Medicina
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Item TERAPIA CON TEJIDO ADIPOSO PARA LA REPARACIÓN Y REGENERACIÓN DE TEJIDOS AFECTADOS POR QUEMADURAS TÉRMICAS: UNA REVISIÓN BIBLIOGRÁFICA DE SU POTENCIAL CURATIVO(2025-06-25) Toapanta Maisanche, Pamela Lizbeth; Batista Castro, Zenia; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaItem CIRUGÍA REFRACTIVA COMO UNA OPCIÓN TERAPÉUTICA PARA LA CORRECCIÓN DE LA MIOPÍA(2025-06-19) Molina Vilca, Daniela Belen; Mendoza Rodríguez, Saimara María; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaRefractive surgery is a technique for ophthalmologic treatments that seeks to minimize or correct the level of refractive errors such as myopia. Currently, techniques such as LASIK (Laser-Assisted in Situ Keratomileusis), PRK (Photorefractive Keratectomy), and SMILE (Small Incision Lenticule Extraction) are used to reduce these conditions. In LASIK treatment, a laser is used to create a flap in the cornea and remodel the underlying tissue, which is very fast. For PRK, the epithelium of the cornea is removed and then the corneal tissue is remodeled with a laser. For SMILE, a lenticule is created within the cornea, which is generally removed through a small incision. In this context, the efficacy and safety of refractive surgery as a therapeutic option to correct myopia is described. The development method used was a bibliographic review of 35 bibliographic sources (articles, theses) that were previously selected in the web databases Google Scholar, PudMed, Science Direct, Ophthalmology Journals, and the use of the Boolean operators "AND" and "OR". With an initial search of 664 possible references to be selected, which were filtered through inclusion/exclusion criteria. The SMILE method proved to be the one with the best recovery speed levels and a lower incidence of post-operative problems. In the case of LASIK and PRK, effective long-term results were found in both, with LASIK being the most precise, however, PRK requires longer recovery times since it presents a greater number of post-operative problems, and it is very specific for people with thin corneas.Item NEUROPLASTICIDAD CEREBRAL: EN LA REHABILITACIÓN NEUROLÓGICA DE PACIENTES DESPUÉS DE ACCIDENTES CEREBRO VASCULARES (ACV): UNA REVISIÓN BIBLIOGRÁFICA(2025-06-19) Guangasig Escobar, José Javier; Estrada Zamora, Esmeralda Maricela; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaBrain neuroplasticity is a fundamental characteristic of the brain to adapt to challenging situations such as going through a stroke (ACV). Short and long-term stroke causes a wide variety of sequelae ranging from cognitive to motor skills. Under this scenario, the present research proposes as a general objective to perform an analysis of the current scientific evidence on the role of brain neuroplasticity in the rehabilitation of patients who have suffered a stroke. The method used was a bibliographic review of 30 articles published in different web databases, finding results only in (Google scholar, Science Direct, MedlinePlus, Dialnet, Institutional Repositories). The use of the Boolean operators “AND”, “OR” was used, using combinations such as: “Neuropaslticity AND stroke rehabilitation”, “Neuroplasticidad cerebral AND ACV”, “Stroke AND brain plasticity AND rehabilitation”; “Rehabilitación neurológica AND ataque cerebrovascular”, “Functional recovery AND neurplasticity AND stroke”, the same group of combinations was used for the OR operator. Proceeding to read the summary of those that were previously selected, inclusion/exclusion factors, quality/validity, and relevance of the different studies found were used. Among the main findings found, it is reflected that the use of various techniques is necessary for adequate functional recovery. Cognitive stimulation, virtual advance technologies, brain-computer interfaces, exercises and, above all, timely and early diagnoses. In addition, pharmacotherapy also stands out within these tools, even reflecting that the combination of them is viable.Item ANÁLISIS CLÍNICO Y AVANCES EN EL TRATAMIENTO EN EL PINZAMIENTO FEMOROACETABULAR: REVISIÓN BIBLIOGRÁFICA(2025-06-19) Vizcaino Balseca, Kerly Celeste; Garay Villamar, Daniel Gustavo; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaFemoroacetabular impingement (PFA) is a structural alteration of the hip characterized by abnormal contact between the femoral head and the acetabulum, causing pain and restriction of movement, with the risk of osteoarthritis, especially in young people and athletes. An electronic search was carried out for scientific articles published from January 2018 to 2024 in the PubMed, Scopus, Web of Science and ScieLO databases. The PFA is classified into CAM, Pincer and mixed. The CAM variant involves an irregular femoral head that generates friction; the Pinza, acetabular overcoverage that limits movement; and the mixed, the combination of both. Its diagnosis includes symptoms, physical examination and imaging studies, where MRI and x-ray are key. Initial treatment is conservative (physiotherapy and analgesia), but if symptoms persist or there is progression of damage, surgery is required. Hip arthroscopy is preferred for its lower morbidity and faster recovery compared to open surgery, although the choice depends on the structural damage and the experience of the surgeon. In conclusion, the treatment of AFP must be adapted to each patient. While conservative approaches control initial pain, surgery, especially arthroscopy, is the best option to restore functionality and avoid complications. In advanced cases it should be carefully evaluated, since the prognosis may be limited.Item ASOCIACIÓN ENTRE LA COMPOSICIÓN DE LA MICROBIOTA INTESTINAL: RELACIÓN CON LA ENFERMEDAD CELIACA Y DESNUTRICIÓN(2025-06-19) Maridueña Paredes, Lizbeth Sarahi; Torres Torres, Johny Mauricio; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaThe aim was to determine the association between the composition of the intestinal microbiota and its relationship with celiac disease and malnutrition. A systematic review was carried out following the PRISMA guidelines, using databases such as PubMed, Dialnet, Google Scholar, SciELO and Elsevier. Studies published between 2020 and 2024 in Spanish and English, which analysed the composition of the intestinal microbiota in patients with celiac disease, were included. The selection of studies was carried out through a threephase process: review of titles and abstracts, evaluation of the full text and final data extraction. The results revealed an intestinal dysbiosis characterised by a significant reduction in beneficial bacteria (Bifidobacterium and Lactobacillus) and an increase in potentially pathogenic bacteria (Bacteroides and Escherichia coli). These microbial alterations are not only a consequence of celiac disease, but play a fundamental role in its development. Microbial changes were identified up to 18 months before clinical manifestation, suggesting their potential as an early biomarker. Factors such as antibiotic use, birth route and type of feeding significantly influence the composition of the microbiota. In conclusion, the intestinal microbiota plays a crucial role in the pathogenesis of celiac disease and malnutrition. Microbial alterations compromise nutrient absorption, modify the immune response and affect intestinal permeability. Emerging therapeutic strategies focus on microbiota modulation through probiotics, prebiotics and fecal microbiota transplantation, representing a promising approach for the management of these conditions.Item DENERVACIÓN SIMPÁTICA RENAL UNA ALTERNATIVA TERAPÉUTICA EN PACIENTES CON HIPERTENSIÓN ARTERIAL REFRACTARIA(2025-06-18) Castillo Mayorga Alejandra Monserrath; Andrade Albán Noemí Rocio; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaRefractory arterial hypertension (HRT) is characterized by the inability to control blood pressure, which exceeds 140/90 mmHg, despite the use of five or more antihypertensive drugs of different classes, including a long-acting thiazide diuretic and a mineralocorticoid receptor antagonist, at maximum or tolerated doses. Although renal denervation (RDN) has shown potential to reduce blood pressure, its efficacy and safety are still debated, which is why a systematic review was proposed to evaluate the results and effectiveness of RDN in patients with HTN. A descriptive and systematic approach based on the PRISMA guidelines was used, reviewing literature in PubMed, Embase, Cochrane Library and Scopus, with terms MeSH and DECs, and limiting the search to articles in English or Spanish published in the last five years. Those that do not focus on the topic or different from the language indicated were excluded, resulting in 15 articles for review. The results and conclusion indicate that RDN has shown a significant reduction in systolic and diastolic blood pressure in some cases, with decreases of between 5 mmHg and 32 mmHg. However, the results are inconsistent: some studies report modest or no reductions compared to sham treatments or standard controls; and, improvements in blood pressure are usually more evident in the short term, but the long-term efficacy and effects on cardiovascular events and kidney function still require more research.Item PROTEÍNA ACIDA FIBRILAR GLIAL EN SANGRE COMO MÉTODO DIAGNÓSTICO DE TRAUMATISMO CRANEOENCEFÁLICO: UNA REVISIÓN SISTEMÁTICA Y METAANÁLISIS(2025-06-18) Riofrío Ponce, Edison Joshua; Salazar Garcés, Luis Fabián; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaIntroduction: traumatic brain injury (TBI) is a leading cause of morbidity and mortality worldwide. Glial fibrillary acidic protein (GFAP) has been proposed as a blood-based diagnostic biomarker for TBI, but its clinical utility remains uncertain. This meta-analysis assessed the diagnostic accuracy of GFAP in identifying TBI. Method: a systematic search was conducted in biomedical databases for studies published between 2019 and 2024. Clinical trials with adequate sample sizes and standardized GFAP detection methods were included. Sensitivity, specificity, and predictive values were analyzed using statistical models to evaluate diagnostic accuracy. Results: seven studies with a total of 3 209 patients were included. The overall sensitivity of GFAP was 0,91 (95 % CI: 0,83–0,96), demonstrating a high capacity to detect TBI. However, specificity was moderate (0,61, 95 % CI: 0,48–0,73), indicating a higher rate of false positives. The summary ROC curve confirmed a good general diagnostic performance but highlighted limitations in differentiating TBI from other neurological conditions. Conclusions: GFAP exhibited high sensitivity as a diagnostic biomarker for TBI, making it a useful tool for early detection. However, its low specificity suggests the need for combination with other biomarkers to improve diagnostic accuracy.Item EFICACIA TERAPÉUTICA DE LOS ANESTÉSICOS DISOCIATIVOS EN DEPRESIÓN(2025-06-18) Montufar Guevara Julia del Pilar; Padilla Vinueza Verónica Elizabeth; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaIntroduction: Depression is a prevalent mental disorder that significantly affects the quality of life despite the existence of conventional treatments, a large proportion of patients do not respond adequately to these, the use of dissociative drugs for the treatment of depression has gained attention. in recent years, especially with the use of ketamine. This anesthetic has been used clinically for decades and has demonstrated rapid and significant antidepressant properties, especially in patients with resistant depression. Methods: This is a review of the literature that analyzes the therapeutic efficacy of dissociative anesthetics, such as ketamine. Using databases such as Pubmed, Scopus and Google Scholar, the articles were filtered using inclusion and exclusion criteria. Discussion: Research reveals that these medications offer a promising alternative for refractory patients, contributing to a rapid and positive response compared to traditional antidepressants. Conclusions: Dissociative anesthetics represent a viable option in the therapy of depression, especially in contexts where conventional treatments have failed, highlighting the need for specialized training in these drugs due to the need for follow-up and adequate monitoring in the patient due to the adverse effects of its administration, in addition to its availability in mental health clinics.Item RECONSTRUCCIÓN DEL LIGAMENTO PATELOFEMORAL MEDIAL CON EL USO DE INJERTO SINTÉTICO EN LUXACIONES DE ROTULA(2025-06-18) Tenelema Chango Milton Fabian; Salgado Oviedo Gabriela Socorro; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaGeneral Objective: To describe the recovery time in patients with a tear of the medial patellofemoral ligament who underwent surgical intervention using synthetic grafts compared to conservative treatment. Specific Objectives: Compare the complication rates in patients treated conservatively and those who underwent reconstruction of the medial patellofemoral ligament using synthetic grafts. Evaluate the reliability of the Kujala, Lysholm, Tegner, and Oxford scales in assessing knee dislocation through a comparative analysis of pre- and postoperative clinical functionality outcomes, with the aim of identifying the most suitable tool for restoring joint stability and functionality. Analyse the application of a selective algorithm to determine the age group eligible for surgical intervention through medial patellofemoral ligament reconstruction, considering anatomical and functional criteria. Methodology: The following information is a compilation of various bibliographies covering the period 2020–2024, with the purpose of generating current, accurate, and concise information supported by scientific evidence obtained from the following databases: PubMed, Uptodate, Scopus, Scielo, Medical Science, and Springer Open. Articles were meticulously reviewed, selecting those with Levels I and II evidence. Subsequently, an analysis was carried out to include them in this review. Results: A bibliographic search was conducted, resulting in a total of 45 articles, including meta-analyses, randomised trials, and systematic studies related to the treatment of medial patellofemoral ligament reconstruction using synthetic grafts. Thirty articles were excluded due to insufficient data and lack of favourable statistical information post-surgery. Final database: 15 articles with Levels I and II evidence.Item DISRUPTORES ENDOCRINOS: UN RIESGO EN LA SALUD REPRODUCTIVA DE LAS MUJERES(2025-06-18) Balladares Mise, Evelyn Jhomayra; Gavilanes Saenz. Victor Patricio; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaEndocrine disruptors (EDs) are substances that have hormonal activity and are found in the environment. They can interfere with various physiological processes in humans and animals, affecting systems such as the central nervous, endocrine, bone and immune systems. The objective of the research is to evaluate the impact of endocrine disruptors on women's reproductive health. The methodology consisted of a bibliographic study, for which various databases of relevance in the medical and scientific field were used; include PubMed, Embase, Cochrane Library, Web of Science, Scopus, LILACS, and Google Scholar. Endocrine disruptors interfere with this system by mimicking, blocking or altering the production, release, transport or elimination of natural hormones. In conclusion, exposure to endocrine disruptors represents a significant concern due to their ability to interfere with the endocrine system, crucial for hormonal regulation and reproductive health in humans.