Trabajos de Titulación - Medicina
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- ÍtemAcceso AbiertoTerapia con células madres mesenquimales: plasma rico en plaquetas en lesiones tendinosas y ligamentosas(Universidad Católica de Cuenca., 2023) Bustamante Pacheco, Daniel Mateo; Flores Flores, Martín; 0105670608In the field of sports medicine, injuries can occur at different levels, most of them correspond to tendon injuries either in their extension or insertion point, becoming chronic in many cases. The clinical trials reviewed on the benefits of platelet-rich plasma therapy have awakened the interest of specialists for its application in the development of new therapies for chronic injuries that affect quality of life. General objective: to describe the benefits of mesenchymal stem cell therapy in tendon and ligament injuries. Observations: despite the fact that PRP has been under study for more than a decade, the peak of trials is just in 2019, being mostly compared with corticosteroids in short and/or long term based on pain and functionality scales either as monotherapy by infiltration or adjuvant to surgical treatment, with positive results in most cases, however, the need for a broader study and even more varied in terms of the type of injury to be treated is much repeated. Conclusions: PRP presents better results in combined therapy with SH, and as for monotherapy, based on the evidence, it is recommended to stop the infiltrative practice with corticosteroids due to its limited benefit in the short term, being widely surpassed in the long term by PRP. Ligaments present less benefit, only the catalytic effects of healing predominate.
- ÍtemAcceso AbiertoNeoplasia intrapapilar mucinosa del páncreas. Reporte de caso(Universidad Católica de Cuenca., 2023) Carrillo Velasco, Genesis Pauleth; Martínez Calderón, Hernán Patricio; 0705673705Introduction: Mucinous intrapapillary neoplasia of the pancreas was first described in 1980. Its incidental diagnosis in routine cross-sectional imaging studies has increased. Branched duct intraductal papillary mucinous neoplasms (BD-IPMN) are the most common cystic lesions encountered in practice and carry a low, but not insignificant, risk of developing cancer in the long term. Most lesions are asymptomatic and benign, however some carry a significant risk of malignant degeneration, so correct identification of these lesions is paramount. Objective: Develop the case report of a patient with mucinous intrapapillary neoplasia of the pancreas. Methodology: A clinical case of a 51-year-old female who was admitted to the emergency room due to severe abdominal pain is reported, an imaging study was performed in which a mass with a diagnosis suggestive of IPNM was visualized, a splenopancreaticoduodenectomy was performed, which presented complications, for which is converted to laparotomy, a histopathologic diagnosis of IPNM is provided. Conclusions: IPNM is characterized by a mass with an abundant amount of mucinous material, its progression is slow, its diagnosis is usually incidental when performing imaging studies, it presents a cancerous tendency with an average of 5 years, its therapy must be radical surgery to avoid recurrences, which occur in 60-70% of patients with tail and body of residual pancreas.
- ÍtemAcceso AbiertoEstudio electrofisiológico como método de estratificación de riesgo de muerte súbita en el Síndrome de Brugada(Universidad Católica de Cuenca., 2023) Calderón Centeno, Clarisa Isabel; Carpio Toro, María Daniela; 0107362311Introduction: electrophysiological study has been used as a diagnostic method and predictor of sudden cardiac death in patients with Brugada syndrome, allowing stratification of the risk of developing malignant ventricular arrhythmias. However, in recent years, its usefulness has been questioned. Objective: to describe the electrophysiological study as a method for stratifying the risk of sudden death in Brugada syndrome. Methods: an electronic search was performed in databases such as: Pubmed, ScienceDirect and Scielo in a period from January 2018 to February 2023, keywords such as; Cardiac Arrhythmias, Brugada Syndrome, Electrophysiologic Techniques, Sudden Death were also used, according to bibliographic descriptors DeCS and MeSH in addition to bilean operators such as "AND, OR and NOT". Results: a total of 14 studies were identified, most of them reported the electrophysiological study as a good predictor of risk of sudden cardiac death, the main findings were: right bundle branch block and ST segment deviation in lead V1, QT prolongation, type 1 ECG pattern, presence of a prolonged Tpeak-Tend QRS interval with ventricular effective refractory period <200, and other arrhythmic events that in patients with Brugada Syndrome may increase the risk of sudden death. Conclusion: electrophysiological study in patients diagnosed with Brugada syndrome is a good marker of long-term cardiac events and may even be useful for predicting a greater association with risk of sudden death.
- ÍtemAcceso AbiertoAplicación de tecnología de edición de genes como alternativa de tratamiento en pacientes con VIH(Universidad Católica de Cuenca., 2023) Cabrera Avila, Paola Alexandra; Flores Montesinos, Carlos Enrique; 0107631236Human immunodeficiency virus (HIV) is characterized by progressively damaging the immune system, which is why therapeutic methods have been developed over the years to alleviate the symptoms presented by patients. However, these methods do not eradicate the disease. Gene therapy is a promising alternative when it comes to virus eradication, as it proposes gene editing to eliminate the virus from the cell. Currently, new therapeutic strategies are being explored, such as the use of gene editing technology, to reduce viral replication and eliminate HIV from the human genome. Improving adherence to antiretroviral treatment (ART) is important, and the impact of side effects on adherence is being reviewed. Knowledge about ART can moderate the relationship between side effects and adherence. In general, the findings of this review suggest that continuous research is necessary to find alternative HIV treatments and improve the quality of life for people living with this disease. The new therapeutic strategies show promise, but further studies are needed to evaluate their safety and efficacy. Improving adherence to ART remains a significant challenge, and effective interventions are needed to enhance adherence and prevent drug resistance. In conclusion, the findings suggest that gene therapies have great potential to improve the quality of life for people living with HIV/AIDS and enhance the effectiveness of antiretroviral treatment.
- ÍtemAcceso AbiertoTratamiento quirúrgico como alternativa terapéutica en pacientes con migraña(Universidad Católica de Cuenca., 2023) Arias Quezada, Juan Andrés; Espinosa Espinosa, Hermel; 0105194898Introduction: Migraine is a debilitating disorder that is more prevalent in females. It is an incurable disease, and there are patients who do not respond to conventional treatment. Migraine surgery has shown success in symptom control and improvement in quality of life. General objective: To determine the effectiveness of surgical treatment as a therapeutic alternative in patients with migraine. Methodology: A descriptive study with a literature review was conducted. Eligibility criteria were established for the search of information in scientific databases such as PubMed, Scopus, ScienceDirect, Elsevier and Scielo. Results: Migraine surgery has shown success rates ranging from 58.3% to 100%, with significant improvements in migraine symptoms. The results support the effectiveness of the surgery, with statistically significant differences (p < 0.05). Conclusion: The effectiveness of migraine surgery is conditioned by various factors. However, in all cases, it has been above 50%. Different criteria should be considered for the application of this surgery, and although there are some classifications, the most commonly used one is provided by the ICHD. Regarding treatment, it can be symptomatic or prophylactic.
