Trabajos de Titulación - Medicina
URI permanente para esta colecciónhttps://dspace.ucacue.edu.ec/handle/ucacue/23
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Examinando Trabajos de Titulación - Medicina por Asesores "Mercado González, Andrés Felipe"
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Ítem Acceso Abierto Colangiocarcinoma hepático en el embarazo. Caso clínico y revisión de la literatura(Universidad Católica de Cuenca., 2024) Vicuña Paredes, María Augusta; Mercado González, Andrés Felipe; 0302330618OBJECTIVE: The cholangiocarcinoma is a malignant hepatic neoplastic disease, is very rare and infrequent in the pregnancy, with an incidence of 10 cases per 10 000 pregnancies. Described with the worst prognosis of tumor pathology due to its late diagnosis, which is mainly due to exacerbation of the symptoms, the initial diagnosis made with the imaging studies such as the ultrasound and the tomography; the treatment is purely surgical. It has a 5-year survival rate of 5 %-10 % and can be confused with other diseases such as the obstructive cholestasis or the HELLP syndrome. CLINICAL CASE: The present case describes a patient with hepatic cholangiocarcinoma during her pregnancy, who came to the clinic due to initially presenting intense pain in the epigastrium and in the right hypochondrium. The diagnosis made through laboratory tests, the tumor markers, the imaging tests (ultrasound, and tomography) and the biopsy. The delivery occurred at week 28 of pregnancy, by cephalovaginal route with preeclampsia and vaginitis; In the postpartum period, the administration of analgesics was restricted due to existing liver damage confirmed by tomography and biopsy. CONCLUSION: In this type of case, the diagnostic and treatment schemes proposed for a non-pregnant woman are due to the infrequency of reports of cholangiocarcinoma in pregnant women.Ítem Acceso Abierto Eficacia de la quimioterapia intraperitoneal hipertérmica en el cáncer de ovario en mujeres adultas: revisión sistemática(Universidad Católica de Cuenca., 2023) Abad Barahona, Vanessa Isabel; Minchala Sucuzhañay, Flor Dalila; Mercado González, Andrés Felipe; 1719216630; 0302569363Context: In ovarian cancer, cytoreductive surgery is the treatment of choice, followed by adjuvant chemotherapy; where, hyperthermic intraperitoneal chemotherapy controls residual disease, with the combination of physical (thermal) and chemical (chemotherapeutic) methods prior to the formation of adhesions. Objective: To determine the efficacy of hyperthermic intraperitoneal chemotherapy in ovarian cancer in adult women. Methodology: Systematic review of primary studies published in PubMed, Scopus and Web of Science from 2013 to 2023, in Spanish and English. Results: A total of 133,393 articles were obtained, 108 were selected after the first reading, later considering the inclusion and exclusion criteria, 9 studies were used for the present review. The categories hyperthermic intraperitoneal chemotherapy, Cytoreductive Surgery, Survival, Endothelial Ovarian Cancer are described. Conclusion: Research results support the efficacy of HIPEC as a promising therapeutic approach for ovarian cancer treatment, demonstranting an overall survival of 35 months and progression – free survival of 15.6 months.Ítem Acceso Abierto Nivel de conocimiento sobre métodos anticonceptivos en unidades educativas, Ecuador(Universidad Católica de Cuenca., 2024) Iglesias Argudo, Lisbeth Carolina; Mendieta Zumba , Daniela Belén; Muñoz Muñoz , Ana Gabriela; Mercado González, Andrés Felipe; 0302135819; 0105565899; 0350141511The objective of this study was to demonstrate the level of knowledge that students and teachers of Azuay schools have about contraceptive methods in educational units of Azuay-Ecuador, in the period May - June 2022. Descriptive, crosssectional study, with a target population that includes both students and teachers of educational units of Azuay, in cantons such as Cuenca and Chordeleg. The time of execution of the research project was from May to July. Of the 367 respondents, 43.7% of men had a high level of knowledge about contraceptive methods, with a significance level of 0.03 regarding age and religion, 80.7% had knowledge about condoms and 80.7% know the male condom as a method of protection. Knowledge about contraceptive methods in this population is regular, within which, the most identified methods are the condom and emergency pill. Geographic location and socioeconomic level, among others, are variables that influence the acquisition of information, which is why improving this knowledge is fundamental.Ítem Acceso Abierto Terapias de reemplazo de hormonas para personas transgénero en países de América Latina(Universidad Católica de Cuenca., 2024) Robles Becerra , Guillermo Nicolás; Mercado González, Andrés Felipe; 0107124802Importance: In Latin America there are no hormone replacement therapy protocols in all countries, which means this population is not properly addressed within the health systems. This would be justified by showing that currently, according to studies analyzed by the World Professional Association for Transgender Health, at least 0.3% of adults identify themselves as transgender and 1.2% of children and adolescents also identify themselves as such. Observations: It is observed that most protocols have been adapted to the health systems of Latin American countries in which hormone replacement therapy protocols exist, in addition to being based on international guidelines such as those of the World Professional Association for Transgender Health and the Endocrine Society. Conclusions and Relevance: The protocols available in Latin America are on the way to serve as a reference for those countries that do not have them. They can be studied and adapted to the reality of each country, considering the availability of drugs and the expansion of primary health care systems. That said, the relevance of this study lies in the visibility of the transgender population as a population that can and should be attended in the health systems of all countries.
