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 , Efectividad de células madre y plasma rico en plaquetas en el tratamiento de artrosis: revisión sistemática(Universidad Católica de Cuenca., 2026) Rodriguez Martinez, Andrew SebastianIntroduction: Osteoarthritis is a chronic, degenerative joint disease that poses a significant threat to health worldwide. Although current treatments focus on symptom relief, their effectiveness in repairing joint damage has been found to be limited. Several recent studies have shown that stem cells and plasma contribute to cartilage repair, as well as to anti-inflammatory modulation and immune regulation in patients with osteoarthritis. Objective: To compare the effectiveness of treatment with PRP (platelet-rich plasma) and stem cells in patients with osteoarthritis in terms of pain, function, and quality of life. Methodology: A systematic review was conducted of articles published between 2020 and 2025 that were relevant to the research objective, based on the PRISMA guidelines, published in English or Spanish, and selected from the PubMed, Scopus, and SciELO databases. Results: The use of stem cells and PRP in osteoarthritis was associated with reduced pain, as assessed using the Visual Analog Scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), as well as improved function and stimulation of cartilage regeneration. These regenerative therapies, whether used individually or in combination, demonstrated superior benefits over conventional treatments, with a positive impact on patients’ quality of life. Conclusion: Regenerative therapies using stem cells and PRP reduce pain and improve function, representing a promising alternative for addressing the underlying pathology of osteoarthritis. Keywords: osteoarthritis, therapy, stem cells, plasma, quality of lifeItem type: Ítem , Access status: Acceso Abierto , Factores asociados a depresión en adultos mayores atendidos en el Centro de Salud Javier Loyola, Azogues – Ecuador. Periodo Agosto 2024-Febrero 2025(Universidad Católica de Cuenca., 2026-06-19) Juela Molina, Adriana AlexandraIntroduction: In recent years, an increase in the older adult population has been observed, leading to a rise in the prevalence of depression in this age group. Various social and economic factors contribute to this condition, especially when older adults must assume the role of caregivers for ill spouses. Furthermore, reduced income and the loss of loved ones contribute to social isolation. According to international studies, approximately 30% of older adults may experience depression. Objective: To identify factors associated with depression among older adults attending the Javier Loyola Health Center in the city of Azogues in 2024-2025. Materials and Methods: The study employed a quantitative, analytical, observational, cross-sectional design, in which a socioeconomic stratification survey, the Gijón Socio-Familial Evaluation Scale, and the Yesavage Depression Scale were used. A sample of 227 older adults was obtained from a total population of 1,197 older adults, using a 20% proportion and a 95% confidence level; therefore, the sample size was 227 participants. Results: It was estimated that 43.2% of the older adults in the study population experienced depression. Furthermore, those with high socio-familiar risk were 2.76 times more likely to present depression, while those with low or lower-middle socioeconomic status showed 1.51 times higher probability of depression. These results provided a comprehensive understanding of the factors associated with depression in this community. Keywords: Older Adults, Social Support, DepressionItem type: Ítem , Access status: Acceso Abierto , Eficacia de las intervenciones en el estilo de vida para el tratamiento de la obesidad en niños: revisión sistemática(Universidad Católica de Cuenca., 2026-06-18) Vega Chuint, Jimsomp AlejandroIntroduction: Childhood obesity represents a growing global problem with significant clinical implications, as it is characterized by an excessive accumulation of adipose tissue that substantially increases the risk of metabolic and cardiovascular disorders. In particular, this problem has been exacerbated by factors related to modern lifestyles, such as the consumption of ultra-processed foods and a decline in physical activity. Childhood obesity is estimated to be associated with a high long-term burden of disease, underscoring the importance of implementing effective lifestyle intervention strategies for its prevention and management. Objective: To evaluate the effectiveness of lifestyle interventions for the treatment of obesity in children through a systematic review of the scientific literature, with the aim of improving children’s nutritional status. Methodology: A descriptive systematic review was conducted in accordance with the PRISMA 2020 statement. The literature search was performed in PubMed, Scopus, LILACS, SciELO, and Medline Plus. Twelve studies that met the established inclusion criteria were selected. Results: It was found that multicomponent interventions, involving family participation and long-term follow-up, were the most effective for improving body mass index (BMI), body composition, eating habits, and quality of life in children with obesity. Keywords: childhood obesity, lifestyle interventions, risk factors, body mass index, treatmentItem type: Ítem , Access status: Acceso Abierto , Memantina versus rivastigmina en el tratamiento de Alzheimer. Revisión sistemática(Universidad Católica de Cuenca., 2026-06-17) Molina Paguay, Jessica EstefaníaAlzheimer's disease is a progressive neurodegenerative disorder that affects memory, reasoning, and the ability to perform daily activities. Furthermore, it can cause changes in the behavior and identity of individuals who suffer from it. The disease typically progresses gradually and is classified into mild, moderate, and severe stages. Clinical manifestations vary among patients depending on the disease stage. At the brain level, neuronal damage, loss of neuronal connections, and cell death occur. Various studies suggest that this disease develops from the interaction of genetic and environmental factors, as well as lifestyle habits, that affect the brain over time. Therefore, the following research question arises: Which medication is most effective for treating Alzheimer’s disease? Methodology: A systematic review was conducted in accordance with the PRISMA 2020 guidelines. Information was collected from scientific databases such as PubMed and ProQuest. The selected articles were evaluated using methodological scales to ensure the quality and currency of the scientific evidence obtained over the past five years. Conclusions: The results show that memantine is primarily used in moderate and severe stages of Alzheimer’s disease, while rivastigmine is used in mild to moderate stages. Both medications are part of the treatment regimen and have different mechanisms of action. It is concluded that the choice of medication depends on the disease stage and the patient’s clinical course, and that no definitive answer exists regarding which is superior. Keywords: disorder, Alzheimer's disease, memantine, rivastigmine, effectivenessItem type: Ítem , Access status: Acceso Abierto , Eficacia y seguridad de leflunomida y metotrexato en el tratamiento de artritis reumatoide. Revisión sistemática(Universidad Católica de Cuenca., 2026-06-17) González González, Lisseth SelenaBackground: Rheumatoid arthritis (RA) is a chronic disease characterized by pain, deformity, and functional impairment due to progressive joint damage. This study compares the efficacy and safety of two disease-modifying antirheumatic drugs, leflunomide (LEF) and methotrexate (MTX), through a systematic review. In addition, their clinical characteristics and safety profiles were analyzed to identify effective treatment options that promote treatment adherence and improve patients’ quality of life. Methods: A literature search was conducted in databases such as PubMed, ScienceDirect, SciELO, and the Cochrane Library, selecting studies published between 2016 and 2024. Inclusion criteria included clinical trials and observational studies comparing the efficacy and safety of LEF and MTX in patients with rheumatoid arthritis. Results: The findings support the efficacy and safety of both methotrexate (MTX) and leflunomide (LEF) in the treatment of rheumatoid arthritis. MTX remains the first-line drug, showing better results when a stable dose of 10–25 mg/week is maintained and when combined with prednisone, sulfasalazine, or biologic therapies. The comparative review showed that MTX has better long-term tolerability than LEF. Furthermore, therapeutic combinations such as tocilizumab plus MTX or rituximab plus LEF can optimize the clinical response. In terms of safety, low-dose MTX is associated with hematologic, gastrointestinal, and pulmonary adverse effects, while LEF is associated with a higher risk of infections and other adverse events. Keywords: rheumatoid arthritis, leflunomide, methotrexateItem type: Ítem , Access status: Acceso Abierto , Prevalencia del trastorno por atracón en los estudiantes de la Universidad Católica de Cuenca sede Azogues, Ecuador 2024-2025(Universidad Católica de Cuenca., 2026-06-17) Lagos Contreras, Erick Paul; Franco Roca, Samanta MadeleyBinge eating disorder (BED) represents a global problem that impacts students from emotional and physical health. This study focused on evaluating the prevalence of BED in medical students at the Catholic University of Cuenca, Azogues Campus, between 2024 and 2025. For this purpose, a quantitative approach with a cross-sectional descriptive design was used, with a sample of 293 randomly selected students. The OEWP-R and S-EDE-Q questionnaires were administered to identify the disorder and associated factors. Discussion: The results showed that BED mainly affected women (15.7%) and young people aged 21 to 23 years (43.8%). It was found that feelings of guilt were more common among women (91.3%) and students aged 18 to 20 years (95.8%). Studies have shown that there is a significant link between psychological and nutritional factors associated with binge eating. Conclusion: Negative body image perception (OR = 5.35) and dietary restriction habits (OR = 10.10) were identified as the factors with the strongest association. These results support the factors described in the development of the disorder. The high prevalence of BED observed in the sample indicates the need for more focused attention on these aspects within the academic context. Keywords: arterial hypertension, non-pharmacological treatment, non-adherence, determining factorsItem type: Ítem , Access status: Acceso Abierto , Evaluación de los determinantes del incumplimiento del tratamiento no farmacológico en pacientes con hipertensión arterial en el Centro de Salud El Tambo, Cañar- Ecuador, periodo 2024- 2025(Universidad Católica de Cuenca., 2026-06-17) Jaramillo Gallardo, Mayerly Juliana; Montalvo Cusme, Stevens MarcoAdherence to non-pharmacological treatment in patients with arterial hypertension is essential for its control. However, there is limited information in Ecuador, especially in El Tambo, Cañar, which hinders a comprehensive understanding of the factors influencing adherence in this context. Objective: To evaluate the determinants of non-adherence to non-pharmacological treatment in patients with arterial hypertension treated at the El Tambo Health Center, Cañar, between 2024 and 2025, using a validated survey, to propose interventions to improve adherence. Methodology: A quantitative, descriptive-analytical, cross-sectional study was conducted at the El Tambo Health Center. Simple random sampling was used among patients with essential hypertension who were prescribed non-pharmacological interventions between May 2024 and February 2025. A total of 214 participants were included, who met the specified inclusion criteria, while patients with severe comorbidities or irregular attendance were excluded. Discussion: The mean age was 56.98 years (range 41–73). Male participants predominated, and most were married, had a secondary education, and had stable employment. The frequency of non-adherence was high, with knowledge of control measures identified as the main factor associated with non-adherence. Other sociodemographic factors, such as age, educational level, and occupation, also influenced non-adherence. Conclusions: The high frequency of non-adherence underscores the need for educational and support strategies. Improving knowledge about the disease and preventive measures can increase adherence, suggesting the need for educational programs to foster treatment adherence. Keywords: arterial hypertension, non-pharmacological treatment, non-adherence, determining factors Certificamos que el documento que antecede es fiel copia del documento enviado por el/la estudiante Jaramillo Gallardo Mayerly JulianaItem type: Ítem , Access status: Acceso Abierto , Factores de riesgo asociados a parto prematuro: revisión sistemática(Universidad Católica de Cuenca., 2026) Tigre Saltos, Miriam AlexandraIntroduction: Preterm labor is defined as a series of uterine contractions accompanied by cervical changes occurring between 20 weeks and 0 days of gestation and before 37 weeks and 0 days. It constitutes a significant global public health concern and poses a significant risk to maternal and fetal well-being. Objective: To conduct a comprehensive analysis of the risk factors associated with preterm birth through a systematic review of the available scientific literature, thereby contributing to a better of their impact on maternal-fetal health. Methodology: The systematic review was conducted using the academic databases provided by the Catholic University of Cuenca, which includes search platforms such as Scopus, PubMed, ScienceDirect, Taylor & Francis, Web of Science, Springer, and ProQuest. Results: The study identified various risk factors associated with preterm birth; however, the main factors identified included preeclampsia, gestational and presentational diabetes, intrauterine growth restriction (IUGR), parity, lack of prenatal care, tobacco use, anemia, low socioeconomic status and educational level urinary tract infections, and a history of preterm birth. Conclusions: The complexity of the risk factors associated with preterm birth was analyzed, ranging from maternal medical conditions to socioeconomic and lifestyle factors. Keywords: newborn, risk, factors, preterm, prematureItem type: Ítem , Access status: Acceso Abierto , Eficacia de la glibenclamida versus la bexaglifocina en disminución de la hemoglobina glicosilada para el tratamiento de la diabetes mellitus tipo 2: revisión sistemática(Universidad Católica de Cuenca., 2026) Altamirano Espinoza, Angélica VivianaBackground: Type 2 Diabetes Mellitus (T2DM) is a chronic disease worldwide that has shown an alarming increase in cases, from 425 million in 2017 to nearly 360 million by 2045, according to the latest reports from the International Diabetes Federation (IDF). Therefore, there is a need for innovative therapeutic options, such as Bexagliflozin and Glibenclamide, both of which have shown promising results in the treatment of T2DM. This systematic review focuses on providing a concrete and detailed overview of the best therapeutic option for treating T2DM. Objectives: To evaluate the efficacy of Glibenclamide compared with Bexagliflozin in reducing glycosylated hemoglobin for the treatment of type 2 diabetes mellitus. Methods: A systematic review was conducted following the PRISMA 2020 guidelines, along with different parameters to ensure the robustness of the results. Results: Glibenclamide has demonstrated greater effectiveness in terms of reducing glycosylated hemoglobin levels, ranging from 1.5% to 2%, compared with Bexagliflozin, which shows a reduction of 0.8% to 1.5%. However, Glibenclamide has greater hypoglycemic effects, which is one of the most important complications associated with this drug. On the other hand, Bexagliflozin offers additional parameters, such as weight loss and cardiovascular benefits. Therefore, the choice between these two medications should be based strictly on the evaluation of the patient's profile, considering all underlying clinical conditions. Keywords: bexagliflozin, type 2 diabetes mellitus, glibenclamide.Item type: Ítem , Access status: Acceso Abierto , Asociación entre las variables antropométricas y la actividad física en los docentes de la Universidad Católica de Cuenca campus- Azogues, Ecuador.2024-2025(Universidad Católica de Cuenca., 2026) Bravo Calle, Jhocelyn Nicol; Regalado Vazquez, Nicole FernandaIntroduction: Overweight and obesity are common health issues among university faculty members and are associated with low levels of physical activity, which negatively impacts their well-being and quality of life. Objective: To examine the association between anthropometric variables and physical activity among faculty members at the Catholic University of Cuenca, Azogues Campus, Ecuador, during the 2024–2025 academic year. Methodology: An observational, analytical, cross-sectional study was conducted with 212 faculty members aged 23 to 72 years, selected through a consensus-based non-probability sampling method. Anthropometric measurements included weight, height, body mass index (BMI), arm circumference, abdominal circumference, calf circumference, and waist-to-hip ratio. Physical activity levels were assessed using the PAQ-1 questionnaire. Results: For the statistical analysis, bivariate analysis and Spearman’s correlation coefficient were used, with a significance level of p < 0.05. The sample consisted of 50.5% women and 49.5% men, of whom 46.7% were classified as overweight and 11.4% as obese. A statistically significant association was identified between arm circumference and physical activity level, suggesting that higher physical exercise levels are associated with healthier muscle mass values in this body region. Conclusions: Arm circumference is an important indicator of the impact of physical activity on muscle mass among university faculty members. The findings highlight the need to implement health promotion strategies and encourage active lifestyles among this population, given the presence of abnormalities in anthropometric variables. Keywords: anthropometry, faculty members, physica exercise, obesity, overweightItem type: Ítem , Access status: Acceso Abierto , Adherencia a la medicación psicofarmacológica en adultos con trastornos mentales del Instituto de Neurociencias de Guayaquil, Ecuador. 2024(Universidad Católica de Cuenca., 2026) Déleg Sari, Boris Adrián; Díaz Vargas, Jherling KarineIntroduction: Psychopharmacological adherence in patients with mental illnesses such as schizophrenia and depression, among others, is important for improving patients’ quality of life, as well as for helping to prevent relapses. Objective: To determine the prevalence of adherence to psychopharmacological medication among adults undergoing long-term treatment for mental disorders at the Mental Health Center of Ecuador in 2024. Methodology: A quantitative, descriptive, observational study was conducted with 379 patients with mental disorders treated at the Mental Health Center of Ecuador in 2024. The Morisky-Green scale was applied to measure adherence to psychopharmacological medication. Results: Adherence to psychopharmacological medication in the study population was mostly low (57.5%). The Morisky scale showed adequate reliability and validity. Adherence to psychopharmacological medication was lower among women, as well as in younger individuals. The type of medication did not influence adherence. The number of psychopharmacological drugs taken was also not statistically significant; however, lower adherence was observed as the number of medications increased. Conclusions: The patients studied generally show low adherence to psychopharmacological medication, especially among women and individuals under 40 years of age. Keywords: mental disorders, adherence, psychotropic drugs, MoriskyItem type: Ítem , Access status: Acceso Abierto , Conocimientos y actitudes de los médicos del primer nivel de atención para el diagnóstico de patología mamaria y el uso de métodos de imagen, Distrito 03D01, Cañar - Ecuador, 2024 - 2025(Universidad Católica de Cuenca., 2026) Alvarado Zambrano, Paula; Romero Meza, Karoline MercedesBackground: The detection of breast pathologies using imaging methods poses a challenge for primary care; understanding the protocols ensures appropriate referral when necessary and prioritizes timely treatment. Objective: To assess the knowledge and attitudes of primary care physicians in District 03D01 regarding the use of imaging methods for the diagnosis of breast pathologies. Methodology: A quantitative, descriptive, cross-sectional study conducted in primary care health facilities in District 03D01. The study included family physicians, general practitioners, and rural physicians with at least six months of experience in the management of breast pathologies, excluding those on leave, in internships, or not engaged in clinical practice. Results: Of the 122 physicians (100%) in District 03D01, 57.38% participated in the survey, with a majority coming from rural areas (57.1%). The majority were male general practitioners (75.7% and 34.3%, respectively). Although 84.3% are involved in referrals for imaging studies, only 74.3% show interest in the topic, and just 27.1% receive annual training. Furthermore, although the recommended starting age for each method is known, the frequency of mammography is not known by 71.4% of participants, as well as the management protocol for BI-RADS categories 0, 1, 2, and 3 are unknown. Conclusions and Implications: The study highlights gaps in the understanding and management of breast pathologies in primary care; improvements are needed in training, the implementation of standardized protocols, and the updating of clinical guidelines to optimize detection and treatment. Keywords: BI-RADS, mammography, breast pathology, imaging techniques, breast cancer screeningItem type: Ítem , Access status: Acceso Abierto , Adherencia al tratamiento de trastornos neuropsiquiátricos en pacientes de consulta externa en el Instituto de Neurociencias de Guayaquil, enero 2023 - abril 2024(Universidad Católica de Cuenca., 2026) Guerreo Mora, Jack Xander; Idrovo Valarezo, Paula GabrielaIntroduction: Neuropsychiatric disorders are defined as conditions that alter an individual’s perception, thinking, mood, or behavior. Treatment adherence refers to the extent to which patients take medication according to the prescribed dosage and schedule, and maintain this regimen over time. Objective: To analyze treatment adherence among outpatients with neuropsychiatric disorders treated at the Guayaquil Institute of Neurosciences between January 2023 and April 2024. Methodology: An observational and correlational study that analyzed adherence to psychotropic medications in 342 patients with neuropsychiatric disorders. Secondary data processed in Jamovi v2.3.28 were used to describe frequencies, percentages, measures of central tendency, and measures of dispersion. In addition, nonparametric statistical tests (chi-square) were applied to establish associations between variables. Results: The most common neuropsychiatric disorders were schizophrenia and delusional disorders (16.5%), followed by neurotic and somatoform disorders (11.7%). Sixty-three-point seven percent (63.7%) of participants showed low adherence to their treatment plans, with 34.5% demonstrating moderate adherence, and only 1.8% showing high adherence. A statistically significant association was found between treatment adherence and diagnosis (p < 0.001) and between treatment adherence and type of medication (p < 0.001). Conclusions: The distribution of neuropsychiatric disorders is heterogeneous, with a concerning low level of treatment adherence, which affects quality of life. Adherence varies depending on the diagnosis and medication, highlighting the need for personalized strategies, psychoeducation, and clinical follow-up to optimize mental health outcomes. Keywords: treatment adherence, neurocognitive disorders, organic mental disordersItem type: Ítem , Access status: Acceso Abierto , Efectividad e inmunogenicidad de la vacuna contra el dengue tetravalente recombinante CYD-TDV versus la vacuna TAK-003. Revisión sistemática(Universidad Católica de Cuenca., 2026) Ruiz Espinoza, Alexander GeovannyIntroduction: Dengue remains a significant public health problem in tropical and subtropical regions; therefore, vaccination represents a preventive strategy that complements vector control. Objective: To evaluate the effectiveness and immunogenicity of the recombinant tetravalent vaccine CYD-TDV versus the TAK-003 vaccine. Methods: A systematic review was conducted following the PRISMA 2020 methodology. The search was performed in PubMed, Scopus, Cochrane Library, ClinicalTrials.gov, and ScienceDirect, considering publications from 2019 to 2024. Twenty-two human studies evaluating the efficacy, effectiveness, immunogenicity, or safety of CYD-TDV and TAK-003 were included. The results were synthesized narratively and in tabular form, without estimating a pooled overall effect measure. Results: TAK-003 showed favorable results across several clinical outcomes, with an initial efficacy of 80.2% against virologically confirmed dengue and protection against hospitalization ranging from 84.1% to 90.4%. Its immune response was sustained, with higher titers against DENV-2, although with relatively lower performance against DENV-3. CYD-TDV showed better results in seropositive individuals, but limitations were observed in seronegative individuals due to the described risk of hospitalization or severe dengue. Conclusions: TAK-003 may have greater applicability in populations with heterogeneous serological status, whereas CYD-TDV remains mainly useful in people with documented prior infection. Keywords: dengue, tetravalent dengue vaccine, CYD-TDV, TAK-003, immunogenicityItem type: Ítem , Access status: Acceso Abierto , Eficacia de vacunas de ARNm versus vacunas inactivadas en la prevención de infecciones por COVID-19: revisión sistemática(Universidad Católica de Cuenca., 2026) Guamán Lema, Luis Javier; Chuchuca Aguilar, Tiffany NaomiIntroduction: The COVID-19 pandemic was one of the most significant global public health challenges, driving the accelerated development of multiple vaccine platforms, such as messenger Ribonucleic Acid (mRNA) vaccines and inactivated vaccines, which demonstrated substantial clinical benefits; however, differences in efficacy, safety, and applicability across epidemiological contexts remain evident. Objective: To compare the efficacy and safety of mRNA vaccines and inactivated vaccines in preventing COVID- 19 infection, hospitalization, and mortality among pediatric and adult populations. Methods: A systematic review was conducted in accordance with the PRISMA 2020 guidelines. Randomized controlled trials and observational studies published between December 2020 and September 2024 were identified through searches in PubMed, Scopus, and Web of Science. Studies lacking direct comparisons, quantifiable outcomes, or involving nonhuman populations were excluded. Methodological quality and risk of bias were assessed using validated assessment tools. Results: Of the total of 1,024 records identified, 20 studies were included, involving approximately 60,000 participants. The mRNA vaccines, mainly BNT162b2 and mRNA-1273, demonstrated higher efficacy against symptomatic infection, with values close to 95%, whereas inactivated vaccines achieved between 50% and 66%. Both vaccine platforms significantly reduced hospitalization and mortality rates. The mRNA vaccines were associated with a higher frequency of mild-to-moderate reactogenicity, whereas inactivated vaccines exhibited greater tolerability. Conclusions: mRNA vaccines provide superior protection against symptomatic and severe COVID-19. However, inactivated vaccines remain safe and valuable alternatives in healthcare systems with operational limitations. Keywords: COVID-19 vaccines, mRNA vaccines, inactivated vaccines, SARS-CoV-2, vaccine efficacyItem type: Ítem , Access status: Acceso Abierto , Manejo fisioterapéutico versus manejo quirúrgico del linfedema de miembro superior posterior a disección de ganglios linfáticos axilares por cáncer de mama: revisión sistemática(Universidad Católica de Cuenca., 2026) Suárez Guillén, Samantha BelénObjective: To compare physiotherapeutic and surgical treatments used in the management of upper limb lymphedema following axillary lymph node dissection for breast cancer, evaluating their effectiveness in reducing edema volume, restoring mobility, and improving quality of life. Methodology: A systematic review was conducted of clinical intervention and observational studies published over the past seven years, in any language, that provided relevant information on therapeutic approaches for this condition. Articles were identified in PubMed, Elsevier, and Springer. The search was completed in November 2024. The risk of bias was assessed using the RoB 1 and RoB 2 tools, following the PRISMA 2020 guidelines. Results: Thirteen studies were included, of which 9 were clinical trials and 4 were observational studies, with a total population of 870 patients. The evidence analyzed showed that Complex Decongestive Therapy remains the treatment of choice due to its multimodal approach, safety, and ability to be combined with other conservative interventions. Discussion: The main limitation identified was the scarcity of studies directly comparing physiotherapeutic and surgical treatments. However, the available findings suggest that physiotherapeutic yields better outcomes in reducing arm volume, improving function, and enhancing patients’ perceived well-being. Conclusions: Physiotherapeutic treatment seems to be superior to surgical treatment in this population. However, comparative studies and long-term follow-up are needed to confirm the long-term surgical efficacy. Keywords: arteriovenous anastomosis, arm, manual lymphatic drainage, breast cancer lymphedemaItem type: Ítem , Access status: Acceso Abierto , Prevalencia y factores asociados al Trastorno Disfórico Premenstrual en estudiantes de la carrera de Medicina en la Universidad Católica de Cuenca campus Azogues en el periodo septiembre 2024- febrero 2025(Universidad Católica de Cuenca., 2026) Peñaloza Minchala, Stephany Guadalupe; Rivera Ortiz, Jennifer MaribelIntroduction: Premenstrual Dysphoric Disorder (PMDD) is a physical and emotional condition categorized in the DSM- V by the American Psychiatric Society within the chapter of mood disorder. With a prevalence of 1.8 - 5.8%. It occurs in the luteal phase of the menstrual cycle and improves in the postmenstrual stage; with symptomatic severity that affects the integral health of the patient. Objective: To determine the prevalence and factors associated with PMDD in female students of Medicine at the Catholic University of Cuenca, Azogues campus, for the period September 2024- February 2025. Methodology: A non-experimental, quantitative, correlational, cross- sectional cohort study was carried out with a sample of 278 students, calculated using the finite population formula, from a total universe of 796 students from first to tenth cycle, with the application of a validated survey. Results: Of the 271 respondents, the age group 18 to 21 years represented 61.5% (171), of whom 98.89% were currently unmarried. A total of 24.8% met the diagnostic criteria for PMDD and 69.7% for PMS. No direct associated factors were determined; however, drug use was identified with an OR 1.59 95% CI 0.64- 3.9 P= 0.307; tobacco use OR 1.4 95% CI 0.48- 4, P= 0.531; early menarche OR 1.24 95% CI 0.47- 3.25, P= 0.65. Conclusions: A quarter of the population studied suffers from PMDD, with PMS being the most prevalent, no factors associated with the pathology were found. Key words: PMDD, mental health, premenstrual syndrome.Item type: Ítem , Access status: Acceso Abierto , Diabetes mellitus gestacional como factor asociado a depresión posparto: revisión sistemática(Universidad Católica de Cuenca., 2026) Guaraca Muñoz , Amanda LizbethGestational diabetes mellitus (GDM) and postpartum depression (PPD) are considered public health problems with maternal-infant impact due to the high prevalence rates reported for each condition (15.6% and 19.8%, respectively), with an association found in different studies. This systematic review aimed to analyze all scientific evidence to determine the reported association between GDM and PPD. The bibliographic search was conducted in the biomedical databases PubMed, Scopus, and Web of Science to identify observational studies. It was observed that 17 out of 24 studies, including 8 cohort studies and 9 cross-sectional studies, indicated an association between gestational diabetes mellitus and postpartum depression, with adjusted odd ratios (aORs) ranging from 1.56 to 2.12 with a 95% confidence interval. Therefore, the findings determine that most of the studies analyzed report an association between GDM and PPD; thereby supporting the integration of mental health screening and follow-up care for women with GDM, prioritizing more vulnerable subgroups. Keywords: gestational diabetes mellitus, postpartum depression, risk factor, maternal healthItem type: Ítem , Access status: Acceso Abierto , Efectividad terapéutica de la noradrenalina versus la terlipresina en el síndrome hepatorrenal. Revisión sistemática(Universidad Católica de Cuenca., 2026) Crespo Peñafiel, Nicole AndreaObjective: To compare the efficacy and safety of norepinephrine and terlipressin in the treatment of hepatorenal syndrome (HRS), while also evaluating the clinical, therapeutic, and economic factors associated with the use of both drugs. The aim was to provide scientific evidence to facilitate medical decision-making and contribute to the development of treatment strategies adapted to different healthcare settings. Methodology: Randomized clinical trials that directly compared norepinephrine and terlipressin in adult patients diagnosed with HRS were included. Observational studies, systematic reviews, meta-analyses, and non-comparative articles were excluded. The literature search was conducted in PubMed, Scopus, and Web of Science. Methodological quality and risk of bias were evaluated using the RoB 2.0 tool, considering domains such as randomization, outcome measurement, and selective reporting. Data were synthesized through a comparative analysis of hemodynamic parameters, renal function, survival, and occurrence of adverse effects. Results: Fifteen clinical trials with a total of 2,712 patients were included. Terlipressin demonstrated a significant improvement in renal function, as evidenced by an average reduction of 30% in serum creatinine levels. However, it was associated with relevant adverse effects, especially respiratory failure and abdominal pain. Norepinephrine showed comparable efficacy, along with a more favorable safety profile and lower cost. Conclusion: Although terlipressin remains the standard treatment for severe cases of HRS, norepinephrine represents an effective, safe, and accessible alternative in resource-limited settings, such as Ecuador. These findings support the need for clinical guidelines adapted to the local settings. Keywords: norepinephrine, hepatorenal syndrome, drug therapy, terlipressin.Item type: Ítem , Access status: Acceso Abierto , Eficacia de la anastomosis colónica primaria versus colostomía en pacientes con diverticulitis aguda Hinchey IV. Revisión sistemática(Universidad Católica de Cuenca., 2026) Crespo Mora, Iveth AnddreinaObjectives: To evaluate the perioperative and postoperative efficacy of Primary Colonic Anastomosis (PCA) and colostomy in patients with acute Hinchey IV diverticulitis, as well as to compare postoperative complication rates, length of hospital stay, and mortality among patients undergoing these procedures. Methodology: This is a systematic literature review based on a search of scientific literature in PubMed, the Cochrane Library, Scopus, and Google Scholar. The included studies were published in English and Spanish within the last five years and were selected according to predefined inclusion and exclusion criteria. The results were synthesized using analytical-synthetic and inductive methods. Results: A total of seven articles related to the surgical management of acute Hinchey IV diverticulitis were evaluated, including multicenter and single-center cohort studies. These studies were rated as being of high methodological quality, with scores ranging from 10 to 11 out of 14, reflecting a robust methodology for assessing the outcomes of surgical techniques. Discussion: According to various studies, Primary Colonic Anastomosis (PCA) was associated with lower mortality (5.3%) compared with colostomy (10.6–14%). The main complications of colostomy included surgical site infection, sepsis, and enteric fistulas. PCA was associated with a lower rate of serious complications despite a higher number of hospital admissions. Conclusions: PCA is considered an effective and safe option in stable patients, with lower mortality, fewer complications, and a better quality of life. Colostomy remains useful in cases of emergency, peritonitis, or comorbidities, and is associated with a longer hospital stay. These results support its surgical use in selected patients. Keywords: acute diverticulitis, Hinchey IV, primary colonic anastomosis, colostomy, postoperative complications
