Trabajos de Titulación - Sede Azogues - Medicina
URI permanente para esta colecciónhttps://dspace.ucacue.edu.ec/handle/ucacue/89
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Item type: Ítem , Access status: Acceso Abierto , Riesgo de diabetes mellitus tipo II en personas de las parroquias de Taday y Guapán del cantón Azogues según el cuestionario de Findrisk, periodo octubre 2024 - enero 2025(Universidad Católica de Cuenca., 2026) Alvarracín Cantos, Mónica Estefanía; Peralta Briones, Alexandra NarcizaBackground: Type 2 diabetes mellitus (T2DM) is a major cause of morbidity and mortality worldwide. The FINDRISK questionnaire is a non-invasive, low-cost screening tool used to estimate an individual’s 10-year risk of developing T2DM in primary health care settings. Objective: To estimate the risk of T2DM according to the FINDRISK questionnaire and identify associated factors among adults aged 20–64 years residing in the Taday and Guapán parishes of Azogues Canton, Ecuador, by assessing sociodemographic, anthropometric, and behavioral characteristics and determining the proportion of individuals eligible for confirmatory biochemical testing. Methods: A population-based, community-based cross-sectional study was conducted from October 2024 to January 2025. A two-stage stratified random sampling method was applied, with sample allocation by parish. Sociodemographic characteristics, physical activity, dietary habits, family history, and anthropometric measurements were collected. Descriptive statistics and association analyses using chi-square (χ²) tests of association were performed to examine the relationships between risk categories and covariates. Results: A total of 357 participants were included, of whom 51.8% were women. The age distribution was as follows: 18–44 years, 54.9%; 45–59 years, 33.6%; and ≥60 years, 11.5%. Excess body weight (BMI ≥25) was identified in 64.1% of participants; 53.2% reported <30 minutes of physical activity per day; 47.9% did not consume fruits and vegetables daily; 40.6% reported the use of antihypertensive medication and/or hypertension; 46.2% reported a history of hyperglycemia; and 74.2% had a family history of diabetes mellitus. According to the FINDRISK score, 38.7% of participants (n≈138) were classified as having low risk, 31.4% (n≈112) as slightly elevated risk, 17.1% (n≈61) as moderate risk, 11.8% (n≈42) as high risk, and 1.1% (n≈4) as very high risk. Approximately 30% of participants had a FINDRISK score ≥12 points and were therefore considered eligible for confirmatory biochemical testing. Conclusions: In the Taday and Guapán parishes, approximately one in three screened adults requires priority confirmatory biochemical testing through fasting plasma glucose (FPG) and/or glycated hemoglobin (HbA1c), with an oral glucose tolerance test (OGTT) if the results are discordant, as well as participation in lifestyle interventions. This stepwise approach appears feasible within the local primary health care setting. Longitudinal follow-up and further research are recommended to estimate progression to T2DM and evaluate the impact of the interventions. Keywords: type 2 diabetes mellitus, surveys and questionnaires, risk factors, body mass index, screening programs.Item type: Ítem , Access status: Acceso Abierto , Efectividad de la laminectomía versus laminoplastía en la resolución de la estenosis lumbar: revisión sistemática(Universidad Católica de Cuenca., 2026) Avecillas Cevallos, Diego AlejandroIntroduction: Lumbar spinal stenosis is a frequent cause of pain and disability in older adults. Its surgical treatment mainly includes laminectomy and laminoplasty, techniques with significant differences in terms of effectiveness, stability, and postoperative complications. Objective: To compare the clinical effectiveness of laminectomy versus laminoplasty in patients with lumbar spinal stenosis, evaluating functional, biomechanical, and safety parameters. Methodology: A systematic review of 30 studies published between 2001 and 2025 was conducted, retrieved from databases such as PubMed, Scopus, Web of Science, and Cochrane. Clinical trials, cohort studies, and comparative studies evaluating outcomes such as ODI, JOA, instability, bleeding, reoperation rate, and functional recovery were included. NIH methodological quality criteria and a narrative analysis using effect measures (RR, OR, MD) were applied. Results: Laminoplasty showed advantages in several clinical aspects: a lower complication rate (>50% lower), less blood loss (<200 mL), reduced risk of postoperative instability (RR: 0.62), and faster functional recovery (<4 weeks). Although both techniques improved long-term function, laminoplasty better preserved biomechanics and reduced the need for instrumentation. Conclusions: Laminoplasty may represent a more favorable alternative in selected cases, but its implementation depends on surgical experience and available resources. Further high-quality research is recommended to establish definitive guidelines. Keywords: Spinal surgery, lumbar spinal stenosis, laminectomy, laminoplasty, functional recovery.Item type: Ítem , Access status: Acceso Abierto , Riesgo de diabetes mellitus tipo II en personas de 20 a 64 años de las parroquias Azogues y Luis Cordero del cantón Azogues según el cuestionario Findrisk, periodo octubre 2024- enero 2025.(Universidad Católica de Cuenca., 2026) Arias López, Ariel Fabricio; Vázquez Calle, Michelle EstefaníaItem type: Ítem , Access status: Acceso Abierto , Riesgo de diabetes mellitus tipo II en personas del cantón Biblián según el cuestionario Findrisk, periodo octubre 2024 - enero 2025(Universidad Católica de Cuenca., 2026) Guamán Minga, Sammy Fernanda; Maza Torres, Ivana DayaraBackground: Type 2 diabetes mellitus is one of the leading causes of death in Ecuador; early detection reduces complications and healthcare costs. In the canton of Biblián, the combination of sedentary lifestyle and abdominal obesity suggests a high level of vulnerability that has not yet been quantified. Objective: To quantify the risk of developing type 2 diabetes among adults aged 20–64 years in the canton of Biblián using the FINDRISK questionnaire and to analyze its relationship with sociodemographic factors. Methodology: A cross-sectional population-based study was conducted. Stratified random sampling (by parish, sex, and urban-rural area) was used to include 370 residents without a previous diagnosis of diabetes. Data on age, sex, BMI, waist circumference, physical activity, and family history were collected. The analysis (SPSS v21) used the chi-square test (χ²) and odds ratios (OR) with 95% confidence intervals (CI). Results: Among the 370 participants (59% women; median age 41 years), 18% had moderate risk, 13% high risk, and 4% very high risk. Overall, 35% (95% CI: 30–40) required preventive intervention. An elevated waist circumference tripled the likelihood of high/very high risk (OR 3.1; 95% CI: 2.1–4.6; p < 0.001), while physical inactivity doubled the likelihood (OR 2.5; 95% CI: 1.7–3.8; p = 0.002). Conclusions and Implications: More than one-third of adults in Biblián showed a clinically significant risk of developing type 2 diabetes, supporting the integration of FINDRISK screening and lifestyle-based programs into local primary healthcare to prevent the disease and its complications. Keywords: waist circumference, type 2 diabetes mellitus, risk factors, FINDRISK, public health.Item type: Ítem , Access status: Acceso Abierto , Prevalencia de Enterococcus faecium y Enterococcus faecalis resistentes a la vancomicina: revisión sistemática(Universidad Católica de Cuenca., 2026) Ávila Córdova, Freddy Andrés; Quezada López, Camila IsabelIntroduction: Enterococcus faecalis and Enterococcus faecium are opportunistic hospital pathogens capable of persisting and acquiring antimicrobial resistance. Vancomycin resistance (VRE) represents a global threat, associated with increased mortality, hospital stay, and costs, especially in intensive care unit (ICU) and hematopoietic transplant recipients. Objectives: To establish the worldwide prevalence of vancomycin-resistant E. faecium and E. faecalis, identify factors associated with mortality and therapeutic failure, and evaluate antimicrobial and infection control strategies. Methodology: Cross-sectional observational studies published between 2015 and 2025, in English or Spanish, on hospitalized patients with VRE infection or colonization were included. Quality was assessed using Joanna Briggs Institute (JBI) and National Heart, Lung, and Blood Institute (NHLBI), complemented by narrative analysis and comparative tables. Results: A total of 29 studies met the criteria from 1,612 records, with samples ranging from 46 to over 9,000 patients from Europe, America, and Asia. Colonization varied between 4% and 43%, and mortality reached 50%. E. faecium showed higher resistance, mortality, and hospital stay. Linezolid and daptomycin showed variable results, while control measures reduced transmission. Discussion: Prevalence varied by region and population. Most studies presented a low to moderate risk of bias, although methodological differences and sampling limitations existed. Resistance was related to therapeutic failure, especially in E. faecium. Conclusions: Vancomycin resistance represents a growing challenge, with a worse prognosis and limited therapeutic options. It is essential to strengthen surveillance, optimize antimicrobial use, and develop new treatment and control strategies. Keywords: Enterococcus faecalis, Enterococcus faecium, vancomycin resistance, antimicrobial therapy, epidemiological surveillanceItem type: Ítem , Access status: Acceso Abierto , Eficacia de la lactoferrina como tratamiento para la anemia ferropénica en niños: revisión sistemática(Universidad Católica de Cuenca., 2026) Garcia Zambrano , Litta Daniela; Pacheco Campoverde, Iván FabricioBackground: Iron-deficiency anemia (IDA) is a global public health problem, especially in children, affecting cognitive, motor, and immune development. Treatment with iron salts is effective but causes gastrointestinal side effects that affect adherence. Lactoferrin, a glycoprotein with high affinity for iron and anti-inflammatory properties, has emerged as a more tolerable alternative. This study aims to evaluate its efficacy and tolerability in children with IDA in Ecuador, compared with conventional treatment. Objectives: To generate scientific evidence to improve the management of iron-deficiency anemia in children, optimizing treatment adherence and effectiveness. A systematic review of clinical and observational studies in lactoferrin for the treatment of IDA in children was conducted, using databases such as PubMed, Scopus, and SciELO between 2015 and 2025. Methods: Studies involving children with iron-deficiency anemia, an intervention with lactoferrin, compared with placebo or iron supplements, and at least one outcome on efficacy (hemoglobin, ferritin) or safety were included. Studies in adults, non-representative samples, or publications without peer review were excluded. Selection was conducted in two phases by independent reviewers. Methodological quality was assessed using the NHLBI tools and the ROB 2 tool, following the PRISMA 2020 guidelines. Results: Relevant clinical data (hemoglobin, ferritin, dose, treatment duration, and demographic characteristics) were extracted and standardized to evaluate the comparative efficacy of lactoferrin, using effect measures and risk ratios. Keywords: childhood anemia, iron deficiency, lactoferrin, alternative treatment, public health.Item type: Ítem , Access status: Acceso Abierto , Eficacia del dienogest en el tratamiento de la endometriosis frente a los análogos de la GnRH: revisión sistemática(Universidad Católica de Cuenca., 2026) Heras Cisneros , Doménica AlexandraEndometriosis is a chronic inflammatory condition that primarily affects women of reproductive age and is associated with symptoms such as chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility. Available treatments include dienogest and gonadotropin-releasing hormone (GnRH) analogs. Both treatment modalities have been shown to be effective in relieving symptoms; however, significant differences have been reported in recurrence rates, quality of life, and adverse effects. Objective: To compare the efficacy of dienogest with that of GnRH analogs in the treatment of endometriosis through a systematic review. Methods: A systematic review will be conducted in accordance with the PRISMA guidelines. Randomized controlled trials and systematic reviews with meta-analyses published between 2020 and 2025 will be included. Searches will be performed in major databases, including PubMed, Scopus, the Cochrane Library, Web of Science, Springer Link, Taylor & Francis, and SciELO. Results: Dienogest and GnRH analogs are similarly effective in managing endometriosis-related pain and recurrence. Dienogest has a more favorable safety profile, with fewer hot flashes and less vaginal dryness, although it is associated with a higher incidence of irregular bleeding and weight gain. GnRH agonists may cause bone loss and should be limited to 6 months when not combined with add-back hormonal therapy. Sequential treatment with GnRH agonists followed by dienogest may improve treatment adherence and reduce adverse effects. Furthermore, dienogest is more cost-effective for postoperative management. Keywords: Endometriosis, dienogest, GnRH analogs, quality of life, recurrenceItem type: Ítem , Access status: Acceso Abierto , Conocimientos, actitudes y prácticas sobre la detección de cáncer de cuello uterino en estudiantes de la Universidad Católica de Cuenca, sede Azogues en el periodo marzo 2025-agosto 2025(Universidad Católica de Cuenca., 2026) Gallegos Núñez, María Belén; Mora Vásquez, María IsabelBackground: Although preventable, cervical cancer remains a cause of mortality in Ecuador. Identifying gaps in knowledge, attitudes, and practices among students can help strengthen reproductive health education. Objective: To assess knowledge, attitudes, and practices regarding cervical cancer screening among female students at the Catholic University of Cuenca, Campus Azogues, during March to August 2025. Methodology: An observational, descriptive, cross-sectional study was conducted at the Catholic University of Cuenca, Campus Azogues, from March to August 2025, with institutional approval. Participants were adult students enrolled in the Medicine, Nursing, Dentistry, Law, and Criminology programs. Students with cervical cancer, a history of hysterectomy, pregnancy, or those who did not provide informed consent were excluded. Stratified sampling was used to ensure representativeness. Results: The study included 357 students, primarily aged 18–20, from urban areas, and unmarried, with a predominance of medical students. A total of 64.4% had low levels of knowledge, 59.7% had moderate attitudes, and 82.1% engaged in inadequate preventive practices. Preventive behaviors were significantly associated with race (knowledge: χ²=38.770, p<0.001; attitude: χ²=25.486, p=0.001; practices: χ²=12.194, p=0.016) and marital status (practices: χ²=13.245, p=0.010). Conclusions: Students demonstrated basic knowledge about cervical cancer but were unaware of the frequency of (HPV) Human Papillomavirus detection and progression. Despite favorable attitudes toward prevention, cultural, economic, and emotional barriers persist. Preventive practices were mostly inadequate, and academic and sociodemographic factors influence behaviors, highlighting the need to strengthen reproductive health education. Keywords: cervical cancer, students, prevention, screeningItem type: Ítem , Access status: Acceso Abierto , Riesgo de diabetes mellitus tipo II en personas de las parroquias de San Francisco y Aurelio Bayas del cantón Azogues según el cuestionario Findrisk, periodo octubre 2024 - enero 2025(Universidad Católica de Cuenca., 2026) Rojas Rojas, Paula Annabel; Suárez Brito, Vanessa VeronicaBackground: Type 2 diabetes mellitus (T2DM) is an increasingly prevalent chronic disease that causes serious complications and significantly affects public health, especially in regions such as Latin America. In fact, many cases go undiagnosed for a long time. Objective: To establish the risk of T2DM in the adult population aged 20 to 64 years according to the Finnish Diabetes Risk Score (FINDRISK) questionnaire in the parishes of San Francisco and Aurelio Bayas in the canton of Azogues, Cañar, Ecuador, during the period October 2024 to January 2025. Methodology: An observational, quantitative, cross-sectional study with a descriptive approach was conducted among 347 randomly selected individuals aged 20 to 64 years. The FINDRISK questionnaire was administered, informed consent was obtained, and the Ethics Committee (CEISH) granted approval. Results: The study found that most participants were young adults and women. A high prevalence of overweight and obesity (71.2%) and low physical activity (53.6%) was observed, and 22.5% of participants had hypertension. Associations were found between the risk of developing T2DM and factors such as age, family history, hypertension, physical activity, and BMI (p < 0.05). As age increased, the risk score also increased, and ANOVA confirmed significant differences in risk by age group. Conclusions: These findings reflect the urgent need to implement primary prevention strategies and promote healthy lifestyles, as well as to continue evaluating this population through follow-up and similar studies in other communities in the country. Key words: type 2 diabetes mellitus, risk factors, prevalence, health promotion, EcuadorItem type: Ítem , Access status: Acceso Abierto , Riesgo de diabetes mellitus tipo II en adultos de las parroquias Borrero y Cojitambo del cantón Azogues según el cuestionario Findrisk, periodo octubre 2024 - marzo 2025(Universidad Católica de Cuenca., 2026) Andrade Váquez , Johanna Anahi; Morocho Quizhpilema, Janeth AlexandraBackground: Type 2 diabetes mellitus constitutes a public health problem. Rural populations are more vulnerable. Objective: To determine the level of risk of developing type 2 diabetes mellitus in adults aged 20 to 64 years from the Borrero and Cojitambo parishes of the canton of Azogues through the application of the FINDRISK questionnaire during October 2024–March 2025. Methodology: An observational, descriptive, and cross-sectional study was conducted in 357 adults selected through stratified probability sampling (143 from Cojitambo; 214 from Borrero). The validated FINDRISK questionnaire was administered, and anthropometric measurements were recorded. Statistical analysis was descriptive and bivariate, using the chi-square test with a 95% confidence interval. Results: The mean age was 41.8 years (95% CI: 40.3–43.3). A high or very high risk of developing diabetes was found in 21.0% of participants in Cojitambo and 26.2% in Borrero. The prevalence of overweight or obesity was 77.9%. Significant differences between parishes were observed in sedentary behavior (49.7% vs. 62.6%; p = 0.015), inadequate fruit and vegetable consumption (21.7% vs. 39.7%; p < 0.001), hypertension (19.6% vs. 35.0%; p = 0.002), and a history of hyperglycemia (35.0% vs. 46.7%; p = 0.027). Conclusions: There is a prevalence of risk of developing type 2 diabetes mellitus in both parishes, with a predominance of modifiable factors. Preventive interventions focused on promoting physical activity and improving dietary patterns are required. These findings support the need to strengthen rural primary care. Keywords: adults, type 2 diabetes mellitus, risk factors, FINDRISK, primary prevention.Item type: Ítem , Access status: Acceso Abierto , Endocarditis infecciosa asociada a bacterias gramnegativas resistentes a carbapenémicos: revisión sistemática(Universidad Católica de Cuenca., 2026) Maldonado Aldaz, Genesis Scarleth; Navarrte Suarez, Nayeli VicentaIntroduction: Endocarditis is a serious infection capable of causing valvular destruction, embolic complications, and organ failure. In recent years, increasing resistance of Gram-negative bacilli to carbapenems has created a new scenario for this disease because of their growing presence in healthcare settings and the diagnostic and therapeutic challenges that may arise when they act as etiological agents. Objective: To analyze the available scientific evidence on infective endocarditis caused by carbapenem-resistant Gram-negative bacteria, providing a basis for the understanding and comprehensive management of this emerging entity in medical practice. Methods: A PRISMA 2020 systematic review of cohort studies published from 2015 to 2025 involving adults with confirmed infective endocarditis, comparing the etiology of carbapenem-resistant Gram-negative bacilli. Results: Carbapenem-resistant Gram-negative bacilli accounted for approximately 1.1% of all cases of endocarditis and 11% of cases in a series of endocarditis caused by Gram-negative. A high incidence of prosthetic was documented, with an in-hospital mortality rate ranging from 5% to 36.5%. A correlation was identified between advanced resistance, persistent bacteremia, and the absence of surgical intervention, along with the risk of resistance developing during treatment. Conclusions: It was observed that this type of endocarditis is uncommon but associated with high clinical severity, complex hospital settings, and exposure to procedures or prosthetic material. Outcomes depend on frailty, comorbidities, and an individualized antimicrobial approach with close microbiological monitoring. Keywords: carbapenemases, endocarditis, bacterial infections, prosthetic heart valves, bacterial drug resistanceItem type: Ítem , Access status: Acceso Abierto , Riesgo de diabetes mellitus tipo II en personas de las parroquias Déleg y Solano del cantón Déleg según el cuestionario Findrisk, periodo octubre 2024-enero 2025(Universidad Católica de Cuenca., 2026) Morocho Sarango, Karelis Samantha; Ortiz Solano, Karla VivianaType 2 Diabetes Mellitus (T2DM) represents a growing public health challenge on a global scale, especially in rural areas where access to preventive and educational services is limited. In Déleg Canton, the insufficient characterization of population risk makes it difficult to design relevant interventions adapted to the local context. Objective: To determine diabetes risk in people aged 20 to 64 years from the parishes of Déleg and Solano through the implementation of the FINDRISK test. The association between sociodemographic variables, risk factors, and risk levels for the development of the disease was analyzed. Methodology: A descriptive, observational, cross-sectional study with a quantitative approach was conducted. The FINDRISK tool was applied using stratified random sampling, considering sex and parish. The sample consisted of 340 people. Results: The findings showed a significant proportion of people at moderate to very high risk of developing T2DM. This indicates the need to implement screening strategies and educational programs aimed at primary prevention at the community level. Keywords: Type 2 diabetes mellitus, risk factors, FINDRISK, prevalenceItem type: Ítem , Access status: Acceso Abierto , Deterioro cognitivo en adultos mayores pertenecientes a asociaciones de pensionados y jubilados de la provincia del Cañar, Ecuador 2025(Universidad Católica de Cuenca., 2026) Ananguano Castañeda, Eduarda Mayerli; Tinoco Herrera , Fabián AlejandroIntroduction: Cognitive impairment is a progressive alteration of higher mental functions that affects about 10% of older adults, with prevalence increasing with age. In Ecuador, population aging is a growing public health challenge, and in the province of Cañar, it poses a particular challenge for public health. Early detection is essential to prevent its progression. Objective: To identify cognitive impairment among older adults belonging to the Associations of Pensioners and Retirees of the province of Cañar, Ecuador, in 2025. Methodology: A quantitative, descriptive, and cross-sectional study was conducted with a sample of 100 adults aged 65 years and older. Four instruments were administered: Mini Mental State Examination (MMSE), Katz Index, AMAI Index, and a sociodemographic-clinical questionnaire. Statistical analysis was performed using SPSS v25 software, using frequencies, means, and Chi-square tests (p < 0.05). Results: More than half of the participants (53%) presented cognitive impairment, which was associated with low educational level (p = 0.025), polypharmacy (p = 0.006), functional dependence (p < 0.001), and lack of cognitive stimulation (p < 0.001). No association was found with sex, age, or ethnicity. Prevalence was higher among individuals with a low socioeconomic level and those without regular physical activity. Conclusions: A high prevalence of cognitive impairment was found among older adults in Cañar, associated with low educational level and lack of mental stimulation. Differences were observed in the associations, possibly related to activity levels and institutional support. Strengthening these spaces can promote active aging and prevent cognitive impairment through a community-based approach. Keywords: older adults, cognitive impairment, functional dependence, polypharmacyItem type: Ítem , Access status: Acceso Abierto , Efectividad comparativa de la gastrectomía versus bypass gástrico en adultos con obesidad: revisión sistemática.(Universidad Católica de Cuenca., 2026) Pogyo Morocho , Angel Fabian; Rodriguez Cedeño, Nathaly GislayneIntroduction: Obesity is a major public health problem and is associated with multiple comorbidities. In obese adults requiring surgical treatment, vertical sleeve gastrectomy and Roux-en-Y gastric bypass are among the most commonly used bariatric procedures; however, differences persist in weight loss, metabolic outcomes, and complication profiles. This study aimed to compare the effectiveness of both procedures in adults with obesity through a systematic review of the scientific literature. To this end, a systematic review was conducted in accordance with the PRISMA 2020 guidelines, using searches in Scopus, PubMed, and Web of Science. Studies published within the established eligibility period that evaluated clinical outcomes for both procedures, including changes in body mass index (BMI), metabolic control, and complications, were included. Fifteen studies were included in the synthesis. The results showed that both procedures were associated with a significant reduction in BMI. Gastric bypass showed a trend toward greater weight loss and improvement in some metabolic comorbidities, while vertical sleeve gastrectomy presented a favorable profile for certain safety and tolerability outcomes. However, heterogeneity was identified among the studies analyzed. It was concluded that both procedures are effective alternatives for the surgical treatment of adults with obesity. Although gastric bypass offers advantages in certain weight and metabolic outcomes, the choice of procedure should be individualized, considering clinical characteristics, risks, patient preferences, and the team’s experience. Keywords: vertical sleeve gastrectomy, Roux-en-Y gastric bypass, obesity, bariatric surgery, adultsItem type: Ítem , Access status: Acceso Abierto , Eficacia de la fototerapia en el tratamiento del vitíligo: revisión sistemática(Universidad Católica de Cuenca., 2026) Andrade Ávila, Doménica CamilaBackground: Vitiligo is a chronic acquired skin disease characterized by the progressive loss of melanocytes and the appearance of depigmented macules. Its aesthetic, psychological, and social impact represents a therapeutic challenge. Phototherapy has demonstrated favorable results in repigmentation and disease stabilization. Objective: To evaluate the efficacy of phototherapy in the treatment of vitiligo in adults and children by analyzing the scientific evidence on the main therapeutic modalities. Methods: A systematic review was conducted following the PRISMA 2020 guidelines. Randomized controlled trials published between 2007 and 2025, in English and Spanish, were included. Studies were identified through searches in PubMed, Scopus, Web of Science, and the Cochrane Library. Methodological quality and risk of bias were assessed using RoB 2. Results: Eighteen randomized controlled trials evaluating different phototherapy modalities were selected. Narrowband ultraviolet B (NB-UVB) was the most studied modality and showed better clinical results, particularly in facial and cervical lesions. Most studies reported repigmentation greater than 50% after six to twelve months of treatment. Combination therapies showed greater efficacy than monotherapy. Adverse effects were mainly mild and transient, with erythema and temporary hyperpigmentation being the predominant effects. Conclusion: Phototherapy, particularly NB-UVB, is an effective alternative in adults and children. However, methodological heterogeneity limits the comparison of results and highlights the need for research with standardized protocols. Keywords: phototherapy, excimer lasers, ultraviolet rays, repigmentation, vitiligoItem type: Ítem , Access status: Acceso Abierto , Características epidemiológicas del cáncer de páncreas en Ecuador, periodo 2008-2023.(Universidad Católica de Cuenca., 2026) Granada Mora, Victor Daniel; Velepucha Ludeña, Paola Del CieloBackground: Pancreatic cancer is a malignancy with high lethality and low survival, positioning it as an emerging public health priority. In Ecuador, the absence of updated nationwide studies hinders the development of effective prevention strategies and oncological care policies. Objective: Analyze the epidemiological characteristics of pancreatic cancer in Ecuador during the period 2008-2023. Methods: This was a descriptive cross-sectional epidemiological study based on secondary data from a free access database which was the National Institute of Statistics and Censuses (INEC), encompassing hospital discharge records and mortality data. All registered cases of pancreatic cancer (ICD-10: C25) were included, without restrictions regarding age, sex, or geographical region. Variables analyzed included age, sex, ethnicity, region, area of residence, mortality, and annual incidence. A total of 10,818 cases were recorded, with an almost equal distribution between males (50.51%) and females (49.49%); most cases occurred in individuals over 60 years of age. Results: The national incidence rate increased from 2.35 (2008) to 7.31 (2023) per 100,000 inhabitants. Mortality also showed an upward trend, reaching 4.66 in 2022. The case fatality rate remained high, with a national average close to 80%, and reaching 100% in provinces with limited healthcare infrastructure. Conclusions and relevance: Pancreatic cancer demonstrates a growing and highly lethal pattern in Ecuador. These findings highlight the urgent need to strengthen early diagnostic strategies and ensure equitable access to specialized treatment, particularly in regions with limited oncological coverage. Key words: case fatality rate, Ecuador, incidence, mortality, pancreatic cancer.Item type: Ítem , Access status: Acceso Abierto , Prevalencia y factores asociados al consumo y abuso de bebidas alcohólicas, en adolescentes del colegio José Benigno Iglesias Biblián-Ecuador 2024-2025(Universidad Católica de Cuenca., 2026) Barreto Guallpa, Frank Emmanuel; Prado Saquisili, Alan StevenAlcoholic beverage consumption during adolescence constitutes a public health problem due to its early onset and its physical, emotional, and social repercussions, which may affect academic performance, interpersonal relationships, and overall well-being. Objective: To analyze the frequency of alcohol consumption and related factors among students at the José Benigno Iglesias Educational Unit during the 2024–2025 academic period. Methodology: A quantitative, observational, descriptive, and cross-sectional study was conducted using census sampling of 282 students who met the inclusion criteria. The AUDIT questionnaire and a survey on psychosocial factors were administered. Results: Fifty-five percent (55%) of adolescents reported having consumed alcohol at least once, and 40% showed indications of risky or harmful alcohol consumption or possible dependence. Higher alcohol consumption was associated with male sex, middle or late adolescence, frequent attendance at parties, romantic disappointments, maternal migration, and parental permissiveness (p < 0.001). Reading, sports activities, and listening to music were significantly associated with protective factors (p < 0.05). Conclusions: A high prevalence of alcohol consumption was evidenced. Identifying risk and protective factors is essential for designing preventive strategies adapted to the canton’s educational and social context. Keywords: adolescent, alcoholism, adolescent behavior, risk factors, protective factors, prevalence.Item type: Ítem , Access status: Acceso Abierto , Percepción de los usuarios sobre la calidad del servicio brindado en el centro de salud de Piñas, el Oro - Ecuador, marzo-agosto 2025(Universidad Católica de Cuenca., 2026) Feijoó Gallardo, Eduardo NicolásBackground: Evaluating the quality of health services is essential to ensuring the efficiency of the system and user satisfaction. In the context of primary care, understanding user perceptions allows for the identification of opportunities for improvement and the strengthening of local health management. Objective: To analyze users’ perceptions of the quality of service provided at the Piñas Health Center in the province of El Oro, in relation to sociodemographic characteristics, during the period from March to August 2025, using the “SERVQUAL” survey. Methodology: A quantitative, non-experimental, cross-sectional, descriptive, and correlational study was conducted at a primary care center in the Piñas canton. The sample consisted of 211 users attending consultations or related activities, selected through simple random sampling. The SERVQUAL questionnaire was used to collect information on perceived quality. The surveys were administered in paper format and subsequently analyzed using SPSS through descriptive statistics and the chi-square test. Results: A total of 125 women (59.2 %) and 86 men (40.8 %) participated, most of whom had a high school education (64 %) and were between the ages of 20 and 29 (31.8 %). 91.9 % rated the care as good or excellent. No statistically significant association was found between sociodemographic variables and perceived quality (p > 0.05). Conclusion: The favorable perception among users reflects a positive evaluation of the service, linked to the overall quality observed across the SERVQUAL dimensions, indicating that expectations are adequately met in the context of primary care. Keywords: quality, healthcare services, perception, usersItem type: Ítem , Access status: Acceso Abierto , Prevalencia y características en enfermedad pulmonar obstructiva crónica en el Distrito 03D01, Cañar - Ecuador, 2014 – 2024(Universidad Católica de Cuenca., 2026) Loya Torres, Andrés Roberto; Velásquez Morocho, Byron VinicioBackground: Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease and public health problem due to its morbidity and mortality, impact on quality of life, and burden on health systems. Objective: To determine the prevalence of COPD in the 03D01 Health District of Cañar during 2014–2024, identifying epidemiological trends and associated characteristics. Methodology: An observational, analytical, retrospective, and cross-sectional study was conducted, using records from the Ministry of Health. People ≥40 years of age with a diagnosis of COPD (ICD-10 J40–J44) were analyzed. Of 3,174,699 records, 827,570 eligible records were analyzed, identifying 1,504 diagnoses. The prevalence and distribution according to sex, age, ethnicity, residence, and year were estimated. Results: The prevalence based on administrative records was 0.18%. Males accounted for 53.92% and females for 46.08% . The group aged 80 years or older accounted for 53.52%, followed by the group aged 70 to 79 years (23.87%). Mestizo ethnicity accounted for 99.27% and Azogues accounted for 71.21% of the cases. An increase was observed between 2022 and 2024. There was a significant association between COPD and sex, age, residence, and year of care (p < 0.05). Conclusion: COPD was frequently recorded in older adults attended to in District 03D01. The increase during the pandemic and post-pandemic is a trend observed in administrative records and does not show an increase in population-level prevalence. These results provide local evidence to strengthen prevention, timely diagnosis, and comprehensive management of COPD at the first level of care. Key words: COPD, prevalence, epidemiology, records, EcuadorItem type: Ítem , Access status: Acceso Abierto , Efectividad del abordaje directo anterior versus el abordaje posterior en la artroplastia total de cadera: revisión sistemática(Universidad Católica de Cuenca., 2026) Spósito Mirandas, Elton CleberBackground: Total hip arthroplasty (ATC) is an intervention used to treat degenerative conditions and fractures. The surgical approach influences the functional results. The direct anterior approach (DAA) has gained prominence compared with the posterior approach (PA) for its possible benefits in early recovery, although controversies persist regarding its overall effectiveness. Objective: To compare the effectiveness of DAA versus PA in THA, considering functional recovery, postoperative complications and medium-term results. Methods: A systematic review of studies published between 2014 and 2024 in PubMed, Scopus and SciELO was conducted. Studies with at least 40 patients per group and results on function, complications, or surgical revision were included. Studies without a comparison group, duplicates and gray literature were excluded. The methodological quality was evaluated using NIH and RoB1 tools. Results: The ADA showed lower pain levels, better early HHS and WOMAC scores, and a lower rate of dislocations. However, it presented a higher risk of intraoperative complications, such as fractures and nerve injuries, especially during the learning curve. The PA showed similar long-term functional results, although with a higher incidence of dislocations. Discussion: The ADA offers advantages in early recovery, but requires more technical training and specific resources. The PA has a more stable learning curve. The choice should be individualized according to the patient, the surgeon's experience and the available resources. Conclusions: The ADA provides early functional advantages, although it requires greater surgical skill. The choice of approach must balance efficacy, safety and clinical context. Keywords: direct anterior approach, posterior approach, total hip arthroplasty, surgical complications
