Trabajos de Titulación - Sede Azogues - Medicina
URI permanente para esta colecciónhttps://dspace.ucacue.edu.ec/handle/ucacue/89
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Envíos recientes
Ítem Acceso Abierto Tratamiento quirúrgico para Parkinson: actualización bibliográfica.(Universidad Católica de Cuenca., 2025) Herrera Brito, José Armando; Crespo Argudo, Karla Marcela; 1104571540Introduction: Parkinson’s disease is a chronic condition characterized by the progressive loss of dopaminergic neurons, leading to disabling motor symptoms. In the initial stages, pharmacological treatments are employed; nonetheless, in cases of insufficient response or advanced disease phases, surgical interventions such as deep brain stimulation (DBS), thalamotomy, and pallidotomy are considered. Objective: To identify the current surgical techniques used in the treatment of Parkinson's disease. Method: A systematic review following PRISMA 2020 guidelines was conducted, utilizing information from the last 5 years and databases including PubMed, Scopus, and Springer. Results: Eighty percent of the included studies focused on Deep Brain Stimulation. It produced sustained motor improvements in 75–80% of patients in the long term. Pallidotomy and thalamotomy improved motor symptoms in 65% of cases. These ablative procedures are irreversible and carry risks (hemorrhages, infections). Furthermore, benefits in non-motor symptoms were observed in approximately 70% of patients treated with DBS. Conclusions: DBS is the surgical technique of choice for advanced Parkinson's disease due to its high efficacy (80% motor improvement) and adjustable nature. Pallidotomy and thalamotomy are options for selected cases, providing significant improvements (65%) but with irreversible risk. Collectively, these surgical procedures improve long-term symptomatic control and reduce medication dependency. The selection of the technique should be individualized based on clinical criteria. Keywords: Parkinson’s, functional surgery, Deep Brain Stimulation, pallidotomy, thalamotomyÍtem Acceso Abierto Polímeros biocompatibles basados en hidroxiapatita y colágeno quitosano aplicados al campo de la medicina regenerativa: revisión sistemática(Universidad Católica de Cuenca., 2025) Cabrera Ortega, Alexander Sebastián; Gutiérrez Ortega, Fausto Horacio; 0302849880Regenerative medicine has continuously evolved, integrating increasingly advanced technologies based on synthetic biological materials. These materials are designed in various sizes and shapes to facilitate the adhesion and proliferation of different types of cellular structures, enabling tissue growth and regeneration. Objective: To analyze the use of biocompatible polymers based on hydroxyapatite and collagen-chitosan in regenerative medicine. Methodology: A systematic review was conducted using the following databases: Scopus, PubMed, ScienceDirect, SciELO, and the Cochrane Library, covering the period from January 2019 to December 2024. Health descriptors (DeCS and MeSH) were used to identify keywords, and Boolean connectors AND and OR. Results: Selection criteria were applied, and 41 articles published within the specified time frame were included. Nine hundred thirty records were excluded for not meeting the methodological criteria relevant to the research topic. Additionally, 83 articles were excluded for failing to meet inclusion criteria, which required experimental studies involving support structures in their application in regenerative medicine, both in vivo and in vitro. A data matrix was used to validate each document during the data curation process. Conclusions: Advances in medicine have enabled the implementation of new technologies involving biopolymers in the development of cellular structures, improving their properties for the regeneration of specific tissues and thereby enhancing patients' quality of life. Keywords: biopolymers, regenerative medicine, tissue engineering, collagen-chitosan, hydroxyapatiteÍtem Acceso Abierto Eficacia de la monoterapia versus terapia combinada para el tratamiento de la hiperplasia endometrial: revisión sistemática.(Universidad Católica de Cuenca., 2025) Mejía Rodríguez, Ana Graciela; Mejía Rodríguez, Jessica Raquel; Vélez Vintimilla, Ana Paula; 0302737457; 0302737465Background: Endometrial hyperplasia is an abnormal proliferation of the endometrium that, if left untreated, can progress to endometrial carcinoma. Therapeutic management includes monotherapy with progestins and combination therapy with other agents, such as metformin. However, the most effective strategy to reduce histologic progression, recurrence rates, and adverse effects is still under debate. Objective: To evaluate the efficacy of combination therapy with progestins plus metformin compared to progestin monotherapy for the treatment of endometrial hyperplasia through a systematic review of scientific literature. Methods: A systematic review was conducted following PRISMA guidelines. Studies were retrieved from databases including PubMed, Scopus, Cochrane Library, and LILACS. Clinical trials and observational studies comparing monotherapy and combination therapy in patients with endometrial hyperplasia without atypia or with atypia were included. Results: Endometrial hyperplasia is a premalignant lesion with a high incidence and a significant risk of progression to endometrial cancer. This systematic review compared the efficacy of the levonorgestrel-releasing intrauterine device (LNG-IUD) versus combination therapy with megestrol and metformin, revealing a higher regression rate with the LNG-IUD (91.15% vs. 81.74%). The therapeutic response was more favorable in cases of hyperplasia without atypia, and no significant differences were found based on patient age. Keywords: endometrial hyperplasia, megestrol, levonorgestrel, metformin, treatment outcomeÍtem Acceso Abierto Síndrome de superposición Asma-EPOC. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Lopez Torres, Mercy Alejandra; Galán Avecillas, Estefanía Pamela; 1401239338Background: Asthma-COPD (Chronic Obstructive Pulmonary Disease) Overlap Syndrome (ACOS) is the existence of both asthma and COPD pathologies in a single patient. Currently, this syndrome has been of special interest due to an increase in respiratory symptoms, a higher degree of exacerbations and a deteriorated lifestyle. General objective: To describe the update of the Asthma-COPD overlap syndrome. Specific objectives: To define COPD. To identify the new methods used for the diagnosis of COPD. To indicate the updated treatment for COPD. The research question is: What are the updates of the asthma-EPOC overlap syndrome? Methods: A search was made in PubMed, Scopus, and SciELO databases. We Open access, in full, or incomplete articles published in the last five years, in Portuguese, English, and Spanish were selected. The samples included young people, adults, older adults, and BALB/c rodents. Irrelevant or non-scientific articles were excluded. Conclusions: ACOS reveals the coexistence of asthma and COPD, associated with pollutants and a negative impact on lung function and quality of life. The importance of updated diagnostic methods and personalized treatments is highlighted. Keywords: asthma-COPD overlap syndrome, dyspnea, lung function, forced spirometry, mixed lung disorderÍtem Acceso Abierto Complicaciones perinatales en neonatos de madres con diabetes gestacional. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Matute Ortiz, Doménica Monserrathe; Barzallo Ochoa, Tania Pamela; 0350093696Background: Gestational diabetes mellitus is a metabolic disorder characterized by increased glucose levels detected in the early stages of gestation. It leads to various complications in the neonate, thereby increasing the risk of neonatal mortality. Objective: To determine the perinatal complications in neonates born to mothers with gestational diabetes. Methods: An exploratory, observational, retrospective, and cross-sectional approach was utilized based on the PRISMA 2020 guidelines. It includes studies published within the last five years and scientific journals from digital repositories such as SCOPUS, SCIENCE-DIRECT, MEDLINE, and COCHRANE. Results: A total of 735 studies were obtained after applying the search criteria. Subsequently, this research applied selection parameters, yielding a total of 25 articles that were analyzed individually. Among these, the main perinatal complications identified were respiratory distress syndrome, large for gestational age neonate, macrosomia, and neonatal jaundice. However, these complications were associated with an increase rate of hospitalization in neonatal intensive care units. Additional reported complications included neonatal hypoglycemia, hyperbilirubinemia, and birth trauma. Conclusion: The main perinatal complications in neonates born to mothers with gestational diabetes were anthropometric and metabolic, comparable to those mentioned in the broader literature. Keywords: neonates, gestational diabetes, pregnancy complicationsÍtem Acceso Abierto Implicaciones clínicas de la obesidad en adultos. Revisión Sistemática.(Universidad Católica de Cuenca., 2025) Suscal Guillén , Kimberly Paulette; Guerra Ortega, Diana Laura; 0301987194Background: The growing silent pandemic of obesity in the last decades and the increase of comorbidities have increased the morbid mortality rate; therefore, obesity has come to be positioned as a potent risk factor for the development of different clinical implications. Objective: To understand the clinical implications of obesity in adulthood through a systematic review using reliable scientific information sources. Methodology: A systematic review of the PRISMA 2020 model, through analysis of clinical trials, meta-analysis studies, and articles in Spanish and/or English collected from scientific databases such as ResearchGate, Scopus, and PubMed, including information from the last five years was conducted. Results: Thirty articles were collected showing that obesity acts as the main precursor of other clinical conditions due to the inflammatory mediators generated by the accumulation of adipose tissue, which alter the physiology of the organs and trigger the appearance of implications mainly at the hepatic, cardiorespiratory, and endocrine-metabolic levels. Discussion: The time at which the development of clinical implications begins in individuals with obesity has not been estimated, but it is mentioned that weight control helps to prevent disease progression. However, a subgroup of patients with obesity is metabolically healthy, indicating that adequate weight control could decrease the rate of comorbidities triggered by this factor. Keywords: adults, BMI, obesity, metabolic disordersÍtem Acceso Abierto Modulación de la microbiota intestinal en el tratamiento de la obesidad. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Urgiles Calderón, Sabrina Lizbeth; Cordero Cordero, Gabriela del Rosario; 0350091617Research on the relationship between gut microbiota and obesity has significantly increased in recent decades. The first connection was established through studies in mice; researchers have identified a relationship between dietary interventions and microbiota composition. These studies have demonstrated that modulation of the gut microbiota can increase the population of beneficial microorganisms and lead to changes in body weight, providing a potential therapeutic approach for obesity, a metabolic disorder that has become a public health crisis. Since 1975, the prevalence of obesity has tripled and continues to rise significantly. Therefore, this study aims to explore gut microbiota modulation as a treatment for obesity. A qualitative systematic review was conducted following PRISMA guidelines, involving the selection of original scientific articles published within the last five years, in Spanish or English, from various academic databases. Data were extracted and analyzed from multiple studies focusing on the type of intervention applied and its effects on patients, particularly with anthropometric and biochemical parameters, as well as its impact on gut microbiota composition. The findings suggest that different diets, as well as the intake of prebiotics and probiotics, can alter the composition of the gut microbiota, which in turn may be used as a treatment strategy for obesity by improving and regulating anthropometric measures and biochemical markers, such as glucose levels and lipid profiles. Keywords: gut microbiota, obesity, diet, probiotics, prebioticsÍtem Acceso Abierto Factores de riesgo de pérdida auditiva en población adulta. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Siguencia Chaca, Wilson Alexander; Espinoza Palomeque, Gustavo Adolfo; 0302656913Background: Hearing loss, defined as damage to the ability to perceive sound stimuli, has significantly increased in recent years, with a disabling effect on approximately 430 million people worldwide in 2023. According to the World Health Organization, this figure is expected to rise to 700 million by 2050. The main objective of this study is to analyze the risk factors for hearing loss in adults aged 19 and older. Method: A systematic review was conducted using the following databases: PubMed, Scopus, Springer Open, and Web of Science. The review included studies published from 2019 onward, encompassing cross-sectional, cohort, longitudinal studies, and meta-analyses. Relevant data were extracted and organized into tables. Results: Sixteen studies were analyzed, identifying diabetes mellitus type 2, noise exposure, smoking, hypertension, obesity, and advanced age as key risk factors. The prevalence and risk associated with each factor were identified. Additionally, the relationship between hearing loss and gender was assessed, and the pathophysiological mechanisms underlying hearing loss were described. Conclusions: The evidence presented in this review indicates that common societal risk factors contribute significantly to the development of hearing loss, particularly among adults. Furthermore, the review found that males are more likely to experience hearing loss. Keywords: hearing loss, adults, risk factors, sensorineural hearing lossÍtem Acceso Abierto Calidad de vida en pacientes oncológicos. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Suárez Vélez, Brian Martín; Carrión Ordoñez , Julia Irma; 0350145199Cancer is one of the leading causes of reduced quality of life worldwide. This systematic review examines the functional status of oncology patients using the Karnofsky Performance Scale and the Eastern Cooperative Oncology Group (ECOG) scale, aiming to identify patterns of impairment based on clinical and demographic factors. Methodology: A comprehensive search was conducted in scientific databases such as PubMed, Scopus, and ProQuest. Studies published between 2019 and 2024 that used the scales mentioned above to assess patient functionality were selected. Observational and clinical studies with medium or high methodological quality were included and organized according to the type of cancer, age, sex, and progression rate (aggressive, indolent, or variable). Results: Twenty-five studies comprising 6,908 patients were analyzed. Aggressive cancers exhibited greater functional impairment (ECOG ≥2, Karnofsky ≤60), while those with indolent progression showed greater variability. Variable progression types showed the best functional levels. It was evidenced that patients over 70 years old showed greater impairment, while the relationship with gender was inconsistent. Conclusions: The Karnofsky and ECOG scales are effective tools for assessing functional quality of life. The rate of cancer progression directly impacts functional status, with aggressive tumors causing faster and more severe deterioration. These findings highlight the need for therapeutic strategies focused on functional preservation and patient well-being. Keywords: cancer, quality of life, ECOG, Karnofsky, oncologyÍtem Acceso Abierto Diabetes Mellitus tipo 1 en la infancia. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Herrera González, Lenin Israel; Izquierdo Coronel, Diana Carolina; 0302501242Background: Type 1 diabetes is a disease characterized by hyperglycemia due to deficient pancreatic insulin secretion conditioned by the destruction of pancreatic B cells by the action of autoantibodies present in the pancreas. This study aims to analyze the current theoretical references of type 1 diabetes in childhood. Methodology: This literature review was conducted following the PRISMA 2020 guidelines, focusing on the implications of type 1 diabetes mellitus in the lives of infants, the therapeutics, and lifestyle maintenance. No variables were manipulated. A first selection of 186 studies was extracted from which 35 articles were selected that met the inclusion criteria in digital databases. Results: Nine studies indicate that type 1 diabetes is an autoimmune disease, associated with hyperglycemia as a typical manifestation and its debut as diabetic ketoacidosis; 16 studies show that the use of continuous insulin infusers and an artificial pancreas system associated with continuous glucose monitoring improve glycemic control; and 11 studies contain information on nutritional education as a fundamental tool in metabolic control. Conclusions: Type 1 diabetes is a chronic autoimmune disease that impacts the quality of life of affected children. Current evidence suggests that glycemic control, lifestyle changes, and a therapeutic approach are essential for the prevention of micro and macrovascular complications. Keywords: type 1 diabetes mellitus, childhood, treatmentÍtem Acceso Abierto Sensibilidad y especificidad de los marcadores tumorales CA-125 versus HE4 en el diagnóstico precoz de cáncer de ovario: revisión sistemática(Universidad Católica de Cuenca., 2025) Celdo Suña, Miriam Veronica; Sarmiento Rios, Islenia Fernanda; Vélez Vintimilla, Ana Paula; 0302912795; 1104300171Background: Ovarian neoplasms are a leading cause of gynecologic cancer mortality worldwide, primarily due to delayed diagnosis. Serum biomarkers play a key role in detecting this disease, with CA125 being the most historically used. However, its low specificity has prompted the search for more accurate markers, such as human epididymal protein 4 (HE4), which has demonstrated superior specificity in differentiating between benign and malignant masses. Objective: To determine the sensitivity and specificity of the CA-125 versus HE4 tumor markers in the early diagnosis of ovarian cancer through a systematic literature review. Methodology: A comprehensive systematic search was conducted, consulting scientific databases such as PubMed, Scopus, and the Cochrane Library including studies published both in English and Spanish within the past decade. Observational and diagnostic studies reporting data on the sensitivity and specificity of CA125 and HE4 will be included. The QUADAS-2 tool was used to assess methodological quality and ensure the validity of the findings obtained. Expected Results: HE4 is anticipated to exhibit higher specificity than CA125, thereby reducing false positives in ovarian cancer diagnosis. The findings of this review may contribute to improving early detection strategies and optimizing the use of biomarkers in clinical practice. Conclusions: CA125 and HE4 are key biomarkers for ovarian cancer diagnosis, but they exhibit important differences in performance regarding their sensitivity and specificity. Keywords: ovarian cancer, CA125, human epididymal protein 4Ítem Acceso Abierto Actividad Física como alternativa terapéutica para ansiedad y depresión. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Chacha Verdugo , Juan Josué; Hidalgo Pozo, María José; 0302992979Background: In recent years, the application of physical activity as a therapeutic alternative for both the management and prevention of anxiety and depression has garnered increasing research interest. In this context, countries such as the United Kingdom, Australia, and the United States have developed models integrating physical activity to promote mental health benefits. Objective: To analyze the role of physical activity as a therapeutic alternative for anxiety and depression through a systematic review. Methods: This study follows the PRISMA 2020 guidelines for systematic reviews. The review included original research articles, systematic reviews, meta-analyses, and clinical trials published between 2019 and 2023 in English and/or Spanish. Only open-access articles indexed in databases such as Web of Science, Cochrane, PubMed, and Scopus were considered. Mendeley was used as the reference management tool. Results: A total of 662 scientific articles were initially identified across the selected databases. After applying inclusion and exclusion criteria, 25 studies were deemed eligible for analysis. Findings indicate that physical activity plays a significant role in managing and reducing symptoms of depression and anxiety across all age groups. In some cases, its effectiveness surpassed that of standard pharmacological treatments. Conclusions: Physical activity significantly reduces symptoms of both anxiety and depression and serves as an effective complement to pharmacological treatment. Keywords: anxiety, depression, physical activity, strength exercises, flexibility exercisesÍtem Acceso Abierto Actualización en el tratamiento de la cirrosis hepática. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Bustos Avendaño, Jorge Israel; Faicán Rocano, Pedro Fernando; 0350005526Background: Despite advances in research, liver cirrhosis remains a potentially fatal condition, and its incidence is increasing globally due to alcoholism and other problems such as obesity and excessive consumption of medications. General objective: To analyze the patterns in the treatment of liver cirrhosis. Methods: The present systematic review was carried out using a search based on the PRISMA model, obtaining information in the databases Scopus, PubMed, SciELO, and Google Scholar; using keywords such as treatment, liver cirrhosis, drugs, and complications. In addition, Boolean operators ―AND, OR and NOT―facilitate the search. Results: A total of 28 scientific articles were analyzed, which 9% of the publications belonged to the Scopus database, 23% to Google Scholar, 54% to PubMed, and 14% to SciELO. Discussion: The treatment of specific complications ―such as hepatic encephalopathy, ascites, portal hypertension, hepatorenal syndrome, cirrhotic cardiomyopathy, hepatopulmonary syndrome, acute or chronic liver failure, and spontaneous bacterial peritonitis― requires a multidisciplinary approach. Risk factors for the treatment of liver cirrhosis are concomitant diseases such as diabetes, alcohol consumption, obesity, and medications. Liver transplantation remains the definitive treatment for liver cirrhosis and its complications, this procedure is performed after carefully selecting candidates and taking the necessary preoperative measures to ensure optimal results. Keywords: treatment, liver cirrhosis, complications, liveÍtem Acceso Abierto Actualización en el tratamiento de hepatitis tipo B. Revisión Sistemática(Universidad Católica de Cuenca., 2025) García Ortega, María Emilia; Faicán Rocano, Pedro Fernando; 0302930599Background: Hepatitis B chronically affects millions of individuals worldwide and can lead to serious complications such as cirrhosis and liver cancer. General Objective: To identify current therapeutic options for the treatment of hepatitis B. Specific Objectives: To compare treatment guidelines for acute and chronic hepatitis B, assess the efficacy of current therapeutic strategies in chronic hepatitis B, and synthesize recent advancements in its management. The research question guiding this review is: What is the efficacy of current treatments for chronic hepatitis B in terms of viral suppression, improvement of liver function, and prevention of hepatic complications? Methods: A comprehensive literature search was conducted using scientific databases such as Scopus, Web of Science, PubMed, SciELO, and Google Scholar. Studies published in the last five years were considered, including both open-access and subscription-based formats, in English and Spanish. Studies unrelated to hepatitis B or lacking scientific rigor were excluded. Results: Fourteen scientific articles were analyzed: 60% from PubMed, 20% from Google Scholar, 10% from Scopus, and 10% from SciELO. Selection criteria included title, authorship, language, objectives, and findings. Discussion: The review highlights that acute hepatitis B generally does not require pharmacological treatment, whereas chronic hepatitis B is managed with antiviral agents such as tenofovir and entecavir due to their proven efficacy. Additionally, emerging therapies such as HeberNasvac and combinations with immunosuppressive agents are explored in specific cases. Keywords: hepatitis B, acute, chronic, therapeutic options, clinical efficacyÍtem Acceso Abierto Soporte nutricional enteral temprano en cuidados intensivos. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Bustos Avendaño , Daniel Enrique; Álvarez Ochoa, Robert Iván; 0350005518Background: Enteral nutrition for critically ill patients has evolved significantly since the mid-20th century. Initially, its use was limited by technical challenges and a lack of knowledge regarding its benefits. However, advances in medical technology and growing evidence of its positive effects—such as reduced infections and mortality—have established it as an essential component of intensive care unit (ICU) treatment. Parenteral nutrition is now preferred, whenever feasible, because of its ability to preserve intestinal function and strengthen the immune system. Methods: A systematic review of the scientific literature published between 2019 and 2023 was conducted using databases such as Scopus and PubMed. Studies written in English and Spanish, with open access and full text available, were considered. Papers that did not meet these criteria were excluded. Results: Of the 76,499 publications identified, only 33 articles were selected for the final analysis after applying inclusion criteria and conducting a thorough analytical reading. These studies were chosen based on their relevance to the research objective. Conclusions: Enteral nutritional support has been shown to reduce mortality, strengthen gastric immunity, and shorten hospital stays. These benefits are more significant when nutritional support is implemented early and adapted to the patient’s comorbidities. Keywords: nutrition, support, intensive care unitÍtem Acceso Abierto Cirugía oncoplástica en cáncer de mama. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Idrovo Idrovo, Cinthya del Rocío; Bermeo Ortega, Juan Carlos; 0302932934Background: Breast cancer over time has been on the rise; however, advances in medical technology have led to the development of improved techniques aimed at enhancing patients' quality of life. Among these is oncoplastic surgery, which has had a significant impact on the field of medicine by allowing the removal of the tumor while preserving the breast. Objective: To analyze the role of oncoplastic surgery in the treatment of breast cancer through a systematic review of articles and studies published within the past five years. Methods: Relevant information was collected from original scientific articles, meta-analyses, observational studies, and gray literature, including undergraduate and postgraduate theses. Notable databases such as SciELO, PubMed, Scopus, and Elsevier were used. Through analyzing these sources, key data of interest were identified, which were subsequently used to establish the study's findings. Results: The principal advantages of this surgical technique were identified, as well as the main complications, highlighting the order of frequency of occurrence, and finally, the influence on the lifestyle of each patient in the physical, emotional, sexual, and other aspects. Conclusions: Oncoplastic surgery is one of the first and most accepted treatment options for breast cancer, since it has been determined that its reoperation rates are relatively low and its positive contribution to patients’ quality of life. Keywords: oncoplastic surgery, breast cancer, breast-conserving surgeryÍtem Acceso Abierto La obesidad y su tratamiento farmacológico. Revisión Sistemática(Universidad Católica de Cuenca., 2024) Zhagñay Segarra, Doménica Dayanara; Espinoza Palomeque, Gustavo Adolfo; 0302400833Background: Obesity is a chronic disease characterized by excessive accumulation of body fat. It has gained significance due to the large number of individuals affected and the consequences it entails. The World Health Organization (WHO) has reported that between 1975 and 2016, the global prevalence of this disease tripled, and it is currently one of the most frequently observed conditions in medical consultations (1). A crucial aspect of managing this condition, in addition to physical exercise and diet, is the use of various medications developed to help patients achieve their weight loss goals and improve their quality of life. As such, the FDA and the EMA have approved a list of highly effective medications for the treatment of obesity, including phentermine/topiramate, naltrexone/bupropion, liraglutide, semaglutide, orlistat, among others (6). Objective: To analyze the pharmacological treatments for obesity currently in use through a systematic review. Methods: This research follows the PRISMA 2020 guidelines for conducting a systematic review, using information collected from SciELO, Scopus, Redalyc, Dialnet, and PubMed, together with the Zotero bibliographic manager. Results: Benefits include reductions in weight, waist circumference, blood pressure, lipid levels, glycated hemoglobin, and inflammatory markers. Conclusions: The use of medications is an effective weight loss strategy that should always be accompanied by exercise, healthy diet, and behavioral therapy. Keywords: obesity, drugs, treatmentÍtem Acceso Abierto Acromegalia y gigantismo diagnóstico y tratamiento. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Vicuña Crespo, Luis Manuel; Idrovo Vásquez, Víctor Aníbal; 0302675251Background: Acromegaly and gigantism are complex disorders that present significant diagnostic challenges, with an annual incidence of three to four new cases per million inhabitants. Objective: To describe the various diagnostic and therapeutic approaches for the treatment of patients with acromegaly and gigantism. Methods: A systematic review of studies published between 2019 and 2023 was conducted using databases such as PubMed, Scopus, Elsevier, Clinical Endocrinology, and SciELO. Results: Seventeen articles in Spanish and English met the inclusion criteria. Clinical suspicion contributed to the initial diagnosis in 60% to 98.5% of cases. Serum growth hormone (GH) levels and insulin-like growth factor I (IGF-I) were identified as initial biochemical tests, with usage rates between 71.3% and 86%. Regarding treatment, cabergoline showed low efficacy in acromegaly management (37%) compared to somatostatin analogs such as octreotide (81.6%) and lanreotide (82%) (p = 0.001). Pegvisomant (PEGV) achieved an effectiveness of 62.9% (p < 0.001). Surgical intervention demonstrated a 70% success rate in acromegaly caused by microadenomas and 64.9% in macroadenomas, with complete remission reaching 76% when postoperative adjuvant therapy ―such as radiotherapy― was employed (p = 0.02). Conclusion: Acromegaly and gigantism are rare and often underdiagnosed conditions, primarily due to a lack of awareness in clinical practice. Diagnosis begins with clinical evaluation, hormonal laboratory tests, and imaging studies. Currently, a wide range of pharmacological and surgical treatment options are available, aimed at improving patient prognosis. Keywords: acromegaly, gigantism, growth hormone (GH), endocrinology, adenomaÍtem Acceso Abierto Actualización del manejo del carcinoma ductal infiltrante luminal A en pacientes con enfermedad metastásica. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Campoverde Martínez, Nicole Guadalupe; Buenaño Rodríguez, Christian Eduardo; 0350009916Background: Luminal invasive ductal carcinoma A presents HR to progesterone and estrogen, with the absence of HER2 and with the cell multiplication marker Ki67 below 14%. These particularities show a good prognosis, evolution, and prosperous response to hormone therapy (1,2). General Objective: To investigate the current management of patients with metastatic disease. Specific Objectives: To detail cyclin inhibitor drugs, to analyze safety considering response rate, overall survival, and side effects, and to compare efficacy and impact in relation to other therapies. Research Question: What is the management of luminal infiltrating ductal carcinoma A in patients with metastatic disease? Methods: Databases were analyzed to compile information, being SciELO, Scopus, and PubMed, considering observational, cost-effectiveness, randomized, descriptive, and meta-analysis studies of original articles on patients with advanced disease published locally and internationally, with a range of less than five years and available mainly in Spanish and English, in full text and open access. Results: Twenty-five scientific articles corresponding to the databases mentioned were analyzed; they were referenced with their title, author, year, objectives, the total sample size, and the results of these studies. Conclusions: The cyclin inhibitors Ribociclib, Palbociclib, and Abemaciclib, employed in the management of this neoplasm, are beneficial in terms of efficacy and tolerability; they present advantages by specifically targeting checkpoints in the cell period interfering with cancer cell proliferation. Keywords: carcinoma, breast, luminal A, metastasis, cyclin inhibitorsÍtem Acceso Abierto Tratamiento de la disfunción eréctil. Revisión Sistemática(Universidad Católica de Cuenca., 2025) Peralta Caceres, Milton Andres; Barrera Macancela, Johanna Margoth; 0105126197Background: Erectile dysfunction is defined as the constant lack of ability to attain or maintain an erection to achieve satisfactory sexual activity, affecting approximately 76% of the global population, with an estimated increase in the number of individuals. The objective is to analyze the various treatment methods for erectile dysfunction through the investigation of scientific data sources. Methodology: A systematic review was performed using a search in the following databases: PubMed, Scopus, Ovid, Taylor & Francis, and Web of science. The information collected was from 2019. Cross-sectional, longitudinal, cohort, and randomized articles were included. All studies and the most important elements were placed in tables. Results: Eighteen studies were analyzed, including treatments for lifestyle change, the use of phosphodiesterase-5 inhibitors, intracavernous injection, testosterone hormone replacement therapy, vacuum erection devices, penile prosthesis implantation, cognitive behavioral therapy, and regenerative therapies—either individually or in combination. Conclusions: All the evidence collected demonstrates that erectile dysfunction treatments present an efficacy that, although inferior to combined therapies of 2 treatments, retain their importance, also emphasizing the advantages and disadvantages involved in the use of a treatment, which encourages a comprehensive analysis prior to the administration of a treatment for erectile dysfunction. Keywords: erectile dysfunction, treatment, pharmacotherapy, surgery, regenerative therapy
