Medicina
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Item DIANAS MOLECULARES EN LA INMUNOTERAPIA CONTRA EL CÁNCER DE MAMA EN MUJERES EN EDAD FÉRTIL. REVISIÓN BIBLIOGRÁFICA(2026-03-13) De La Fuente Fernández, Ángeles Tamia; Acosta Acosta, Josué; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaIntroduction: The problem of breast cancer in women of childbearing age is still a relevant and current issue, which merits reviewing the research carried out by experts in the field. Objective: To compare the available scientific evidence on the progress in the development of new oncological therapies aimed at specific molecular targets for the control of breast cancer in women of childbearing age. Methods: Non-experimental descriptive study, with qualitative methodology for data collection. An integrated approach was used in the evaluation to methodically collect the literature from reliable academic sources, such as Science direct and PubMed. The key phrases included in the bibliographic search were "Molecular target", "Immunotherapy", "Breast cancer", "Women" and "Childbearing age", refining the search with the boolean operator AND, through the DeSC / MeSH terms. Results: 200 eligible publications were identified, eliminating 75 for being duplicates and irrelevant, 60 for having been published before 2019; 50 for having fewer than 6 women in their studies, aged over 60 years, addressing other types of cancer. Finally, 15 complete articles were included from the screening, meeting the inclusion criteria.Item Manejo nutricional y control metabólico en la diabetes mellitus tipo 1: Revisión bibliográfica(2025-10-16) Yaule Narváez, Karen Dennise; Zabala Haro, Alicia Monserrath, Md. Mg.; Universidad Técnica de Ambato / Facultad de Ciencias de la Salud / Carrera de MedicinaThis article is aimed at examining the scientific evidence on how dietary nutritio n a l interventions affect the metabolic control of patients with type 1 diabetes mellit us (DM1). The analysis of key strategies like carbohydrate count, low glycemic index diets, and comprehensive dietary patterns involves evaluating how they impact clinica l indicators such as glycosylated hemoglobin (HbA1c), glycemic variability, and sustainability of results through therapeutic adherence. The most significant finding is that glycemic control is significantly improved when customized nutritional strateg i es are used, particularly when they are supported by technological and educational tools that promote patient autonomy, in the context of continuous follow-up by a multidisciplinary team.Item Perspectivas en el desarrollo de fármacos cardiometabólicos(2025-10-16) Valverde Casa Fernanda Elizabeth; Medina Medina Doris Raquel, Dra. Esp; Universidad Técnica de Ambato / Facultad de Ciencias de la Salud / Carrera de MedicinaIntroduction: epicardial adipose tissue (EAT) has emerged as a risk marker and therapeutic target in cardiometabolic diseases due to its anatomical proximity to the myocardium and its active involvement in inflammatory and atherogenic processes. Its reduction has been associated with improvements in cardiovascular profiles, particularly in individuals with type 2 diabetes (T2D), obesity, and coronary artery disease (CAD). Objective: to investigate the impact of cardiometabolic drugs on the reduction of EAT and their implications in cardiometabolic diseases. Methodology: a qualitative systematic review was conducted on relevant articles published in the last five years, in English and Spanish, that evaluated the effect of sodium-glucose cotransporter type 2 inhibitors (SGLT2-i), glucagon-like peptide-1 receptor agonists (GLP-1 RA), and statins on EAT. Results: GLP-1 RAs (such as semaglutide and dulaglutide) significantly reduce EAT volume in patients with T2D and obesity, with improvements in inflammation and glycemic control. SGLT2-i reduce EAT through hemodynamic mechanisms and anti-inflammatory effects. Statins exhibit a moderate anti-inflammatory effect and a modest reduction in EAT, attributed to their antioxidant and endothelialmodulating properties. Conclusion: GLP-1 RAs are the most effective agents in reducing EAT, followed by SGLT2-i. Statins show a less pronounced effect on EAT reduction, supporting their strategic use in the prevention and management of cardiovascular diseases in patients with high metabolic risk.Item Células madres estromales como terapia innovadora en el tratamiento de displasia broncopulmonar neonatal: Revisión bibliográfica(2025-10-16) Vaca Pérez Evelyn Carolina; Solís Armijos Ana Gabriela, Dra. Esp; Universidad Técnica de Ambato / Facultad de Ciencias de la Salud / Carrera de MedicinaIntroduction: Bronchopulmonary dysplasia (BPD) is a chronic lung disease that affects newborns, especially those with extremely low birth weight. Objective: This review explores the potential of stromal stem cells (MSCs) in the treatment of BPD, analyzing preclinical and clinical studies that highlight their efficacy and mechanisms of action. Methodology. A bibliographic review was carried out in scientific databases such as Proquest, Scopus, Springer, Web of Science, Google Scholar, selecting studies between 2018 and 2024. Preclinical and clinical research on the use of stromal stem cells for the treatment of bronchopulmonary dysplasia was included. Results: The results show that the patients who benefit most from treatment with mesenchymal stem cells (MSCs) for bronchopulmonary dysplasia (BPD) are mainly extremely premature newborns, early administration shows more favorable results. Conclusion: Although multiple benefits have been shown in animal trials, further clinical studies are still needed to optimize treatment protocols, especially with regard to dose and route of administrationItem VALOR DE LA ECOGRAFÍA EN LA DISPLASIA CONGÉNITA DE CADERA. REVISIÓN BIBLIOGRÁFICA(2025-10-16) Lindo Morales, Anthony Joel; Valverde Gavilánez, Manuel Ricardo; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaIntroduction: Congenital hip dysplasia (CHD) is an orthopedic disorder in newborns that affects the relationship between the femoral head and the acetabulum. Ultrasound is essential for early diagnosis as it allows real-time visualization of hip anatomy without radiation. Regarding screening, the universal approach proposes ultrasound for all newborns, although it can lead to unnecessary treatment; selective screening focuses on newborns with risk factors and is recommended by pediatric entities to optimize resources and accuracy. Objectives: To describe the importance of ultrasound as the primary diagnostic method for the early detection of congenital hip dysplasia, analyzing its impact on the quality of life and overall development of pediatric patients. Materials and Methods: A literature review of 44 articles on the use of ultrasound in the diagnosis of CHD and its impact on quality of life was conducted. The search was conducted in scientific databases such as Web of Science and PubMed. After applying exclusion criteria, 25 relevant articles published in the last 5 years were selected. Results and Discussion: Ultrasonography is essential for the early diagnosis of CHD as it allows for accurate assessment of the relationship between the femoral head and the acetabulum in newborns and infants younger than 6 months. Its main value lies in its ability to detect abnormalities before femoral bone ossification is complete, facilitating the identification of mild dysplasias and improving the chances of correction without the need for invasive surgical interventions. Conclusions: CHD is a developmental abnormality of the hip in newborns, and early diagnosis is essential to prevent long-term complications. Ultrasonography is key for early detection as it allows for assessment of the relationship between the femoral head and the acetabulum using the alpha and beta angles, facilitating classification and treatment.Item Moduladores de la proteína reguladora de la conductancia transmembrana de la fibrosis quística (cftr) de triple combinación: Revisión bibliográfica(2025-10-16) Ugsha Toaquiza Lisbeth Mercedes; Apolo Loayza Kerly Yuliana, Dra. Esp; Universidad Técnica de Ambato / Facultad de Ciencias de la Salud / Carrera de MedicinaIntroduction:Cystic fibrosis is an autosomal recessive genetic disease that affects the function of the CFTR channel. The most common mutation is F508del, found in approximately 90% of patients. CFTR modulators have significantly improved treatment by increasing respiratory function and reducing exacerbations, which impacts survival and quality of life. Materials and Methods:A qualitative systematic review was conducted by searching scientific databases for articles on triple combination CFTR modulators. Relevant studies published in the last 5 years in English and Spanish were included. The selected articles provided information on the efficacy, safety, and adverse effects of the treatments. Results:Cystic fibrosis is caused by mutations in the CFTR gene, primarily affecting the lungs and digestive system. Triple combination modulators such as elexacaftor, tezacaftor, and ivacaftor have shown improvements in lung function and quality of life, especially in patients with common mutations like F508del. Studies also highlight the variability in treatment response, particularly among subgroups of patients with less common mutations. Conclusions:Triple therapy with elexacaftor-tezacaftor-ivacaftor has proven effective in improving lung function and quality of life in patients with cystic fibrosis, especially those with the F508del mutation. The treatment’s safety profile is acceptable, although variations in response among different patient subgroups must be considered.Item MICROBIOTA FECAL EN EL TRATAMIENTO DE LA VAGINITIS BACTERIANA RECURRENTE. REVISIÓN BIBLIOGRÁFICA(2025-10-16) Jijón Calero, Alexandra Elizabeth; Belalcázar Sánchez, Yajaira Monserrath; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaIntroduction. Recurrent Bacterial Vaginosis (BV) is a common disorder in women of reproductive age, characterized by an imbalance in the vaginal microbiota, with a decrease in lactobacilli and an increase in pathogens such as Gardnerella vaginalis, which has a high recurrence rate and resistance to conventional treatments. Vaginal dysbiosis makes antibiotic treatment difficult, which has prompted the exploration of therapeutic alternatives such as fecal microbiota transplantation (FMT). Objective. To evaluate the effectiveness and safety of FMT in the treatment of recurrent BV. Methodology. Analysis of eight previous clinical studies and systematic reviews using the PRISMA methodology. Results. FMT may be a promising option for restoring vaginal microbial balance, reducing disease recurrences, and improving the quality of life of affected women. Conclusion. Despite positive preliminary results, further research is needed to confirm its effectiveness and ensure its safety before its widespread implementation in clinical practice.Item Manejo del trauma hepático, desde la perspectiva del diagnóstico y tratamiento: Revisión bibliográfica(2025-10-16) Tutasig Mollocana Karen Nicole; Andrade Salinas Paul Roberto, Dr Esp; Universidad Técnica de Ambato / Facultad de Ciencias de la Salud / Carrera de MedicinaIntroduction: Liver trauma represents a relevant cause of morbidity and mortality, especially in the context of blunt abdominal trauma. This systematic review aimed to compare the efficacy of surgical and nonsurgical management. Methods: By analyzing observational clinical studies and systematic reviews published between 2019 and 2024, rigorous inclusion criteria were applied, and 22 relevant articles were identified through databases such as PubMed, Scopus, and Web of Science. Results: Nonsurgical treatment (NST) is evidently highly effective in hemodynamically stable patients, with success rates of 83% to 100%, especially when protocols with angioembolization and intensive monitoring are implemented. However, surgery remains essential in cases of instability, major vascular injuries, or NST failure. Discussion: It is highlighted that the complication rate is lower with NST, although its success depends on adequate patient selection and resource availability. In contrast, surgical management is associated with higher morbidity and mortality but remains vital in critical situations. Conclusion: NQT is a safe and effective strategy in controlled settings, and comprehensive multidisciplinary care is key to improving clinical outcomes and quality of life for trauma patients.Item ESTRATEGIA COMUNITARIA PARA LA DEPRESIÓN RESISTENTE AL TRATAMIENTO FARMACOLÓGICO: REVISIÓN BIBLIOGRÁFICA(2025-10-16) Ibáñez Herrera, Jailene Mercedes; Morales Lozada, Gladys Piedad; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaIntroduction: Treatment-resistant depression is a serious disorder that does not respond to several antidepressants, affecting quality of life and increasing the risk of suicide. Studies have been conducted with the use of ketamine and esketamine. Multidisciplinary management is required, combining pharmacological, psychological, and electroconvulsive approaches. Objective: To determine a comprehensive community strategy that provides support and effective treatment for people with depression who are resistant to pharmacological treatment. Methods: A literature review was conducted in PubMed, Cochrane, Science Direct, and Elsevier using the terms "depression," "resistance," "treatment," "psychotherapy," and "pharmacotherapy." Of 100 articles published between 2019 and 2024, 22 relevant articles on current therapeutic options for treatment-resistant depression were selected, using DeCS/MeSH terms such as "Treatment-resistant depression," "medicine," "drugs," and "psychotherapy." Results: Treatment-resistant depression is defined as a lack of response to two or more antidepressant treatments. It affects up to 30% of patients with major depression. The lack of a precise definition hampers research, the development of new therapies, and clinical treatment. Treatment strategies include combinations of antidepressants, esketamine, brain stimulation therapies, psychotherapy, and multidisciplinary approaches. Conclusions: Treatment-resistant depression negatively impacts quality of life and carries a high risk of suicide. It is associated with sociodemographic factors and comorbidities, and its management requires a multidisciplinary approach that includes pharmacotherapy, psychotherapy, and neurostimulation. Community support plays a fundamental role.Item Comparativa entre la manga gástrica y el bypass gástrico como tratamiento para la obesidad: Revisión de la literatura(2025-10-16) Toapanta Montesdeoca Carol Solange; Loaiza Merino Iván Patricio, Dr. Esp; Universidad Técnica de Ambato / Facultad de Ciencias de la Salud / Carrera de MedicinaObesity is a chronic, multifactorial disease that is associated with a significant increase in metabolic and cardiovascular comorbidities, underscoring the need for effective treatments. The objective of this research is to compare the effectiveness, safety and long-term results of these procedures through a review of the scientific literature. An electronic search was carried out for scientific articles published from January 2019 to 2024 in the PubMed, Scopus, Web of Science and ScieLO databases. Scientific evidence suggests that the two procedures have different benefits; the choice of each of these has to focus on the criteria given by scientific associations and societies duly recognized worldwide. In conclusion, both gastric sleeve and gastric bypass are effective interventions to treat morbid obesity, with clear benefits in weight loss and improvement of comorbidities. Gastric bypass stands out for offering a faster and more sustained weight reduction, particularly in cases of extreme obesity or severe comorbidities such as type 2 diabetes, although it implies a greater risk of long-term nutritional deficiencies due to its malabsorption component. In contrast, the gastric sleeve, less invasive and with fewer postoperative complications, minimizes the impact on nutrient absorption, although it can exacerbate gastroesophageal reflux. The choice of procedure depends on the specific clinical needs of the patient.