Trabajos de Titulación - Medicina
URI permanente para esta colecciónhttps://dspace.ucacue.edu.ec/handle/ucacue/23
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Item type: Ítem , Access status: Embargo , Correlación de los niveles séricos de vitamina D y la presencia de lesiones osteomusculares en atletas de fondo de la Federación Deportiva del Azuay, 2025(Universidad Católica de Cuenca., 2026) Idrovo León , Diana Aracely; Cueva Jimenez , Amy SalomeProyecto de Titulación embargado para publicación. Estará disponible a la fecha de publicación o de cierre de embargoItem type: Ítem , Access status: Acceso Abierto , Eficacia del Olmesartán en comparación con el Perindopril en el control de la Hipertensión Arterial: Revisión Sistemática(Universidad Católica de Cuenca., 2026) Paredes García, Amanda Michelle; Samaniego Chalán, Cristina LisethTitle: Efficacy of olmesartan compared with perindopril in the control of arterial hypertension: a systematic review. Objective: To analyze the comparative efficacy of olmesartan and perindopril in the treatment of hypertension in adults, with the purpose of providing scientific evidence to support clinical and therapeutic decisions. Methodology: Studies in English and Spanish from the past five years that evaluated the medications olmesartan and perindopril in patients with hypertension were reviewed. Reviews, case reports, and studies without a scientific basis were excluded. Three scientific databases were used to search for information: PubMed, Taylor & Francis, and Web of Science. Risk of bias assessment was assessed using RoB 2 tools and Joanna Briggs Institute (JBI) critical appraisal tools. Results: Several clinical and observational studies were analyzed. Both drugs were effective in reducing blood pressure. Olmesartan was better tolerated and had a lower incidence of cough, while perindopril combined with other medications, such as indapamide and amlodipine, showed a greater reduction in blood pressure. Discussion: The lack of direct head-to-head comparisons between the two drugs limits the ability to reach a definitive conclusion; the analyzed studies show methodological heterogeneity and a risk of indirect bias. Therefore, higher-quality evidence is required. Conclusions: Both drugs are effective and safe, thus the choice of medication must be individualized according to the patient's needs. Furthermore, direct comparative studies are recommended.Item type: Ítem , Access status: Acceso Abierto , Alteraciones en la conectividad cerebral asociadas al consumo de Ayahuasca y sus implicaciones en trastornos psicóticos: Revisión sistemática(Universidad Católica de Cuenca., 2026) Villa Paredes , Scarlet Paulina; Valarezo Álvarez , Daniela VanessaIntroduction: Ayahuasca consumption has garnered significant interest due to its effects on brain connectivity and its possible implications in psychotic disorders. Although there are studies on its neurobiological effects, its specific relationship with brain alterations remains little explored. Therefore, a systematic literature review is presented, aiming to consolidate the available knowledge and open new research directions regarding its potential. Objective: To determine the alterations in brain connectivity caused by the consumption of Ayahuasca and its possible implications in the development of psychotic disorders. Methodology: A systematic review will be carried out following the PRISMA 2020 guidelines. Searches will be conducted in PubMed and Taylor & Francis using terms from Descriptors in Health Sciences (DeCS), Medical Subject Headings (MeSH), and Boolean operators for the construction of the search algorithms. Results: Ayahuasca consumption causes alterations in brain connectivity, especially in the default mode network, decreasing its activity. An increase in brain entropy was observed, indicating greater functional disorganization. These alterations are associated with intense psychedelic experiences. In vulnerable individuals, psychotic symptoms may be triggered.Item type: Ítem , Access status: Embargo , Evolución de la letalidad de las enfermedades transmisibles por vectores en el Ecuador. Periodo 2018 - 2023(Universidad Católica de Cuenca., 2026) Castillo Solís , Nancy Steffany; Naula Capelo , Emily CarolinaProyecto de Titulación embargado para publicación. Estará disponible a la fecha de publicación o de cierre de embargoItem type: Ítem , Access status: Acceso Abierto , Eficacia de la técnica transabdominal preperitoneal laparoscópica versus la reparación transabdominal preperitoneal asistida por robot en el manejo de hernias inguinales en adultos. Revisión sistemática(Universidad Católica de Cuenca., 2026) Ferret Aguilar, Rosario; Samaniego Tapia , Mirian Del CisneIntroduction: This systematic review compares the efficacy of two minimally invasive surgical techniques in adults with inguinal hernia: laparoscopic transabdominal preperitoneal technique (LTAPP) and robotic-assisted transabdominal preperitoneal repair (RTAPP). Outcomes including recurrence, postoperative pain, hospitalization, functional recovery, and complications, are analyzed. Objective: To evaluate the efficacy of LTAPP versus RTAPP in the treatment of inguinal hernia in adults, considering key clinical indicators. Methodology: Studies published between 2020 and 2025 were selected from PubMed, Web of Science, and Springer Link databases. Inclusion criteria were limited to human clinical trials involving individuals aged 18 years or older; reviews, case reports, and gray literature were excluded. Risk of bias was assessed using the RoB 2 and JBI tools. The synthesis was based on clinical outcomes. Results: Ten studies with more than 1300 patients were analyzed. Both techniques showed low recurrence rates (<3.6%). RTAPP was associated with shorter hospitalization times (0-1.5 days) and slightly faster recovery, but also with a higher frequency of seromas and mild hematomas. Pain control was comparable in both techniques. Discussion: Both techniques are safe and effective. RTAPP offers advantages in early recovery, although with higher cost and minor complications. Methodological limitations and heterogeneity suggest the need for more robust studies. Conclusions: LTAPP and RTAPP are valid approaches. The choice should be based on available resources, the patient’s profile, and the surgical team’s experienceItem type: Ítem , Access status: Acceso Abierto , Eficacia y seguridad en la inmunoquimioterapia con anticuerpos monoclonales anti-PDL1 versus quimioterapia con platino en el cáncer pulmonar de células no pequeñas: revisión sistemática(Universidad Católica de Cuenca., 2026) Alvarado Aguilar , Katheryn Nicole; Asanza Narváez , Lilian AndreaObjective: To evaluate the efficacy and safety of anti-PD-L1 monoclonal antibodies immunochemotherapy compared to platinum-based chemotherapy in patients with non-small cell lung cancer (NSCLC). Methodology: A systematic review was performed following the PRISMA 2020 methodology. The search was carried out in PubMed, Scopus, and ProQuest databases, using DeCS/MeSH descriptors combined with Boolean operators. Open-access clinical and observational studies published in the last decade, in English or Spanish, were included. The selection process was conducted using the Rayyan software, and the methodological quality of the studies was evaluated using the ROBINS-I and RoB 2 tools to assess the risk of bias. Results: Sixteen studies were analyzed, of which five were clinical trials. Immunotherapy treatments, such as pembrolizumab and atezolizumab, showed better objective response rates (up to 64.6%) and progression-free survival (up to 12.8 months) compared to traditional chemotherapy (4.5 months). The benefits were more significant in patients with high PD-L1 expression. Discussion: Immunochemotherapy significantly improves clinical outcomes over conventional chemotherapy, particularly in selected subgroups. However, the toxicity profile requires careful patient evaluation. Conclusions: Anti-PD-L1 immunochemotherapy represents a more effective therapeutic strategy with sustained benefits in advanced NSCLC. It is recommended to individualize treatment and to continue with randomized studies of higher methodological quality.Item type: Ítem , Access status: Acceso Abierto , Aplicación de Deep Learning como inteligencia artificial para el diagnóstico del cáncer de cuello uterino en citología en base líquida en comparación con técnicas tradicionales: revisión sistemática(Universidad Católica de Cuenca., 2026) Cuenca Bravo , Daniel Leonardo; Floreano Almeida, Roberto HeansleyIntroduction Cervical cancer remains one of the main cancerous pathologies that causes death in women worldwide, especially in countries with scarce resources. Conventional cytology and histopathological analysis, although irreplaceable, are often based on the expert’s personal opinion and on technical equipment that is not always available. In this context, AI and, particularly, deep learning, is emerging as a profitable alternative to enhance health diagnostic processes. Objective: To analyze the impact of AI applications on the accuracy and effectiveness of histopathological diagnosis of cervical cancer through a systematic review of recent literature. Methodology: A systematic review was conducted following the PRISMA 2020 guidelines. The review covered scientific articles published from 2020 to 2025, retrieved from databases such as PubMed, Scopus, and Cochrane. Diagnostic cytology and histopathological case studies using deep learning techniques, particularly convolutional neural networks, were included in the review. The Rayyan platform assisted in record management, while QUADAS-2 was used to assess the risk of bias. Sensitivity, specificity, and clinical feasibility were considered as the main parameters. Expected Results: It is expected to identify AI methodologies with high diagnostic accuracy, as well as to demonstrate the challenges involved in their implementation in real clinical settings. The intention is to promote improvements in early detection systems and reduce health inequalities, particularly in resource-limited regions.Item type: Ítem , Access status: Acceso Abierto , Eficacia y seguridad de ketamina + dexmedetomidina versus propofol en la sedación para endoscopias digestivas altas: una revisión sistemática(Universidad Católica de Cuenca., 2026) Garcés Villacís , Sheccid Slacknak; Lema Sumba , Magensy JohannaIntroduction: Sedation for upper gastrointestinal endoscopy requires effective medications to ensure hemodynamic stability and patient comfort. Although propofol is frequently used, it can cause adverse effects. The combination of ketamine and dexmedetomidine (Ketodex) has emerged as an alternative with a better safety profile. Objective: To compare the efficacy and safety of Ketodex versus propofol in adult patients undergoing upper gastrointestinal endoscopy. Methodology: The review included studies published between 2019 and 2024, in English or Spanish, focused on patients over 18 years of age. Systematic reviews, meta-analyses, and case reports were excluded. The search was conducted between November 2024 and April 2025 in the following databases: PubMed, Scopus, Taylor & Francis, and Google Scholar. The risk of bias was assessed using the RoB 2 and JBI tools. Results: A total of 14 studies were analyzed, including clinical and observational trials, with a total sample size of more than 1,000 participants. Data were organized into comparative tables with clinical variables, outcomes, and adverse events. Ketodex demonstrated greater hemodynamic stability and faster recovery, whereas propofol was associated with higher rates of desaturation and hypotension. Discussion: The main limitations were methodological heterogeneity and the risk of bias in some studies. Despite these limitations, the results with Ketodex were clinically relevant. Conclusion: The combination of ketamine and dexmedetomidine represents an effective and safer alternative to propofol for sedation during upper gastrointestinal endoscopy.Item type: Ítem , Access status: Acceso Abierto , Prevalencia del consumo de cigarrillo electrónico y sus factores asociados en estudiantes de Arquitectura de la Universidad Católica de Cuenca Matriz, periodo 2025(Universidad Católica de Cuenca., 2026) Chapa Asmal , Sherly Katherine; Tapia Arbito, Blanca LucreciaIntroduction: Electronic cigarettes (ECs) have emerged as a growing concern in the university environment, especially among young people without a history of tobacco use, who begin using them due to misperceptions and psychosocial factors. Given their impact on public health, the current study aimed to identify the prevalence of and factors associated with electronic cigarette use among architecture students at the Catholic University of Cuenca, during the 2025 period. Methodology: An observational, cross-sectional study was carried out between March and April 2025. A stratified sample of 205 students was used. Data collection was developed through a structured survey with sociodemographic variables, history of substance use, perceived stress (PSS), and perception of electronic cigarettes (technology acceptance model). Statistical analysis was performed with SPSS v26, considering a p-value <0.05. Results: The prevalence of consumption was 25.9%. A significant association was observed between consumption and high levels of stress (p<0.001), favorable perception of electronic cigarettes (p<0.001), and a history of using other substances (p<0.001). No relationship was found with sex or age. Conclusions: Electronic cigarette use is closely related to psychosocial factors, which requires interventions in mental health, product regulation, and preventive education in the university context.Item type: Ítem , Access status: Acceso Abierto , Evaluación de la crononutrición en trabajadores de la Fundación Municipal de la Mujer y el Niño, Cuenca 2025(Universidad Católica de Cuenca., 2026) Guiracocha Cajamarca, Henry Fabricio; Vintimilla Contreras, Joel SebastianIntroduction: Chrononutrition, a discipline that examines the relationship between eating schedules and circadian rhythm, has been shown to impact metabolic health. In work contexts with irregular schedules, this desynchronization can favor the development of obesity, type 2 diabetes, and dyslipidemias. Objective: To evaluate chrononutrition patterns in workers of the Municipal Foundation for Women and Children of Cuenca in 2025. Methodology: Quantitative, non-experimental, and descriptive study conducted from August 2024 to August 2025. A structured questionnaire, including sociodemographic and anthropometric data, as well as the validated Chrononutrition Questionnaire, was administered to 111 workers. Pregnant women and people individuals with eating disorders or treatments that alter circadian rhythm were excluded. Data were analyzed using SPSS v20, employing both descriptive and inferential statistics (chi², OR, p<0.005). Results: A total of 111 workers were included, with 66.7% being women. Of the participants, 65.8% were overweight or obese, and 53.2% were centrally obese. Eating breakfast after 09:00 and lunch for more than 20 minutes were associated with a lower risk of excess weight. In contrast, overnight fasting of less than 10 hours, irregular intake, and high-caloric-load dinner were associated with a higher risk of central obesity and dyslipidemia. Conclusions: Irregular and delayed eating habits increase metabolic risk. Structured eating and adequate overnight fasting may be protective, supporting preventive strategies based on the timing of intake in occupational settings.Item type: Ítem , Access status: Acceso Abierto , Encarnizamiento terapéutico vs cuidados paliativos en pacientes oncológicos en estado terminal: revisión sistemática(Universidad Católica de Cuenca., 2026) Salinas Silva , Ailyn Madelaine; Valdez Verdugo, Irenne MireyaTitle: Therapeutic Obstinacy vs. Palliative Care in Terminally Ill Cancer Patients: A Systematic Review Objectives: To evaluate therapeutic obstinacy and palliative care in terminally ill cancer patients through a systematic review. Methodology: This systematic review followed the PRISMA 2020 guidelines and applied PICO strategies to compare therapeutic obstinacy versus palliative care in terminally ill cancer patients. Studies published in English and Spanish over the last 5 years were included. The search was conducted in PubMed and WoS (Web of Science), using Health Sciences Descriptors (DeCS)/Medical Subject Headings (MeSH) descriptors and Boolean operators. The risk of bias was assessed using Risk of Bias 2 (RoB 2) and Joanna Briggs Institute (JBI) tools. Results: A total of 14 recent articles published between 2022 and 2025 were included. The main findings objectively and in a balanced manner demonstrated that therapeutic obstinacy significantly reduces quality of life and considerably increases the emotional suffering of patients and their families. Conversely, early palliative care showed benefits in reducing depressive symptoms and promoted a positive environment for both patients and their families. Discussion: The evidence presents inherent limitations related to retrospective observational designs, particularly a potential risk of selection bias, variability in the interventions applied, and a lack of uniformity in the operational definitions used. Conclusions: Therapeutic obstinacy considerably impairs the quality of life and emotional well-being of terminally ill cancer patients, whereas palliative care, especially when implemented early, provides clear benefits in symptomatic and emotional management.Item type: Ítem , Access status: Acceso Abierto , Eficacia y perfil de seguridad de la morfina versus la metadona en el manejo del dolor postoperatorio. Revisión sistemática(Universidad Católica de Cuenca., 2026) Rios Torres , Karolina Del Cisne; Mayllazhungo Loja, Mirian JanethBackground: Postoperative pain is a common sequela of surgical procedures, resulting from the physiological response to the manipulation of organs and tissues. Constant monitoring is essential for the patient’s complete recovery. A complete approach is needed, including opioid analgesics, NSAIDs (nonsteroidal anti-inflammatory drugs), and regional anesthesia. If not properly treated, it may become a chronic postsurgical pain, affecting the patient’s quality of life. Objective: To evaluate the efficiency and safety profile of morphine in comparison to methadone for the treatment of postsurgical pain, through a systematic review of available literature. Methodology: A systematical review was conducted, which included scientific articles selected from medical information repositories, such as Scopus, Taylor & Francis, PubMed, SciELO, and Web of Science. Keywords were also used in the research, and requirements were considered for the selection to optimize the results, including studies published within the last five years, content related to the investigation, and scientific articles with randomized trials in English and Spanish. The PRISMA 2020 methodology was used as reference, along with a quality assessment of the studies and a risk of bias analysis using the RoB2 digital tool. Discussion: Methadone supplies better analgesia and security than morphine in different surgical procedures, although some limitations exist. Conclusion: methadone is evidenced to be a more feasible and reliable option for postoperative pain treatment, offering different opportunities for analgesic efficiency and a safer profile when compared to morphine.Item type: Ítem , Access status: Acceso Abierto , Predicción diagnóstica de la endometriosis en mujeres en edad reproductiva mediante inteligencia artificial: una revisión sistemática(Universidad Católica de Cuenca., 2026) Cedeño Ferrin, Carlos Julio; Álvarez Ordoñez , Johanna GabrielaTitle: Diagnostic Prediction of Endometriosis in Women of Reproductive Age Using Artificial Intelligence: A Systematic Review Objective: To evaluate the methods and outcomes of using artificial intelligence for the diagnostic prediction of endometriosis in women of reproductive age, to determine its accuracy and clinical feasibility. Methodology: A systematic review was conducted based on the scientific literature available in the following databases: PubMed, Wiley Online Library, PLOS ONE, ScienceDirect, arXiv, Sage Journals, and SpringerLink. A total of 646 studies were identified and screened according to the PRISMA guidelines. Of these, 14 scientific articles relevant to the research topic and published within the last five years met all criteria and were included. Results: Of the 646 articles retrieved, 2.16% (n=14) met the inclusion criteria. All included studies (100%) reported significant improvements in diagnostic accuracy using artificial intelligence: 64.3% (n=9) used image-based models, 28.6% (n=4) analyzed biomarkers and clinical data, and 21.4% (n=3) evaluated mobile apps and self-reports. Furthermore, 71.4% (n=10) reported an area under the curve (AUC) greater than 0.87, and 42.8% (n=6) achieved a sensitivity greater than 90%, highlighting the effectiveness of these methods and supporting their clinical feasibility. Conclusions: Artificial intelligence improves endometriosis diagnosis by offering noninvasive, personalized, and highly accurate approaches. Although it still needs validation and regulation, integrating it into clinical practice can support more efficient, patient-centered care.Item type: Ítem , Access status: Acceso Abierto , Eficacia y seguridad de Triamcinolona Intralesional versus Metilprednisolona oral en el control y manejo de la mastitis granulomatosa idiopática: revisión sistemática(Universidad Católica de Cuenca., 2026) Chacón Carrión, Patricio Alejandro; Espinoza Yupangui , Jessica PaolaObjectives: This systematic review compares the effectiveness and safety of two treatments for idiopathic granulomatous mastitis: locally injected triamcinolone versus oral methylprednisolone. This benign condition commonly occurs in women of reproductive age. Methodology: Observational studies or clinical trials that directly compared the two treatments were included. The search was conducted in PubMed, Scopus, Taylor & Francis, Cochrane, Springer, and Wiley Online Library up to March 2025. RoB 2 and JBI were used to assess the risk of bias. The most important results of the studies were organized in tables to facilitate comparison. Results: From two clinical trials and three cohorts analyzing more than 300 women, the results suggest that directly injected triamcinolone resolves lesions more quickly, with fewer recurrences and a lower need for surgery due to complications or poor response. Furthermore, this treatment modality produces fewer side effects, leading to greater adherence. Discussion: Although not all analyzed studies employed similar protocols, most indicated that using corticosteroids locally yields clear benefits. However, due to the short follow-up, long-term recurrence cannot be determined. Conclusions: Both treatments can be beneficial, but injected triamcinolone is more effective and should be considered the first option for treating idiopathic granulomatous mastitis. To strengthen this recommendation, additional studies that follow patients for a more extended period and use standardized interventions are neededItem type: Ítem , Access status: Acceso Abierto , Inhibidores Janus Cinasa (inhibidores JAK) como terapia de primera línea en pacientes con enfermedad inflamatoria intestinal vs terapia médica convencional. Revisión sistemática(Universidad Católica de Cuenca., 2026) Méndez Bravo, Omar Alexander; Muñoz Ganazhapa, Mario EnriqueTitle: Janus Kinase Inhibitors as First-line Therapy in Patients with Inflammatory Bowel Disease Versus Conventional Medical Therapy: A Systematic Review. Objective: To analyze the efficacy and safety of Janus kinase inhibitors as first-line treatment compared with conventional medical therapy in patients with inflammatory bowel disease. Methodology: A systematic review was conducted in accordance with the PRISMA 2020 statement, using the following eligibility criteria: clinical trials and observational studies published in the last 5 years in English and Spanish were included, involving patients over 18 years of age diagnosed with IBD. Databases such as PubMed and Cochrane were searched between November 2024 and April 2025. The risk of bias was assessed using the Rob2 tool for clinical trials and the JBI tool for observational studies. Results: Eleven articles were included, showing that JAK inhibitors (filgotinib and upadacitinib) demonstrated notable superiority in terms of clinical remission, symptom reduction, and improvement in quality of life compared to conventional therapy, which was associated with a higher incidence of adverse effects. Discussion: The studies indicated that JAK inhibitors offered sustainable efficacy and a favorable safety profile; however, most studies had a high risk of bias and small sample sizes. Conclusion: JAK inhibitors presented an effective and safe alternative to conventional therapy, highlighting their significant impact as a first-line treatment for IBD.Item type: Ítem , Access status: Acceso Abierto , Comparación del uso de vonoprazan y esomeprazol en el manejo de pacientes con enfermedad por reflujo gastroesofágico erosivo: revisión sistemática(Universidad Católica de Cuenca., 2026) Castillo Condoy , María Stefany; Gonzaga Tejada , Jean DiegoProyecto de Titulación embargado para publicación. Estará disponible a la fecha de publicación o de cierre de embargoItem type: Ítem , Access status: Acceso Abierto , Eficacia y seguridad del Trastuzumab Deruxtecan versus Trastuzumab Pertuzumab en pacientes con cáncer de mama HER2 positivo. Revisión sistemática(Universidad Católica de Cuenca., 2026) Merchán Arica, Joseph Alexander; Padilla Balarezo, Jean PierreIntroduction: HER2 breast cancer represents a rather aggressive form of neoplasms, which has prompted the development of targeted therapies to improve the prognosis of patients. Among these options are Trastuzumab Deruxtecan (T-DXd) and the combined scheme of Trastuzumab with Pertuzumab (T+P), both of which are widely used in different clinical scenarios. Objective: To evaluate the efficacy and safety of Trastuzumab Deruxtecan versus Trastuzumab Pertuzumab in patients with HER2-positive breast cancer. Methodology: A systematic review was conducted following PRISMA 2020 guidelines. Thirteen studies belonging to a period equal to or less than five years, at the date of the present study, selected after a search in PubMed and Scopus, were included. Clinical trials and observational studies were analyzed, and the risk of bias was assessed with validated tools (RoB 2 and Newcastle-Ottawa). Results: The findings demonstrate that T-DXd exhibits a higher efficacy in terms of progression-free survival (10 - 17 months) and objective response rates (up to 62%). However, it presents a higher risk of pulmonary adverse effects, such as interstitial lung disease. In comparison, T+P showed moderate efficacy, but with a more manageable safety profile. Conclusion: Trastuzumab Deruxtecan represents an emerging alternative, particularly in patients with advanced or refractory disease, although its use requires careful risk assessment. The therapeutic decision should be individualized according to the characteristics and needs of each patient.Item type: Ítem , Access status: Acceso Abierto , Eficacia del plasma rico en plaquetas en múltiples dosis versus monodosis en el tratamiento de la gonartrosis: Revisión sistemática(Universidad Católica de Cuenca., 2026) Amaguaya Amaguaya, Ingrid Dalay; Duchitanga Torres , Sebastián AlejandroTitle: Efficacy of Multiple-Dose Versus Single-Dose Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis. A Systematic Review. Objectives: To evaluate the efficacy of platelet-rich plasma (PRP) administered in multiple doses versus a single dose in reducing pain, improving joint function, and enhancing quality of life in patients with knee osteoarthritis. Methodology: We included randomized clinical trials and observational studies (2019–2024) in English involving patients with knee osteoarthritis (Kellgren-Lawrence grades I–IV) that compared single-dose or multiple-dose PRP with other intra-articular interventions or with each other. We excluded systematic reviews, animal studies, and studies with incomplete data. Studies were retrieved from PubMed, Scopus, and Taylor & Francis, with searches conducted through February 15, 2025. Risk of bias was assessed using GRADEpro, classifying studies as high, moderate, or low risk. Results were summarized in descriptive tables, comparing changes in VAS and WOMAC scores at 6 weeks and 3, 6, and 12 months. Results: Six articles (4 randomized clinical trials, 2 prospective studies) involving 392 patients were included. Multiple doses of PRP significantly reduced pain (VAS) and improved function (WOMAC) at 12 months compared with a single dose, particularly in patients with mild-to-moderate knee osteoarthritis. Discussion: Limitations included heterogeneity in PRP preparation and bias among patients. Multiple doses yielded better results in the early stages. Conclusion: Multiple doses of PRP are more effective at reducing pain, improving function, and enhancing quality of life in patients with knee osteoarthritis. A regimen of three injections is recommended.Item type: Ítem , Access status: Acceso Abierto , Terapia electroconvulsiva en comparación con la Estimulación Magnética Transcraneal en episodios depresivos post COVID-19. Revisión sistemática(Universidad Católica de Cuenca., 2026) Andrade Chimbo, Diana Kasandra; Calero Ortiz , Steeven AnthonyIntroduction: COVID-19 left numerous sequelae, significantly affecting people's quality of life. Among these consequences, depression is of particular concern, with uncertainty regarding its neurobiological impact. Therefore, therapies such as Electroconvulsive Therapy (ECT) and Transcranial Magnetic Stimulation (TMS) have emerged as potentially viable treatment options. General Objective: To evaluate the efficacy of Electroconvulsive Therapy and Transcranial Magnetic Stimulation in the treatment of post-COVID-19 depressive episodes. Methodology: A systematic review was conducted based on the criteria established by the PRISMA 2020 statement, including articles published in Spanish and English, with free access, and involving individuals aged ≥18 years. Reviews, meta-analyses, and gray literature that did not address ECT and/or TMS for post-COVID-19 depression were excluded. Searches were conducted in the PubMed, Taylor & Francis, and Scopus databases from November 2024 to March 2025, using the JBI tool. Results: Case reports and cross-sectional studies highlighted the efficacy of TMS, associated with high tolerability, in moderate cases, whereas ECT showed greater efficacy in severe cases. Good adherence to the procedures was identified, with minor adverse effects. Discussion: The results supported the use of these therapies on an individualized basis; however, limitations such as methodological heterogeneity and small sample sizes increased the risk of bias. Conclusions: TMS is recommended for moderate cases and ECT for severe cases; however, further controlled studies are needed to strengthen the evidence supporting this practice.Item type: Ítem , Access status: Acceso Abierto , Asociación entre el uso de etinilestradiol y el riesgo de candidiasis vulvovaginal en mujeres en edad reproductiva: revisión sistemática(Universidad Católica de Cuenca., 2026) Pacheco Peláez , Melany Tatiana; Espín Vélez , Doménica NahomiAssociation between ethinylestradiol use and the risk of vulvovaginal candidiasis in women of reproductive age: a systematic review Introduction: Vulvovaginal candidiasis (VVC) is a common infection of the lower genital tract in women of reproductive age. Factors such as vaginal microbiome imbalance and the use of hormonal contraceptives, especially ethinylestradiol, can promote Candida albicans. Objectives: To analyze the association between ethinylestradiol use and the risk of vulvovaginal candidiasis in women of reproductive age. Methodology: Eligibility criteria: Original studies in English, Spanish, Portuguese, and French, published between 2019 and 2024, were included. Reviews, studies with incomplete data, and animal studies were excluded. Information Sources: PubMed, Scopus, Taylor & Francis, Cochrane, ProQuest. Risk of bias: Assessed using the GRADEpro tool. Synthesis of results: Contingency tables were grouped according to specific objectives. Results: Eleven studies (cross-sectional, cohort, and experimental) were included, involving approximately 5086 women. Most showed a positive association between ethinylestradiol use and the risk of VVC, especially with combined oral contraceptives. Only one study demonstrated a possible protective effect. Discussion: Studies with very low certainty, methodological limitations, and bias predominated, which reduces the strength of the conclusions. However, a possible relationship between ethinylestradiol and VVC is evident. Conclusions: There is a possible association between ethinylestradiol use and an increased risk of VVC. It is recommended to consider individual factors, select appropriate contraceptive methods, and perform antifungal tests in recurrent cases.
