Trabajos de Titulación - Medicina
URI permanente para esta colecciónhttps://dspace.ucacue.edu.ec/handle/ucacue/23
Examinar
Envíos recientes
Ítem Acceso Abierto Terapias de reemplazo de hormonas para personas transgénero en países de América Latina(Universidad Católica de Cuenca., 2024) Robles Becerra , Guillermo Nicolás; Mercado González, Andrés Felipe; 0107124802Importance: In Latin America there are no hormone replacement therapy protocols in all countries, which means this population is not properly addressed within the health systems. This would be justified by showing that currently, according to studies analyzed by the World Professional Association for Transgender Health, at least 0.3% of adults identify themselves as transgender and 1.2% of children and adolescents also identify themselves as such. Observations: It is observed that most protocols have been adapted to the health systems of Latin American countries in which hormone replacement therapy protocols exist, in addition to being based on international guidelines such as those of the World Professional Association for Transgender Health and the Endocrine Society. Conclusions and Relevance: The protocols available in Latin America are on the way to serve as a reference for those countries that do not have them. They can be studied and adapted to the reality of each country, considering the availability of drugs and the expansion of primary health care systems. That said, the relevance of this study lies in the visibility of the transgender population as a population that can and should be attended in the health systems of all countries.Ítem Acceso Abierto Factores de riesgo asociado a la amputacion del miembro inferior en pacientes con Diabetes Mellitus(Universidad Católica de Cuenca., 2024) Apolo Toledo, Karla Carolay; Vera Pulla, Raul David; 1450298797Introduction: Diabetes mellitus is a non-communicable chronic metabolic disorder characterized by deficient insulin production by the pancreas, resulting in high blood glucose values. Among the most frequent complications are neuropathies, ulcers, and diabetic foot, which cause significant morbidity and mortality in addition to generating spending on health systems and disability in patients who suffer from them. Objective: Identify the risk factors associated with lower limb amputation in patients with diabetes mellitus. Methodology: A narrative bibliographic review was carried out on the risk factors associated with lower limb amputation in patients with diabetes mellitus. A search for original articles, Meta-analysis and experimental clinical studies was carried out in the databases: PubMed, Google Scholar, and MEDLINE between the years 2015 to 2023, the DeCS/MeSH terms: "Diabetes Mellitus" "Risk Factors" "Amputation" "Lower Extremity". Conclusion: Several risk factors were analyzed; among the factors with the highest prevalence are male sex, smoking habits, and the time of evolution of the disease, which significantly increase the presentation of foot ulcers and consequently their amputation. In addition to these factors, neuropathy is mentioned as a fundamental axis in the development and gradation of the disease.Ítem Acceso Abierto Historia de la lepra lepromatosa en Cuenca-Ecuador(Universidad Católica de Cuenca., 2024) Galarza Álvarez, Jenny Fernanda; Flores Montesinos, Carlos; 0107370090Lepromatous is the most aggressive form of leprosy, characterized by being multinodular, chronic, and infectious, caused by Mycobacterium leprae, affecting the skin and peripheral nerves. It was introduced in Ecuador with the arrival of the Spanish and has become a health problem since then. The World Health Organization eliminated leprosy as a health issue in 2000; however, in 2013 and 2014, Ecuador registered 144 cases, and in 2021, 51 cases were reported. Leprosy was introduced in Ecuador in 1493 with the arrival of the Spanish and approximately in the province of Azuay around 1822 through the troops from Popayán and Magdalena, belonging to the liberating army, with Perezpata being the first leprosarium founded in Cuenca in 1816, and later, in 1886, the Mariano Estrella leprosarium. Among the treatments used, chaulmoogra oil was one of the most commonly used treatments. This is a forgotten disease, and due to its new handlings and diagnostic methods, no new cases of leprosy have been documented in Cuenca, which is why the Mariano Estrella leprosarium became a health center due to the lack of patients. In search of relevant information, a search for physical and digital literature resources was conducted in the libraries of Cuenca, historical archives, the Museum of Medicine, and the Mariano Estrella Hospital.Ítem Acceso Abierto Asociación entre el estado nutricional y función pulmonar en niños sin enfermedad respiratoria(Universidad Católica de Cuenca., 2023) Castro Lopez, Tamara Guadalupe; Cardoso Landivar, Jose David; 0105179204The WHO defines malnutrition as a deficiency, excess or imbalance in the intake of energy and nutrients. The nutrition of mothers, babies and children has been shown to have a major impact on their growth and development, as well as their future socio-economic status. Studies carried out by the National Health and Family Survey, the United Nations International Children's Emergency Fund and the WHO have shown that malnutrition rates in adolescents, pregnant and lactating women, and children are alarmingly high. Objective. The objective of this study is to evaluate the association between nutritional status and lung function in children without respiratory disease. Materials and method. A narrative bibliographic review of observational studies in the scientific literature was carried out to investigate the relationship between nutritional status and lung function in children without respiratory disease. Original articles and meta-analyses were searched in the Medline (Pubmed), SciELO, and Web of Science databases, using the following search algorithm: (nutritional status) and (children) and (respiratory disease). Conclusion. In conclusion, nutrition is essential for respiratory health. Malnutrition increases the risk of respiratory infection, while at the same time, infection increases energy and nutrient consumption, which can lead to malnutrition. In addition, malnutrition also affects lung function and structure, as well as the immune system's ability to fight infection. Therefore, it is important to ensure adequate nutrition to prevent and treat respiratory diseases.Ítem Acceso Abierto Probióticos como prevención y tratamiento a las infecciones del aparato reproductor femenino(Universidad Católica de Cuenca., 2023) Largo Rivera, Victor Manuel; Muñoz Cajilima, Juan Pablo; 0706985041Recurrent vulvovaginal infections represent a frequent problem in clinical practice, and also bring great social and psychological consequences for women. The development of resistance to commonly used antimicrobials for its treatment and a greater understanding of the function of the vaginal microbiota have raised the need for new treatment strategies. Probiotics have emerged as an alternative to antibiotics due to their ability to restore and maintain the balance of the microbiota, strengthen the immune system, and display antimicrobial properties. The objective in carrying out this narrative review was to know the usefulness of probiotics in the treatment and prevention of the most common infections, that is, bacterial vaginosis and vulvovaginal candidiasis, and to provide an update on their current understanding. To do this, relevant studies were retrieved from the data sources of the last 5 years. In vitro and clinical studies show that probiotics based mainly on Lactobacillus strains and yeasts (Saccharomyces cerevisiae) have positive effects on the composition of the vaginal microflora by promoting the proliferation of Lactobacilli ssp., restoring the balance of the vaginal microbiota and prevent infections. They also show the antimicrobial properties of probiotics against G. vaginalis and C. albicans and are therefore effective for the prevention and treatment of BV and CVV. Probiotics are presented as a viable clinical alternative to conventional treatment by reducing the use of antibiotics, promoting less development of bacterial resistance and fewer recurrences.Ítem Acceso Abierto Abuso de la Metanfetamina: Neurotoxicidad dopaminérgica y alteración de la conciencia(Universidad Católica de Cuenca., 2024) Berrezueta Berrezueta, Johanna Alexandra; Chalco Calle, Diego Fernando; 1727437111Methamphetamine (MA or meth) is a derivative of amphetamine. Its consumption causes damage to the substantia nigra pathways in the brain, reducing dopaminergic markers such as the dopamine transporter (DAT) and tyrosine hydroxylase (TH). This results in low dopamine levels and its metabolites, inflammation, and oxidative stress. It is a drug that is highly available, accessible in cost, and produces euphoric and pleasurable effects. However, its use is often associated with alterations in consciousness, psychosis, violence, mood disorders, and irritability. Literature Review: Methamphetamine acts primarily at the pulmonary level and in the central nervous system. At the pulmonary level, it can cause various respiratory diseases. MA crosses the blood-brain barrier and enters brain tissue, interfering with the transmission of neurotransmitters such as dopamine, noradrenaline, and serotonin, generating euphoric effects and altering neuronal activity. In the long term, MA abuse can lead to neurocognitive disorders, personality alterations, and aggressive behaviors. Conclusions: Methamphetamine abuse represents a serious and multifaceted threat to public health, not only because of its neurotoxic effects but also because of its ability to significantly alter the consciousness and behavior of individuals. To effectively address this crisis, it is essential to implement preventive and treatment strategies, strengthen laws and drug control policies, and foster cooperation among governments, health organizations, and communities.Ítem Acceso Abierto Ozonoterapia como tratamiento complementario en la úlcera de pie diabético(Universidad Católica de Cuenca., 2024) Guamán Carchipulla, Fabiola Dayanara; Guamán Torres, Julio Guillermo; 0105786073Type 2 diabetes mellitus (DM2) is a disease caused by elevated blood glucose over a long period of time. It is known that 15-20% of diabetics present a diabetic foot ulcer throughout their lives, 85% end in amputation and 50% of amputees will need a new amputation in the next 5 years. This is because a poorly controlled ulcer directly affects the motor and sensory function of the lower limb involved, as a consequence of which tactile, vibratory and proprioceptive sensitivity is altered. The latest medical updates have shown a failure in the conventional therapeutic plan for diabetic foot, reaching amputation on several occasions as the definitive treatment and with this, an increase in poor quality of life. That is why in the search for an alternative or complementary therapy we find ozone therapy, its benefits lie in the healing properties that ozone possesses, such as its antimicrobial action, its increase in the speed of the oxidation process and in the regeneration tissue, thus decreasing healing time, stimulates the immune system, and helps by increasing vascularity. This molecule is thought to be ideal for the adjunctive treatment of diabetic foot ulcer wounds. Regarding the methodology, a bibliographic review was carried out consulting the "Scopus, ScienceDirect, PubMed and Cochrane" databases. The inclusion criteria were original articles in English and Spanish, articles that are within the last 5 years and whose abstract is complete. The exclusion criteria were information from theses, blogs, web pages and articles that are not published in scientific journals. The keywords were combined with the operators "AND" and "OR" in order to configure the search strategy.Ítem Acceso Abierto Uso de corticoides en cólico renal: revisión sistemática de la literatura(Universidad Católica de Cuenca., 2023) Saltos Bravo, Melanie Valentina; Intriago Cedeño, Cristina Moserrat; Salgado Ordóñez, Octavio José; 1312830241; 1314589654Importance: Patients with abdominal and lumbar pain commonly present in the emergencies of the different health centers, a type of pain manifestation is mentioned as colic and when it is generally accompanied by renal-urological symptoms, it could be considered as renal colic. The author wonders if corticosteroids are used for therapeutic management of renal colic. Objective: The objective of this study is to determine if corticosteroids serve as therapeutic management for renal colic. Method: A systematic review without meta-analysis has been completed following the criteria of the PRISMA protocol. The search was carried out in the PubMed, Scopus, Web of Science, Taylor and Francis, Proquest databases between June 01, 2019 and June 01, 2023. For the search strategy, terms such as "Renal Colic ”, “Corticosteroids”, “Pain”, “Treatment”, “Methylprednisolone”. The Boolean operator of choice was “AND”. Results: The search results after adequate filtering yielded four articles obtained through the databases. In PubMed, 11 articles were found, 21 studies in Scopus, 19 in Taylor and Francis, 2 in Web of Science and 22 in Proquest. Conclusion and relevance: It is concluded that corticosteroids are not used within the first-line treatment scheme for renal colic, however, in combination with non-steroidal anti-inflammatory drugs, they help reduce vegetative symptoms such as nausea and vomiting.Ítem Acceso Abierto Técnicas moleculares usadas en el diagnóstico y estudio del virus de la viruela símica(Universidad Católica de Cuenca., 2023) Monteros Cedillo, Aly Daniel; Flores Montesinos, Carlos Enrique; 0705464261In july 2022, worlds organizations declare the monkeypox as a public health issue due to epidemic outbreaks in countries that have not previously reported by the. This infection is caused by a virus of the orthopoxvirus family, endemic in central and occidental Africa, who has been considered the most important orthopoxvirus internationally. Actually, the rapid detection of the disease is important for epidemiological control and it´s performed by molecular laboratory techniques such as: real time PCR, recombinase polymerase amplification (RPA), GeneXpert and loop-mediated isothermal amplification (LAMP). The objective of this study was describe the molecular techniques used in the diagnostic and study of the monkeypox virus. Molecular screening test, despite being different, showed high sensibility and specificity in the gen target detection. However, the studies performed in RPA were fast in a time between 7 – 30 minutes, and present the best detection limits compared with the other test and they detected the genes: G2R, G2L and necrosis tumoral factor binding protein, which suggests high reliability.Ítem Acceso Abierto Reporte de Caso: Neuromielitis Óptica(Universidad Católica de Cuenca., 2023) Méndez Guerrero, Juan Andrés; Mejía Almeida, Julia Alexandra; 0705162683The case of a 25-year-old woman with Neuromyelitis Optica, also known as Devic's disease, is presented. This is a rare autoimmune condition that affects the Central Nervous System, specifically the optic nerves and spinal cord. This condition is characterized by sudden loss of visual acuity and motor problems. The patient meets the diagnostic criteria for neuromyelitis optica due to signs of myelopathy and acute amaurosis. The decision is made to initiate treatment by interrupting the pregnancy and subsequently administering methylprednisolone in bolus doses. However, due to the lack of improvement, biological therapy, specifically Rituximab, is chosen. Rituximab, classified as a monoclonal antibody against CD20, is considered an important option when the first-line treatment is ineffective and has shown positive results from the first dose. The aim of the research is to determine the clinical and therapeutic profile of patients diagnosed with neuromyelitis optica. It is concluded that the patient suffers from Neuromyelitis Optica, exhibiting both visual and motor symptoms, with a disability level of 18 points according to the Expanded Disability Status Scale (EDSS). Despite receiving intravenous methylprednisolone treatment, her progress has been unfavorable. However, after completing the treatment cycle, a significant improvement in her clinical condition is observed, reflected in a final EDSS score of 8 points.Ítem Acceso Abierto Alteraciones metabólicas en mujeres adultas obesas como efecto del uso de dietas cetogénicas(Universidad Católica de Cuenca., 2023) Aucay Yunga, Doris Elizabeth; Mora Domínguez, Gina Fabiola; 0106507593Obesity has become a growing epidemic worldwide, and despite being a modifiable factor, it is highly prevalent, standing out even more in the female population. This disorder is the key pattern for developing most chronic diseases, the main reasons for mortality. The ketogenic diet is characterized by a marked restriction of carbohydrates with an increase in fats and proteins, for years it has been recommended as a treatment for neurological disorders, however, it is currently an effective and widely used tool since it not only has effects on control of lipids and glycemia, but also contributes to rapid loss of body weight in patients with obesity, and benefits have even been seen in patients with "type 2 diabetes mellitus", "non-alcoholic fatty liver disease", "mild kidney disease", polycystic ovarian syndrome, endometrial cancer, etc. The duration of the ketogenic diet in each patient continues to cause controversy and uncertainty, however, in this bibliographic review, in most cases, short-term side effects are not evident, so it is considered a safe therapeutic option in these periods, without However, the long-term side effects are unknown. In addition, poor adherence to this treatment option due to its low percentage of carbohydrates and its high costs, leads patients to opt for different approaches with which they can lead a better lifestyle.Ítem Acceso Abierto Manejo de la lesión renal aguda postquirúrgica(Universidad Católica de Cuenca., 2024) Cristian Fernando, Saquisili Paida; Bueno Castro, Ándres Santiago; 0302598719Introduction: Perioperative evaluation is essential to reducing morbidity and mortality because patients undergoing major surgical procedures may experience hemodilution and hemorrhage due to various aspects during surgical procedures. Methodology: It is a narrative literature review study, a comprehensive review of the literature on managing postsurgical acute kidney injury from scientific databases, such as PubMed, SciELO, Cochrane Library, and ScienceDirect, using part of the PRISMA strategy. Results: Currently, limited literature is available to standardize the management of postsurgical acute kidney injury. Conclusions: Predictive scales for the risk of developing postsurgical acute renal failure are variable. Given the complexity of cardiac surgery, studies have shown that non-cardiac surgery is associated with more significant complications and the development of postsurgical acute renal failure. A protocolized algorithm is recommended to avoid discrepancies in assessment and prevent complications.Ítem Acceso Abierto Actualización de Enfoque Diagnóstico de Diabetes Gestacional: Test O'Sullivan vs Test Tolerancia de Glucosa(Universidad Católica de Cuenca., 2023) Ramirez Nieto, Xavier Ernesto; Salazar Torres, Zoila Katherine; 0704959089This study compared the effectiveness of the O'Sullivan test and the Glucose Tolerance Test (GTT) in detecting gestational diabetes (GD), a metabolic condition that occurs during pregnancy and can have negative effects on the health of the mother and baby. Early detection of GD is crucial to prevent long-term complications. The results indicate that the GTT is a more accurate and reliable diagnostic tool than the O'Sullivan test, reducing the rate of false positives and negatives. The GTT is performed between weeks 24 and 28 of pregnancy, measuring fasting glucose levels and after an oral load of 75 grams of glucose, allowing for the evaluation of glucose tolerance throughout pregnancy and early diagnosis of GD cases. The treatment of GD includes a healthy eating plan, moderate exercise, and, when necessary, oral hypoglycemic medications or insulin. It is important for women with GD to regularly monitor their blood glucose levels and blood pressure to avoid complications. After giving birth, these women have a higher risk of developing type 2 diabetes in the future, so they should continue to monitor their health and undergo regular testing for diabetes. In conclusion, the GTT is more effective in detecting GD compared to the O'Sullivan test, contributing to the prevention of complications in the mother and baby.Ítem Acceso Abierto Beneficios del abordaje clínico temprano en pacientes con glaucoma de ángulo abierto(Universidad Católica de Cuenca., 2024) Reynel Rios, Everth Adrian; Cervantes Anaya, Luis Alberto; 1104127624Open-angle glaucoma is the most common and prevalent ocular affectation in the world, this disease generally affects people over 40 years of age in 90% of the population. Glaucoma occurs when intraocular pressure is elevated because the duct becomes blocked and fluid cannot drain normally. This type of glaucomatous optic neuropathy is very silent and often does not present any sign or symptom that alerts patients, which is why it is extremely important to recognize this ocular pathology in its early stages, through a good diagnosis accompanied by a good ocular examination, in order to avoid complications, such as the gradual loss of sight on the side that is affected, since it is one of the main complications of this type of glaucoma. For this we are going to explain the importance of the benefit of early clinical management of open-angle glaucoma. For this, a non- experimental study will be carried out, of a narrative type of bibliographic review. The correct clinical management of patients suffering from this ophthalmopathy is important, since in this way it will be less complicated to treat it early, without it evolving and can generate or bring with it multiple affectations, which in the end will end up deteriorating the view of the patient and lifestyle as such. This is why it is of great importance to be able to diagnose this type of ocular involvement in a timely and early manner.Ítem Acceso Abierto Factores de progresión que aceleran el deterioro de la función renal en pacientes con enfermedad renal crónica(Universidad Católica de Cuenca., 2024) Reyes Pérez, Eddy Santiago; Bueno Castro, Andres Santiago; 0106202658Introduction: Chronic kidney disease (CKD) is a pathology that has become a global health problem because its prevalence rate has been increasing over the years. However, it remains a silent epidemic since the early clinical picture is not significant. Because of this, the main progression factors must be taken into account once chronic kidney disease is already present; among them are modifiable progression factors such as age, sex, race and low birth weight, and non-modifiable progression factors such as arterial hypertension, diabetes mellitus, obesity, smoking, hyperuricemia, acid-base disorders, and the use of nephrotoxic drugs. Objective: To describe the progression factors that accelerate the deterioration of renal function in patients with chronic kidney disease. Methodology: A literature review of scientific articles indexed in specialized scientific databases was conducted using a qualitative approach. Results: Non-modifiable progression factors increase the progression of chronic kidney disease; once associated with modifiable progression factors, they increase the deterioration of renal function, which is why they should be controlled as much as possible to avoid their progression. Conclusion: Control of CKD progression factors is essential; in some cases, it can significantly slow disease progression. It should be done early, which implies knowledge by the primary care physician.Ítem Acceso Abierto Encefalitis Autoinmune Anti-NMDAR, un reto diagnóstico. Reporte de caso(Universidad Católica de Cuenca., 2024) Fernández Ojeda, Paula Vanessa; Esqueda Jimenez, Aleifel Antonio; 0105535900Background: Encephalitis due to antibodies against N-methyl-D-aspartate receptors is an autoimmune disease. However, factors such as herpes simplex virus infection and some neoplasms that trigger the production of these antibodies are required. Nowadays, the etiology of a large percentage of these cases is unknown. The condition presents clinical manifestations that mimic psychiatric disorders, making timely diagnosis and the establishment of adequate therapy difficult, which can limit complications and potential sequelae. Case description: A 17-year-old female patient presented to the health center with depression, easy crying, irritability, and behavioral changes that progressively worsened. She was treated with benzodiazepines, antipsychotics, and mood stabilizers. Since she showed no improvement, she was transferred to another health facility where the progression of neurological deterioration persists due to an altered state of consciousness, aphasia, and catatonic position, leading to a diagnosis of acute encephalitis. A cerebrospinal fluid study was conducted with a request to determine anti-N-methyl-D-aspartate receptor antibodies, which returned positive. Management began with plasmapheresis sessions without a favorable response, prompting the decision to use Rituximab, resulting in progressive improvement in the clinical condition. Conclusion: Anti-N-methyl-D-aspartate receptor encephalitis represents a diagnostic challenge due to its similarity with psychiatric disorders; this pathology should be considered in cases with imprecise clinical presentations. Determining anti-N-methyl-D-aspartate receptor immunoglobulin G in cerebrospinal fluid represents the study of choice. Timely initiation of treatment allows for damage limitation and prompt patient recovery.Ítem Acceso Abierto Eficacia de la quimioterapia intraperitoneal hipertérmica en el cáncer de ovario en mujeres adultas: revisión sistemática(Universidad Católica de Cuenca., 2023) Abad Barahona, Vanessa Isabel; Minchala Sucuzhañay, Flor Dalila; Mercado González, Andrés Felipe; 1719216630; 0302569363Context: In ovarian cancer, cytoreductive surgery is the treatment of choice, followed by adjuvant chemotherapy; where, hyperthermic intraperitoneal chemotherapy controls residual disease, with the combination of physical (thermal) and chemical (chemotherapeutic) methods prior to the formation of adhesions. Objective: To determine the efficacy of hyperthermic intraperitoneal chemotherapy in ovarian cancer in adult women. Methodology: Systematic review of primary studies published in PubMed, Scopus and Web of Science from 2013 to 2023, in Spanish and English. Results: A total of 133,393 articles were obtained, 108 were selected after the first reading, later considering the inclusion and exclusion criteria, 9 studies were used for the present review. The categories hyperthermic intraperitoneal chemotherapy, Cytoreductive Surgery, Survival, Endothelial Ovarian Cancer are described. Conclusion: Research results support the efficacy of HIPEC as a promising therapeutic approach for ovarian cancer treatment, demonstranting an overall survival of 35 months and progression – free survival of 15.6 months.Ítem Acceso Abierto Cáncer de mama hereditario relacionado a mutaciones en BRCA1/BRCA2: una revisión sistemática(Universidad Católica de Cuenca., 2023) Achig Carrion, Kevin Alexander; Cabrera Palacios, Maria Cristina; Acosta Acero, Marcy Viviana; 1105007510; 0302470331The objective of this work is to carry out a systemic bibliographic review of hereditary breast cancer relatedto BRCA1/BRCA2 Mutations, for which the PRISMA method and a systematic bibliographic review were used, using a qualitative approach and a descriptive study based on a meta reflective study, carrying out an exhaus-tive analysis. Due to the review of relevant information, information about hereditary breast cancer related to BRCA1/BRCA2 mutations was sought. The results indicate that one in eight women will develop breast cancerin their lifetime. This type of cancer may have a genetic origin, and mutations in the BRCA1 and BRCA2 genes have been identified as the main cause of hereditary breast cancer. Likewise, he identified mutations in the BRCA1 and BRCA2 genes as the most common and ha ve been the subject of numerous studies related to susceptibility to breast cancer. Similarly, women carrying these mutations were found to have a significantly increased lifetimerisk of breast cancer,with estimates ranging from 45% to 65% for BRCA1 and 45% to 85% for BRCA2. Finally, it is concluded that when performing the analysis of the articles included in the review,it was determined that nine of the ten scientific articles established the relationship or link between hereditary breast cancer and the presence of BRCA1/BRCA2 mutations. In the same way, it was possible to establish thatthe problem is not only centered on the carrier woman, since genetics could significantly affect a gene-carry-ing daughter, with a 50% chance of also developing breast cancerÍtem Acceso Abierto Estado nutricional y su relación con nivel socioeconómico en escolares de la comunidad Uunt Wichim, parroquia Sevilla Don Bosco. Morona Santiago. 2023(Universidad Católica de Cuenca., 2023) Rivadeneira Garzon, Anthony Joshua; Herrera Jaramillo, María Isabel; 1400890156Background: Malnutrition is a worldwide health problem and is associated with various factors, among them, the socioeconomic level of the family nucleus. Objective: To determine the nutritional status and its relationship with socioeconomic level in schoolchildren of the Uunt Wichim community, Sevilla Don Bosco, Morona Santiago-Ecuador, in the period April-June 2023. Methodology: A cross-sectional observational study was carried out between March and May 2023, with schoolchildren of both genders and ages between 5-12 years, from a community located in Morona Santiago-Ecuador. The height and weight of the schoolchildren were taken, to evaluate the socioeconomic level, the parents or legal guardians filled out the Graffar-Méndez Castellano scale. Results: A total of 68 schoolchildren participated in the study, with a median and an interquartile range of 10.0 (7.0 - 12.0) years, and 40 (58.8%) were female. Of the schoolchildren, 23.5% were undernourished, 8.8% were overweight and 1.5% were obese. In relation to the socioeconomic level, 7.4% belonged to stratum III, 69.1% to stratum IV and 23.5% to stratum V. Schoolchildren belonging to stratum III and V presented differences in BMI (p = 0.011), likewise, there were differences in BMI between schoolchildren belonging to stratum IV and V (p < 0.001). Conclusions and relevance: The schoolchildren presented a double burden of malnutrition. The results show that the nutritional status of schoolchildren is related to the socioeconomic level of the family nucleus. It is necessary to develop strategic interventions to eradicate malnutrition.Ítem Acceso Abierto Síndrome de Heyde asociado al factor de Von Willebrand(Universidad Católica de Cuenca., 2024) Cárdenas Andrade, Gabriel Joseph; Reibán Espinoza, Esteban Adrián; 0107130379Introduction: Heyde's syndrome is a disorder that was described for the first time in 1958. This disorder can cause high mortality and morbidity rates if the correct diagnosis is not made. Objectives: Bring up an approach of Heyde Syndrome to focus the attention of different researchers and provide a compilation of updated information for a better understanding of the topic. Methods: Articles such as Meta-Analysis, Bibliographic Reviews, Systematic Reviews and clinical tests were taken in consideration for this article, leaving behind articles that did not meet the inclusion criteria mentioned before. MeSH terms such as: "Aortic stenosis AND Gastrointestinal AND Hemorrhage AND Syndrome AND Von Willebrand” were used for the search. Results: Heyde's syndrome usually occurs at advanced ages, there are not enough studies, therefore there is no data for this disorder, making it difficult to diagnose. Aortic stenosis in Heyde's syndrome is a key finding when it is accompanied by gastrointestinal bleeding. Demonstrating that aortic stenosis is related to metalloprotease activity producing a Von Willebrand proteolysis. Conclusion: Heyde's syndrome is a complicated pathology, with characteristic signs and symptoms such as aortic stenosis, gastrointestinal bleeding and anemia. Surgically placed or transcatheter prostheses can improve the severity of this pathology, especially in patients with advanced aortic stenosis.
