Trabajos de Titulación - Sede Azogues - Medicina
URI permanente para esta colecciónhttps://dspace.ucacue.edu.ec/handle/ucacue/89
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Envíos recientes
Ítem Acceso Abierto Inmunoterapia como tratamiento actual para Cáncer colorrectal. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Aguilar Mora, Elian Alberto; Buenaño Rodriguez, Christian Eduardo; 0705621126Immunotherapy for colorectal cancer (CRC) has increased its development at an accelerated rate in the last 10 years. Several high-quality clinical trials have been conducted in the last decade to examine the application of programmed death receptor (1DPD-1) / programmed death ligand (PD-L1) inhibitors in patients with metastatic colorectal cancer (mCRC). However, the clinical benefits, including the effectiveness and safety of these anti-CCRCC managements, remain controversial. Objective: To analyze the efficacy of Pembrolizumab as immunotherapy in patients with colorectal cancer, using a systematic review. Methodology: In this study, a systematic review was conducted to determine the efficacy of immunotherapy as a modern treatment for CRC. Detailed searches were performed in several bibliographic databases, including PubMed, Taylor & Francis, Scopus, and ProQuest, among others, published until 2023. The search terms used were “metastatic colorectal cancer,” “immunotherapy,” “PD-1,” “PD-L1,” and study subjects at different stages of pathology were included. Relevant articles that met the established inclusion criteria were selected and analyzed. Results: Anti-PDL- 1/PD-1 (Pembrolizumab) therapy in advanced dMMR/MSI-H CRC was associated with improved survival. Anti PD-1/PD-L1 combined with anti-angiogenic drugs, targeted agents, or chemotherapy could be effective in MSS mCRC. Conclusions: Immunotherapy was effective for BRAF and KRAS/NRAS (RAS/RASRAS) mutated CRC. The high incidence of grade II and III adverse reactions at 85% reveals the importance of multidisciplinary work and further research and updates on this topic. Keywords: immunotherapy, metastatic colorectal cancer, PD-1, PD-L1, PembrolizumabÍtem Acceso Abierto Eficacia del Tofacitinib y Baricitinib en el tratamiento de artritis reumatoide: revisión sistemática(Universidad Católica de Cuenca., 2025) Díaz Carrera, Mizhell Tatiana; Buenaño Rodríguez, Christian Eduardo; 0302633664Introduction: Rheumatoid arthritis is a chronic condition that significantly impacts patients’ quality of life. The development of Janus kinase inhibitors, such as tofacitinib and baricitinib, represents an effective therapeutic alternative. However, it is necessary to analyze the available evidence to determine their efficacy and safety. Methods: A systematic literature review was conducted from January 2010 to June 2024, following PRISMA guidelines. The search was performed in PubMed, Scopus, Cochrane Library, and ClinicalTrials.gov, using MeSH terms related to tofacitinib, baricitinib, and rheumatoid arthritis. Randomized clinical trials, comparative studies, and systematic reviews that evaluated clinical efficacy, as expressed by remission, DAS28, and ACR responses, were included. Quality assessment was performed using NHLBI criteria, and risk of bias was assessed using the RoB 2 tool. Results: A total of 45 studies were identified, of which 34 were selected after applying eligibility criteria. Finally, 17 studies published between 2010 and 2024 met the specific objectives, highlighting adequate methodological quality and a low risk of bias in key domains such as random sequence generation and intervention blinding. Relevant outcomes included significant clinical response rates (ACR20) and sustained improvements in the DAS28 scores; however, limitations remain regarding the clarity of adverse event reporting and loss to follow-up. Conclusion: Both tofacitinib and baricitinib are effective therapeutic alternatives for the management of rheumatoid arthritis, with consistent evidence of clinical improvement in standardized parameters.Ítem Acceso Abierto Eficacia de acetónido de triamcinolona intralesional versus 5-fluorouracilo intralesional para el tratamiento de cicatrices hipertróficas y queloides: revisión sistemática(Universidad Católica de Cuenca., 2025) Guamán Rodríguez, Karol Dennisse; Heras Cisneros, Jonnathan Miguel; Peláez Vélez, Luzmila Carolina; 1724501885; 0105960058Background: Hypertrophic scars and keloids are fibroproliferative disorders resulting from an abnormal skin healing response, causing aesthetic, functional, and psychological impairment. Among the therapeutic options, intralesional injections of triamcinolone acetonide (TAC) and 5-fluorouracil (5-FU) have shown efficacy. However, controversy persists regarding which provides better outcomes in terms of volume reduction, symptomatic improvement, and adverse effects. Objective: To determine the efficacy of intralesional triamcinolone acetonide compared to intralesional 5-fluorouracil in the treatment of hypertrophic scars and keloids. Methods: A systematic review was conducted following the PRISMA 2020 guidelines, including randomized controlled trials (RCTs) studies that guarantee robustness of the results. The risk of bias was assessed using the ROB-2 tool. Results: The reviewed studies indicate that intralesional 5-fluorouracil is more effective in reducing the volume of keloid and hypertrophic scars compared to triamcinolone acetonide. Moreover, 5-FU has a more favorable safety profile, with fewer adverse effects such as skin atrophy and hypopigmentation. However, TAC remains superior in managing inflammatory symptoms such as pruritus and pain, suggesting that treatment choice should be based on the individual characteristics of each lesion and the patient’s therapeutic priorities. Discussion: Intralesional 5-FU appears to be preferable for reducing scar size, whereas TAC is useful in cases with prominent inflammation. Therefore, combining both agents may optimize clinical outcomes. Treatment decisions should be individualized based on symptoms and tolerance. Keywords: triamcinolone acetonide, hypertrophic scar, 5-fluorouracil, keloidsÍtem Acceso Abierto Prevalencia de Vaginosis bacteriana en pacientes del Centro de salud Nº 1 de la ciudad de Loja de enero 2022- diciembre 2023(Universidad Católica de Cuenca., 2025) Acevedo Balcázar, Ariana Salomé; Arias Peláez, María Cristina; 1150357422Bacterial vaginosis (BV) is a common gynecological infection that has been associated with various obstetric complications and an increased risk of acquiring sexually transmitted infections. In 2015, a study conducted at Health Center No. 2 in Loja reported a prevalence of 23%, highlighting the need for updated data to provide a current epidemiological overview. Objective: To determine the prevalence of bacterial vaginosis at Health Center No. 1 in the city of Loja from January 2022 to December 2023. Methods: This was an observational, descriptive, cross-sectional, and retrospective study based on vaginal secretion test results recorded in an anonymized database from the statistics department of Health Center No. 1 in the city of Loja from January 2022 to December 2023. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 27, which determined descriptive statistical tests. Results: The prevalence of bacterial vaginosis at Health Center No. 1 was 7.83% in 2022 and 9.23% in 2023, with an overall prevalence of 8.5%. The most prevalent age group was between 24 and 26 years, and the most frequent microorganism was Gardnerella vaginalis, with 83.5%. Conclusions: A higher prevalence of bacterial vaginosis was recorded in 2023 compared to 2022, highlighting the need to strengthen preventive measures and guide future research. Keywords: prevalence, bacterial vaginosis, vaginal infection, reproductive ageÍtem Acceso Abierto Eficacia y seguridad del Pitolisant en el tratamiento de la narcolepsia: revisión sistemática(Universidad Católica de Cuenca., 2025) Orbe Orbe, Willian Isael; Galán Avecillas, Yadira Alexandra; 03028005783Title: Efficacy and Safety of Pitolisant in the Treatment of Narcolepsy: A Systematic Review. Objective: To determine the efficacy and safety of pitolisant in the treatment of narcolepsy. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines, using the databases Scopus, PubMed, ScienceDirect, SciELO, and Cochrane Library. Scientific studies published between 2020 and 2025 were included randomized clinical trials, meta-analyses, and full-text articles in Spanish or English on patients diagnosed with narcolepsy. The search incorporated Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH), combined with Boolean operators AND and OR. Results: Fifteen studies were included after applying tools such as the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE), Grading of Recommendations Assessment, Development and Evaluation (GRADE), and OXFORD. A total of 100 studies were excluded because they did not meet the methodological criteria, and 181 were excluded based on the selection criteria. Discussion: Pitolisant is presented as an effective and safe therapeutic option for narcolepsy, reducing excessive daytime sleepiness (EDS) and cataplexy, improving quality of life. Its safety profile is favorable, with mild and transient adverse effects. Limitations: The review identified publication and citation biases, difficulties with duplicate studies, exclusion of languages other than English and Spanish, and a lack of data on long-term effects. Conclusions: Pitolisant is an effective and safe therapeutic option for narcolepsy, demonstrating low abuse potential and a favorable adverse effect profile. Keywords: Efficacy, narcolepsy, pitolisant, safetyÍtem Acceso Abierto Eficacia y seguridad de inhibidores del cotransportador sodio glucosa tipo 2 versus biguanidas en el tratamiento de la diabetes mellitus Tipo 2 en adultos mayores: revisión sistemática(Universidad Católica de Cuenca., 2025) Mogrovejo Pinos, Lizbeth Augusta; Rojas Caldas, Lissbeth Juliana; Sanango Reinoso, Wilmer Stalin; 0302471552; 0350012985Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and biguanides are commonly prescribed pharmacological agents in the treatment of Type 2 Diabetes Mellitus (T2DM). Both aim to regulate blood glucose levels through different mechanisms of action. Objective: To evaluate the efficacy and safety of SGLT2 inhibitors compared to biguanides in the treatment of T2DM in the elderly population. Methods: A systematic review was conducted using databases such as PubMed, SpringerLink, and Elsevier. Medical subject headings and Boolean operators (AND/OR) were used to optimize the search. Open-access articles published in English or Spanish since 2020 were included. The selection process followed the PRISMA 2020 guidelines. The risk of bias was assessed using the RoB-2 tool, and methodological quality was evaluated with the National Institute of Health (NIH) assessment tool. Results: Dapagliflozin was the SGLT2 inhibitor that demonstrated the greatest efficacy, reflected in a greater reduction in glycated hemoglobin (HbA1c), and was associated with fewer adverse effects compared to other drugs. However, the studies did not show statistically significant differences between treatments, and the patient’s age influenced the results. Conclusions: Dapagliflozin emerged as the most effective and safest option among the evaluated medications. Nevertheless, further targeted research in the older adult population is necessary to validate these findings. Keywords: Type 2 diabetes mellitus, biguanides, adverse effects, metformin, glycated hemoglobinÍtem Acceso Abierto Tratamiento quirúrgico para Parkinson: actualización bibliográfica.(Universidad Católica de Cuenca., 2025) Herrera Brito, José Armando; Crespo Argudo, Karla Marcela; 1104571540Introduction: Parkinson’s disease is a chronic condition characterized by the progressive loss of dopaminergic neurons, leading to disabling motor symptoms. In the initial stages, pharmacological treatments are employed; nonetheless, in cases of insufficient response or advanced disease phases, surgical interventions such as deep brain stimulation (DBS), thalamotomy, and pallidotomy are considered. Objective: To identify the current surgical techniques used in the treatment of Parkinson's disease. Method: A systematic review following PRISMA 2020 guidelines was conducted, utilizing information from the last 5 years and databases including PubMed, Scopus, and Springer. Results: Eighty percent of the included studies focused on Deep Brain Stimulation. It produced sustained motor improvements in 75–80% of patients in the long term. Pallidotomy and thalamotomy improved motor symptoms in 65% of cases. These ablative procedures are irreversible and carry risks (hemorrhages, infections). Furthermore, benefits in non-motor symptoms were observed in approximately 70% of patients treated with DBS. Conclusions: DBS is the surgical technique of choice for advanced Parkinson's disease due to its high efficacy (80% motor improvement) and adjustable nature. Pallidotomy and thalamotomy are options for selected cases, providing significant improvements (65%) but with irreversible risk. Collectively, these surgical procedures improve long-term symptomatic control and reduce medication dependency. The selection of the technique should be individualized based on clinical criteria. Keywords: Parkinson’s, functional surgery, Deep Brain Stimulation, pallidotomy, thalamotomyÍtem Acceso Abierto Polímeros biocompatibles basados en hidroxiapatita y colágeno quitosano aplicados al campo de la medicina regenerativa: revisión sistemática(Universidad Católica de Cuenca., 2025) Cabrera Ortega, Alexander Sebastián; Gutiérrez Ortega, Fausto Horacio; 0302849880Regenerative medicine has continuously evolved, integrating increasingly advanced technologies based on synthetic biological materials. These materials are designed in various sizes and shapes to facilitate the adhesion and proliferation of different types of cellular structures, enabling tissue growth and regeneration. Objective: To analyze the use of biocompatible polymers based on hydroxyapatite and collagen-chitosan in regenerative medicine. Methodology: A systematic review was conducted using the following databases: Scopus, PubMed, ScienceDirect, SciELO, and the Cochrane Library, covering the period from January 2019 to December 2024. Health descriptors (DeCS and MeSH) were used to identify keywords, and Boolean connectors AND and OR. Results: Selection criteria were applied, and 41 articles published within the specified time frame were included. Nine hundred thirty records were excluded for not meeting the methodological criteria relevant to the research topic. Additionally, 83 articles were excluded for failing to meet inclusion criteria, which required experimental studies involving support structures in their application in regenerative medicine, both in vivo and in vitro. A data matrix was used to validate each document during the data curation process. Conclusions: Advances in medicine have enabled the implementation of new technologies involving biopolymers in the development of cellular structures, improving their properties for the regeneration of specific tissues and thereby enhancing patients' quality of life. Keywords: biopolymers, regenerative medicine, tissue engineering, collagen-chitosan, hydroxyapatiteÍtem Acceso Abierto Eficacia de la monoterapia versus terapia combinada para el tratamiento de la hiperplasia endometrial: revisión sistemática.(Universidad Católica de Cuenca., 2025) Mejía Rodríguez, Ana Graciela; Mejía Rodríguez, Jessica Raquel; Vélez Vintimilla, Ana Paula; 0302737457; 0302737465Background: Endometrial hyperplasia is an abnormal proliferation of the endometrium that, if left untreated, can progress to endometrial carcinoma. Therapeutic management includes monotherapy with progestins and combination therapy with other agents, such as metformin. However, the most effective strategy to reduce histologic progression, recurrence rates, and adverse effects is still under debate. Objective: To evaluate the efficacy of combination therapy with progestins plus metformin compared to progestin monotherapy for the treatment of endometrial hyperplasia through a systematic review of scientific literature. Methods: A systematic review was conducted following PRISMA guidelines. Studies were retrieved from databases including PubMed, Scopus, Cochrane Library, and LILACS. Clinical trials and observational studies comparing monotherapy and combination therapy in patients with endometrial hyperplasia without atypia or with atypia were included. Results: Endometrial hyperplasia is a premalignant lesion with a high incidence and a significant risk of progression to endometrial cancer. This systematic review compared the efficacy of the levonorgestrel-releasing intrauterine device (LNG-IUD) versus combination therapy with megestrol and metformin, revealing a higher regression rate with the LNG-IUD (91.15% vs. 81.74%). The therapeutic response was more favorable in cases of hyperplasia without atypia, and no significant differences were found based on patient age. Keywords: endometrial hyperplasia, megestrol, levonorgestrel, metformin, treatment outcomeÍtem Acceso Abierto Síndrome de superposición Asma-EPOC. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Lopez Torres, Mercy Alejandra; Galán Avecillas, Estefanía Pamela; 1401239338Background: Asthma-COPD (Chronic Obstructive Pulmonary Disease) Overlap Syndrome (ACOS) is the existence of both asthma and COPD pathologies in a single patient. Currently, this syndrome has been of special interest due to an increase in respiratory symptoms, a higher degree of exacerbations and a deteriorated lifestyle. General objective: To describe the update of the Asthma-COPD overlap syndrome. Specific objectives: To define COPD. To identify the new methods used for the diagnosis of COPD. To indicate the updated treatment for COPD. The research question is: What are the updates of the asthma-EPOC overlap syndrome? Methods: A search was made in PubMed, Scopus, and SciELO databases. We Open access, in full, or incomplete articles published in the last five years, in Portuguese, English, and Spanish were selected. The samples included young people, adults, older adults, and BALB/c rodents. Irrelevant or non-scientific articles were excluded. Conclusions: ACOS reveals the coexistence of asthma and COPD, associated with pollutants and a negative impact on lung function and quality of life. The importance of updated diagnostic methods and personalized treatments is highlighted. Keywords: asthma-COPD overlap syndrome, dyspnea, lung function, forced spirometry, mixed lung disorderÍtem Acceso Abierto Complicaciones perinatales en neonatos de madres con diabetes gestacional. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Matute Ortiz, Doménica Monserrathe; Barzallo Ochoa, Tania Pamela; 0350093696Background: Gestational diabetes mellitus is a metabolic disorder characterized by increased glucose levels detected in the early stages of gestation. It leads to various complications in the neonate, thereby increasing the risk of neonatal mortality. Objective: To determine the perinatal complications in neonates born to mothers with gestational diabetes. Methods: An exploratory, observational, retrospective, and cross-sectional approach was utilized based on the PRISMA 2020 guidelines. It includes studies published within the last five years and scientific journals from digital repositories such as SCOPUS, SCIENCE-DIRECT, MEDLINE, and COCHRANE. Results: A total of 735 studies were obtained after applying the search criteria. Subsequently, this research applied selection parameters, yielding a total of 25 articles that were analyzed individually. Among these, the main perinatal complications identified were respiratory distress syndrome, large for gestational age neonate, macrosomia, and neonatal jaundice. However, these complications were associated with an increase rate of hospitalization in neonatal intensive care units. Additional reported complications included neonatal hypoglycemia, hyperbilirubinemia, and birth trauma. Conclusion: The main perinatal complications in neonates born to mothers with gestational diabetes were anthropometric and metabolic, comparable to those mentioned in the broader literature. Keywords: neonates, gestational diabetes, pregnancy complicationsÍtem Acceso Abierto Implicaciones clínicas de la obesidad en adultos. Revisión Sistemática.(Universidad Católica de Cuenca., 2025) Suscal Guillén , Kimberly Paulette; Guerra Ortega, Diana Laura; 0301987194Background: The growing silent pandemic of obesity in the last decades and the increase of comorbidities have increased the morbid mortality rate; therefore, obesity has come to be positioned as a potent risk factor for the development of different clinical implications. Objective: To understand the clinical implications of obesity in adulthood through a systematic review using reliable scientific information sources. Methodology: A systematic review of the PRISMA 2020 model, through analysis of clinical trials, meta-analysis studies, and articles in Spanish and/or English collected from scientific databases such as ResearchGate, Scopus, and PubMed, including information from the last five years was conducted. Results: Thirty articles were collected showing that obesity acts as the main precursor of other clinical conditions due to the inflammatory mediators generated by the accumulation of adipose tissue, which alter the physiology of the organs and trigger the appearance of implications mainly at the hepatic, cardiorespiratory, and endocrine-metabolic levels. Discussion: The time at which the development of clinical implications begins in individuals with obesity has not been estimated, but it is mentioned that weight control helps to prevent disease progression. However, a subgroup of patients with obesity is metabolically healthy, indicating that adequate weight control could decrease the rate of comorbidities triggered by this factor. Keywords: adults, BMI, obesity, metabolic disordersÍtem Acceso Abierto Modulación de la microbiota intestinal en el tratamiento de la obesidad. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Urgiles Calderón, Sabrina Lizbeth; Cordero Cordero, Gabriela del Rosario; 0350091617Research on the relationship between gut microbiota and obesity has significantly increased in recent decades. The first connection was established through studies in mice; researchers have identified a relationship between dietary interventions and microbiota composition. These studies have demonstrated that modulation of the gut microbiota can increase the population of beneficial microorganisms and lead to changes in body weight, providing a potential therapeutic approach for obesity, a metabolic disorder that has become a public health crisis. Since 1975, the prevalence of obesity has tripled and continues to rise significantly. Therefore, this study aims to explore gut microbiota modulation as a treatment for obesity. A qualitative systematic review was conducted following PRISMA guidelines, involving the selection of original scientific articles published within the last five years, in Spanish or English, from various academic databases. Data were extracted and analyzed from multiple studies focusing on the type of intervention applied and its effects on patients, particularly with anthropometric and biochemical parameters, as well as its impact on gut microbiota composition. The findings suggest that different diets, as well as the intake of prebiotics and probiotics, can alter the composition of the gut microbiota, which in turn may be used as a treatment strategy for obesity by improving and regulating anthropometric measures and biochemical markers, such as glucose levels and lipid profiles. Keywords: gut microbiota, obesity, diet, probiotics, prebioticsÍtem Acceso Abierto Factores de riesgo de pérdida auditiva en población adulta. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Siguencia Chaca, Wilson Alexander; Espinoza Palomeque, Gustavo Adolfo; 0302656913Background: Hearing loss, defined as damage to the ability to perceive sound stimuli, has significantly increased in recent years, with a disabling effect on approximately 430 million people worldwide in 2023. According to the World Health Organization, this figure is expected to rise to 700 million by 2050. The main objective of this study is to analyze the risk factors for hearing loss in adults aged 19 and older. Method: A systematic review was conducted using the following databases: PubMed, Scopus, Springer Open, and Web of Science. The review included studies published from 2019 onward, encompassing cross-sectional, cohort, longitudinal studies, and meta-analyses. Relevant data were extracted and organized into tables. Results: Sixteen studies were analyzed, identifying diabetes mellitus type 2, noise exposure, smoking, hypertension, obesity, and advanced age as key risk factors. The prevalence and risk associated with each factor were identified. Additionally, the relationship between hearing loss and gender was assessed, and the pathophysiological mechanisms underlying hearing loss were described. Conclusions: The evidence presented in this review indicates that common societal risk factors contribute significantly to the development of hearing loss, particularly among adults. Furthermore, the review found that males are more likely to experience hearing loss. Keywords: hearing loss, adults, risk factors, sensorineural hearing lossÍtem Acceso Abierto Calidad de vida en pacientes oncológicos. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Suárez Vélez, Brian Martín; Carrión Ordoñez , Julia Irma; 0350145199Cancer is one of the leading causes of reduced quality of life worldwide. This systematic review examines the functional status of oncology patients using the Karnofsky Performance Scale and the Eastern Cooperative Oncology Group (ECOG) scale, aiming to identify patterns of impairment based on clinical and demographic factors. Methodology: A comprehensive search was conducted in scientific databases such as PubMed, Scopus, and ProQuest. Studies published between 2019 and 2024 that used the scales mentioned above to assess patient functionality were selected. Observational and clinical studies with medium or high methodological quality were included and organized according to the type of cancer, age, sex, and progression rate (aggressive, indolent, or variable). Results: Twenty-five studies comprising 6,908 patients were analyzed. Aggressive cancers exhibited greater functional impairment (ECOG ≥2, Karnofsky ≤60), while those with indolent progression showed greater variability. Variable progression types showed the best functional levels. It was evidenced that patients over 70 years old showed greater impairment, while the relationship with gender was inconsistent. Conclusions: The Karnofsky and ECOG scales are effective tools for assessing functional quality of life. The rate of cancer progression directly impacts functional status, with aggressive tumors causing faster and more severe deterioration. These findings highlight the need for therapeutic strategies focused on functional preservation and patient well-being. Keywords: cancer, quality of life, ECOG, Karnofsky, oncologyÍtem Acceso Abierto Diabetes Mellitus tipo 1 en la infancia. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Herrera González, Lenin Israel; Izquierdo Coronel, Diana Carolina; 0302501242Background: Type 1 diabetes is a disease characterized by hyperglycemia due to deficient pancreatic insulin secretion conditioned by the destruction of pancreatic B cells by the action of autoantibodies present in the pancreas. This study aims to analyze the current theoretical references of type 1 diabetes in childhood. Methodology: This literature review was conducted following the PRISMA 2020 guidelines, focusing on the implications of type 1 diabetes mellitus in the lives of infants, the therapeutics, and lifestyle maintenance. No variables were manipulated. A first selection of 186 studies was extracted from which 35 articles were selected that met the inclusion criteria in digital databases. Results: Nine studies indicate that type 1 diabetes is an autoimmune disease, associated with hyperglycemia as a typical manifestation and its debut as diabetic ketoacidosis; 16 studies show that the use of continuous insulin infusers and an artificial pancreas system associated with continuous glucose monitoring improve glycemic control; and 11 studies contain information on nutritional education as a fundamental tool in metabolic control. Conclusions: Type 1 diabetes is a chronic autoimmune disease that impacts the quality of life of affected children. Current evidence suggests that glycemic control, lifestyle changes, and a therapeutic approach are essential for the prevention of micro and macrovascular complications. Keywords: type 1 diabetes mellitus, childhood, treatmentÍtem Acceso Abierto Sensibilidad y especificidad de los marcadores tumorales CA-125 versus HE4 en el diagnóstico precoz de cáncer de ovario: revisión sistemática(Universidad Católica de Cuenca., 2025) Celdo Suña, Miriam Veronica; Sarmiento Rios, Islenia Fernanda; Vélez Vintimilla, Ana Paula; 0302912795; 1104300171Background: Ovarian neoplasms are a leading cause of gynecologic cancer mortality worldwide, primarily due to delayed diagnosis. Serum biomarkers play a key role in detecting this disease, with CA125 being the most historically used. However, its low specificity has prompted the search for more accurate markers, such as human epididymal protein 4 (HE4), which has demonstrated superior specificity in differentiating between benign and malignant masses. Objective: To determine the sensitivity and specificity of the CA-125 versus HE4 tumor markers in the early diagnosis of ovarian cancer through a systematic literature review. Methodology: A comprehensive systematic search was conducted, consulting scientific databases such as PubMed, Scopus, and the Cochrane Library including studies published both in English and Spanish within the past decade. Observational and diagnostic studies reporting data on the sensitivity and specificity of CA125 and HE4 will be included. The QUADAS-2 tool was used to assess methodological quality and ensure the validity of the findings obtained. Expected Results: HE4 is anticipated to exhibit higher specificity than CA125, thereby reducing false positives in ovarian cancer diagnosis. The findings of this review may contribute to improving early detection strategies and optimizing the use of biomarkers in clinical practice. Conclusions: CA125 and HE4 are key biomarkers for ovarian cancer diagnosis, but they exhibit important differences in performance regarding their sensitivity and specificity. Keywords: ovarian cancer, CA125, human epididymal protein 4Ítem Acceso Abierto Actividad Física como alternativa terapéutica para ansiedad y depresión. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Chacha Verdugo , Juan Josué; Hidalgo Pozo, María José; 0302992979Background: In recent years, the application of physical activity as a therapeutic alternative for both the management and prevention of anxiety and depression has garnered increasing research interest. In this context, countries such as the United Kingdom, Australia, and the United States have developed models integrating physical activity to promote mental health benefits. Objective: To analyze the role of physical activity as a therapeutic alternative for anxiety and depression through a systematic review. Methods: This study follows the PRISMA 2020 guidelines for systematic reviews. The review included original research articles, systematic reviews, meta-analyses, and clinical trials published between 2019 and 2023 in English and/or Spanish. Only open-access articles indexed in databases such as Web of Science, Cochrane, PubMed, and Scopus were considered. Mendeley was used as the reference management tool. Results: A total of 662 scientific articles were initially identified across the selected databases. After applying inclusion and exclusion criteria, 25 studies were deemed eligible for analysis. Findings indicate that physical activity plays a significant role in managing and reducing symptoms of depression and anxiety across all age groups. In some cases, its effectiveness surpassed that of standard pharmacological treatments. Conclusions: Physical activity significantly reduces symptoms of both anxiety and depression and serves as an effective complement to pharmacological treatment. Keywords: anxiety, depression, physical activity, strength exercises, flexibility exercisesÍtem Acceso Abierto Actualización en el tratamiento de la cirrosis hepática. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Bustos Avendaño, Jorge Israel; Faicán Rocano, Pedro Fernando; 0350005526Background: Despite advances in research, liver cirrhosis remains a potentially fatal condition, and its incidence is increasing globally due to alcoholism and other problems such as obesity and excessive consumption of medications. General objective: To analyze the patterns in the treatment of liver cirrhosis. Methods: The present systematic review was carried out using a search based on the PRISMA model, obtaining information in the databases Scopus, PubMed, SciELO, and Google Scholar; using keywords such as treatment, liver cirrhosis, drugs, and complications. In addition, Boolean operators ―AND, OR and NOT―facilitate the search. Results: A total of 28 scientific articles were analyzed, which 9% of the publications belonged to the Scopus database, 23% to Google Scholar, 54% to PubMed, and 14% to SciELO. Discussion: The treatment of specific complications ―such as hepatic encephalopathy, ascites, portal hypertension, hepatorenal syndrome, cirrhotic cardiomyopathy, hepatopulmonary syndrome, acute or chronic liver failure, and spontaneous bacterial peritonitis― requires a multidisciplinary approach. Risk factors for the treatment of liver cirrhosis are concomitant diseases such as diabetes, alcohol consumption, obesity, and medications. Liver transplantation remains the definitive treatment for liver cirrhosis and its complications, this procedure is performed after carefully selecting candidates and taking the necessary preoperative measures to ensure optimal results. Keywords: treatment, liver cirrhosis, complications, liveÍtem Acceso Abierto Actualización en el tratamiento de hepatitis tipo B. Revisión Sistemática(Universidad Católica de Cuenca., 2025) García Ortega, María Emilia; Faicán Rocano, Pedro Fernando; 0302930599Background: Hepatitis B chronically affects millions of individuals worldwide and can lead to serious complications such as cirrhosis and liver cancer. General Objective: To identify current therapeutic options for the treatment of hepatitis B. Specific Objectives: To compare treatment guidelines for acute and chronic hepatitis B, assess the efficacy of current therapeutic strategies in chronic hepatitis B, and synthesize recent advancements in its management. The research question guiding this review is: What is the efficacy of current treatments for chronic hepatitis B in terms of viral suppression, improvement of liver function, and prevention of hepatic complications? Methods: A comprehensive literature search was conducted using scientific databases such as Scopus, Web of Science, PubMed, SciELO, and Google Scholar. Studies published in the last five years were considered, including both open-access and subscription-based formats, in English and Spanish. Studies unrelated to hepatitis B or lacking scientific rigor were excluded. Results: Fourteen scientific articles were analyzed: 60% from PubMed, 20% from Google Scholar, 10% from Scopus, and 10% from SciELO. Selection criteria included title, authorship, language, objectives, and findings. Discussion: The review highlights that acute hepatitis B generally does not require pharmacological treatment, whereas chronic hepatitis B is managed with antiviral agents such as tenofovir and entecavir due to their proven efficacy. Additionally, emerging therapies such as HeberNasvac and combinations with immunosuppressive agents are explored in specific cases. Keywords: hepatitis B, acute, chronic, therapeutic options, clinical efficacy
