamic instability. The therapeutic management of acute uncomplicated diverticulitis (AUD) (0a and Ia) is based on symptom control. In contrast, complicated diverticulitis is based on surgical intervention, with the Hartmann procedure being the treatment of choice. Objective: To investigate the update on clinical-therapeutic management according to the modified Hinchey classification of diverticular disease. Methodology: A descriptive systematic review was conducted using a qualitative approach and a non-experimental design structured according to PRISMA 2020 guidelines. The information was based on scientific articles from PubMed, Google Scholar, SciELO, Elsevier, and NIH databases. Results: Twenty-seven articles were included in this review. PubMed: 9 articles, Google Scholar: 3 articles, SciELO: 1 article, NIH: 11 articles, and Elsevier: 3 articles. Conclusions: There is increasing evidence that not treating uncomplicated colonic diverticulitis with antibiotics is a safe and effective treatment alternative. In cases of Hinchey I and II, fluids, analgesia, and antibiotic therapy should be administered, and in cases of Hinchey II, percutaneous drainage will be evaluated according to the abscess size. Treatment in patients with Hinchey III to IV consists of emergency surgical intervention, with the Hartmann procedure being the most commonly used. Keywords: diverticulitis, diverticular disease, Hinchey, Hartmann procedure, treatment
- ÍtemAcceso AbiertoActualización del manejo del síndrome compartimental en miembro Superior e Inferior, Diagnóstico y Técnica Quirúrgica(Universidad Católica de Cuenca., 2023) Sánchez Cañar , Darío Javier; Capote LLanares, Miguel Ángel; 0106491863Introduction: Compartment syndrome involves increased pressure in muscular compartments, mainly in the lower limbs. It can cause ischemia, edema, and tissue damage. It can be acute or chronic, with various triggers such as fractures, requiring thorough assessment and possibly surgical treatment to relieve pain. Objective: To review compartment syndrome in the upper and lower limb management, diagnosis, and surgical technique. Methodology: A qualitative, descriptive research was conducted through the bibliographic review of scientific literature published from 2018 to 2023 in Spanish and English, using the PRISMA method and utilizing search tools from scientific databases like PubMed, SciELO, SCOPUS, and Web of Science. Results: The systematic review highlights common clinical features that include disproportionate pain, paresthesia, edema, and muscle weakness triggered during exercise. The diagnosis is based on intra-compartmental pressure, although clinical signs are essential. Various surgical techniques, including fasciotomy, are discussed as the primary treatment, although alternative approaches are recognized. Conclusion: Compartment syndrome management combines early diagnosis through clinical assessment, measurements, and intra-compartmental pressure supported by clinical suspicion. Fasciotomy is the main technique, especially in acute cases, and its early performance is crucial.
