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: Acceso Abierto , Efectos secundarios en el uso de inhibidores de cotransportadores de sodio y glucosa en el tratamiento de Diabetes Mellitus Tipo 2(Universidad Católica de Cuenca., 2025) Fajardo Jiménez, René Vicente; Reibán Espinoza , Esteban Adrián; 0929902310According to epidemiological data, approximately 23.5 million people worldwide suffer from type 2 diabetes mellitus, which poses serious challenges for healthcare systems, as well as for the management and achievement of sustained metabolic regulation. Treatment with SGLT2 inhibitors ―a novel non-insulin therapy that helps maintain glycemic control― has been shown to cause adverse effects, primarily associated with the onset of genitourinary infections, diabetic ketoacidosis, bladder cancer, and bone disorders. Objective: To collect bibliographic information on the “Side Effects of Using Sodium- glucose Cotransporter Inhibitors in the Treatment of Type 2 Diabetes Mellitus.” Expected Results: The use of SGLT2 inhibitors has been proven to have clinically significant adverse effects, including diabetic ketoacidosis, nephropathies, genitourinary infections, and osteoporosis, which were the most important ones identified in this review.Item type: Ítem , Access status: Acceso Abierto , Reporte de caso: Distrofia Muscular de Duchenne con variante hemicigota en el exón 45(Universidad Católica de Cuenca., 2025) Villa Ayora , Paola Estefanía; Jaramillo Álvarez , Christian Andrés; 0106901713Background: Duchenne muscular dystrophy is a serious, rare condition that affects 1 in every 3,600-6,000 male births worldwide. It has a high mutation rate, with 1 in 3 cases presenting a de novo mutation. The phenotype is related to the location of the genetic variant; however, there is no clear relationship between deletions and phenotype severity. This disease is associated with neurodevelopmental disorders and severe orthopedic complications. Treatment with a monoclonal antibody (Translarna) has proven useful, showing good results in slowing the progression of the disease. Case Presentation: A 24-year-old male patient with an unclear diagnosis of plantar pathology who used devices such as insoles without improvement in his condition. After collecting signs, symptoms, complementary tests, and molecular studies, a diagnosis of Duchenne muscular dystrophy was reached. Once the disease was confirmed, the patient was treated with corticosteroids and supplemented with creatine daily for four years without showing improvement in his clinical condition. From the age of 18 to the present, he has been treated with a monoclonal antibody (Translarna), which has kept the patient in a stable clinical condition and slowed the progression of the disease. Expected Conclusions: It is expected to raise awareness about the rarity of Duchenne muscular dystrophy, especially its genetic mutations such as the hemizygous exon 45 variant, and the effectiveness of the monoclonal antibody (Translarna) as an available treatment for this disease.Item type: Ítem , Access status: Acceso Abierto , Sufrimiento fetal agudo: PH fetal del cuero cabelludo intraparto(Universidad Católica de Cuenca., 2025) Almestar Japon, Katherine Fernanda; Duran Vega , Oswaldo Jair; 0107149585Introduction: Acute fetal distress involves a series of obstetric complications, altering the normal course of a eutocic delivery. Fetal scalp pH testing is of utmost importance to determine if the fetus is receiving enough oxygen, which could be useful for the early detection of acute fetal distress. Literature Review: Examination of the fetal scalp is very important to corroborate fetal well-being. It helps us with the early diagnosis of acute fetal distress, thereby preventing irreversible neurological damage. Conclusions: Intrapartum fetal scalp sampling is performed as a complementary method, being a great indicator of fetal hypoxia. With proper intervention, it plays a crucial role in the early diagnosis of fetal distress.Item type: Ítem , Access status: Acceso Abierto , Resistencia a ciprofloxacino en infecciones del tracto urinario por escherichia coli(Universidad Católica de Cuenca., 2025) Apolo Guerrero, Laura Mishelle; Gallegos Merchán, Juan Diego; 0705543270Introduction: Urinary tract infection (UTI) is characterized by a significant increase in pathogenic microorganisms in a urine sample obtained sterilely. More than 95% of urinary tract infections (UTIs) are caused by a single bacterial species, with Echerichia coli (E. coli) responsible for 75-95% of cases of acute uncomplicated cystitis. From 2018 to 2020, it is estimated that 0.7% of outpatient consultations, equivalent to 7 million annual consultations by women, are related to urinary tract infections. Women report an annual prevalence of 10.8%. Its diagnosis is based on agar dilution methods, molecular techniques and CHROMagar Orientation. General objective: To carry out a review of the literature on resistance to ciprofloxacin in urinary tract infections due to Echerichia Coli. Methodology: databases such as Pubmed, Scielo, Scopus and Science Direct were used, applying advanced search to compile 16 useful articles from the last 6 years with great relevance for this review Expected results with this work it is expected to contribute to clinical practice by providing information relevant to ciprofloxacin resistance in urinary tract infection due to Escherichia coli.Item type: Ítem , Access status: Acceso Abierto , Paradigmas actuales en el tratamiento de enfermedad hepática esteatósica asociada a disfunción metabólica(Universidad Católica de Cuenca., 2025) Calle Hidalgo, Angelo Andreu; Aldas Erazo , Manuel Rafael; 1725019374Liver disease associated with metabolic dysfunction has emerged as a significant clinical entity within hepatology. It is characterized by hepatic fat infiltration, excluding factors such as alcohol consumption or other exogenous substances. Addressing this pathology is of utmost importance due to its growing prevalence and close association with obesity, insulin resistance, and type 2 diabetes. Despite its clinical relevance, there is no clear consensus on the optimal treatment for this condition. This literature review aims to establish a standardized approach to the treatment of this disease. Evidence indicates that hygiene, dietary measures, and exercise are effective at all stages of the disease, even in reversing fibrosis. However, adherence to these general measures is low, necessitating the exploration of pharmacological treatments. Currently, regulatory bodies have not approved specific pharmacological treatments for this condition. The results indicate that the use of pioglitazone and vitamin E are effective therapeutic approaches for treating this pathology and are supported by international societies; however, they are not exempt from adverse effects, which is why the use of other pharmacological therapies has been considered in this reviewItem type: Ítem , Access status: Acceso Abierto , Resistencia bacteriana a macrólidos en infecciones respiratorias(Universidad Católica de Cuenca., 2025) Molina Asitimbay , Darwin David; Cardoso Landivar , José David; 0106066053Introduction: Antibiotic resistance, particularly to macrolides, represents a significant public health problem. Although antimicrobial resistance is a natural phenomenon, the COVID-19 pandemic has exacerbated this problem, jeopardizing the effectiveness of treatments and increasing morbidity and mortality. Literature Review: The causes of macrolide resistance are complex and multifactorial. Key contributing factors include the lack of new effective antibiotics and the inappropriate prescription of existing antibiotics, whether through overuse or misuse. The mechanisms of macrolide resistance include mutations in specific genes, the activity of methyltransferase enzymes, and the presence of efflux pumps. Furthermore, macrolide resistance rates vary significantly across different regions and pathogens. Conclusions: Overall, Asian countries show higher levels of resistance compared to Europe and the United States. This situation negatively impacts public health, compromising the effectiveness of treatments and increasing the economic burden, morbidity, and mortality, especially in patients with severe respiratory infections. The growing macrolide resistance in respiratory system infections is a pressing issue that demands urgent and multifaceted solutions. It is crucial to understand the resistance mechanisms and epidemiological trends to guide decision-making and optimize treatments.Item type: Ítem , Access status: Acceso Abierto , Terapia ANTI-TNF versus NO ANTI-TNF en el manejo de la enfermedad de Crohn perianal fistulizante(Universidad Católica de Cuenca., 2025) Alvarez Sarmiento, Josseline Elizabeth; Ascaribay Mora , Andrés Fernando; Aldás Erazo , Manuel Rafael; 0106092380; 0106627565Title: Anti-TNF Therapy versus Non-Anti-TNF Therapy in Perianal Fistulizing Crohn's Disease Objective: To determine the effectiveness of Anti-TNF Therapy versus Non-Anti-TNF therapy in managing fistulizing perianal Crohn's disease. Methodology: The PRISMA declaration was used through databases such as PubMed, Cochrane, SciELO, ProQuest, and ScienceDirect, using search algorithms based on keywords. In addition, eligibility and inclusion criteria were applied, including articles published within the last five years, a list of biologics as therapy for CD (Crohn’s Disease) perianal fistulizing, original articles in Spanish and English; and exclusion criteria such as those that are not scientific and do not support the research question. Additionally, to determine the risk of bias in the studies, the Newcastle-Ottawa scale was applied, and finally, to synthesize the results, the Excel tool was used in which the interventions of the participants in each article were initially described, whether with the use of one or another biological. Results: In this review, a total of 31 articles, including both descriptive studies and clinical trials, were used, involving a total of 6803 participants with fistulizing perianal CD. On average, the included articles demonstrated a clinical remission rate of 37.82% and a response rate of 59.21% non-anti-TNF therapy patients. However, those patients with anti-TNF therapy achieved a remission rate of 50.67% and a response rate of 67.77%. In addition, adverse effects were found in both therapeutic profiles, such as skin erythema, recurrent infections, and worsening of perianal CD, among others. Conclusions: Although both therapies are feasible, TNF inhibitors stand out in response and clinical remission in maintenance. However, they present more significant adverse effects.Item type: Ítem , Access status: Acceso Abierto , Clip endoscópico para la prevención del sangrado después de la resección de pólipos colorrectales(Universidad Católica de Cuenca., 2025) Bustamante Correa, Karla Elizabeth; Calle Rodas, Daniel Alejandro; 0107559445Colorectal polyps are lesions that protrude from the surface of the mucosa into the lumen of the colorectum. They are treated surgically, and bleeding is the most common complication during the procedure. However, 10% of patients may bleed for up to 3 days after resection, which is usually managed by endoscopic hemostasis using coagulation forceps, adrenaline injections, and thermal coagulation methods. Currently, endoscopic clips have gained popularity as a new hemostatic technique. Despite their good results, they have limitations depending on patient-specific factors and the technique applied by the endoscopist. This literature review aims to describe the efficacy of endoscopic clips as a preventive measure for bleeding after colorectal polyp resection. Considering the benefits and limitations of the technique, several authors justify that clipping is appropriate according to clinical criteria and the individual characteristics of the patient. However, others contrast this with evidence suggesting the lack of efficacy of routinely use of clips to close resection sites, especially in polyps smaller than 20 mm. The effectiveness of clips for prophylactic purposes in bleeding remains controversial due to the significant gap in the standardization of data collected across different studies. The size of the polyps, resection technique, number of clips used to close the lesion, and endoscopist training are the main factors that affect the resultsItem type: Ítem , Access status: Acceso Abierto , Hipotiroidismo congénito(Universidad Católica de Cuenca., 2025) Montaño Loja , Angie Tamara; Vanegas Cobeña , Nancy Esperanza; 0107171365Congenital hypothyroidism (CH) is a medical condition in which a newborn has a defect in the production of thyroid hormones. An absent, underdeveloped, or malformed thyroid gland can cause this. Discussion of CH is extremely important due to its profound implications for the health and development of newborns. Neonatal screening plays a fundamental role in the early detection and effective management of this condition. This practice allows affected newborns to be identified before they show clinical symptoms, facilitating early initiation of treatment with levothyroxine. Early detection and timely treatment are crucial to prevent delays in physical and mental development, as well as to reduce the risk of long-term complications associated with CH. In conclusion, a comprehensive understanding of congenital hypothyroidism requires a multidisciplinary approach that includes early detection, appropriate treatment, and continuous monitoring of the patient.Item type: Ítem , Access status: Acceso Abierto , Complicaciones pulmonares causadas por la utilización del cigarrillo electrónico(Universidad Católica de Cuenca., 2025) Porras Carrillo , Gabriela Katherine; Maldonado Valverde, Andrés; 0706210556The use of electronic cigarettes has raised concerns due to potential lung complications. Although they have been promoted as a less risky alternative to traditional smoking, studies show they are not without risks to lung health. One of the main complications is acute lung injury, such as bronchiolitis obliterans, a serious disease that can lead to permanent lung dysfunction and, in extreme cases, death. However, there has been an increase in cases of lung diseases, especially among young people who use e-cigarettes with liquids containing nicotine and other additives. Another significant complication is the development of lipid pneumonia, a lung condition in which tissues become inflamed due to the inhalation of oils and other components present in the liquids used in e-cigarettes. This condition can cause symptoms such as breathing difficulties, coughing, chest pain, and other serious respiratory symptoms. Furthermore, electronic cigarettes can aggravate pre-existing respiratory conditions, such as asthma and chronic obstructive pulmonary disease (COPD). Exposure to the chemical components and fine particles in e-cigarette aerosol can irritate the airways and worsen symptoms in people who already have these diseases. In summary, even though that e-cigarettes have been promoted as a better and safer option than conventional smoking, their use carries significant risks to lung health. Both patients and healthcare personnel need to be aware of these complications and take measures to prevent their occurrenceItem type: Ítem , Access status: Acceso Abierto , Vitamina D y cáncer de mama(Universidad Católica de Cuenca., 2025) Lopez Vallejo, Maria Eduarda; Ochoa Bravo , Andrea Catalina; 1316160504Introduction: The relationship between vitamin D and breast cancer has been a subject of growing interest in medical research, as numerous studies suggest an association between adequate vitamin D levels and a significant reduction in the risk of developing neoplasms of the mammary gland. Sun-derived vitamin D, primarily known for its role in bone health, has emerged as a potentially crucial factor in the prevention and progression of various types of neoplasms, including breast cancer. Clinical and experimental studies support its role in tumor inhibition, improved prognosis, and lower incidence in populations with adequate sun exposure. Consequently, this literature review aims to highlight the relationship between breast cancer pathology and vitamin D. Objective: To conduct a narrative literature review on the relationship between vitamin D and breast cancer. Methodology: A scientific literature search was conducted using databases such as PubMed, Scopus, SciELO, and Web of Science, covering 10 years up to the present, and focusing on studies related to vitamin D and cancer. Conclusion: Vitamin D deficiency plays a significant role as a major risk factor for the development of breast neoplasia. Maintaining adequate vitamin D levels helps combat the growth and spread of this carcinoma.Item type: Ítem , Access status: Acceso Abierto , Anticuerpos monoclonales como tratamiento de esclerosis múltiple: efectividad, seguridad y perspectivas futuras(Universidad Católica de Cuenca., 2025) Ramón Once , Jheymi Marcela; Jaramillo Alvarez , Christian Andrés; 1400859425TITLE: Monoclonal Antibodies as a Treatment for Multiple Sclerosis: Efficacy, Safety, and Future Prospects. The treatment of multiple sclerosis may include lifestyle changes and/or the administration of drugs, depending on the severity and clinical manifestations presented by the patient. OBJECTIVE: To analyze the efficacy and safety associated with the use of monoclonal antibodies as a treatment for multiple sclerosis. METHODOLOGY: This research consists of a descriptive literature review with a qualitative approach, supported by 55 publications obtained from scientific databases such as Scopus, Lilacs, Redalyc, PubMed, Web of Science, and SciELO. CONCLUSION: Multiple sclerosis has no cure, but the emergence of monoclonal antibodies represents a reliable alternative to reduce the severity of symptoms, control the progression of disability, prevent new relapses, and improve the quality of life of patients.Item type: Ítem , Access status: Acceso Abierto , Efectos de los inhibidores del cotransportador sodio-glucosa tipo 2 en la anemia(Universidad Católica de Cuenca., 2025) Reinoso Astudillo , Evelyn Marcela; Reiban Espinoza, Esteban Adrian; 0107488108Introduction: The relevance of this review lies in the growing evidence that sodium-glucose cotransporter 2 inhibitors (SGLT2i) go beyond their traditional use in managing type 2 diabetes, showing potential benefits for treating anemia associated with chronic diseases such as chronic kidney disease and heart failure. This review examines the impact of SGLT2i on erythropoiesis, thereby enhancing life expectancy and quality of life. Literature Review: Recent studies indicate that SGLT2i improve tissue hypoxia and anemia by inhibiting glucose reabsorption in the renal tubules, reducing oxygen consumption, and improving renal tissue oxygenation. This results in an elevation of erythropoietin production, an increase in hematocrit and hemoglobin levels, and an improvement in survival, as well as a reduction in renal and cardiovascular events. The underlying mechanisms include reducing inflammation and modulating hypoxia signaling and ferrokinetics. Conclusions: SGLT2i have an extended therapeutic effect that goes beyond glycemic control, also including the regulation of anemia in patients with chronic diseases. These findings suggest a paradigm shift in the therapeutic approach, offering a more comprehensive treatment for these comorbidities.Item type: Ítem , Access status: Acceso Abierto , El papel del macrófago en la migración de las células troncohematopoyéticas a la médula ósea(Universidad Católica de Cuenca., 2025) Cabrera Donoso, Arianna Camila; Puente Mosquera , Karola Adriana; 0107463655The hematopoietic system, which encompasses the production of blood cells, is profoundly influenced by the presence and function of macrophages. These cells play a key role in regulating erythropoiesis, the immune response, and tissue repair. Their involvement ranges from the creation of specialized niches for red blood cell production to the modulation of the hematopoietic microenvironment and the inflammatory response. A thorough understanding of macrophage biology and function can significantly impact the diagnosis, treatment, and development of therapies for hematological disorders, such as leukemia and anemia. Their functional plasticity and diversity offer promising opportunities for more targeted and effective therapeutic interventions. However, further research is still needed to fully unravel the role of macrophages in hematological health and pathology, highlighting the importance of continuing research in this field in the search for new therapeutic strategies.Item type: Ítem , Access status: Acceso Abierto , Relación entre el Parkinson y la depresión: causas y tratamiento(Universidad Católica de Cuenca., 2025) Oliveros Ramón, Lizbeth Estefanía; Jaramillo Loaiza, Walter Viterio; 0106340003Introduction: Patients with Parkinson's disease present a higher incidence of depressive symptoms compared to the general population. This association is attributed to neurobiological, psychological, and psychosocial factors. Treatment is of vital importance due to the multiple implications depression may have on disease progression and patients’ quality of life, since effective treatment of depression can contribute to an improvement in the emotional, social, and functional well-being of the patient with Parkinson's disease. This paper aims to describe the relationship between Parkinson's disease and depression, with reference to its causes and treatment. Literature Review: A narrative-type investigation was conducted, including 15 articles in Spanish and English from the last 5 years. The current literature highlights dopaminergic neuronal degeneration in the central nervous system as the main cause of Parkinson's disease. Regarding treatment, the efficacy of antidepressants already used in clinical practice has been demonstrated, as well as alternative therapies. These findings underscore the importance of a comprehensive approach to treating depression in patients with Parkinson's disease. Conclusions: The relationship between Parkinson's disease and depression is complex, as it involves neurobiological, psychological, and social causes. The psychological impact of a chronic illness and the loss of independence lead to social isolation, which can exacerbate depressive episodes. Conventional antidepressant treatments are effective; however, alternative therapies have also demonstrated their value and effectiveness in improving motor and non-motor symptoms associated with Parkinson's disease.Item type: Ítem , Access status: Acceso Abierto , Complicaciones de la Trombosis Venosa Esplácnica(Universidad Católica de Cuenca., 2025) Silva Tene, Katherine Mabel; Puente Mosquera, Karola Adriana; 0803076694Introduction: Splanchnic Venous Thrombosis (STV) is an infrequent but serious condition, involving the formation of a blood clot in the splanchnic venous system, transporting blood through several digestive organs such as the spleen, liver, small intestine, and colon. In some cases, STV may be asymptomatic; which makes its complications potentially life-threatening. This literature review aims to describe the complications of STV to improve its diagnosis and treatment. Theoretical Framework: Among the main complications identified from this review are portal hypertension, caused by obstruction of portal blood flow; splenic infarction, triggered by necrosis of splenic tissue due to insufficient blood supply; mesenteric thrombosis, resulting from thrombosis of the mesenteric veins, leading to intestinal ischemia; and pulmonary thromboembolism, which occurs when a blood clot detaches and moves to the lung. Conclusions: Splanchnic venous thrombosis is a disease with the potential to trigger life-threatening complications. Therefore, it should be diagnosed in time and, in turn, provided with adequate treatment to prevent these complications. In addition, as it is a rare disease, further studies are needed to understand and improve the underlying mechanisms of STV and to develop more effective preventive and therapeutic strategies.Item type: Ítem , Access status: Acceso Abierto , Efectividad de las estrategias de telemedicina en el seguimiento de pacientes con enfermedades cardiacas crónicas(Universidad Católica de Cuenca., 2025) Mora Sacaquirin, Juan Carlos; Chunchi Ayala , Luis Mario; 0705433613Introduction Telemedicine, defined as medical practice supported by mobile devices and wireless technology, has experienced rapid growth in response to healthcare challenges, particularly in the management of chronic diseases such as heart failure. Key Findings of the Review Telemedicine has proven to be an effective tool that contributes to reducing mortality and hospitalizations in patients with chronic heart disease. Remote cardiac monitoring enables early detection of decompensation, improving clinical outcomes. The combination of telemonitoring and pharmacological support reduces both mortality and hospitalizations. It is also effective and cost-effective in cardiovascular risk prevention, cardiac rehabilitation, and chronic diseases management. Technological advances and data management will further optimize these strategies. Conclusions Medicine 4.0 is transforming the care of chronic heart disease through advanced technologies such as telemonitoring and mobile health systems, improving the efficiency and quality of care without replacing the physician. However, it faces challenges such as data security and initial implementation costs, especially in areas with limited resources.Item type: Ítem , Access status: Acceso Abierto , Infiltrado de adipocitos en médula ósea y su relación con la progresión del mieloma múltiple(Universidad Católica de Cuenca., 2025) Romero Vintimilla, José Rodrigo; Castillo Mosquera, Paulette Geovanna; Puente Mosquera , Adriana; 0706967155; 1719717850TITLE: Adipocyte Infiltration in Bone Marrow and Its Relationship with the Progression of Multiple Myeloma OBJECTIVE: This research aims to determine the relationship between adipocyte infiltration in bone marrow and its relationship with the progression of multiple myeloma. METHODOLOGY: A systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement in the PubMed, Scopus, and WoS databases, searching for clinical trials on adipocyte infiltration in bone marrow and its relationship with disease progression. RESULTS: Ten clinical trial-type research articles that met the eligibility criteria were included. The selected articles determined that bone marrow adipose tissue increased disease progression through the inhibition of adiponectin, the increase of proto-oncogenes, and the decrease of tumor suppressor genes and chemoresistance. A combination of three drugs was effective in 75% of cases in co-cultured cells with normal adipocytes. However, only 46% of the cells inhibited myeloma cell growth in those with increased adipocytes. DISCUSSION: Several studies found that adipose tissue infiltration in the bone marrow was associated with progression from monoclonal gammopathy of undetermined significance (MGUS) to symptomatic multiple myeloma phase or chemoresistance in certain patients, although some mechanisms remain unclear. CONCLUSION: Based on the research, adipocyte infiltration in the bone marrow of patients with multiple myeloma is related to disease progression. This is due to the action of adiponectin at the cellular microenvironment level through various signaling pathways, inhibiting cell apoptosis and increasing clonal proliferation.Item type: Ítem , Access status: Acceso Abierto , Consumo de cafeína y anomalías congénitas: Revisión sistemática(Universidad Católica de Cuenca., 2025) Urgiles Rolland, Jorge Thomas; Ríos Romero, Kimberly Aniana; Muñoz Cajilima, Juan Pablo; 3040090023; 1719559484Introduction: Caffeine consumption produces effects on the fetus during pregnancy; however, the relationship between these changes and the appearance of congenital malformations is not entirely clear. Therefore, early detection of caffeine consumption in all pregnant women and women of childbearing age is encouraged to limit its consumption and prevent malformations. Objective: To determine the association between caffeine consumption during pregnancy and congenital anomalies. Methodology: A systematic review was conducted using the PRISMA 2020 statement. For this purpose, the search was performed in PubMed, Web of Science, and Scopus databases. The articles were selected using eligibility criteria, and the risk of bias was assessed using the ROBINS-I tool. Results: The results indicate that coffee consumption is associated with oral and craniofacial malformations, although some studies did not find this relationship. Adverse effects of caffeine on fetal blood flow, metabolism, increased amniotic fluid volume, cardiac and genital abnormalities, and low birth weight were also identified; however, other studies did not observe adverse effects with low doses of caffeine. Furthermore, coffee consumption has been associated with decreased fetal bone density and neurological alterations. Finally, although the evidence is limited, some studies suggest possible genetic alterations associated with caffeine consumption. Discussion: Pregnancy is a dynamic process influenced by internal and external factors, including diet. Some studies suggest that caffeine consumption is associated with oral and craniofacial malformations, cardiac, fetal growth, neurological, and genetic alterations. However, other studies do not find these relationships, and several present a high risk of bias. These limitations highlight the need for more rigorous and well- designed research to clarify the effects of caffeine on embryonic development. Conclusion: The systematic review reveals that coffee consumption is associated with oral and craniofacial malformations, cardiac, vascular, and neurological alterations in fetuses, low birth weight, and decreased bone density. Although some studies found that there is no relationship with certain anomalies and that low doses of caffeine seem not to have negative effects, the general evidence suggests possible risks for embryonic development.Item type: Ítem , Access status: Acceso Abierto , Amiloidosis cutánea: reporte de caso(Universidad Católica de Cuenca., 2025) López Guerrero, Ángela Patricia; Carlos Rolando; 0104987482Primary cutaneous amyloidosis is a rare pathology, particularly in its primary form, which may be associated with systemic diseases. It generally goes unnoticed and has a higher prevalence in women, with a ratio of 9:1. In Ecuador, it is more common in the coastal region and typically occurs in countries situated along the equatorial line. Its symptomatology is nonspecific, making diagnosis difficult. To date, there is no gold standard treatment; however, its management is symptomatic and yields non-curative results, a topic that remains controversial among healthcare professionals. A 30-year-old female patient presents with a case of a scaly and pruritic dermatosis in the form of macules on the upper back, neck, and hands since adolescence. Previously, she underwent treatments with corticosteroids and moisturizers, resulting in periods of remission and exacerbation. Upon physical examination, macroglossia and desquamative eruptions were noted, leading to a biopsy that confirmed the diagnosis of primary cutaneous amyloidosis. For treatment, the patient has adopted hygienic-dietary measures, moisturizers, topical corticosteroids, and antihistamines. Therefore, primary cutaneous amyloidosis is considered rare, challenging to diagnose, and subject to controversial treatment.
