Trabajos de Titulación - Sede Azogues - Medicina
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- ÍtemAcceso AbiertoFactores de riesgo, diagnóstico y tratamiento de la psoriasis del cuero cabelludo. Revisión sistemática(Universidad Católica de Cuenca., 2024) Gutiérrez Avila, Denisse Melissa; Peláez Vélez , Luzmila Carolina; 1104379126Background: Psoriasis is a chronic autoimmune skin condition characterized by scaly, whitish or silvery, shiny, erythematous, and pruritic plaques, with the scalp being one of the most commonly affected areas. Its management in clinical practice is challenging due to its resistance to treatment and tendency to recur. Objectives: To describe the risk factors that influence the appearance of scalp psoriasis, and the diagnostic methods and updated treatments of this pathology. Design: A systematic review was conducted. Methods: Eligible studies were identified in the PubMed digital database by applying the filter of the last five years. The terms searched were “scalp psoriasis” and “psoriasis del cuero cabelludo.” The articles were screened according to title, abstract, and content for selection. Results: Forty sources were included (intervention articles, literature review, and case reports), considering the inclusion criteria for further analysis. Discussion: The predominant risk factors for developing scalp psoriatic lesions include family history, sun exposure, stress, and medications, such as adalimumab and hydroxychloroquine. According to the reviewed sources, the diagnosis should involve anamnesis, physical examination, dermoscopy, and biopsy. Recommended treatments include topical medications (corticosteroids), systemic therapies (methotrexate), phototherapy, and biologic drugs (brodalumab). Keywords: psoriasis, scalp, trichoscopy, phototherapy
- ÍtemAcceso AbiertoEfectividad de la vacuna del virus del papiloma humano en la prevención del cáncer cervicouterino. Revisión Sistemática(Universidad Católica de Cuenca., 2024) Rojas Reyes, Greinny Adamaries; Flores Barrera, German Emilio; 1105156242Background: Human Papillomavirus (HPV) is a virus with high oncogenic potential associated with cervical cancer, making it necessary to implement preventive measures aimed at reducing morbidity and mortality. Objective: To determine the effectiveness of the HPV vaccine in preventing cervical cancer. Method: A systematic review based on publications from cohort studies, case-control studies, and literature reviews selected according to inclusion and exclusion criteria from the past five years, retrieved from the databases UpToDate, Web of Science, Scopus, and PubMed. Results: The data were summarized descriptively. Evidence shows that the HPV vaccine is statistically effective when administered to individuals under 14 (OR: 0.39 (0.23-0.64) 95% CI). Multiple studies demonstrate effectiveness with vaccination regimens of one, two, and three doses, including in women with a history of cervical lesions positive for high-risk oncogenic HPV (OR: 0.19 (0.13-0.27) 95% CI). Keywords: Human Papillomavirus, cervical cancer, papillomavirus vaccines
- ÍtemAcceso AbiertoParadigmas actuales de la hipertensión pulmonar persistente neonatal. Revisión Sistemática(Universidad Católica de Cuenca., 2024) Muzha Arévalo , Carla Samantha; González Cárdenas , Juan Manuel; 0302416284Persistent pulmonary hypertension of the newborn (PPHN) is a heterogeneous condition associated with significant mortality; it is delimited by a defect in the fetal-neonatal circulation causing cyanosis, hypoxemia, and respiratory acidosis; pharmacological management seeks to reduce pulmonary vascular resistance. Therefore, the first line of treatment is Nitric Oxide, Sildenafil; Bosentan, Treprostinil, Iloprost, Adenosine, and Hydrocortisone are highlighted as second and third-line treatments for refractory PPHN. However, the use of these oral agents is limited due to their high cost, necessitating the exploration of alternative treatment modalities for PPHN. The use of these oral agents is limited by the lack of acquisition by the health system due to their high cost, making it unavoidable to know the alternative treatment modalities in PPHN. Objective: To analyze the current pharmacological paradigms associated with PPHN through a systematic review. Methodology: This is a descriptive, qualitative, inductive research linked to the PRISMA statement. Twenty-five full-text articles were evaluated from various scientific databases such as Cochrane, Scopus, PubMed, Proquest, Taylor & Francis, UpToDate, and Web of Science. Results: The safety and efficacy of pharmacological therapies are based on their mechanisms of action (cGMP, PDE type 5 and 3, PC, and ET). Treprostinil, which reduces the risk of treatment discontinuation, has shown effectiveness in combination therapy with Nitric Oxide. Bosentan increases the rate of clinical improvement but poses a risk of liver toxicity; however, further evidence is needed for these medications in neonates. Keywords: Sildenafil, Nitric Oxide, Treprostinil, Bosentan, Selexipag.
- ÍtemAcceso AbiertoEfectividad de fisioterapia como tratamiento al esguince de tobillo. Revisión Sistemática(Universidad Católica de Cuenca., 2024) Rivera Caldas, Jonnathan Marcelo; Capote Llanares, Miguel Ángel; 0302712443Objective: To assess different physical therapy modalities in treating ankle sprain. Methodology: A systematic, retrospective, and descriptive review was conducted following the PRISMA 2020 guidelines. Inclusion criteria comprised scientific articles published from 2019 to 2024 in English or Spanish, indexed in scientific databases, full text, and free access. Exclusion criteria comprised articles that did not meet the established timeframe for publication, covering topics related to incomplete fractures or sprains of other body parts. PubMed, SciELO, Scopus, Springer, and Web of Science databases were used to identify the studies. The articles' bias risk was evaluated using Cochrane Review Manager 5.4.1. The results were synthesized and presented in a summary table with the following sections: title, author, country, year, type of study, results, and associated factors. Results: Ten randomized clinical trials involving 405 participants were included and assessed physiotherapeutic strategies such as Kinesio Tape, mobilization with movement, transcutaneous electrical nerve stimulation, proprioceptive neuromuscular facilitation, strength training, and functional training in the reduction of edema, pain, mobility and improvement in strength, balance, and functionality of the ankle in patients with lateral ankle sprain. Conclusions: Physical therapy offers several effective strategies for treating ankle sprain. Techniques such as Kinesio Tape, mobilization with motion (MWM), electrical stimulation (TENS and NEMS), and proprioceptive neuromuscular facilitation have been demonstrated to improve functional recovery, reduce pain, and decrease edema significantly. Keywords: sport, sprain, physiotherapy, ankle, treatment
- ÍtemAcceso AbiertoManejo clínico y abordaje terapéutico de la mordedura de serpiente en pacientes de edad avanzada(Universidad Católica de Cuenca., 2024) Minchala Avecicha, José Andrés; Arias Peláez, María Cristina; 0302163738Snakebites are common in tropical areas, affecting people of all ages, with elderly individuals being particularly at risk. Effective clinical management involves continuous monitoring and follow-up, as the prognosis for recovery depends on the patient's clinical condition. Objective: To describe the clinical management and therapeutic approach to snakebites in elderly patients. Methodology: This research is a descriptive and qualitative literature review. A comprehensive search was conducted on Elsevier, PubMed, UpToDate, Google Scholar, SciELO, ScienceDirect, Oxford Academy, and Research Gate databases. The 30 most relevant scientific articles published in the last five years, according to the eligibility criteria, were selected using the PRISMA 2020 guidelines. Results: Among the 30 selected papers, 90% of snakebites were caused by the Vipiridae family. The first-line treatment in 70% of cases involved antivenom serum, while 60% did not recommend prophylactic antibiotics. Conclusions: The physical examination is fundamental to distinguish the type of accident presented by the patient and the stage in which it is due to the effect of the venom of the Vipiridae family. The first choice treatment is based on using antiphonic serum, analgesia with Paracetamol, and avoiding prophylactic antibiotics. Keywords: snake bite, ophidian accident, treatment, management
