Medicina
URI permanente para esta comunidadhttps://dspace.ucacue.edu.ec/handle/ucacue/22
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Examinando Medicina por Asesores "Cárdenas Heredia, Freddy Rosendo"
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Ítem Acceso Abierto Cuál es el indicador más utilizado para evaluar la calidad de vida en pacientes con artritis reumatoide, revisión sistemática(Universidad Católica de Cuenca., 2024) Narvaez Molina, David Santiago; Álvarez Astudillo, Juan Alberto; Cárdenas Heredia, Freddy Rosendo; 0105446686; 0105826721Introduction: Rheumatoid Arthritis is a chronic systemic inflammatory disease, with a prevalence in Ecuador ranging from 0.5 to 2%. Symptoms include joint pain, fatigue, and sleep disturbances, which influence the quality of life and can lead to disability. The indicator that enables objectively assessing the prognosis of the patients’ quality of life should be identified. Objective: To describe the most commonly used indicator for assessing the quality of life in patients with rheumatoid arthritis. Methodology: This is a systematic review developed through the PRISMA methodology. A comprehensive search was conducted employing PubMed, Scopus, and Web of Science databases. The search terms used were DeCS/MeSH terms, corresponding to "Indicators of quality of life," "arthritis," "rheumatoid," and "instruments," utilizing various articles obtained about adult populations and the quality of life indicators in rheumatoid Arthritis. Results: A total of 133 scientific articles were analyzed in the initial search. After applying inclusion and exclusion criteria, 14 articles suitable for this research were selected. Several quality-of-life indicators were identified, such as the QoL-Ra Scale, RADAR, AIMS, and AIMS 2, with the AIMS being the most commonly used. Conclusions: The Arthritis Impact Measurement scale (AIMS) permits for a better assessment of the quality of life in patients with Rheumatoid Arthritis in most of the identified studies, as it provides greater effectiveness and efficiency, improving quality of life assessment.Ítem Acceso Abierto Prevalencia de recidiva de cáncer en pacientes sometidas a cirugía oncoplástica conservadora de mama(Universidad Católica de Cuenca., 2024) Rojas Espinoza, Aython Ronald; Cárdenas Heredia, Freddy Rosendo; 0104284195Cancer recurrence contemplates a scenario in which the pathology reappears in the patient's organism after receiving a particular treatment and after a certain period in which it could not be detected. Objective: To determine the prevalence level of cancer recurrence in patients undergoing breast-conserving oncoplastic surgery. Methodology: This research consists of a descriptive systematic review with a qualitative approach based on 49 publications obtained from scientific search engines such as Scopus, LILACS, Redalyc, PubMed, Web of Science, and SciELO. Results: Worldwide, it is estimated that 30% of patients who underwent conservative oncoplastic surgery suffered from disease recurrence. In Spain, the recurrence percentage fluctuates between 11% and 21%, while in Latin America, it averages 18% to 25% five years after surgery. It denotes skin necrosis, hematomas, seromas, and infections among the main postoperative complications. The risk factors are age (when the person is 50 years old or younger), smoking, obesity, complementary treatments, histological grade, and the size evidenced by the tumor. Conclusions: The technique used depends on the tumor’s size and location. Any alteration requires that the breast have a specific volume, which is why, in many cases, patients with small breasts show few beneficial results. Furthermore, they emphasize the aesthetic result and show a minimal risk of postoperative complications.Ítem Acceso Abierto Quiste de ovario en paciente postmenopáusica: Reporte de Caso(Universidad Católica de Cuenca., 2024) Argüello Molina, Sofia Sulamita; Cárdenas Heredia, Freddy Rosendo; 1900814698Background: Serous ovarian cystadenoma is a common tumor derived from the superficial celomic epithelium. It can be benign, of low malignant potential or invasive; the majority are benign tumors with thin walls and fluids that are usually unilocular or paucilocular; they represent 20% and 50% of all ovarian tumors. In perimenopausal and postmenopausal patients, the finding of an adnexal mass is considered abnormal and should be immediately investigated, as the risk of malignancy increases in postmenopausal women from 8-45%. Case presentation: A 47-year-old female patient with a history of hypertension complains of hypogastric pain persisting for two months, described as constant heaviness, moderate intensity, exacerbated by movement, physical exertion, and changes in position. A gynecological examination reveals a painful and mobile mass of approximately five centimeters in the left adnexa. Later that day, an ultrasound is performed, which reports an ovarian mass with clear borders and no internal or external excrescence. One week later, exploratory laparotomy and cystectomy are performed, with a positive histopathological report for serous cystadenoma measuring 5x5x4 cm. The patient's recovery was favorable, and she was discharged 48 hours later. Conclusions: Serous ovarian cystadenoma is a pathology and its definitive diagnosis is based on pathological anatomy. Treatment in postmenopausal women will be surgical (cystectomy or oophorectomy).Ítem Acceso Abierto Utilización de la oxibutinina en el manejo de vejiga hiperactiva en mujeres de edad adulta: revisión sistemática(Universidad Católica de Cuenca., 2024) Vélez Medina, Leslye Tatiana; Rodríguez Vintimilla , Viviana Matilde; Cárdenas Heredia, Freddy Rosendo; 1150061313; 0302010004Overactive bladder affects a large proportion of adult women, leading to significant morbidity and reduced quality of life. In Ecuador, oxybutynin is a commonly prescribed medication to treat this syndrome. However, its effectiveness in single administration and combined with non-pharmacological treatments is not clear and there are no clinical guidelines. This study seeks to analyze, through a systematic review, the effectiveness of managing overactive bladder in adult women through the administration of oxybutynin. A duplicate bibliographic search will be conducted in electronic databases, including Pubmed, Medline, Cochrane, Elseiver and ScienceDirect, to identify relevant scientific articles and management guidelines published in the last 5 years in English and Spanish. Subsequently, the articles obtained in the search will be filtered by reviewing the inclusion criteria and titles and abstract. The process will be detailed in a flowchart. The articles included in the final selection will be reviewed in their entirety and relevant information will be included in the results. This systematic review will provide an updated summary of the efficacy of oxybutynin administered alone and in combination with non-pharmacological treatments in adult women with overactive bladder. Additionally, it will identify appropriate management protocols. The results of this review will be of interest to doctors, patients and policy makers to make informed decisions about the optimal management of this syndrome in the population most vulnerable to presenting it, adult women.
