Sede Azogues - Medicina
URI permanente para esta comunidadhttps://dspace.ucacue.edu.ec/handle/ucacue/88
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Examinando Sede Azogues - Medicina por Asesores "Capote Llanares, Miguel Ángel"
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Ítem Acceso Abierto Eficacia de la enoxaparina versus el rivaroxabán en la prevención del tromboembolismo venoso en trauma ortopédico: revisión sistemática(Universidad Católica de Cuenca., 2025) Nivelo Alvarez, Paula Renata; Capote Llanares, Miguel Ángel; 0954297040Venous thromboembolism (VTE) is a condition that leads to the formation of a blood clot in a blood vessel, which can travel and eventually block blood flow, endangering the patient’s life. Objective: To analyze the efficacy of enoxaparin versus rivaroxaban in preventing venous thromboembolism in orthopedic trauma. Methodology: A systematic review with a descriptive design and mixed approach was conducted following the PRISMA method parameters, analyzing 22 articles from scientific sources such as PubMed, Scopus, Lilacs, Redalyc, SciELO, and Web of Science. Results: Obesity, smoking, hypertension, diabetes, a history of venous thrombosis, and hospitalization were the predominant risk factors. Additionally, women over 60 years old were prevalent in both groups. The administered dose of enoxaparin was 40 mg/day for durations of 10, 14, 30, 35, and 90 days, while the daily dose of rivaroxaban was 10 mg for 7, 14, 35, 42, and 90 days. Enoxaparin reduced the risk of deep vein thrombosis (DVT) to 2.11% and pulmonary embolism (PE) to 0.57%. Rivaroxaban reduced DVT to 2.30% and PE to 0.13%. Both medications were well-tolerated by patients, though they presented common adverse effects such as bleeding at a low incidence. Conclusions: Both drugs effectively prevent VTE, but rivaroxaban revealed greater efficacy in preventing PE and did not present mortality cases. Keywords: venous thromboembolism, adverse effects, prevention, enoxaparin, rivaroxabanÍtem Acceso Abierto Eficacia de los alambres retrógrados laterales versus los alambres retrógrados cruzados en el manejo de las fracturas supracondíleas del codo en niños: revisión sistemática(Universidad Católica de Cuenca., 2025) Garcia Padilla, Jonathan Leonidas; Capote Llanares, Miguel Ángel; 0302429014Background: Supracondylar elbow fractures are among the most common bone injuries in children, accounting for 70% of all elbow fractures. They are classified using the Gartland Classification System and require appropriate treatment to prevent complications such as loss of mobility or angular deformities. Thus, the choice of fixation method, whether lateral or crossed retrograde wires, can significantly influence clinical outcomes. Objective: To evaluate the efficacy of lateral retrograde wires versus crossed retrograde wires in the management of supracondylar elbow fractures in children, in terms of bone healing, functionality, and postoperative complications. Methods: A systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statements, utilizing Medical Subject Headings (MeSH) terms to facilitate information retrieval from various databases. Additionally, the ROB-1 tool for randomized clinical trials and the Review Manager (RevMan) software were used. Results: The findings indicate that both methods have advantages and disadvantages in terms of efficacy and safety. The studies analyzed revealed that lateral retrograde wires tend to provide greater fixation stability, resulting in a lower rate of postoperative complications. On the other hand, crossed retrograde wires are preferred in certain cases due to their ease of use and shorter surgical time. However, the variability of the results suggests that the choice of method should be individualized based on the specific characteristics of each fracture and patient. Keywords: retrograde wires, consolidation, supracondylar fracturesÍtem Acceso Abierto Tratamiento rehabilitador de la parálisis cerebral infantil. Revisión Sistemática(Universidad Católica de Cuenca., 2024) Guaman Yansaguano, Jonnathan Patricio; Capote Llanares, Miguel Ángel; 0302514328Background: This systematic review analyzes the problems of rehabilitative treatment in children with infantile cerebral palsy (ICP). Objective: To evaluate the effectiveness of rehabilitation treatment in children with ICP, analyzing its impact on motor function, autonomy, and quality of life of patients through a systematic review of updated and relevant scientific literature. Methods: This review was based on PRISMA 2020 guidelines; observational studies and randomized clinical trials (RCTs) were employed. Results: A remarkable variability could be appreciated in the effectiveness of the assessment scales, specifically the Bobath Foundation Scale and the Gross Motor Function Scale (GMFM). The Bobath Scale indicated greater consistency in evaluating motor and functional development, while the GMFM effectively measured specific changes in gross motor function over time. The positive predictive value of the Bobath Scale ranged from 70% to 95%, depending on clinical context and type of Intracerebral hemorrhage (ICH), whereas the GMFM ranged from 60% to 90%. Regarding the negative predictive value, the GMFM had a more consistent performance, approximately 75%-98%, compared to the Bobath Scale at 50%-85%. Furthermore, likelihood ratios indicated that the GMFM might be more effective in identifying significant functional improvements in children with ICP. Keywords: motor function, cerebral palsy, rehabilitation treatment
