Medicina

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    INNOVACIONES EN LA RECONSTRUCCIÓN DEL LIGAMENTO CRUZADO ANTERIOR EN ATLETAS
    (Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-09-26) Hidalgo Alvarez, Karen Nicole; Garay Villamar, Daniel Gustavo
    Introduction: Sports injuries, and particularly those of the anterior cruciate ligament (ACL), stand as significant obstacles that threaten the career and performance of athletes. Because of this, the scientific and medical community has responded to this challenge with a series of groundbreaking innovations that address the limitations associated with traditional reconstruction techniques and fundamentally transform the recovery experience for athletes. Objectives: The general objective of this article is to comprehensively analyze and evaluate innovations in anterior cruciate ligament reconstruction in athletes, to understand their effectiveness, safety, and potential impact on clinical outcomes. Methodology: To meet this objective, a methodology with a qualitative approach and an exploratory-descriptive type of research was used, since it seeks to deepen the understanding of innovations in ACL reconstruction and describe the experiences of athletes in this context. In addition, an exhaustive review of the scientific and medical literature was carried out using various databases, concluding that, in terms of the technological and material advances used in ACL reconstruction, the positive impact of advanced imaging techniques, surgical navigation systems, state-of-the-art biomaterials and fixation devices. Results: Surgical techniques, technological advances, and care focused on long-term outcomes have transformed this intervention into a highly specialized discipline. Conclusions: The review of surgical techniques for anterior cruciate ligament (ACL) reconstruction in athletes shows a significant evolution, from patellar tendon autografts to minimally invasive innovations. Technological advances, such as advanced imaging and modern biomaterials, have improved the precision and success of surgeries, reducing complications and speeding recovery. General area of study: Medicine. Specific area of study: Traumatology. Type of study: Degree project / Scientific article.
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    TRATAMIENTO DE REEMPLAZO HORMONAL ENFOCADO EN LAS OPCIONES DE FERTILIDAD EN MUJERES CON SÍNDROME DE TURNER
    (Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-09-26) Garcia Nuñez, Marcos Andrés; Cruz Castillo, Yessenia Magaly
    Introduction: Hormone replacement therapy in women with Turner Syndrome, focusing on estrogen, progesterone, and gonadotropins such as FSH and LH, is critical for addressing infertility associated with this genetic condition. This study reviews existing literature to assess the efficacy of these drugs in improving ovarian function and fertility options. Objective: To analyze and synthesize current literature on hormone replacement treatment options and their effectiveness in enhancing fertility in women with TS. Methodology: A literature review was conducted on medical platforms such as PubMed and MEDLINE, using keywords such as "Turner Syndrome", "Hormone Replacement Therapy", and "Fertility". Studies from the last 5 years, in both English and Spanish, focused on hormonal treatments and fertility, were included. Results: Reviewed studies indicate that drugs like estrogen and progesterone in hormone replacement therapy can improve ovarian function in women with TS. Some cases reported success using FSH and LH to stimulate ovulation. However, variability in responses and potential side effects require careful consideration. Conclusions: Treatment with estrogen, progesterone, FSH, and LH offers possibilities for fertility improvement in TS, but must be personalized and rigorously monitored to optimize outcomes and minimize risks.
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    VISIÓN GENERAL SOBRE LAS NUEVAS TÉCNICAS EN EL MANEJO DE LA OSTEOMIELITIS AGUDA Y CRÓNICA
    (Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-09-26) Cevallos Mejía, Ariel Mateo; Toctaquiza Silva, Roberto Carlos
    Osteomyelitis is an inflammatory disease that affects the bone and is caused by an infectious process that leads to inflammation. This process represents a high morbidity and as a consequence could lead to disability. The most common microorganisms related to the pathology are Staphylococcus aureus and Staphylococcus epidermidis. There are two well-defined forms, acute and chronic, which are differentiated by the presence of necrotic bone. Acute osteomyelitis is of hematogenous cause and is predominant in pediatric age, and it is important to note that in the initial stages we will not find dead bone; and the difference with chronic osteomyelitis is that here we do find necrotic bone, product of the arrival of pathogens to a bone affected by surgery or trauma. The therapeutic approach is multidisciplinary and depends on the stage of the disease and its classification, and is based on six fundamental pillars: surgical debridement, microbiological diagnosis, obliteration of the dead space, antibiotic therapy directed to the causative microorganisms and finally the reconstruction of soft tissues and bone.
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    TERAPÉUTICA PARA EL BLOQUEO DE LA MARCHA EN PACIENTES CON PARKINSON
    (Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-09-25) Tinoco Aguilar, Noelia Lisseth; Acosta Gavilánez, Roberto Iván
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    DOLOR CRÓNICO Y SU ABORDAJE CON CANNABIDIOL: UNA OPCIÓN TERAPÉUTICA
    (Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-09-25) Vega Cueva, John Omar; Salinas Velastegui, Verónica Gabriela
    Introduction: chronic pain is a health problem that affects millions of people in the world, generating an important biopsychosocial problem, which is why there are several types of therapeutic approaches, such as the use of cannabidiol for its anti-inflammatory, analgesic and neuroprotective qualities. Objectives: perform a bibliographic review on cannabidiol and how this active ingredient is a treatment option for chronic pain.Materials and methods: a search on cannabidiol as a treatment for chronic pain was carried out in several databases such as: Medline/PubMed, LILACS-BIREME and SciELO, including inclusion and exclusion criteria of the reviewed articles.Results: chronic pain is a condition that is characterized by the persistence of pain for more than 3 months, affecting quality of life and whether or not it is associated with true tissue damage. Worldwide, it affects more than 2 billion people and in Ecuador, about 21% of the population suffers from this pathology. Chronic pain can be of various types such as: neuropathic pain, nociceptive pain, centralized pain, mixed pain and idiopathic pain, which have unique characteristics that allow their differentiation.Cannabidiol has been involved in severalinvestigations to treat chronic pain. This is a chemical compound found in the cannabis plant, along with another variety of so-called cannabinoids, such as tetrahydrocannabidiol (THC), which is characterized by its effects. psychoactive, while cannabidiol lacks them. Generally speaking, cannabidiol acts on the body's endocannabinoid system, which regulates pain, immune function, etc. For this reason, it is believed that cannabidiol can reduce pain and inflammation. Although there is no minimum or maximum dose of cannabidiol to treat chronic pain, it can vary from 10 mg to 6000 mg. Therefore, strengthening research regarding cannabidiol as a therapy for chronic pain is vital to determine if it can be an alternative to the classic treatments that exist for chronic pain.Conclusions: several investigations have been carried out regarding the use of cannabidiol independently as a therapy for the treatment of pain, where no clear results have been found regarding the effectiveness of this medication, in additionto the fact that the result found will depend on the dosage. given to the population that has undergone this treatment scheme.
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    INTERVENCIONES DE AFRONTAMIENTO ANTE LA DEPRESIÓN EN PACIENTES CON DIABETES MELLITUS TIPO 2
    (Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-09-25) Urrutia Chari, Fernando Ramiro; Tufiño Aguilar, Andrea Alexandra
    Introduction: Type 2 diabetes mellitus (T2DM) and depression are serious chronic diseases that often coexist. Depression is almost twice as common in people with DM2 as in the general population. When both conditions are present, they are associated with worse glycemic control, poorer self-care, reduced quality of life, increased risk of complications, and increased mortality. Despite its importance, a significant number of patients with T2DM and depression remain untreated or even diagnosed. There is a lack of studies and management guidelines on the simultaneous treatment of these two conditions. Objectives: This literature review aims to analyze the different coping interventions against depression in patients with DM2 with the purpose of having a complete overview of the available treatment options and identifying the most effective strategies. In addition to identifying the factors that predispose patients with DM2 to develop depression. Methodology: A bibliographic review of meta-analyses, randomized clinical trials and systematic reviews published between 2018 and 2024 was carried out, obtained from databases such as PubMed, Google Scholar and Scopus. Risk factors, different coping interventions against depression, their definitions, effectiveness and modes of application supported by scientific evidence were identified. The most relevant articles were selected and the most significant information was classified. Main results: The main risk factors for developing depression in patients with DM2 include biological aspects (hyperglycemia, vascular damage, complications), behavioral (lifelong treatment, obesity, physical inactivity, sleep disturbances), socioeconomic (low socioeconomic status, expenses on medication, social instability, low educational level), environmental and psychological. The most effective interventions to deal with depression in patients with T2DM are cognitive-behavioral therapy (CBT), group CBT, exercise, pharmacological treatment (SSRI) and online treatment. To improve both depression and glycemic control, pharmacotherapy and the combination of CBT with exercise stand out. Selection of the most appropriate intervention should consider the severity of depressive symptoms, patient preferences, available resources, effectiveness, and possible effects on glycemic control. The tiered models provide a useful guide for this selection.
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    EFECTO DEL USO DE ÁCIDO TRANEXÁMICO EN EL TRATAMIENTO DE MELASMA
    (Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-09-25) Tituaña Ortega, Grace Anabel; Castro Batista, Zenia
    This study aimed to investigate the efficacy of tranexamic acid (TXA) in the treatment of melasma, a skin condition that poses challenges due to its chronic nature and variable response to conventional therapies. Methodology: A systematic review of randomized clinical trials was conducted to evaluate the efficacy of tranexamic acid (TXA) in the treatment of melasma. The literature search covered studies from 2019 to October 2023 in various electronic databases. Studies that met strict inclusion criteria were selected, prioritizing controlled and randomized clinical trials. The safety and efficacy of TXA in various formulations and routes of administration, such as oral, transepidermal, and intradermal, were evaluated. Results: The findings demonstrated that TXA, in its different forms of administration, led to a reduction in the Melasma Area and Severity Index (MASI) scores, indicating improvements in skin pigmentation and dermal microcirculation. Reductions in epidermal melanin density and the number of pendulous melanocytes were observed. Additionally, the efficacy of TXA combined with other therapeutic agents, such as ascorbic acid or platelet-rich plasma, to improve melasma was highlighted. Conclusion: TXA emerges as an effective therapeutic option in the treatment of melasma. Its ability to improve MASI scores suggests a positive effect on skin pigmentation and dermal microcirculation. However, challenges such as treatment tolerability and recurrence rates persist.
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    NEOPLASIAS EXTRAMEDULARES COMO FACTOR DE RIESGO EN LA COMPRESIÓN MEDULAR
    (Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-09-25) Tenorio Mogro, Soraya Lisseth; Jurado Melo, Cristina Verónica
    Introduction. Extramedullary neoplasia in spinal cord compression refers to the presence of tumors or lesions that are located outside the spinal cord and that cause compression in it. Objective. Investigate the incidence and prevalence of neoplasms that cause spinal cord compression, identifying the types of tumors most associated with this condition, as well as evaluate the symptoms, diagnosis, and treatments available for these neoplasms. Methodology. Documentary-bibliographic design, exploratory, explanatory, and qualitative modality. Results. It turned out that extramedullary neoplasms that cause spinal compression include meningioma, which are slow-growing benign tumors that develop in the spinal canal; neurofibromas that develop from the cells surrounding the nerves; Schwannomas are histological tumors in the spinal cord. Among the predominant symptoms are pain, weakness in the arms, changes in vision, headache, memory loss, loss of smell, seizures, and language difficulty. Conclusion. Extramedullary neoplasia can have a significant impact on the patient's health. The severity of the symptoms and the prognosis depend on the type of neoplasm, its location, and the degree of spinal compression it causes, thus having the impact of compression of the spinal cord, intense pain in the area, paralysis of the upper and lower extremities, and finally neurological alterations.
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    Respuesta terapéutica del tratamiento antibiótico concomitante al uso del bacillus claussi vs saccharomyces boulardii para el manejo de infecciones intestinales
    (Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-09-25) Tapia Tiglla, Josué Patricio; Bonifaz Díaz, Diego Raúl
    Introduction: Probiotics are microorganisms, mainly bacteria and fungi, which fulfill several beneficial functions that contribute to health, serving as a complement for the treatment of various diseases such as gastrointestinal diseases, for such reason, they constitute a new therapeutic tool for human health care, however, the efficacy of these probiotics depends on several variables. The present literature review focuses on describing the therapeutic effects of the use of Bacillus clausii and Saccharomyces boulardii in the complementary multimodal treatment of intestinal infections. Methodology: For the present bibliographic review, highly relevant scientific studies were analyzed in international databases such as Dialnet, Redalyc, Scopus, ScienceDirect and Pubmed published in recent years. Clinical trials, systematic reviews, randomized controlled trials and meta-analyses focused on the probiotics Bacillus clausii and Saccharomyces boulardii were analyzed. Results: The results of this review reveal that the bacterial probiotic (Bacillus clausii) presents resistance to broad-spectrum antibiotics provided by genes in its genome; on the other hand, the fungus-based probiotic (Saccharomyces boulardii) presents intrinsic resistance to antibiotics due to its natural properties, resulting that both can be used together with antibiotics to treat gastrointestinal infections, the mechanisms of action were identified, and the gastrointestinal diseases in which they are most useful. Conclusion: The use of probiotics Bacillus clausii and Saccharomyces boulardii have shown to be effective in multimodal treatment together with antibiotics in the management of gastrointestinal diseases, however, studies reveal a superiority of Saccharomyces boulardii.
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    REMISIÓN PROGRESIVA DE ANTIDIABÉTICOS EN PACIENTES OBESOS SOMETIDOS A CIRUGÍA BARIÁTRICA
    (Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-09-25) Tamayo Malusin, Michelle Estefanía; Morales Solís, Jorge Marcelo
    Introduction: Bariatric surgery has been established as an effective procedure for managing overweight and associated diseases, especially type 2 diabetes (T2DM). The link between bariatric surgery and diabetes remission has gained attention in the medical community. Objective: To determine the effectiveness of bariatric surgery in progressively reducing the need for antidiabetic medication in obese patients with type 2 diabetes. Methodology: A comprehensive literature review was conducted, selecting studies addressing bariatric surgery and its impact on obese diabetic patients. Longitudinal and crosssectional studies reporting pre- and postoperative data were included. Results: Studies indicate a significant remission of type 2 diabetes post-bariatric surgery, with a notable reduction or elimination of antidiabetic medication use. Remission varies according to the type of surgery, being most notable in techniques such as gastric bypass and sleeve gastrectomy. Conclusions: Bariatric surgery proves to be an efficient option for reducing T2DM in obese individuals, significantly reducing the need for antidiabetic medication. This underscores the importance of considering this surgical procedure in the therapy of individuals with T2DM and obesity.