Trabajos de Titulación - Medicina
URI permanente para esta colecciónhttps://dspace.ucacue.edu.ec/handle/ucacue/23
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Ítem Acceso Abierto Complicaciones asociadas a la cirugía de Fontan realizada en pacientes pediátricos con cardiopatías congénitas – Revisión Sistemática(Universidad Católica de Cuenca., 2025) Romero Tacuri , Erika Josselyn; Inga Correa , Mary Lisseth; Merchán Bustos , Fabian Andres; 0704557420; 0105732002Introduction: Complications associated with Fontan surgery represent a high incidence in both pediatric and adult patients, among the most frequent complications are cardiac and pulmonary due to the circulation system, therefore, they represent a great challenge for both patient’s physicians and patients undergoing this surgery. General objective: Complications associated with Fontan surgery performed in pediatric patients with congenital heart disease will be determined. Methodology: It is a systematic study without meta-analysis in which PRISMA-type methodology was used to search the literature. In addition, articles that meet the inclusion criteria will be used. For the development of the systematic review, the following scientific databases were selected: Scielo, Pubmed, Redalyc and Proquest. The search strategies focused on the identification of DECS terms, which correspond to: Congenital heart disease, Fontan surgery, complications, surgical technique, physiology. The languages used will be English – Spanish. For the analysis of bias, the CASP questionnaire will be used. Results: In Fontan patients, an increase in thoracic duct diameter with age is observed, associated with pleural effusion and higher functional class. High atrial volume indicates risk of arrhythmias. Severe liver disease is the most common complication, but recent surgery reduces its risk. Biomarkers such as NT-proBNP and GDF-15 predict cardiac events. Although long-term survival is possible, there is a risk of complications such as structural problems and arrhythmias, and plastic bronchitis varies according to the presence of coronary artery disease. Conclusions: The systematic review highlights common complications in Fontan surgery, such as liver disease and arrhythmias. Although long-term survival is possible, multidisciplinary approaches are needed to improve quality of life and prevent complications.Ítem Acceso Abierto Complicaciones maternas de la embolia de líquido amniótico(Universidad Católica de Cuenca., 2025) Alvarez Illescas , Lisseth Alexandra; Gonzalez Pineda, Julio Cesar; 0150517977Amniotic fluid embolism (AFE) is defined as one of the most catastrophic complications of childbirth, with a high maternal mortality rate of 1 case per 100,000 deliveries. When Amniotic fluid (AF) enters the maternal circulation, it causes immune responses that interact with fetal antigens, leading to several life-threatening complications for the mother, such as pulmonary hypertension and disseminated intravascular coagulation, and potentially resulting in death. There are no prescribed diagnostic criteria; however, the primary focus is the patient's clinical presentation, which includes a characteristic triad of this disease: hemorrhage, hypoxia, and hypertension. Treatment is based on improving the signs and symptoms of the triad to prevent the patient from further complications. Oxygenation should be provided for hypoxia, crystalloids, or inotropic drugs for hypovolemia caused by excessive bleeding, and anticoagulants for disseminated intravascular coagulation.Ítem Acceso Abierto Cirugía con manga gástrica en paciente de 24 años. Reporte de caso(Universidad Católica de Cuenca., 2025) Iñiguez Peña , Emilio Jose; Verdugo Tapia, Juan Carlos; 0104688429Obesity is a global health problem affecting 1.5 billion adults worldwide, including children and adolescents, resulting in increased physical and mental health issues. Obese individuals are at higher risk of developing metabolic and cardiovascular diseases, as well as malignant tumors, resulting in higher mortality rates. Laparoscopic sleeve gastrectomy is widely used in bariatric surgery to reduce mortality. Although sleeve gastrectomy induces anatomical changes and weight loss, there is still a lack of long-term evidence on its effectiveness. A clinical case of a patient with grade II obesity is shared.Ítem Acceso Abierto Liposarcoma mixoide gigante en glúteo. Reporte de caso(Universidad Católica de Cuenca., 2025) Amoroso Muñoz, Evelyn Belen; Flores Flores , Pedro Martin; 0106649411Background: Soft tissue sarcomas are considered rare and account for less than 1% of malignant tumors. The World Health Organization (WHO) established the histological classification based on the tissue of origin. Among sarcomas, liposarcoma is the most common. Objective: To present a case of giant myxoid liposarcoma, its diagnosis, and treatment. Methodology: This is a case report with a descriptive design. The case was analyzed and compared with findings reported in the literature over the past five years regarding this pathology. Results: The clinical case presented reflects the presence of a myxoid liposarcoma measuring 22 x 17 x 11 cm in a young male. The clinical diagnosis was confirmed through CT scan and histopathological examination of a rare type of carcinoma due to its location and the size it had reached. Conclusions: This case showed how effective diagnosis and appropriate treatment can achieve the removal of a large tumor without intraoperative or postoperative complications. Thanks to the contributions of physicians—both professionally and financially—this patient was able to experience some improvement in his quality of life.Ítem Acceso Abierto Síndrome de Felty. Reporte de caso(Universidad Católica de Cuenca., 2025) Picón Tenesaca , Nátaly Estefanía; Vintimilla Ugalde, Jaime Fernando; 0107401796Felty’s syndrome is a rare extra-articular complication of rheumatoid arthritis, with a prevalence of less than 1% among all rheumatoid arthritis cases. It is characterized by the presence of neutropenia and splenomegaly. This condition has a high mortality rate due to the increased susceptibility of patients to infections, which occur as a result of the neutropenia exhibited. A case of a 41-year-old female patient is presented who came for evaluation due to marked asthenia and hyporexia. She was diagnosed with profound neutropenia, requiring hospitalization and early treatment to prevent complications. During her hospital stay, the patient reported joint pain; therefore, rheumatoid factor and anti-cyclic citrullinated peptide antibodies were tested positive. Splenomegaly was observed by ultrasound, and the patient was diagnosed with Felty’s syndrome after presenting with the classic triad.Ítem Embargo Implante valvular bicaval como tratamiento de la insuficiencia valvular tricúspidea severa sintomatica. Reporte del 1er caso en Ecuador(Universidad Católica de Cuenca., 2024) Guzñay Balarezo, Lizbeth Daniela; Ochoa Bravo, Andrea Catalina; 0104864129Ítem Acceso Abierto Participación activa de estudiantes de Medicina de pregrado en las rotaciones clínicas. Revisión bibliográfica(Universidad Católica de Cuenca., 2025) Castro Madero , Nathalie Margarita; Cárdenas Heredia, Freddy Rosendo; 0106957376Medical education significantly influences the development of competencies and knowledge consolidation. These are conducted in the Teaching Support Departments to assess students and provide them with increasingly complex tasks as they interact with patients. This research aims to describe the development of undergraduate medical students' active participation in the teaching-learning process during clinical rotations. A literature review was developed based on scientific articles from online databases such as Scopus, PubMed, and Web of Science. An analysis was also conducted using a matrix to select information. It was evidenced that assisted practices improve the students' academic performance, create more self-confidence by repeating the procedures, and promote their professionalism. The tutorials provided by the teacher reinforce their individual knowledge by centering on the student's mistakes, which improve their skills through practice. Higher education institutions must establish new pedagogical models and roles for teaching support departments, tutors, and students to guarantee quality health care and forster academic excellence and professionalism. Medical education requires an in-depth analysis of the strengths and weaknesses of the participants to improve health services.Ítem Acceso Abierto Lupus eritematoso inducido por fármacos asociado a inhibidores de puntos de control inmunitario(Universidad Católica de Cuenca., 2025) Erraez Ramón, Marlon Damián; Esqueda Jiménez , Aleifel Antonio; 0104754015Introduction: Drug-induced lupus erythematosus is an autoimmune condition. Its severity can vary and mainly affects women, with a pathogenesis that includes hyperactive immune response and genetic, hormonal, and environmental factors. Objective: To demonstrate the association between drug-induced lupus erythematosus and immune checkpoint inhibitors (ICIs). Methodology: A narrative literature review was conducted, analyzing studies from PubMed, Science Direct, and Scopus on the relationship between drug-induced lupus using medications that act as ICIs, focusing on relevant indexed publications and using MESH terminology. Results: Research reveals that medications acting by inhibiting immune checkpoint points, such as pembrolizumab, can reactivate or exacerbate drug-induced lupus erythematosus, with adverse effects ranging from skin reactions to severe complications. Conclusions: The relationship between drug-induced lupus erythematosus and ICIs is complex, offering therapeutic benefits and risks, especially in patients with autoimmune predisposition. The need for a personalized approach and rigorous monitoring is emphasized to improve patient treatment and quality of life.Ítem Restringido Evaluación de riesgo de fracturas osteoporóticas en pacientes con Diabetes Mellitus Tipo 2(Universidad Católica de Cuenca., 2025) Uchuari Rogel , Daniela Alexandra; Salamea Sarmiento , Cecibel; 1105464174Ítem Acceso Abierto Síndrome de Bertolotti: Sacralización de L5 y dolor lumbar, reporte de caso(Universidad Católica de Cuenca., 2025) Morales Jiménez , Jean Diego; Iñiguez Guzman , Carlos Alfredo; 0706680527Bertolotti syndrome is defined as low back pain with or without radicular pain, associated with congenital anomaly in the vertebral morphology (transverse megapophyses with or without fusion with sacral wings or iliac crests), as a consequence of which osteodegenerative facet and disc changes are observed at levels above the transitional vertebra, although it can also manifest itself at the same level with extraforaminal compressive disc pathology. With the aim of presenting a case from the radiological point of view of sacralization of L5 associated with low back pain, we present a patient who presents low back pain for 3 months; it is exacerbated with flexor-extensor and rotational movements of the trunk, he suffers a fall from his own height so an anteroposterior (AP) study of the pelvis and lateral sacro-coccyx is requested where findings related to Bertolotti’s Syndrome are observed. This syndrome should be considered in the differential diagnosis of patients with low back pain with or without radiculopathy.Ítem Acceso Abierto Polimorfismo (CAG) del gen ATXN2 como factor de riesgo relacionado con Diabetes Mellitus Tipo 2(Universidad Católica de Cuenca., 2023) Cabrera Beltrán, Christian José; Castillo Solano, Freddy Damián; 0104405519Diabetes mellitus type 2 (DM2) is one of the most prevalent pathologies worldwide, it is estimated that around 425 million inhabitants currently live with DM2 according to the WHO, the importance of performing molecular tests that allow early diagnosis entails the analysis of several groups of genes involved in the diabetic phenotype with marked insulin resistance and in most cases obesity, among which are the CAG(n) polymorphism in the ATXN2 gene found on chromosome 12q24. The objective of this research is to establish a theoretical update of the relationship between the ATXN2 gene and the CAG(n) polymorphism related to the condition of DM2. The methodology used is an information search using the PubMed and Elsevier databases using keywords, selecting original articles, systematic reviews, and experimental studies published in high-impact journals using Scimago Journal Ranks to select the literature. In conclusion, a relationship between ATXN2 and VNTR CAG(n) directly proportional to the transcriptional activity of the gene with DM2 and other neurodegenerative pathologies is determined.Ítem Acceso Abierto Impacto del Sobrecrecimiento Bacteriano del Intestino Delgado (SIBO) en el Síndrome De Intestino Irritable (SII)(Universidad Católica de Cuenca., 2024) Castro Cabrera, Luisana Stefanía; Coyago Íñiguez, Juan Antonio; 1105976243Introduction: Given the complex interaction between small intestinal bacterial overgrowth and irritable bowel syndrome, which significantly complicates the lives of those affected, this review is necessary to understand how appropriate treatment of these conditions can substantially improve their well-being. Literature Review: This narrative review aimed to explore how small intestinal bacterial overgrowth (SIBO) influences irritable bowel syndrome (IBS). A meticulous search was conducted in databases such as PubMed, SciELO, and Scopus, selecting 39 articles published between January 2019 and December 2023, using specific inclusion and exclusion criteria. The results were organized in tables, and ethical issues were addressed, avoiding the direct involvement of patients. The terms MeSH, DeCS, and Emtree were combined with Boolean operators to refine the search. The findings revealed that a significant proportion of IBS patients also suffer from SIBO, which worsens symptoms such as abdominal pain and bloating. Treatments targeting SIBO, particularly antibiotics and probiotics, effectively improved digestive function and alleviated symptoms. This underscores the importance of considering SIBO in the clinical treatment of IBS. Conclusions: The literature review underscores that effective treatment of IBS is crucial in mitigating its symptoms. It highlights that a proper diagnosis and treatment of IBS can be a decisive factor in improving the quality of life of IBS patients.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.
