Trabajos de Titulación - Sede Azogues - Medicina
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- ÍtemAcceso AbiertoResistencia a betalactámicos. Revisión Sistemática(Universidad Católica de Cuenca., 2024) Pinos Larrea, Kerly Monserrath; Pérez Ramírez , Jacinto Eugenio; 0350309654Background: Resistance to beta-lactam is a global health issue that involves the inability to respond to the action of antibiotics. This systematic review aims to identify factors associated with beta-lactam resistance, the primary microorganisms resistant to these drugs, and their complications. Method: A qualitative, retrospective, cross-sectional study with a descriptive analysis was conducted. The data collection technique was a review of scientific articles published from 2018 onwards, in Spanish and English, from databases such as SciELO, PubMed, Google Scholar, Cochrane, and Scopus, as well as organizations like the World Health Organization and the Pan American Health Organization. Exclusion criteria included non-compliance with years of publication, articles not available in English or Spanish, and those not meeting the objectives. The information was organized into tables. Results: It was obtained 53,719 records. After applying filters, 11 articles were from PubMed, two from Google Scholar, four from Scopus, three from SciELO, and one from Cochrane, along with other sources for theoretical foundation, resulting in 36 sources. Staphylococcus aureus, Neisseria gonorrhoeae, Streptococcus pneumoniae, Haemophilus influenzae, and Escherichia coli are the main microorganisms resistant to beta-lactams. The associated factors include non-prescription use, dosage non-compliance, and improper use by healthcare professionals. Complications include high public costs and increasing morbidity and mortality rates. Discussion: Based on the results, it was deduced that the information collected is consistent across countries, noting that in Ecuador, there is no relevant data on this topic. Other: Self-funded by the author. Keywords: resistance, beta-lactams, antibiotics, factors, complications
- ÍtemAcceso AbiertoActualización de manejo del síndrome de aspiración de líquido amniótico meconial. Revisión sistemática(Universidad Católica de Cuenca., 2024) Perguachi Ortiz, Amanda Gyssel; Alomía Castro, Paúl Esteban; 0350005989This syndrome is defined as a clinical pathology characterized by respiratory failure that occurs in newborns due to meconium amniotic fluid aspiration. The risk of presenting meconium fluid becomes much higher as fetal maturity increases, and its management is based mainly on general measures for respiratory support and hemodynamic stabilization aimed at preventing or treating infections and complications that may occur. Objective: To develop an updated literature review of the primary aspects of managing Meconium Aspiration Syndrome (MAS). Methodology: A qualitative, descriptive, and systematic review was conducted using a format based on PRISMA guidelines. Results: Seven articles were excluded because they did not meet the inclusion and exclusion criteria. For the preparation of the document, 31 articles were analyzed: PudMed (6), Taylor/Francis (2), Web of Science (2), Scopus (9), and Google Scholar (12). Conclusions: MAS is a cause of mortality and morbidity from neonatal respiratory disease worldwide; it occurs in infants born to adolescent mothers or mothers older than 40 years with hypertensive disorders, maternal hemorrhage, or sepsis. Steroid treatment does not reduce mortality rates of MAS but improves the time of oxygen administration, invasive ventilation, and ICU stay. Antibiotics are not recommended for routine treatment of MAS, and surfactant therapy in MAS does not directly improve mortality. Keywords: meconium amniotic fluid, meconium stain, MAS, postmature, surfactant.
- ÍtemAcceso AbiertoInfecciones cutáneas secundarias a una hiperhidrosis focal primaria y su tratamiento.(Universidad Católica de Cuenca., 2024) Cruz Bravo, Carlos Andrés; Arias Peláez, María Cristina; 0302395991Introduction: Primary focal hyperhidrosis is characterized by excessive sweating in specific body areas, such as the palms of the hands, the soles of the feet, the armpits, and the craniofacial region. Constant sweating can lead to skin maceration, increasing susceptibility to bacterial, fungal, and viral infections. Objective: To determine the skin infections secondary to primary focal hyperhidrosis and their treatment. Methodology: A literature review was conducted on scientific databases such as Scopus, Taylor & Francis, UpToDate, and PubMed. Results: Secondary infections to focal hyperhidrosis include fungal, bacterial, and viral infections. Management consists of antifungal medications, antibiotics, and ablative therapy, respectively. Clotrimazole 1% is used twice daily for 2-4 weeks for dermatophytosis mainly caused by Trichophyton rubrum (70%). In punctate keratolysis, the main agent is Corynebacterium spp. (92.2%-100%), treated with erythromycin 4% every 12 hours for 2-3 weeks. Warts caused by HPV frequently subtypes 1, 2, and 4 (80%) are treated with salicylic acid 17%-50% daily for 6-12 weeks. Keywords: hyperhidrosis, infectious skin diseases, sweat, treatment.
- ÍtemAcceso AbiertoEfectividad de denosumab versus bifosfonatos en mujeres post menopáusicas con Osteoporosis. Revisión Sistemática(Universidad Católica de Cuenca., 2024) Cajamarca Guichay, Evelyn Ximena; Fernández Verdugo, Joselyne Viviana; Capote Llanares, Miguel Angel; 0105580013; 0302200464Background: Osteoporosis is a skeletal disease characterized by a decrease in bone mineral density, causing an increase in bone fragility and fractures. In postmenopausal women, there is a decrease in estrogen and, in turn, an increase in osteoclast activity, producing a change in bone microstructure. Objective: To determine the effectiveness of Denosumab versus bisphosphonates as a treatment for Osteoporosis in postmenopausal women through a literature review. Methodology: A systematic review based on the PRISMA 2020 method was conducted. Studies published in the last five years in English and Spanish related to Denosumab and bisphosphonates treatment were included, using databases such as Scopus, SciELO, and Web of Science. Studies older than five years and those not from reliable sources were excluded. The results were synthesized using the National Heart, Lung, and Blood Institute (NHLBI) quality assessment scale to determine the quality of studies, and the risk of bias was evaluated individually employing the Cochrane tool. Results: Nineteen studies were included: 6 from Web of Science, 12 from Scopus, and one from SciELO; additionally, five articles from randomized clinical studies and 14 meta-analyses were also incorporated. Discussion: A similarity in the effectiveness of Denosumab versus bisphosphonates was demonstrated in women with postmenopausal Osteoporosis. Limitations: Number of articles used. Other: Self-funded. Keywords: bisphosphonates, denosumab, post menopause, osteoporosis
- ÍtemAcceso AbiertoEficacia del tratamiento fibrinolítico en pacientes con accidente cerebrovascular isquémico.(Universidad Católica de Cuenca., 2024) Pesántez Coronel, Andrés Esteban; Torres Criollo, Larry Miguel; 0350233342Context: Stroke causes functional limitation in those affected, leading to frailty, worsening of the condition, and an essential demand for healthcare services. Objective: To evaluate the level of scientific evidence through a systematic review of the effectiveness of fibrinolytic therapy in patients with ischemic stroke. Methodology: A systematic review of meta-analyses and systematic reviews published between 2018 and 2023 in PubMed, Scopus, Redalyc, and ScienceDirect was conducted in English and Spanish. Results: Fibrinolysis in patients with ischemic stroke reduces disability secondary to the event. Tenecteplase significantly achieves complete recanalization in an average of 38.5% of patients compared to alteplase, which achieves it in 29%. Regarding bleeding risk, tenecteplase has an average risk of 3.05% and alteplase 2.86%, with statistically significant values (RR: 1.27 with 95% CI [1.02 - 1.57], p = 0.03). Therefore, tenecteplase is considered a reasonable option for treating patients with ischemic cerebrovascular events, considering its minimal bleeding risk compared to alteplase. Conclusions: Both medications are safe and effective for patients with ischemic stroke. Tenecteplase does not result in higher rates of intracerebral bleeding compared to alteplase. The neurological deficit in the stroke can be determined using scales, among which is the NIHSS (National Institutes of Health Stroke Scale), highlighted due to its high sensitivity and specificity. Keywords: fibrinolysis, stroke, fibrinolytic agents, cerebral infarction, treatment.
