Trabajos de Titulación - Medicina
URI permanente para esta colecciónhttps://dspace.ucacue.edu.ec/handle/ucacue/23
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Ítem Acceso Abierto Carcinoma de células renales vs oncocitoma renal reporte de caso: la importancia de la imagenología en la decisión terapéutica(Universidad Católica de Cuenca., 2024) Galindo Merchán, Ronaldo Rivaldo; Galindo Merchán, Ronaldo Rivaldo; 0107231771With high frequency, renal masses are incidentally identified by imaging methods, many of these are renal cell carcinomas, the objective of imaging studies is to differentiate a benign mass from a renal cell carcinoma, up to 20% of the cases. Indeterminate solid renal masses finally turn out to be benign with a higher incidence of benignity in small renal masses (less than 4cm), however in some cases it is not possible to differentiate them; there are radiological signs that incline the diagnosis towards malignancy or benignity, and significantly affect the diagnosis, characterization, staging, orientation of treatment (partial and radical nephrectomy, biopsy and tumor ablation) as well as subsequent evaluation. Presentation of a case of a 74-year-old male patient, who came with abdominal pain in the left flank as the only symptomatology, where after clinical evaluation, complementary ultrasound is recommended in which the presence of a renal mass located in the pole is reported as an incidental finding. lower left kidney, with abundant Doppler flow uptake in its periphery, for which UROTC is suggested, as a complementary method for characterization, definitive image staging where, due to its behavior to contrast medium and absence of invasion to vascular and lymph node structures, raises the diagnosis of chromophobe renal carcinoma vs renal oncocytoma.Ítem Acceso Abierto Alternativas terapéuticas para pacientes diagnosticados con fibrosis pulmonar post COVID-19(Universidad Católica de Cuenca., 2025) Luna López, Mirenjely Sarai; Cardoso Landívar, José David; 1400867154Ítem Acceso Abierto Costo y beneficio de la inmunización contra la rubéola: revisión sistemática(Universidad Católica de Cuenca., 2024) Pesántez Barbecho, Michelle Guadalupe; Salazar Torres, Zoila Katherine; 0107274904Background: Rubella is a disease caused by an RNAtype virus, which belongs to the Rubivirus genus of the Togaviridae family. The vaccine to prevent this pathology is called the triple viral vaccine, because it also protects against measles and mumps. Objective: To analyze the cost-benefit of vaccination against rubella. Methodology: For which a systematic review was carried out, through the search for scientific documents in reliable databases: Scopus, Web of Science and PubMed. The inclusion criteria were: original articles and systematic reviews of the last thirty-two years. While, the exclusion criteria: documents without free access, articles in which their area of study is not related to the life sciences. Data collection was carried out systematically, using the PRISMA statement, in order to avoid omissions. Results: The authors agreed that immunization against rubella results in cost savings for health systems, associated with a decrease in morbidity and mortality rates. However, the study in the United States determined that there is no direct relationship between saving resources and rubella immunization. Conclusion: Immunization against rubella results in cost savings, especially in low-income countries and where there is a higher risk of acquiring the pathology.Ítem Acceso Abierto Prevalencia de recidiva de cáncer en pacientes sometidas a cirugía oncoplástica conservadora de mama(Universidad Católica de Cuenca., 2024) Rojas Espinoza, Aython Ronald; Cárdenas Heredia, Freddy Rosendo; 0104284195Cancer recurrence contemplates a scenario in which the pathology reappears in the patient's organism after receiving a particular treatment and after a certain period in which it could not be detected. Objective: To determine the prevalence level of cancer recurrence in patients undergoing breast-conserving oncoplastic surgery. Methodology: This research consists of a descriptive systematic review with a qualitative approach based on 49 publications obtained from scientific search engines such as Scopus, LILACS, Redalyc, PubMed, Web of Science, and SciELO. Results: Worldwide, it is estimated that 30% of patients who underwent conservative oncoplastic surgery suffered from disease recurrence. In Spain, the recurrence percentage fluctuates between 11% and 21%, while in Latin America, it averages 18% to 25% five years after surgery. It denotes skin necrosis, hematomas, seromas, and infections among the main postoperative complications. The risk factors are age (when the person is 50 years old or younger), smoking, obesity, complementary treatments, histological grade, and the size evidenced by the tumor. Conclusions: The technique used depends on the tumor’s size and location. Any alteration requires that the breast have a specific volume, which is why, in many cases, patients with small breasts show few beneficial results. Furthermore, they emphasize the aesthetic result and show a minimal risk of postoperative complications.Ítem Embargo Marcadores moleculares de mal pronóstico en la leucemia mieloide aguda(Universidad Católica de Cuenca., 2024) Arce López, Dayana Marcela; Reibán Espinoza, Esteban Adrián; 0350066361Ítem Acceso Abierto Calidad de vida post cirugía bariátrica(Universidad Católica de Cuenca., 2024) Llivicura Curillo, Lizbeth Estefanía; Yunga Guamán, Milton Paul; 0107008583Bariatric surgery has been the most widely used treatment to reduce weight in obese patients quickly and sustainably; thanks to its immediate effect, it reduces the comorbidities caused by obesity, thus substantially improving these patients’ quality of life. Therefore, the main objective of this research is to describe the quality of life after bariatric surgery; therefore, an exhaustive search of diverse scientific content, such as original articles, articles with quantitative methodology, meta-analysis, systematic reviews, narrative bibliographic reviews that were found within the last five years of publication without language restriction was performed. The following scientific search engines were used: Scopus, ScienceDirect, Taylor & Francis, Web of Science, PudMed, Springer, and SciELO. In conclusion, bariatric surgery has been beneficial in reducing body weight and significantly improving the quality of life of each patient; however, in the mental health area, although a slight improvement was observed, it does not reach the levels observed in the average weight populationÍtem Embargo Relación entre la duración de la Diabetes Mellitus Tipo 2 y el deterioro cognitivo en 7 clubs de adulto mayor en Cuenca. 2023(Universidad Católica de Cuenca., 2024) Uguña Campoverde, Andrea Alexandra; Guerrero Saltos, Kimberly Nohelia; Solórzano Bernita, Rosa Elizabeth; 0105512339; 1313050203Ítem Acceso Abierto Salud pública y urbanización sostenible(Universidad Católica de Cuenca., 2024) Freire Morales, Nelson Daniel; Ojeda Sánchez, Julio César; 0401503750Introduction: The relationship between public health and sustainable urbanization is fundamental because a well-planned and sustainable urban environment can have significant positive and negative impacts on the population's health. Objective: To synthesize the existing scientific evidence on the impact of sustainable urbanization on Public Health. Methodology: This study reviewed the relationship between public health and sustainable urbanization. Relevant primary articles published in English and Spanish in high-impact journals in recent years were selected. Advanced searches were conducted in PubMed, Scopus, and SciELO databases. A total of 211 articles were identified, 19 of which met the eligibility criteria and were analyzed. Results: The study determined how mismanagement of urbanization processes affects public health, identified the challenges, and indicated the factors that may lead to an increase in the prevalence of chronic diseases. Conclusion: Public health faces challenges concerning sustainable urbanization, such as poor urban planning, lack of government investment, and socioeconomic disparity, which are fundamental barriers. Addressing these barriers requires a collaborative approach, involving the community, implementing effective policies, and allocating resources to build urban environments that promote public health sustainably.Ítem Acceso Abierto Manejo farmacológico del dolor neuropático en el contexto de la salud mental y psiquiatría: una revisión bibliográfica(Universidad Católica de Cuenca., 2024) Zárate Ochoa, Andy Sebastián; Solórzano Bernita, Rosa Elizabeth; 0705399038Introduction: Neuropathic pain represents a challenge in clinical practice and a concern for community well-being. It is a common issue since adequate treatment remains complex due to different patient responses to its pharmacological action and adverse effects. Objective: To describe the various pharmacological strategies in treating neuropathic pain. Methodology: A narrative literature review of research in Spanish and English from the last five years was conducted. Key terms in PubMed, Embase, and Cochrane Library databases were used. Results: The results reveal the necessity for clear definitions, early treatment, multidisciplinary approaches, and local anesthetics management in treating neuropathic pain. Conclusions: Managing neuropathic pain requires a comprehensive and personalized approach. Although there are pharmacological options with multidisciplinary approaches, their efficacy varies, and further research is needed. Treatment strategies should be evidence-based and adapted to the individual needs of patients.Ítem Embargo Anomalía de Ebstein en un paciente con Síndrome De Down, Reporte de caso(Universidad Católica de Cuenca., 2024) Villavicencio Arévalo, Mateo Sebastián; Merchán Bustos, Fabián Andrés; 0105753701Ítem Acceso Abierto Avances de la terapia CRISPR CAS9 en Fibrosis Quística(Universidad Católica de Cuenca., 2024) Vera Matute, María De Los Ángeles; Muñóz Palomeque, Danilo Gustavo; 1104131113Advances in clustered regularly interspaced short palindromic repeats associated with protein 9 therapy have boosted forward research of cystic fibrosis, a weakening genetic disease. This gene-editing technique holds promise for correcting the mutations responsible, offering an exciting prospect for patients. However, this technology is still in clinical trials, as regulatory and safety challenges are being faced, and efforts are ongoing to deal with its limitations by optimizing efficiency, reducing off-target effects, customizing approaches, and developing specific delivery methods. Therefore, continuous research and technique optimization are essential to bring advances from the laboratory to successfully apply them in clinical practice, as in recent years, tests have shown promising results, demonstrating that application in humans could be possible within 5 to 10 years.Ítem Acceso Abierto Utilización de la oxibutinina en el manejo de vejiga hiperactiva en mujeres en edad adulta: revisión sistemática(Universidad Católica de Cuenca., 2024) Vélez Medina, Leslye Tatiana; Rodríguez Vintimilla , Viviana Matilde; Cárdenas Heredia, Freddy Rosendo; 1150061313; 0302010004Overactive bladder affects a large proportion of adult women, leading to significant morbidity and reduced quality of life. In Ecuador, oxybutynin is a commonly prescribed medication to treat this syndrome. However, its effectiveness in single administration and combined with non-pharmacological treatments is not clear and there are no clinical guidelines. This study seeks to analyze, through a systematic review, the effectiveness of managing overactive bladder in adult women through the administration of oxybutynin. A duplicate bibliographic search will be conducted in electronic databases, including Pubmed, Medline, Cochrane, Elseiver and ScienceDirect, to identify relevant scientific articles and management guidelines published in the last 5 years in English and Spanish. Subsequently, the articles obtained in the search will be filtered by reviewing the inclusion criteria and titles and abstract. The process will be detailed in a flowchart. The articles included in the final selection will be reviewed in their entirety and relevant information will be included in the results. This systematic review will provide an updated summary of the efficacy of oxybutynin administered alone and in combination with non-pharmacological treatments in adult women with overactive bladder. Additionally, it will identify appropriate management protocols. The results of this review will be of interest to doctors, patients and policy makers to make informed decisions about the optimal management of this syndrome in the population most vulnerable to presenting it, adult women.Ítem Acceso Abierto Factores de riesgo y consecuencias asociados con la obesidad en adolescentes(Universidad Católica de Cuenca., 2024) Vélez Llivichuzhca, María Isabel; Rimbaldo Loaiza, Viviana Katherine; 0105094718Obesity among adolescents has been cataloged as one of the significant public health concerns. It is worth mentioning that its progression triggers negative consequences in the body image of young people and poses significant threats that affect their physical and mental well-being, not to mention the long-term repercussions that would worsen the quality of life of each individual. This review aims to describe the factors triggering obesity risk in adolescents and the physical and social consequences of this condition. In terms of physical health, it is essential to highlight that obesity increases the risk of developing chronic diseases in adulthood, including type 2 diabetes mellitus (T2DM), cardiovascular diseases, hypertension, respiratory problems, liver diseases, or certain cancers. Risk factors may include unhealthy diet, physical inactivity, and genetic predisposition; for this reason, prevention and early intervention strategies have been considered necessary to reduce these risks. In addition, it is relevant to note the emotional burden of facing stereotypes and prejudices related to body image, which can affect the psychological health of adolescents; it can trigger levels of anxiety, depression, and low self-esteem. These consequences not only affect the present but also shape the future trajectories of adolescents in terms of social relationships, academic development, and career prospectsÍtem Acceso Abierto Manejo de la dermatitis atópica con Dupilumab en pacientes adolescentes(Universidad Católica de Cuenca., 2024) Velepucha Cedillo, Brayan Stiven; Espinoza Cárdenas, Carlos Rolando; 0704667385Atopic dermatitis is a dermatological disease characterized by inflammation and skin irritation with a chronic, recurrent course, leading to outbreaks or skin eruptions. Adolescents represent one of the most vulnerable population groups. Treatment includes lifestyle changes, typical corticosteroid usage, and other drugs such as Dupilumab. Objective: To describe the management of atopic dermatitis with Dupilumab in adolescent patients. Methodology: This study is a literature review, approached under a descriptive-explanatory design, considering the following sources of information: ScienceDirect, PubMed, Scopus, LILACS, Cochrane, Redalyc, SciELO, and ProQuest. Results: Dupilumab significantly reduces the intensity and spread of atopic dermatitis, controlling cutaneous remission and the spread of pruritus, critical aspects of improving the quality of life of adolescents without compromising their physical, cognitive, and psychosocial development. Adverse effects include respiratory problems, angioedema, fever, general body discomfort, joint pain, skin rashes, inflammation of lymph nodes, and allergic reactions in the area where the drug was injected. Conclusion: Dupilumab is a drug that enables improvement at the cutaneous level, reduces the intensity of clinical manifestations associated with the disease, and enhances the patient's quality of life.Ítem Acceso Abierto Parches de insulina en diabetes uso, eficacia y seguridad(Universidad Católica de Cuenca., 2024) Vázquez Maita, María Fernanda; Muñoz Palomeque, Danilo Gustavo; 0302655980Diabetes is a metabolic disease characterized by high blood glucose levels. Currently, there is an increasing prevalence of Diabetes Mellitus, leading to a search for up-to-date, non-invasive, and innovative management, such as insulin patch pumps. This study aims to monitor insulin patches’ use, efficacy, and safety in diabetic patients. Methodology: A descriptive literature review was conducted, extracting data from databases such as Medline, Scopus, Lilacs, Trip Database, Cochrane Library, and Epistemonikos, Conclusion: There are different types of insulin patches, among which patch pumps are the most beneficial, constituting a painless and self-regulated alternative. Additionally, good efficacy and safety have been observed in their use, improving diabetes management.Ítem Embargo Combinación de triple terapia (Elexacaftor/Ivacaftor/Tezacaftor) para la restauración de células epiteliales bronquiales en pacientes con fibrosis quística(Universidad Católica de Cuenca., 2024) Vásquez Méndez, Karen Estefanía; Ramírez Portilla, Cristian Carlos; 0107405847Ítem Acceso Abierto Diagnóstico y tratamiento del carcinoma vulvar en etapa inicial(Universidad Católica de Cuenca., 2024) Vacacela Naula, Bryan Isaac; Guerrero Cevallos, Esteban Rigoberto; 0750348625Introduction: Vulvar carcinoma is considered a rare malignant gynecological neoplasm, which represents 3% to 5% of all carcinomas of the female reproductive system in postmenopausal women. Vulvar carcinoma regularly affects elderly patients, but in recent years, the incidence of vulvar cancer in young women has been increasing and shown to have a variable prevalence. Therefore, the location and demographic conditions of the patient will impact their diagnosis and treatment of early-stage vulvar carcinoma. General Objective: To describe the diagnostic methods, therapeutic measures, and follow-up of vulvar carcinoma in the initial stage. Methodology: This research is designed as a narrative literature review. Different free-access scientific databases were used: PubMed, Web of Science, and LILACS, to gather the information. Publications in Spanish and English were included, published from 2019 – 2023 or other years of great scientific importance from previous years, with the keywords “Vulvar Carcinoma AND Therapeutics AND Diagnosis.” Conclusion: A timely diagnosis of vulvar carcinoma in the initial stage would be beneficial since correct management can be achieved due to the study of the state and stage in which it is found. In addition, its follow-up should be individual according to each patient’s needs.Ítem Acceso Abierto Linfomas doble y triple HIT; como factor de mal pronóstico en Linfoma difuso de células B grandes(Universidad Católica de Cuenca., 2024) Urgiles Pacheco, María De Los Angeles; Reibán Espinoza, Esteban Adrián; 0105578694Introduction: Double- and triple-hit diffuse large B-cell lymphoma (DLBCL) is a hematological malignancy with a MYC, BCL 2, and/or BCL 6 gene rearrangement. Currently, these lymphomas have an incidence of 8% concerning all cases of DLBCL. Unfortunately, its prognosis is generally negative, with a one-year survival rate due to its high aggressiveness because of the conflicting genetic rearrangement and the difficult late diagnosis, treating this pathology as a simple non-Hodgkin lymphoma. Objective: The research aims to study the prognosis of double (DHL) and triple hit (THL) diffuse large B-cell lymphoma. Methodology: A narrative bibliographic review was conducted, collecting information and scientific evidence through the biomedical database PubMed, especially updated English articles from the last five years. Results: This research aimed to demonstrate with scientific information the extremely unfavorable prognosis in patients with double- and triple-hit lymphoma, as well as a low overall survival rate and progression-free survival.Ítem Acceso Abierto Control metabólico con el sistema de monitorización continua de glucosa en pacientes con Diabetes Mellitus Tipo 2(Universidad Católica de Cuenca., 2024) Ulloa Paladines, Nairovy Marcela; Esqueda Jiménez, Aleifel Antonio; 0705937712Introduction: Type 2 Diabetes mellitus (T2DM) is considered the epidemic of the XXI century, causing macrovascular and microvascular complications; thus, adequate metabolic control is vital. Currently, continuous glucose monitoring systems (CGMS) are used to prevent secondary complications by measuring and predicting interstitial glucose variability, which helps prevent episodes of nocturnal hypoglycemia and guide insulin therapies. Objective: To describe the impact of the continuous glucose monitoring system on metabolic control in patients with T2DM. Methodology: An exhaustive search of the scientific literature was conducted to obtain selected information on the use of CGMS in the metabolic control of patients with T2DM in the databases PubMed, Scopus, Web of Science, and SciELO. Meta-analyses, systematic reviews, clinical trials, case-control studies, and cohort studies containing updated data in Spanish and English were used. Results: Seventeen studies were selected out of 734, in which it was found that CGMS allow 24-hour glucose monitoring, detection of nocturnal hypoglycemia, and can guide insulin therapy since they identify glycemic variability. However, their use still has limitations: difficulty entering information into these systems, skin irritation, discomfort due to size, and alarms that interfere with daily activities. Conclusions: CGMS prevent complications as they detect episodes of hypoglycemia and glycemic variability, suggesting it as an effective tool in metabolic control.Ítem Embargo Esclerodermia con ANCA positiva sobreagregada. A propósito de un caso(Universidad Católica de Cuenca., 2024) Uchuari Yaguana, Itaty Maribel; González Ortega, Álvaro Fernando; 1105608630
