Trabajos de Titulación - Sede Azogues - Medicina
URI permanente para esta colecciónhttps://dspace.ucacue.edu.ec/handle/ucacue/89
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Ítem Acceso Abierto Factores psicosociales que intervienen en la alopecia areata. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Chabla Narváez , María José; Vargas Saquicela, Sandra Paola; 0302897061Background: Alopecia areata is characterized as a non-scarring autoimmune disease affecting hair follicles, leading to hair loss in the scalp or body. Its global prevalence is 5%, occurring at any age, but predominantly in young populations. Psychological, genetic, and environmental factors influence its development, including genetic predisposition, viral infections, hormonal changes, and psychological factors like anxiety and stress. Clinical manifestations include hair loss, forming circular or oval patches, and nail lesions. Objective: This systematic review aims to identify the psychological and social factors influencing alopecia areata to answer the question: “What are the psychosocial factors that influence alopecia areata?” Methods: Information from articles and relevant documents found in bibliographic search engines—PubMed, SciELO, Redalyc, and Scopus—will be analyzed, and their selection process will be based on inclusion and exclusion criteria. Additionally, translation tools such as DeepL and bibliographic management tools like Zotero will be utilized for this project. Results: Psychosocial factors affecting alopecia areata were analyzed and identified. Based on this, the clinical manifestations in patients with this condition were described, and the scientific evidence from the studies was validated. Conclusions: Alopecia areata is a complex autoimmune condition influenced by the interaction of genetic, environmental, and psychological factors. Emotional stress plays a significant role in its development and progression, exacerbating the autoimmune response and compromising the health and well-being of patients. Keywords: alopecia areata, psychological factors, social factors, dermatological disordersÍtem Acceso Abierto Efectos adversos de la exposición a antirretrovirales en el embarazo y en el recién nacido.(Universidad Católica de Cuenca., 2025) Andrade Pesántez , María Caridad; Brito Verdugo, Ruth Ariana; Bravo Salinas , Ruth Ariana; 0350100764; 0302072749Background: Each year, approximately 1.3 million HIV-positive women face the need for antiretroviral therapy (ART) during pregnancy, which is crucial to prevent mother-to-child transmission. Although effective, concerns remain about the potential side effects of these drugs. Objective: To identify the adverse effects of antiretrovirals in pregnant women and newborns through a systematic review following the PRISMA 2020 guidelines. Method: A systematic review was conducted according to PRISMA 2020 guidelines by searching scientific databases such as PubMed, SCOPUS, and Web of Science. Articles from the last five years that met predefined inclusion criteria were selected. Results: Based on the established objectives and criteria, 17 studies were selected from PubMed, 16 from SCOPUS, and 16 from Web of Science. The main adverse effects identified during pregnancy were preterm birth, low birth weight, and congenital anomalies. Dolutegravir (DTG) and Tenofovir Disoproxil Fumarate (TDF) were associated with a higher number of side effects, while Atazanavir (ATV) showed greater safety in pregnant women and newborns. Conclusions: Despite the adverse effects identified, the evidence supports that the benefits of ART during pregnancy outweigh the risks, emphasizing its importance in the prevention of mother-to-child transmission. The scientific community is encouraged to expand its perspective on antiretroviral therapy and its association with side effects in pregnant women and newborns to ensure greater safety when initiating treatment. Keywords: HIV, pregnancy, newborn, adverse effects, antiretroviralsÍtem Acceso Abierto Diagnostico serológico en enfermedades tropicales. Revisión Sistemática.(Universidad Católica de Cuenca., 2025) Cabrera Guzmán, Edith Shakira; Ulloa Castro, Adriana Fernanda; 1400784748Background: Tropical diseases are characterized by being infectious and epidemic in nature; thus, they remain a health problem globally in tropical areas, causing a health problem, so they should be diagnosed promptly to prevent spread. Therefore, it is proposed to identify what the serological techniques for the diagnosis of tropical diseases are. The general objective is to describe the diagnosis of tropical diseases through the use of different serological techniques. Methodology: The research was carried out by obtaining scientific reviews and original articles that meet the inclusion criteria: published within the last 5 years, in English and Spanish, and comprising clinical trial articles and systematic reviews, observational studies, and accessible articles. The sources of information were obtained using Google Scholar and the following databases: SciELO, Elsevier, PubMed, Frontiers, National Institutes of Health (NHI), Centers for Disease Control and Prevention (CDC), Redalyc, Multidisciplinary Digital Publishing Institute (MDPI), Clinical Microbiology, Springer and Oxford, using the keywords tropical diseases, serological techniques, Enzyme-Linked Immunosorbent Assay (ELISA), immunoglobulins. Results: The different serological techniques for the diagnosis of these diseases were explained. The importance of early diagnosis was highlighted, according to epidemiological studies, to implement the appropriate preventive measures and to establish vaccination campaigns and thus reduce the incidence of cases. Conclusions: it was demonstrated that serological techniques are important, accessible, and reliable to perform an optimal diagnosis for the detection of these diseases. Keywords: tropical diseases, serological techniques, ELISA, immunoglobulinsÍtem Acceso Abierto Efectos de la semaglutida en pacientes obesos. Revisión sistemática(Universidad Católica de Cuenca., 2025) Yepez Espinoza, Carla Paola; Yepez Espinoza , Carla Paola; 0302654843Background: Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, is a physiological hormone that plays several roles in appetite and glucose regulation. It is available in subcutaneous and oral formulations. It is associated with an inhibitory effect on gastric emptying and a reduction in body weight resulting from decreased appetite and energy intake. This study aimed to analyze the effects of Semaglutide in obese patients through a systematic review based on the PRISMA 2020 guidelines. Methods: The PRISMA 2020 methodology for systematic reviews was applied. A search was conducted for studies examining the effects of glucagon-like peptide-1 (GLP-1) receptor agonists (Semaglutide) as a treatment in obese patients. The scientific literature search was performed in PubMed, Scopus, and UpToDate databases. Publications from the last five years (2019-2023) and open-access articles were also included. Results: Adverse effects, drug effectiveness, and advantages in the treatment of obesity were identified. Conclusions: Conclusions were drawn based on the results obtained from the research. Keywords: GLP-1 receptor agonist, metabolic diseases, obesity, Semaglutide, weight reductionÍtem Acceso Abierto Manejo de la gangrena de Fournier. Revisión sistematica(Universidad Católica de Cuenca., 2025) Granda Ramírez, Katherin Estefania; Rodas Andrade, Jorge Roberto; 1106140872Background: Fournier's Gangrene (FG) is a polymicrobial infection characterized by necrosis caused by anaerobic and aerobic bacteria. It most frequently manifests in the perineal, genital, and abdominal regions, especially in males, older adults, and patients with comorbidities such as diabetes mellitus or immunosuppression. Objective: To identify the most effective management of FG through a systematic review of recent scientific literature. Methods and Materials: A systematic review entitled "Management of Fournier's Gangrene. A Systematic Review" was conducted in the area of surgery. The study is descriptive, retrospective, and with a qualitative approach. The Zotero management tool was used, and the PRISMA 2020 guidelines were applied to select and analyze the included studies. Results: Twenty-five scientific articles were included, in which 100% reported a polymicrobial etiology with aerobic and anaerobic agents. The highest incidence was observed in men over 50 years of age. The most relevant risk factors were found to be diabetes mellitus and states of immunosuppression. Regarding treatment, all studies agreed on the need for early use of broad-spectrum antibiotics combined with aggressive surgical debridement as fundamental pillars to improve survival. Conclusions: Fournier's gangrene continues to represent a medical emergency with a high mortality rate. Early diagnosis and immediate surgical intervention, along with adequate antimicrobial therapy, are crucial to improve patient survival. Diabetes mellitus continues to be the most associated comorbidity and should be considered in the prevention and comprehensive management. Keywords: infection, polymicrobial, gangrene, Fournier, treatmentÍtem Acceso Abierto Violencia intrafamiliar como factor de riesgo para trastorno depresivo mayor en mujeres. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Vázquez Torres, María Elena; Martínez Vergara, Ana Lucía; 0106574379Background: Violence is one of the most significant health problems today as the various ways in which it manifests within the family environment are highly diverse. For instance, there is spousal violence due to the psychological, sexual, and economic control of the victim by their aggressor, and the lack of attention to preventive measures has caused this phenomenon to become more widespread and deeply rooted. Methodology: A data analysis was performed using the PRISMA framework, aiming to summarize and interpret the information systematically. A total of 47 files from different academic sources were available, such as PubMed, Google Scholar, Scopus, Elsevier, Dialnet, and Redalyc. Results: A mental health crisis is being experienced within the country and worldwide. Women, in particular, have been more affected due to violence committed by men. Following the onset of the COVID-19 pandemic, its consequences continue to affect us, as levels of domestic violence and femicides around the world have increased, serving as an indicator of the poor quality of security and governance in our region. As mentioned below, several countries have been more affected by this problem. Conclusions: Domestic violence will be presented as a risk factor for developing major depressive disorder in women from different countries. Keywords: domestic violence, risk factors, major depressive disorder, womenÍtem Acceso Abierto Incontinencia urinaria de esfuerzo en mujeres postparto. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Rodriguez Campoverde , Leslie Suley; Pérez Ruiz, Ariadna; 0350151064Urinary incontinence, characterized by the involuntary loss of urine, may result from anatomical or physiological changes associated with pregnancy, postpartum, and obesity, among other factors. Diagnosis is established through a combination of medical history and complementary laboratory and imaging tests. Management will be individualized and may involve non-pharmacological, pharmacological, and surgical treatments depending on the severity. Objective: To develop an up-to-date document on stress urinary incontinence in postpartum women, aimed at training healthcare professionals through scientific knowledge to improve patient care and quality of life. Materials and Methods: A systematic review was conducted by collecting scientific data from sources such as “Web of Science,” “Redalyc,” “Scopus,” “ProQuest,” "ResearchGate," “ScienceDirect,” "PubMed," “SpringerOpen,” and “Google Scholar,” based on publications in the last five years and the PRISMA 2020 guidelines. Results: This study collected information from 59 articles, of which 30 were selected for the development of this review based on inclusion and exclusion criteria. Conclusions: Among the main factors that cause damage to the pelvic floor are pregnancy, multiparity, and vaginal delivery. Therefore, diagnosis is based on the Valsalva maneuver, urodynamic tests, and Kegel exercises to strengthen the pelvic muscles, helping to reduce symptoms with the combination of drugs such as duloxetine and surgical techniques. Keywords: urinary incontinence, postpartum period, risk factors, pelvic floor disordersÍtem Acceso Abierto Síndrome nefrótico secundario a tiroiditis de Hashimoto. Revisión Sistemática.(Universidad Católica de Cuenca., 2025) Cuesta Ordóñez, Anabel Carolina; Vásquez Calle, María Alicia; 0302619093Background: Several studies have shown that a significant percentage of patients with Hashimoto's thyroiditis present nephrotic syndrome as the main manifestation. General Objective: To describe the relationship between nephrotic syndrome secondary to thyroid dysfunction through the analysis of relevant articles. Specific Objectives: To identify the etiology involved in the development of nephrotic syndrome in patients with Hashimoto's thyroiditis, to interpret both immunological and non-immunological interactions between the thyroid and renal parenchyma, and to evaluate how early treatment of autoimmune thyroiditis may prevent a nephrotic syndrome. Methods: A search was conducted across various databases, including PubMed, Scopus, Google Scholar, SciELO, UpToDate, and DynaMed. Articles published in the last five years in English and Spanish were included. Results: A total of 30 articles were analyzed, of which 56% were from Google Scholar, 23% from PubMed, 14% from Scopus, and 1% from SciELO. Conclusions: The correlation between Hashimoto’s thyroiditis and nephrotic syndrome is complex and influenced by several factors. The association between both conditions is highlighted here, especially with membranous nephropathy, which is one of the main causes of nephrotic syndrome. Furthermore, the interrelationship between the thyroid and kidney underscores the importance of a collaborative approach in the evaluation and management of these conditions to provide comprehensive treatment to affected patients. Keywords: Hashimoto’s thyroiditis, hypothyroidism, nephrotic syndrome, interaction, relationshipÍtem Acceso Abierto Prevalencia y factores de riesgo del síndrome de intestino irritable en adultos jóvenes. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Espinoza Bustos , Jennifer Angelina; Crespo Vintimilla, Edgar Adriano; 0302397674Background: Irritable bowel syndrome (IBS) is a disorder of the digestive system, most prevalent among young adults, causing irregular episodes of abdominal pain, bloating, flatulence, and diarrhea or constipation (1). In 2012, the global prevalence of IBS was estimated at 11.2%, with a higher incidence in women. By 2017, the worldwide prevalence of IBS was 8.8%, while in the Americas it reached 17.5%. Based on the diagnostic criteria, prevalence rates were: Manning (24.8%), Rome II (20.4%), Rome III (15.2%) in countries such as Mexico, Nicaragua, Argentina, Colombia, Uruguay, Peru, Brazil, Venezuela, and Chile (2); and finally, Rome IV (12%). The general objective of the study is based on analyzing the risk factors and prevalence of irritable bowel syndrome in young adults through a systematic review aimed at updating medical knowledge. Methods: This systematic review searched for studies such as meta-analyses, randomized controlled and uncontrolled clinical trials published in scientific articles and graduate or undergraduate theses, using Boolean connectors (AND, OR, NOT), in databases such as Scopus, UpToDate, DynaMed, and Redalyc, among others. Results: The findings were analyzed according to the prevalence of IBS and its associated risk factors. Conclusions: The study concluded that the prevalence of IBS remains significant and varies by geographic region and associated factors. The most related risk factors include psychosocial components, such as stress, anxiety, and depression. Keywords: irritable, bowel, syndrome, prevalence, factorsÍtem Acceso Abierto Manifestaciones clínicas del síndrome inflamatorio multisistémico asociado a COVID-19. Revisión Sistemática.(Universidad Católica de Cuenca., 2025) Flores Izquierdo , Giuliana Gabriela; Astudillo Ávila, Andrés Sebastián; 0302538061Multisystem Inflammatory Syndrome (MIS) is a rare but serious COVID-19 condition resulting from an abnormal immune response characterized by inflammation. In Ecuador, 410 cases were reported by May 2020, with Guayas being the province with the highest percentage (30.73%). Objective: To identify the most frequent and non-severe clinical manifestations of multisystem inflammatory syndrome. Methodology: Data were obtained from scientific databases such as PubMed, Web of Science, Jaypee Journal, Scoupus, and ScienceDirect. Studies in English and Spanish since 2020 focused on MIS in the pediatric population were included. Results: The three main medical organizations present similar diagnostic criteria, with differences in age range: the WHO includes adolescents up to 19 years old, while the Centers for Disease Control (CDC) and Royal College of Paediatrics and Child Health (RCPCH) include them up to 21 years. Among the 20 analyzed studies, the most common symptoms were gastrointestinal and mucocutaneous. The predominant age group was 8 to 8.9 years, with a higher incidence in males. Conclusions: Frequent gastrointestinal symptoms include abdominal pain, nausea, and vomiting. Regarding mucocutaneous symptoms, conjunctival injection, skin rash, and exanthems stand out. Lymphadenopathies occur less frequently. Less common symptoms affect the neurological and respiratory systems, including seizures, headache, dyspnea, and cough. Keywords: multisystem inflammatory syndrome, clinical manifestations, COVID-19, age, genderÍtem Acceso Abierto Prevalencia de síndrome metabólico en niños y adolescentes con obesidad. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Jiménez Puente, María José; Álvarez Ochoa, Robert Iván; 1400828495Background: Metabolic syndrome is a cluster of cardiometabolic risk factors, including “dyslipidemias, hypertension, insulin resistance, central obesity, and impaired glucose levels” (1). This study analyzed the number of children and adolescents with obesity who had this condition. Methods: A systematic review was conducted during the 2023–2024 period. Selected articles were in English or Spanish, published between 2019 and 2023, and available in full-text and open access. Information was collected from Scopus, PubMed, and Web of Science databases. Search terms included combinations such as "Metabolic syndrome children and adolescents with obesity," "metabolic" AND "syndrome" in "children" AND "adolescent," "cardiometabolic consequences." Results: The studies reviewed were categorized to address the research objectives: five studies analyzed children with both obesity and metabolic syndrome; thirteen studies helped identify populations using diagnostic guidelines or alternative parameters; and eight studies focused on cardiometabolic changes as consequences of the syndrome. Conclusions: Children and adolescents with obesity have a high risk of developing metabolic syndrome; however, metabolic syndrome can also occur in individuals without obesity. The most commonly used diagnostic criteria are those from the International Diabetes Federation, Ferranti, and NCEP-ATP III. Children and adolescents with metabolic syndrome are prone to complications such as diabetes mellitus and cardiovascular damage. Keywords: children, adolescents, metabolic syndrome, obesityÍtem Acceso Abierto Desarrollo psicomotor y evolución en los niños con síndrome de Down. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Macías Moreira, María Raquel; Duran Palacios, María Teresa; 1314754860Down syndrome, characterized by the presence of an extra copy of chromosome 21, is the leading cause of intellectual disability of genetic origin. This genetic alteration results in several distinctive physical and cognitive characteristics in affected individuals, who will live with Down syndrome throughout their lives. Currently, a significant shift has been observed in the management of children with this condition. From a very early age, therapies are implemented to promote future independence. Objective: To describe the psychomotor development and progression in children with Down syndrome. Methods: A descriptive and analytical study was conducted, based on the PRISMA 2020 GUIDELINE, to gather information about psychomotor development in children with Down syndrome. Results: A comprehensive systematic review was carried out, compiling information from 25 studies using available scientific evidence to identify psychomotor development milestones and their progression in children affected by this syndrome. Conclusions: Aerobic exercises, neuromuscular training, and hippotherapy have proven to be fundamental to increasing mobility and strength. Stimulation and physical therapy are also crucial; an emphasis is placed on individualizing treatment to meet the unique needs of each child. Keywords: Down syndrome, psychomotor development, progressionÍtem Acceso Abierto Trastornos de la conducta alimentaria y calidad de vida en el adolescente. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Quinteros León , Jeniffer Elizabeth; Romero Castillo, Mishell Valeria; Carrión Ordoñez, Julia Irma; 0302476239; 0302536222Background: Globally, adolescents rank first in incident and prevalent cases of eating disorders, which are alterations related to food intake and associated with cognitive distortions; these disorders have become established as a public health concern due to their high morbidity and mortality rates. This review aims to analyze eating disorders and quality of life in adolescents. Methods: Inclusion criteria included the time frame between 2019 and 2023, age group (adolescents), and open-access articles in Spanish and English that covered the topics established in the objectives; articles not meeting these criteria were excluded. The information search was conducted in the following databases: Redalyc, PubMed, MAG Online Library, SciELO, Dialnet, and ScienceDirect, as well as the website ResearchGate. A flowchart and a table with the parameters used were employed to summarize the results. Results: After filtering and analyzing each article found, thirty studies were included based on inclusion-exclusion criteria, information relevance, language, and year of publication, through a detailed analysis and a data presentation table. Discussion: The evidence supported by the studies shows that the main eating disorders are Anorexia Nervosa, Bulimia Nervosa, and binge eating, which occur mainly in adolescent females, and it was confirmed that these are directly related to a deterioration in quality of life. Multidisciplinary cognitive-behavioral therapy was considered to produce positive outcomes. Keywords: adolescents, anorexia, bulimia, binge eating, quality of lifeÍtem Acceso Abierto Diagnóstico prenatal en pacientes con síndrome de Down. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Sánchez Vera, Valeria Yerilen; Durán Palacios, María Teresa; 1311525271Over time, the association of Down syndrome with chromosome 21 has driven the development of numerous prenatal studies, reflecting the continuous advancements in the field of medicine. These advances have played a crucial role in enabling the early detection of Down syndrome and providing healthcare professionals with more accurate diagnostic tools. Objective: To identify the available prenatal diagnostic techniques for detecting Down syndrome. Methods: A systematic review with a descriptive and retrospective approach was conducted. Databases such as PubMed, Scopus, and Web of Science were used for an exhaustive search of scientific studies, and information published since 2019 was considered with the support of the PRISMA 2020 GUIDE. Results: Eight studies involving prenatal diagnosis techniques for Down syndrome were included, indicating the accuracy of each technique and highlighting the importance of genetic counseling. Conclusions: Prenatal diagnostic techniques for the detection of Down syndrome are divided into non-invasive and invasive methods, showing variability in accuracy according to the stage of gestational age at which the test is performed. The importance of follow-up from the first trimester is emphasized, supported by genetic counseling, which not only guides but also provides the best available options for each couple. Key words: Down syndrome, prenatal method, prenatal diagnosisÍtem Acceso Abierto Efectividad del balón gástrico en el tratamiento de la obesidad. Revisión sistemática(Universidad Católica de Cuenca., 2025) Bermejo Montero, Erika Alexandra; Izquierdo Coronel, Diana Carolina; 0302613239Introduction: Obesity is a multifactorial chronic disease involving excessive increase of adipose tissue in intra-abdominal organs. It can affect anyone regardless of age, socioeconomic status, or cultural background and has significant impacts on cardiovascular, osteoarticular, and metabolic health, as well as sleep disorders and various types of cancer. Today, multiple therapeutic strategies include lifestyle changes, pharmacotherapy, and surgery. However, there is a need for less invasive treatments that offer better results for patients, such as the gastric balloon. Objective: To determine the effectiveness of gastric balloon in the treatment of obesity. Methodology: This research is a systematic review with a mixed approach, addressing quantifiable and non-quantifiable data according to PRISMA methodology guidelines. Results: The results were favorable regarding the duration of gastric balloon use, showing a weight loss of 15.6 kg/m² at six months and 14.8 kg/m² at twelve months. Conclusions: The use of gastric balloon is indicated for individuals with a BMI of 30 to 34.9 kg/m² with one or more comorbid conditions and those with a BMI ≥ 35 kg/m² without comorbidities. It promotes a weight loss of 15 to 20 kg within six months. Occasionally, some adverse effects may occur, such as nausea, vomiting, and balloon migration. Keywords: obesity, gastric balloon, effectiveness, adverse effectsÍtem Acceso Abierto Hábito tabáquico y factores asociados en estudiantes de la Universidad Católica de Cuenca campus Azogues. Abril - septiembre 2023(Universidad Católica de Cuenca., 2025) Ochoa Culala, Eliana Marisol; Heredia Cabrera, Gina Catalina; 0302628136Introduction: Smoking is defined as the occasional or permanent consumption of tobacco. It is considered a non-communicable disease and the leading risk factor for the development of cardiovascular diseases, respiratory conditions, and cancer. In Ecuador, the Ministry of Public Health reported in 2021 that 19 people die daily as a result of complications associated with tobacco use. The characteristics of the smoking habit include the quantity consumed, time of day, age of initiation, and factors motivating its use. Objective: This research aimed to evaluate the characteristics of smoking habits and associated factors among students at the Catholic University of Cuenca, Azogues Campus, from April to September 2023. Methodology: This observational cross-sectional study was conducted with students from the Catholic University of Cuenca, Azogues Campus. Data were collected directly from the student population on a single occasion by administering an online survey, following prior acceptance of participation through informed consent. The survey was validated by experts and gathered information on smoking habit characteristics. Population: Three hundred forty-four (344) students. Results: The prevalence by gender showed that 54% of the participants were male and 46% were female. Conclusions: The prevalence was higher in the male population. Cigarettes were the most consumed in 73%, and daily consumption was less than five cigarettes per day. Social factors associated with consumption are mainly influenced by parents and siblings. Among the psychological factors, 30% do not feel influenced and consume cigarettes for simple pleasure. Keywords: smoking, tobacco, addictionÍtem Acceso Abierto Eficacia del tratamiento con biológicos antirreumáticos en el curso artritis reumatoide. Revisión Sistemática(Universidad Católica de Cuenca., 2025) García Segarra, Lisseth Paola; Novillo Arévalo, Mariela Belén; 0302391743La Rheumatoid arthritis is a chronic systemic inflammatory disease that affects the joints, causing pain, stiffness, deformity, and decreased quality of life and functionality in patients, resulting in irreversible joint damage and progressive disability if not adequately treated. Biologic disease-modifying antirheumatic drugs (DMARDs)—certolizumab pegol, etanercept, and tocilizumab—have revolutionized clinical management by providing an effective alternative to control inflammatory activity and inducing clinical remission, thereby improving patients' quality of life. Objective: To conduct a systematic review of the literature on the efficacy of biologic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis. Methodology: The study, with a retrospective descriptive qualitative approach, follows the PRISMA 2020 model for systematic review. It evaluated the efficacy of biologic disease-modifying antirheumatic drugs—certolizumab pegol, etanercept, and tocilizumab—used as monotherapy or combined with conventional DMARDs or corticosteroids. Nineteen articles were selected based on inclusion criteria. Results: Certolizumab pegol, tocilizumab, and etanercept demonstrated efficacy in achieving clinical and functional remission, with Clinical Disease Activity Index (CDAI) remission rates of 52.3%, 50%, and 43%, respectively. They significantly improved quality of life as measured by the Health Assessment Questionnaire – disability Index (HAQ-DI). Certolizumab pegol showed a lower incidence of serious infections, tocilizumab presented a higher risk of hepatic and hematological abnormalities, and etanercept a higher frequency of respiratory infections. Conclusions: Biologics are effective and safe for the management of rheumatoid arthritis, with differences in efficacy and safety profile that guide the individualized choice of treatment in combination with conventional drugs to enhance clinical and functional response. Keywords: rheumatoid arthritis, biologics, treatment, efficacyÍtem Acceso Abierto Eficacia del tratamiento de artritis psoriásica con anticuerpos monoclonales. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Vargas Flores, Sofía Micaela; Novillo Árevalo, Mariela Belén; 1900846856Background: Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy that affects 20-30% of people with psoriasis and is characterized by a heterogeneous clinical presentation. Objective: To evaluate the efficacy of monoclonal antibody treatment for psoriatic arthritis. Methodology: A systematic review was conducted following the PRISMA 2020 guidelines. Randomized clinical trials published between 2019 and 2023 were included and extracted from Scopus and Web of Science databases. PICO strategies were applied for screening. Results: Seventeen randomized clinical trials were collected, evaluating the efficacy and safety of monoclonal antibodies in the treatment of psoriatic arthritis. Discussion: Therapies targeting IL-17 and IL-23 have demonstrated efficacy in controlling the heterogeneous manifestations of PsA, with ixekizumab and guselkumab standing out. However, TNF inhibitors, such as adalimumab, remain the first-line treatment. IL-17 inhibitors have shown superior remission rates, particularly in axial manifestations. Conclusions: The monoclonal antibodies ixekizumab and brepocitinib have shown greater efficacy in the management of PsA. However, in terms of safety, guselkumab and tildrakizumab stand out, with the most common adverse events involving respiratory tract infections and mild infections. Keywords: psoriatic arthritis, efficacy, monoclonal antibodies, randomized clinical trialÍtem Acceso Abierto Factores de riesgo de muerte súbita cardiaca en pacientes con miocardiopatía hipertrófica. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Velecela Cruz, John Anthony; Astudillo Ávila, Andrés Sebastián; 0302678016Background: Hypertrophic cardiomyopathy is the leading cause of sudden cardiac death in young patients, which may manifest within one hour after the onset of symptoms or within 24 hours of an asymptomatic state. General objective: to investigate the risk factors for sudden cardiac death in patients with hypertrophic cardiomyopathy. Specific objectives: to characterize HCM; to indicate the association between sex and age with SCD risk; and to identify factors that increase the risk of SCD. The research question is: What are the risk factors for sudden cardiac death in patients with hypertrophic cardiomyopathy? Methods: Information was searched in the Scopus, Web of Science, and PubMed databases, including studies from the last five years, open and restricted access, full and partial texts, in English and Spanish, and involving adolescent and adult patients. Publications unrelated to HCM or SCD, and documents with no scientific relevance, were excluded. Results: Twenty-six scientific articles were analyzed, 81% of which belonged to Scopus, 13% to Web of Science, and 6% to PubMed. These were referenced by title, author, language, objectives, and study results. Discussion: HCM is characterized by an increase in the diameter of the left ventricle in the absence of underlying diseases. It is a frequent cause of SCD, which occurs more frequently in young people with risk factors identified through cardiac magnetic resonance imaging or relevant clinical history. Keywords: hypertrophic cardiomyopathy, sudden cardiac death, congenital heart disease, risk factors, early recognitionÍtem Acceso Abierto Manejo actualizado del herpes zóster. Revisión sistemática(Universidad Católica de Cuenca., 2025) Pesántez Ortega, Natalie Paola; Vargas Saquicela, Sandra Paola; 0350007191Background: Herpes zoster (HZ), also known as shingles, occurs when the varicella-zoster virus, which remains latent in spinal ganglia or, more commonly, in cranial nerve pairs V and VII, reactivates, causing painful vesicles in dermatomal areas and cutaneous radicular pain. It is more common in elderly patients or those with a compromised immune system. Over the past six decades, there has been a fourfold increase in reported cases. This systematic review aims to describe the updated management of HZ, addressing the question: What are the current pharmacological and non-pharmacological treatments? Method: This study employs a qualitative, descriptive, and retrospective approach, following the PRISMA 2020 guidelines. The information was obtained from clinical trials, meta-analyses, scientific articles, documents, books, and chapters published within the last five years. The databases consulted included PubMed, SpringerLink, StatPearls, PLOS, IDSA, Scopus, DynaMed, SciELO, UpToDate, Wiley Online Library, Medscape, and Medigraphic. Results: Several studies and articles on managing herpes zoster with antivirals such as acyclovir, valacyclovir, and famciclovir were reviewed. Valacyclovir was highlighted for its efficacy and the importance of early initiation of therapy was emphasized. Non-pharmacological interventions, such as nerve blocks, lotions, and dressings, were also effective. Discussion: The review emphasizes the importance of a comprehensive approach incorporating pharmacological and non-pharmacological strategies. The effectiveness of antivirals, anti-inflammatory drugs, corticosteroids, analgesics, and newer interventions is underscored, as indicated by various authors and studies. Keywords: treatment, herpes zoster, pharmacological, antivirals, non-pharmacological
