Trabajos de Titulación - Medicina
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Examinando Trabajos de Titulación - Medicina por Asesores "Aldás Erazo, Manuel Rafael"
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- ÍtemSolo MetadatosActualización sobre tratamientos utilizados en peritonitis bacteriana espontánea en pacientes cirróticos. Análisis de evidencia científica y su uso en la práctica clínica(Universidad Católica de Cuenca., 2023) Hermida Carrion, Edgar Mateo; Aldás Erazo, Manuel Rafael; 0923796577It’s crucial to address the issue of spontaneous bacterial peritonitis, since it is a lifethreatening infection, which, a few years ago, was unknown, but today it has caused thousands of deaths around the world. The importance lies in the great bacterial resistance against the daily antibiotic scheme, due to a change in the intestinal microbiota. Resistance has markedly increased the short- and long-term mortality rate in patients presenting with the infection. Objective: The general objective of this research is to describe the new treatments used in spontaneous bacterial peritonitis in cirrhotic patients. Methodology: In the methodology used, the review of clinical studies from the main databases of the required field will be included, through a narrative bibliographic review which addresses the subject, as well as the analysis of the data of patients with bacterial peritonitis. spontaneously subjected to the treatments. Expected results: Results are expected to clarify an ideal therapeutic scheme to treat infections in patients, analyze mortality rates, and the different therapeutic successes.
- ÍtemAcceso AbiertoEfecto de la Lactulosa vs Rifaximina en el tratamiento de la encefalopatía hepática en adultos(Universidad Católica de Cuenca., 2023) Reinoso Armijos, Santiago Nicolás; Aldás Erazo, Manuel Rafael; 1104851694Background: Hepatic encephalopathy (HE) is a frequent and fatal complication of different liver diseases, characterized by a wide range of neuropsychiatric symptoms. Its therapeutic approach is oriented according to the type of hepatic encephalopathy; however, using disaccharides such as lactulose or antibiotics like rifaximin has often been recommended. Overall objective: To substantiate the effects of lactulose and rifaximin in adult HE patients. Methodology: Narrative literature review using the following search engines: PubMed, SciELO, and Cochrane, considering the following keywords: "liver cirrhosis," "hepatic encephalopathy," "rifaximin," "lactulose," "treatment," and Boolean connectors, for example, "AND," "OR" and "NOT," as appropriate in English and Spanish. Results: Ten observational studies, five randomized clinical trials, and four meta-analyses were included. The therapeutic approach to HD is mainly based on the indication of lactulose and rifaximin; however, the efficacy of other plasma ammonium-lowering agents, such as probiotics and L-ornithine L-aspartate, has recently been evaluated. Conclusion: Rifaximin, together with lactulose, is effective in managing HD in adult patients. The combined use of these therapeutic agents has better results than lactulose alone.
- ÍtemAcceso AbiertoManejo endoscópico de complicaciones tardías de la pancreatitis aguda. Revisión Bibliográfica(Universidad Católica de Cuenca., 2023) Pulla Enríquez, Andrea Abigail; Aldás Erazo, Manuel Rafael; 0704872605Acute pancreatitis is one of the most common gastrointestinal pathologies, and its management is challenging in the presence of late complications such as walled-off necrosis and pancreatic pseudocyst, which are associated with a mortality rate of approximately 20-40%. Previously, the frontline management for complications of acute pancreatitis was debridement through open surgery. However, it has been determined that this is related to a higher risk of morbidity and mortality, leading to the development of minimally invasive procedures for its resolution. Objective: To determine the endoscopic management of late complications of acute pancreatitis. Methodology: It was a narrative work as a literature review; a search was conducted on scientific documents published from 2019 to 2023 on biomedical databases. Results: Pancreatic pseudocysts and walled-off necrosis are complications that occur four weeks after the disease's onset. They are often resolved spontaneously, but in some cases, drainage is required. Endoscopic techniques such as transmural and transpapillary drainage can be employed. The technique and instruments depend on the characteristics of the lesion and each patient. Conclusions: Late complications were previously managed surgically, but over time, it has been shown that endoscopic management has advantages in terms of costs and hospital stay; also, it presents lower morbidity and mortality and a higher success rate with fewer postoperative difficulties.
- ÍtemEmbargoManejo endoscópico de lesiones subepiteliales del estómago(Universidad Católica de Cuenca., 2023) Gómez Molina, Andrea Carolina; Aldás Erazo, Manuel Rafael; 0104780168Abstract:subepithelial lesions are a major concern for physicians, gastroenterologists, andendoscopists, as they are frequently diagnosed in routine endoscopy practice. Their causes can be attributed to intrinsic lesions of the gastrointestinal tract wall (benign or malignant) as well as extrinsic compressions caused by normal or pathological structures.Objective:to describe the various endoscopic techniques for the management of subepithelial lesions of the stomach.Methodology:literature review. Searches will be conducted in health databases such as Cochrane, PubMed, Dialnet, Cinahl, Scopus, etc. Keywords such as "endoscopy," "endosonography," "stomach," and "gastrointestinal stromal tumors" will be used in both English and Spanish languages. Boolean operators "AND" and "OR" will be used to enhance searches.Conclusions:the majority of these lesions have a benign origin; however, there is a percentage ranging from 12% to 15% associated with malignancy. The diagnosis of these lesions usually occurs incidentally during routine examinations conducted for reasons unrelated to their diagnosis
- ÍtemAcceso AbiertoPrevención primaria del sangrado variceal en pacientes cirróticos(Universidad Católica de Cuenca., 2022) Morocho Chamba, Dayana Del Cisne; Aldás Erazo, Manuel Rafael; 0107031791
- ÍtemAcceso AbiertoSíndrome de Chilaiditi en adulto mayor con dolor abdominal persistente(Universidad Católica de Cuenca., 2024) Narvaéz Vivanco, Bryan Vladimir; Aldás Erazo, Manuel Rafael; 0107322588Background: Chilaiditi syndrome is a low prevalence and incidence pathology and is even less common in older adults. It was described in 1910 in three patients with pain associated with a radiographic finding of a hydro-aerial zone in the right hemidiaphragm, excluding other etiologies. Case description: A 73-year-old female patient attended a health center because of abdominal pain, which was interfering with her sleep and daily activities. Endoscopic studies reveal no relevant findings; computerized tomography shows interposition of a portion of the colon, anterior and superior to the liver. Several treatment schemes for abdominal pain were used without any improvement. Conclusion: Chilaiditi syndrome presents a non-specific clinical condition, which makes the diagnosis difficult. Treatment is varied; in some cases, it can be conservative; however, abdominal pain can be persistent, as in this case; and, sometimes, produce life-threatening complications.
- ÍtemRestringidoSíndrome Hepatorrenal: actualización(Universidad Católica de Cuenca., 2023) Gordon Reyes, Katherine Lucía; Aldás Erazo, Manuel Rafael; 0106594922Hepatorenal syndrome is kidney dysfunction due to a decrease in renal flow secondary to chronic liver disease such as liver cirrhosis or acute liver disease. Causing a decrease in the glomerular filtration. In the classification there are two types recognized, AKI, which is characterized by a rapid and progressive deterioration of kidney function, and Non-AKI, by a slow deterioration, but with a better prognosis. This pathology represents a high mortality rate, so timely diagnosis will be key to successful treatment
- ÍtemAcceso AbiertoUso de probióticos en pacientes con síndrome de intestino irritable(Universidad Católica de Cuenca., 2022) Collaguazo Pérez, Katherine Aracely; Aldás Erazo, Manuel Rafael; 0106816994