Trabajos de Titulación - Sede Azogues - Medicina
URI permanente para esta colecciónhttps://dspace.ucacue.edu.ec/handle/ucacue/89
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Item type: Ítem , Access status: Acceso Abierto , Adherencia a la medicación psicofarmacológica en adultos con trastornos mentales del Instituto de Neurociencias de Guayaquil, Ecuador. 2024(Universidad Católica de Cuenca., 2026) Déleg Sari, Boris Adrián; Díaz Vargas, Jherling KarineIntroduction: Psychopharmacological adherence in patients with mental illnesses such as schizophrenia and depression, among others, is important for improving patients’ quality of life, as well as for helping to prevent relapses. Objective: To determine the prevalence of adherence to psychopharmacological medication among adults undergoing long-term treatment for mental disorders at the Mental Health Center of Ecuador in 2024. Methodology: A quantitative, descriptive, observational study was conducted with 379 patients with mental disorders treated at the Mental Health Center of Ecuador in 2024. The Morisky-Green scale was applied to measure adherence to psychopharmacological medication. Results: Adherence to psychopharmacological medication in the study population was mostly low (57.5%). The Morisky scale showed adequate reliability and validity. Adherence to psychopharmacological medication was lower among women, as well as in younger individuals. The type of medication did not influence adherence. The number of psychopharmacological drugs taken was also not statistically significant; however, lower adherence was observed as the number of medications increased. Conclusions: The patients studied generally show low adherence to psychopharmacological medication, especially among women and individuals under 40 years of age. Keywords: mental disorders, adherence, psychotropic drugs, MoriskyItem type: Ítem , Access status: Acceso Abierto , Conocimientos y actitudes de los médicos del primer nivel de atención para el diagnóstico de patología mamaria y el uso de métodos de imagen, Distrito 03D01, Cañar - Ecuador, 2024 - 2025(Universidad Católica de Cuenca., 2026) Alvarado Zambrano, Paula; Romero Meza, Karoline MercedesBackground: The detection of breast pathologies using imaging methods poses a challenge for primary care; understanding the protocols ensures appropriate referral when necessary and prioritizes timely treatment. Objective: To assess the knowledge and attitudes of primary care physicians in District 03D01 regarding the use of imaging methods for the diagnosis of breast pathologies. Methodology: A quantitative, descriptive, cross-sectional study conducted in primary care health facilities in District 03D01. The study included family physicians, general practitioners, and rural physicians with at least six months of experience in the management of breast pathologies, excluding those on leave, in internships, or not engaged in clinical practice. Results: Of the 122 physicians (100%) in District 03D01, 57.38% participated in the survey, with a majority coming from rural areas (57.1%). The majority were male general practitioners (75.7% and 34.3%, respectively). Although 84.3% are involved in referrals for imaging studies, only 74.3% show interest in the topic, and just 27.1% receive annual training. Furthermore, although the recommended starting age for each method is known, the frequency of mammography is not known by 71.4% of participants, as well as the management protocol for BI-RADS categories 0, 1, 2, and 3 are unknown. Conclusions and Implications: The study highlights gaps in the understanding and management of breast pathologies in primary care; improvements are needed in training, the implementation of standardized protocols, and the updating of clinical guidelines to optimize detection and treatment. Keywords: BI-RADS, mammography, breast pathology, imaging techniques, breast cancer screeningItem type: Ítem , Access status: Acceso Abierto , Adherencia al tratamiento de trastornos neuropsiquiátricos en pacientes de consulta externa en el Instituto de Neurociencias de Guayaquil, enero 2023 - abril 2024(Universidad Católica de Cuenca., 2026) Guerreo Mora, Jack Xander; Idrovo Valarezo, Paula GabrielaIntroduction: Neuropsychiatric disorders are defined as conditions that alter an individual’s perception, thinking, mood, or behavior. Treatment adherence refers to the extent to which patients take medication according to the prescribed dosage and schedule, and maintain this regimen over time. Objective: To analyze treatment adherence among outpatients with neuropsychiatric disorders treated at the Guayaquil Institute of Neurosciences between January 2023 and April 2024. Methodology: An observational and correlational study that analyzed adherence to psychotropic medications in 342 patients with neuropsychiatric disorders. Secondary data processed in Jamovi v2.3.28 were used to describe frequencies, percentages, measures of central tendency, and measures of dispersion. In addition, nonparametric statistical tests (chi-square) were applied to establish associations between variables. Results: The most common neuropsychiatric disorders were schizophrenia and delusional disorders (16.5%), followed by neurotic and somatoform disorders (11.7%). Sixty-three-point seven percent (63.7%) of participants showed low adherence to their treatment plans, with 34.5% demonstrating moderate adherence, and only 1.8% showing high adherence. A statistically significant association was found between treatment adherence and diagnosis (p < 0.001) and between treatment adherence and type of medication (p < 0.001). Conclusions: The distribution of neuropsychiatric disorders is heterogeneous, with a concerning low level of treatment adherence, which affects quality of life. Adherence varies depending on the diagnosis and medication, highlighting the need for personalized strategies, psychoeducation, and clinical follow-up to optimize mental health outcomes. Keywords: treatment adherence, neurocognitive disorders, organic mental disordersItem type: Ítem , Access status: Acceso Abierto , Efectividad e inmunogenicidad de la vacuna contra el dengue tetravalente recombinante CYD-TDV versus la vacuna TAK-003. Revisión sistemática(Universidad Católica de Cuenca., 2026) Ruiz Espinoza, Alexander GeovannyIntroduction: Dengue remains a significant public health problem in tropical and subtropical regions; therefore, vaccination represents a preventive strategy that complements vector control. Objective: To evaluate the effectiveness and immunogenicity of the recombinant tetravalent vaccine CYD-TDV versus the TAK-003 vaccine. Methods: A systematic review was conducted following the PRISMA 2020 methodology. The search was performed in PubMed, Scopus, Cochrane Library, ClinicalTrials.gov, and ScienceDirect, considering publications from 2019 to 2024. Twenty-two human studies evaluating the efficacy, effectiveness, immunogenicity, or safety of CYD-TDV and TAK-003 were included. The results were synthesized narratively and in tabular form, without estimating a pooled overall effect measure. Results: TAK-003 showed favorable results across several clinical outcomes, with an initial efficacy of 80.2% against virologically confirmed dengue and protection against hospitalization ranging from 84.1% to 90.4%. Its immune response was sustained, with higher titers against DENV-2, although with relatively lower performance against DENV-3. CYD-TDV showed better results in seropositive individuals, but limitations were observed in seronegative individuals due to the described risk of hospitalization or severe dengue. Conclusions: TAK-003 may have greater applicability in populations with heterogeneous serological status, whereas CYD-TDV remains mainly useful in people with documented prior infection. Keywords: dengue, tetravalent dengue vaccine, CYD-TDV, TAK-003, immunogenicityItem type: Ítem , Access status: Acceso Abierto , Eficacia de vacunas de ARNm versus vacunas inactivadas en la prevención de infecciones por COVID-19: revisión sistemática(Universidad Católica de Cuenca., 2026) Guamán Lema, Luis Javier; Chuchuca Aguilar, Tiffany NaomiIntroduction: The COVID-19 pandemic was one of the most significant global public health challenges, driving the accelerated development of multiple vaccine platforms, such as messenger Ribonucleic Acid (mRNA) vaccines and inactivated vaccines, which demonstrated substantial clinical benefits; however, differences in efficacy, safety, and applicability across epidemiological contexts remain evident. Objective: To compare the efficacy and safety of mRNA vaccines and inactivated vaccines in preventing COVID- 19 infection, hospitalization, and mortality among pediatric and adult populations. Methods: A systematic review was conducted in accordance with the PRISMA 2020 guidelines. Randomized controlled trials and observational studies published between December 2020 and September 2024 were identified through searches in PubMed, Scopus, and Web of Science. Studies lacking direct comparisons, quantifiable outcomes, or involving nonhuman populations were excluded. Methodological quality and risk of bias were assessed using validated assessment tools. Results: Of the total of 1,024 records identified, 20 studies were included, involving approximately 60,000 participants. The mRNA vaccines, mainly BNT162b2 and mRNA-1273, demonstrated higher efficacy against symptomatic infection, with values close to 95%, whereas inactivated vaccines achieved between 50% and 66%. Both vaccine platforms significantly reduced hospitalization and mortality rates. The mRNA vaccines were associated with a higher frequency of mild-to-moderate reactogenicity, whereas inactivated vaccines exhibited greater tolerability. Conclusions: mRNA vaccines provide superior protection against symptomatic and severe COVID-19. However, inactivated vaccines remain safe and valuable alternatives in healthcare systems with operational limitations. Keywords: COVID-19 vaccines, mRNA vaccines, inactivated vaccines, SARS-CoV-2, vaccine efficacyItem type: Ítem , Access status: Acceso Abierto , Manejo fisioterapéutico versus manejo quirúrgico del linfedema de miembro superior posterior a disección de ganglios linfáticos axilares por cáncer de mama: revisión sistemática(Universidad Católica de Cuenca., 2026) Suárez Guillén, Samantha BelénObjective: To compare physiotherapeutic and surgical treatments used in the management of upper limb lymphedema following axillary lymph node dissection for breast cancer, evaluating their effectiveness in reducing edema volume, restoring mobility, and improving quality of life. Methodology: A systematic review was conducted of clinical intervention and observational studies published over the past seven years, in any language, that provided relevant information on therapeutic approaches for this condition. Articles were identified in PubMed, Elsevier, and Springer. The search was completed in November 2024. The risk of bias was assessed using the RoB 1 and RoB 2 tools, following the PRISMA 2020 guidelines. Results: Thirteen studies were included, of which 9 were clinical trials and 4 were observational studies, with a total population of 870 patients. The evidence analyzed showed that Complex Decongestive Therapy remains the treatment of choice due to its multimodal approach, safety, and ability to be combined with other conservative interventions. Discussion: The main limitation identified was the scarcity of studies directly comparing physiotherapeutic and surgical treatments. However, the available findings suggest that physiotherapeutic yields better outcomes in reducing arm volume, improving function, and enhancing patients’ perceived well-being. Conclusions: Physiotherapeutic treatment seems to be superior to surgical treatment in this population. However, comparative studies and long-term follow-up are needed to confirm the long-term surgical efficacy. Keywords: arteriovenous anastomosis, arm, manual lymphatic drainage, breast cancer lymphedemaItem type: Ítem , Access status: Acceso Abierto , Prevalencia y factores asociados al Trastorno Disfórico Premenstrual en estudiantes de la carrera de Medicina en la Universidad Católica de Cuenca campus Azogues en el periodo septiembre 2024- febrero 2025(Universidad Católica de Cuenca., 2026) Peñaloza Minchala, Stephany Guadalupe; Rivera Ortiz, Jennifer MaribelIntroduction: Premenstrual Dysphoric Disorder (PMDD) is a physical and emotional condition categorized in the DSM- V by the American Psychiatric Society within the chapter of mood disorder. With a prevalence of 1.8 - 5.8%. It occurs in the luteal phase of the menstrual cycle and improves in the postmenstrual stage; with symptomatic severity that affects the integral health of the patient. Objective: To determine the prevalence and factors associated with PMDD in female students of Medicine at the Catholic University of Cuenca, Azogues campus, for the period September 2024- February 2025. Methodology: A non-experimental, quantitative, correlational, cross- sectional cohort study was carried out with a sample of 278 students, calculated using the finite population formula, from a total universe of 796 students from first to tenth cycle, with the application of a validated survey. Results: Of the 271 respondents, the age group 18 to 21 years represented 61.5% (171), of whom 98.89% were currently unmarried. A total of 24.8% met the diagnostic criteria for PMDD and 69.7% for PMS. No direct associated factors were determined; however, drug use was identified with an OR 1.59 95% CI 0.64- 3.9 P= 0.307; tobacco use OR 1.4 95% CI 0.48- 4, P= 0.531; early menarche OR 1.24 95% CI 0.47- 3.25, P= 0.65. Conclusions: A quarter of the population studied suffers from PMDD, with PMS being the most prevalent, no factors associated with the pathology were found. Key words: PMDD, mental health, premenstrual syndrome.Item type: Ítem , Access status: Acceso Abierto , Diabetes mellitus gestacional como factor asociado a depresión posparto: revisión sistemática(Universidad Católica de Cuenca., 2026) Guaraca Muñoz , Amanda LizbethGestational diabetes mellitus (GDM) and postpartum depression (PPD) are considered public health problems with maternal-infant impact due to the high prevalence rates reported for each condition (15.6% and 19.8%, respectively), with an association found in different studies. This systematic review aimed to analyze all scientific evidence to determine the reported association between GDM and PPD. The bibliographic search was conducted in the biomedical databases PubMed, Scopus, and Web of Science to identify observational studies. It was observed that 17 out of 24 studies, including 8 cohort studies and 9 cross-sectional studies, indicated an association between gestational diabetes mellitus and postpartum depression, with adjusted odd ratios (aORs) ranging from 1.56 to 2.12 with a 95% confidence interval. Therefore, the findings determine that most of the studies analyzed report an association between GDM and PPD; thereby supporting the integration of mental health screening and follow-up care for women with GDM, prioritizing more vulnerable subgroups. Keywords: gestational diabetes mellitus, postpartum depression, risk factor, maternal healthItem type: Ítem , Access status: Acceso Abierto , Efectividad terapéutica de la noradrenalina versus la terlipresina en el síndrome hepatorrenal. Revisión sistemática(Universidad Católica de Cuenca., 2026) Crespo Peñafiel, Nicole AndreaObjective: To compare the efficacy and safety of norepinephrine and terlipressin in the treatment of hepatorenal syndrome (HRS), while also evaluating the clinical, therapeutic, and economic factors associated with the use of both drugs. The aim was to provide scientific evidence to facilitate medical decision-making and contribute to the development of treatment strategies adapted to different healthcare settings. Methodology: Randomized clinical trials that directly compared norepinephrine and terlipressin in adult patients diagnosed with HRS were included. Observational studies, systematic reviews, meta-analyses, and non-comparative articles were excluded. The literature search was conducted in PubMed, Scopus, and Web of Science. Methodological quality and risk of bias were evaluated using the RoB 2.0 tool, considering domains such as randomization, outcome measurement, and selective reporting. Data were synthesized through a comparative analysis of hemodynamic parameters, renal function, survival, and occurrence of adverse effects. Results: Fifteen clinical trials with a total of 2,712 patients were included. Terlipressin demonstrated a significant improvement in renal function, as evidenced by an average reduction of 30% in serum creatinine levels. However, it was associated with relevant adverse effects, especially respiratory failure and abdominal pain. Norepinephrine showed comparable efficacy, along with a more favorable safety profile and lower cost. Conclusion: Although terlipressin remains the standard treatment for severe cases of HRS, norepinephrine represents an effective, safe, and accessible alternative in resource-limited settings, such as Ecuador. These findings support the need for clinical guidelines adapted to the local settings. Keywords: norepinephrine, hepatorenal syndrome, drug therapy, terlipressin.Item type: Ítem , Access status: Acceso Abierto , Eficacia de la anastomosis colónica primaria versus colostomía en pacientes con diverticulitis aguda Hinchey IV. Revisión sistemática(Universidad Católica de Cuenca., 2026) Crespo Mora, Iveth AnddreinaObjectives: To evaluate the perioperative and postoperative efficacy of Primary Colonic Anastomosis (PCA) and colostomy in patients with acute Hinchey IV diverticulitis, as well as to compare postoperative complication rates, length of hospital stay, and mortality among patients undergoing these procedures. Methodology: This is a systematic literature review based on a search of scientific literature in PubMed, the Cochrane Library, Scopus, and Google Scholar. The included studies were published in English and Spanish within the last five years and were selected according to predefined inclusion and exclusion criteria. The results were synthesized using analytical-synthetic and inductive methods. Results: A total of seven articles related to the surgical management of acute Hinchey IV diverticulitis were evaluated, including multicenter and single-center cohort studies. These studies were rated as being of high methodological quality, with scores ranging from 10 to 11 out of 14, reflecting a robust methodology for assessing the outcomes of surgical techniques. Discussion: According to various studies, Primary Colonic Anastomosis (PCA) was associated with lower mortality (5.3%) compared with colostomy (10.6–14%). The main complications of colostomy included surgical site infection, sepsis, and enteric fistulas. PCA was associated with a lower rate of serious complications despite a higher number of hospital admissions. Conclusions: PCA is considered an effective and safe option in stable patients, with lower mortality, fewer complications, and a better quality of life. Colostomy remains useful in cases of emergency, peritonitis, or comorbidities, and is associated with a longer hospital stay. These results support its surgical use in selected patients. Keywords: acute diverticulitis, Hinchey IV, primary colonic anastomosis, colostomy, postoperative complicationsItem type: Ítem , Access status: Acceso Abierto , Manejo de la sedación en cuidados intensivos, correlación de dosis sedante guiada por BIS versus RASS. Revisión sistemática(Universidad Católica de Cuenca., 2026) Lituma Pérez, Juliana MaríaObjectives: To determine the correlation between Bispectral index (BIS)-guided sedation dosages and the RASS in critically ill patients in intensive care units. Methodology: Studies published in English and Spanish over the past 10 years, related to BIS- and RASS-guided sedation and adverse events, were included. Inaccessible studies or those in other languages were excluded. Databases such as Scopus, PubMed, and Web of Science were consulted, using keywords related to BIS, RASS, sedation, and intensive care, together with Boolean operators. In addition, validated tools, such as the Cochrane Risk of Bias Tool and the National Heart, Lung, and Blood Institute (NHLBI) were used to assess the methodological quality of the selected and included articles. Results: Monitoring with BIS optimized sedative dosing, reducing complications such as delirium and days of mechanical ventilation. RASS was effective in settings with limited resources and showed benefits in hemodynamic stability. Both methods achieved adequate levels of sedation, although BIS stood out for its precision and reduction of adverse effects. Conclusion: BIS and RASS are complementary approaches to sedation management in the Intensive Care Unit (ICU). While BIS excels in precision, RASS offers practicality and ease of use. Their combined implementation could improve clinical outcomes and optimize the care of critically ill patients, also promoting safe, efficient, and personalized care in intensive care units. Keywords: BIS, RASS, sedation in the ICU, sedative agentsItem type: Ítem , Access status: Acceso Abierto , Prevalencia del consumo de anticonceptivos hormonales y reacciones adversas asociadas a las progestinas que contienen los anticonceptivos hormonales, en estudiantes de la Universidad Católica de Cuenca sede Azogues, Ecuador 2024 – 2025(Universidad Católica de Cuenca., 2026) Calderón Togra, Angie Denisse; Rivera León, Pedro JoséIntroduction: Adverse reactions to the use of hormonal contraceptives are common among users; among the objectives of use are treatments of different pathologies and contraception, the latter being the main one. Within the components of combined or non-combined hormonal contraceptives are progestins, which differ from one another based on the biological receptor they act upon; thus, they can manifest different adverse reactions even though they are all progestins, as described in the present study. Methodology: An observational, correlational, cross-sectional research with a quantitative approach was conducted. The sample was selected using the formula for a finite convenience population; the data were processed in SPSS, obtaining a chi-square result for a population of 321 students. Results: The following findings were observed among 321 students included in the study: the predominant age group was 21–23 years (74.14%), and most participants were single (92.21%). The progestins used included Drospirenone (21%), Dienogest (14%), Levonorgestrel (34%), and Norethisterone (31%). The reported adverse reactions were Drospirenone associated with intermenstrual bleeding, headaches, decrease in acne, absence of menstrual bleeding, and mood changes; Dienogest with weight gain, intermenstrual bleeding, decreased libido, and mood changes; Levonorgestrel with weight gain and increased acne; and Norethisterone with breast tenderness/pain, headaches, increased acne, dizziness, and skin spots. Conclusions: The study reported that 74.14% of the study population used hormonal contraceptives. Norethisterone and Levonorgestrel were the two progestins associated with the most adverse effects compared to Drospirenone and Dienogest. Additionally, these last two progestins were found to have an incidental protective effect against acne. Keywords: acne, contraceptives, headache, hormones, metrorrhagia, progestinItem type: Ítem , Access status: Acceso Abierto , Prevalencia del deterioro cognitivo y factores asociados en adultos mayores atendidos en el Centro de Salud N° 2 de Cuenca - Ecuador. 2024 -2025(Universidad Católica de Cuenca., 2026) Lucero Pesántez, Juan Fernando; Ramón Arévalo, Diana AlexandraThis research aimed to estimate the prevalence of cognitive impairment among older adults treated at Health Center No. 2 in Cuenca, Ecuador, and to identify factors associated with it during the 2024–2025 period, using the Mini-Mental State Examination (MMSE). It was based on an observational, correlational, and cross-sectional study design, with a quantitative approach. The sample included 685 older adults, evaluated using the MMSE and a sociodemographic questionnaire to analyze characteristics associated with cognitive impairment. The results indicated that 46.28% of the participants presented cognitive impairment, 18.99% had suspected pathological cognitive impairment, and 9.78% presented dementia. The prevalence was higher among individuals aged between 75 and 84 years, with a predominance of dementia in men and with mild cognitive impairment in women. Factors such as low educational level, elementary occupations, hypertension, diabetes mellitus, and depression showed a significant association with cognitive impairment. Alcohol consumption was also associated with cognitive impairment, while smoking and body mass index did not present significant associations. It is concluded that cognitive impairment in older adults represents an important health problem. Its association with modifiable factors emphasizes the need for health promotion and prevention strategies, in addition to the integration of a multidisciplinary team for its timely management. Keywords: cognitive dysfunction, cognitive impairment, older adult, associated comorbiditiesItem type: Ítem , Access status: Acceso Abierto , Sensibilidad y especificidad del ADOS – 2 y el ADI- R en el diagnóstico del trastorno del espectro autista en niños: revisión sistemática(Universidad Católica de Cuenca., 2026) Mantilla Aguilar, Marcelo Sebastián; Ortega Izquierdo, Pamela AnahíTitle: Sensitivity and specificity of ADOS-2 and ADI-R in the diagnosis of Autism Spectrum Disorder in children: a systematic review. Objectives: To evaluate and compare the sensitivity and specificity of the diagnostic methods ADOS-2 and ADI-R in identifying Autism Spectrum Disorder (ASD) in the pediatric population. Methodology: Observational studies (retrospective cohorts studies and case-control studies) published between 2014 and 2024 in English and Spanish were included. Incomplete articles, clinical trials, and studies conducted in non-pediatric populations were excluded. Information sources included Scopus, SciELO, PubMed, EBSCO, Web of Science, Redalyc, Springer, and ScienceDirect. The ROBINS tool and the National Heart, Lung, and Blood Institute guidelines were used to assess risk of bias and methodological quality. Sensitivity, specificity, and positive likelihood ratios (PLR) and negative likelihood ratios (NLR) were analyzed. Results: Seven studies with 3,570 participants were included. ADOS-2 showed a sensitivity ranging from 79% to 95% and a specificity ranging from 63% to 92%. ADI-R demonstrated a sensitivity of 77% to 91% and a specificity of 73% to 85%. The combination of both instruments reached a sensitivity of 83% and a specificity of 85%. The PLR ranged from 5 to 10, indicating moderate diagnostic effectiveness, while the NLR was less than 1, reducing the probability of ASD in cases of negative results. Conclusions: The combination of ADOS-2 and ADI-R improves early the detection and diagnostic accuracy of ASD in the pediatric population, reducing clinical errors and promoting a comprehensive assessment. Keywords: ADI-R, ADOS-2, specificity, sensitivity, autism spectrum disorderItem type: Ítem , Access status: Acceso Abierto , Nivel de conocimiento sobre el virus del papiloma humano en estudiantes de bachillerato de la Unidad Educativa José Peralta de Cañar, Ecuador. 2024-2025(Universidad Católica de Cuenca., 2026) Ortiz Padilla, Edison IsraelBackground: In Ecuador, several studies have shown that a considerable portion of adolescents has a low level of knowledge about the Human Papillomavirus (HPV). Many do not understand its mode of transmission or its link to cervical cancer, and there is misinformation about the vaccine and its efficacy. This situation highlights the need to strengthen comprehensive sexual education in the educational system. Objective: To establish the level of knowledge about the human papillomavirus in high school students of the José Peralta Educational Unit, Cañar-Ecuador, 2024-2025. Methodology: A quantitative, non-experimental, descriptive study with a cross-sectional design was conducted using a data collection instrument entitled “Questionnaire on Knowledge of Human Papillomavirus,” with data stored in digital programs such as Excel and SPSS. Results: Out of a total of 239 respondents, 37.5% had a high level of knowledge, 37.5% had a medium level of knowledge, and 25% had low knowledge about HPV (Human Papillomavirus). Conclusions: The study at the José Peralta Educational Unit (Cañar-Ecuador) revealed that the level of knowledge about HPV among high school students is varied, with 37.5% showing medium or high knowledge and 25% low. The majority were 16 years old, females predominated (52.27%), and a high percentage live with their parents. Furthermore, a significant relationship was found between the level of knowledge and factors such as sex, age, and participation in extracurricular activities. Keywords: cancer, prevention, transmission, human papillomavirusItem type: Ítem , Access status: Acceso Abierto , Prevalencia de acné y su relación con la autoestima en adolescentes de la Unidad Educativa José Peralta de la Ciudad de Cañar, Ecuador 2024-2025.(Universidad Católica de Cuenca., 2026) Granda Andrade, Natalia Alejandra; Yambay Sumba, Rosa KarinaIntroduction: Acne is a common skin condition among adolescents caused by the blockage of hair follicles with oil and dead skin cells, resulting in whiteheads, blackheads, pimples, and cysts. This condition can negatively affect self-esteem and quality of life due to its impact on body image and the feelings of embarrassment or frustration it causes. Objective: To determine the prevalence of acne and its relationship to self-esteem among adolescents at the José Peralta School in the city of Cañar, Ecuador, during the 2024–2025 school year. Method: A quantitative, descriptive, and correlational study was conducted. The sample consisted of 229 adolescent students selected at random using Excel’s RAND function. The Rosenberg Self-Esteem Scale was used to measure self-esteem, and a scale assessing the prevalence of acne based on the affected area and severity was used for evaluation. Results: A total of 229 students aged 12 to 18 participated; 55% were female, and 45% were male. Thirty-three percent were in their first year of high school, 33% in their second year, and 34% in their third year. Grade I acne was most prevalent in the anterior chest region (19.2%). Additionally, 78.6% reported average self-esteem, 20.1% reported low self-esteem, and 1.3% reported high self-esteem. Conclusions: A statistically significant relationship was found between the severity of acne and self-esteem levels, confirming the proposed hypothesis and demonstrating the correlation between these two variables in the adolescent population. Keywords: acne, adolescent, self-esteem, level, relationshipItem type: Ítem , Access status: Acceso Abierto , Conocimiento, actitudes y prácticas sobre prevención del virus del papiloma humano en estudiantes de medicina de la Universidad Católica de Cuenca sede Azogues. Ecuador. 2024- 2025(Universidad Católica de Cuenca., 2026) Romero Navas, Stalin SebastiánBackground: HPV has become a global problem due to an increase in its prevalence; according to WHO data, there is evidence of an increase in cases among individuals with multiple sexual partners. Objective: To analyze the knowledge, attitudes, and practices regarding HPV prevention among medical students at the Catholic University of Cuenca, Azogues Campus, Ecuador. 2024–2025. Methodology: The study employs a non-experimental, quantitative, descriptive, and prospective cross-sectional observational design. It was conducted among medical students at the Azogues campus of the Catholic University of Cuenca, involving 1,412 students. The sample consisted of 304 students, with a 95% confidence level and a 5% margin of error. Results: The majority of the students demonstrated a high level of knowledge, as they were enrolled in a health-related program. Furthermore, it was found that most respondents had appropriate attitudes regarding disease prevention; in practice, because they are familiar with the virus and understand how it is transmitted, they act in a way that promotes prevention and helps prevent its further spread. Conclusions and relevance: A high level of knowledge was determined among the students, and their attitudes were found to be appropriate. Regarding sexual practices, participants reported beginning sexual activity between the ages of 14 and 25 while using some type of contraceptive method; the majority reported not having multiple sexual partners, indicating that their practices are appropriate. Keywords: human papillomavirus, prevention, knowledge, attitudesItem type: Ítem , Access status: Acceso Abierto , Escala del modelo de creencias de salud para autoexploración de mama en estudiantes de la Universidad Católica de Cuenca sede Azogues, Ecuador 2024-2025.(Universidad Católica de Cuenca., 2026) Delgado Ramírez, María Alejandra; Méndez González, Alvaro DavidBackground: Breast self-examination (BSE) is a tool for detecting breast abnormalities and aligns with the university's research lines and sublines. Objective: To identify beliefs about breast self-examination according to the “Health Belief Model Scale for Breast Self-Examination” in students from the Catholic University of Cuenca – Campus Azogues. Methodology: An observational, quantitative, descriptive, prospective, and cross-sectional study was conducted. “Google Forms” was used, applying a stratified convenience sampling method among students (women older than 18 years old); statistics such as SPSS and descriptive statistics were used for the analysis. Results: The total number of participants in the study was 321 female students. Of those surveyed, 96.6% were single, 182 studied medicine and nursing, the academic terms presented a homogeneous distribution, 91% had no family history of cancer, 75.1% knew about self-examination, and 76.0% had not performed BSE in the last month, with a statistical correlation between the university level and BSE. The dimensions show a high level of efficacy, seriousness, barriers, and benefits, a moderate perceived susceptibility, and low health motivation. Conclusions and relevance: Breast self-examination represents one of the procedures that allows for the identification of warning signs in the breast. In the results found at the University, women mostly know about it; however, they do not practice it, making it necessary to implement programs that encourage its practice. Keywords: breast self-examination, breast cancer, beliefs, studentsItem type: Ítem , Access status: Acceso Abierto , Eficacia del cierre primario versus la colostomía en pacientes con trauma penetrante de colon: revisión sistemática(Universidad Católica de Cuenca., 2025) Uguña Landi, María JoséBackground: Penetrating colon trauma is a highly complex injury, mainly associated with motor vehicle accidents, occupational accidents, and assaults with sharp or firearms. In Ecuador, it represents the tenth leading cause of death, accounting for 2.53% of all deaths. Traditionally, surgical management was performed using colostomy; currently, primary closure is the preferred technique. Objective: To analyze the efficacy of primary closure compared with colostomy in patients with penetrating colon trauma through a systematic review of clinical trials that evaluate postoperative complications, length of hospital stay, recovery time, morbidity, and mortality. Methodology: The review was conducted following the PRISMA 2020 guidelines. The databases used included PubMed, ScienceDirect, SciELO, and the Cochrane Library, with searches updated through 2024. To assess the risk of bias in randomized clinical trials, the “Risk of Bias 2 (RoB2)” tool from the “Cochrane Collaboration” was applied. Results: A total of 19 studies were included, all of which were clinical trials. The studies were observational and analytical in nature. Medical intervention should be individualized according to the patient’s hemodynamic status and the severity of the injuries. Conclusions: Primary closure is considered the first therapeutic option for treating penetrating colon trauma; however, its application may be limited in cases where injuries involve more than 50% of the intestinal circumference or in the presence of postoperative complications require a second intervention. Regarding the length of hospital stay, it ranges from 5 to 6 days for primary closure, whereas for colostomy it is approximately 10 days. Keywords: primary closure, colostomy, penetrating colon traumaItem type: Ítem , Access status: Acceso Abierto , Efectividad de la nutrición enteral temprana versus la nutrición tardía en pacientes adultos sometidos a resección intestinal: revisión sistemática(Universidad Católica de Cuenca., 2026) Bernal Vásquez, Karen EstefaníaThe early initiation of enteral nutrition has been proposed as a strategy to improve postoperative recovery in patients undergoing gastrointestinal surgery. However, there is variability in the evidence regarding its benefits compared to delayed initiation of enteral feeding. Objective: To determine the effectiveness of early enteral nutrition versus delayed enteral nutrition in adult patients undergoing intestinal resection through a systematic review of the scientific literature. Methodology: A systematic review was conducted in accordance with the recommendations of the PRISMA 2020 guidelines. The literature search was performed in scientific databases. Cohort studies comparing early versus late enteral nutrition were included. Studies were selected using predefined inclusion and exclusion criteria. Data were extracted and organized into a matrix created in Microsoft Excel. The risk of bias in individual studies was assessed using the ROB-1 tool, and study quality was assessed using the NHLBI criteria. Results were synthesized through qualitative narrative analysis. Results: Thirteen studies were included; most reported that early initiation of enteral nutrition is associated with a shorter hospital stay and improved functional bowel recovery, as evidenced by a lower incidence of postoperative ileus. Conclusions: The available evidence suggests that early enteral nutrition is an effective, safe, and potentially beneficial strategy in adult patients undergoing bowel resection, as it promotes gastrointestinal recovery, is well tolerated, and reduces length of hospital stay. Keywords: enteral nutrition, early nutrition, late nutrition, adult patients, bowel resection
