Medicina

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Alternativas terapéuticas para el manejo del síndrome de Asherman
(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2023-07-04) Quile Landa, Evelyn Dayanna; Acosta Gavilánez, Roberto Iván
Asherman's syndrome represents a health problem, because it causes gynecological alterations that affect the menstrual cycle and reproductive function. Currently, the hysteroscopy used to remove adhesions fails to recover the endometrial anatomy, so the percentage of recurrences is high, and the pregnancy rate is low, therefore, adjuvant methods are needed to avoid or reduce these recurrences and improve the receptivity. The objective of this bibliographic review was to describe the main adjuvant therapeutic alternatives used in the postoperative management of recurrences of Asherman's Syndrome. For this, a search was made in the Google Scholar, PubMed and Springer databases, a total of 898 articles were found, those that had other study variables such as: abortion, infertility, pregnancy, those that did not have a text were excluded. complete and those whose publication date was before 2017, in the end 32 articles were selected. Results: estrogens in combination with progesterone at low doses help improve endometrial function, on the other hand, the IUD with hyaluronic acid represents the best option for a good endometrial repair. Conclusion: the use of solid barriers combined with gels and hormonal therapy constitutes the most effective alternative in the treatment of recurrences of Asherman's syn drome, and advances in stem cell therapy guarantee total recovery, but there are still limitations that prevent their use.
ARTRITIS IDIOPÁTICA JUVENIL: UNA ENFERMEDAD LIMITANTE
(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-06-10) Vaca Molina, Joselyn Katherine; Acosta Gavilánez, Roberto Iván
Juvenile idiopathic arthritis (JIA) is the most common type of arthritis in children and adolescents with a chronic course and unknown etiology. The incidence and prevalence of the disease are variable. Worldwide, its incidence ranges between 1.6-23 cases/100,000 children under 16 years of age/year and its prevalence between 3.8-400/100,000. The complications that occur in these patients range from delayed growth and osteoporosis to alteration of several organs. Treatment of JIA requires anti-inflammatory and immunomodulatory medications and physical therapy. Aim. - Collect relevant information on juvenile idiopathic arthritis in the context of a limiting disease in the growth and development of children through an updated bibliographic search, emphasizing complications and treatment for its correct management. Methodology. – Descriptive and retrospective bibliography review by compiling available and updated information in databases such as Google Scholar, PubMed and Science Direct. The inclusion criteria were: articles published from 2019 to the current date (2023), topics directly related to the proposed title such as idiopathic arthritis, growth restriction, complications, articles available and accessible to the public. Likewise. They excluded those articles that had limited accessibility, incomplete texts and inconclusive research results. Each article must be carefully analyzed taking into account the different points of view of each author. Results. – One in three children with JIA has growth retardation, the severity is predicted by the low age of onset of the disease and the long duration of the disease. Correlation and regression analysis showed that low age at diagnosis and disease duration are significant predictors of the severity of stunting. Conclusions. - Growth disturbance is an important complication of JIA, with important implications for both physical and psychosocial health, and its growth can also slow down. It is a major concern for families of young children with JIA and an additional challenge for older children and adolescents facing the impact of the chronic disease.
EFECTO TERAPÉUTICO DE LOS PROBIÓTICOS COMO TRATAMIENTO COADYUVANTE PARA EL TRASTORNO DEPRESIVO MAYOR
(2025-06-13) Caiza Bustos, Anabel Estefania; Acosta Gavilánez, Roberto Iván; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de Medicina
Introduction: In the field of mental health, factors such as unbalanced diet, infections, and sustained stress lead to alterations in the functions of the intestinal microbiota, including the synthesis of neuroactive compounds. Probiotics are attributed a potential therapeutic effect in pathologies such as major depressive disorder (MDD) by modulating the gut-brain microbiota axis. Objective: To identify probiotic strains that have potential effects on the symptoms of major depressive disorder. Materials and methods: A descriptive bibliographic review was carried out with information collected from meta-analyses, systematic reviews, randomized controlled studies, bibliographic reviews, intervention studies, pilot studies obtained from specialized databases such as PubMed, ScienceDirect and Cochrane Library published between 2020 and 2024.Conclusions: The effects are specific to each strain. The capacity of Lactobacillus helveticus and Bifidobacterium longum to boost tryptophan along the serotonin pathway, improving mood, anhedonia and sleep quality, is highlighted. Bifidobacterium breve CCFM1025 regulates the serotonergic system and the metabolism of tryptophan, a precursor of serotonin, capable of alleviating the symptoms of MDD. Despite the positive findings around the strains studied, research in larger populations is required to determine the efficacy and safety of probiotic supplementation to the classic treatment of MDD.
PREVENCIÓN DEL CÁNCER DE TIROIDES EN ATENCIÓN PRIMARIA DE SALUD
(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-06-10) Morales Lozada, Luis David; Acosta Gavilánez, Roberto Iván
Introduction: Thyroid cancer is the most common type of cancer of the endocrine system, so research will provide updated information on this disease and seek to develop strategies to identify risk factors that may be useful in its prevention. Objective: Design prevention strategies that can be applied at the primary care level by general practitioners or specialists in family and community medicine to mitigate the risk of thyroid cancer. Methodology: The present study was carried out under a literature review over the last 5 years using scientific databases: Google Scholar, Scopus, Scielo, PubMed, in addition to web pages, clinical practice guidelines and other sites with information of importance to the study. Results: The causes of thyroid cancer are not yet fully understood, however, some of the factors that would be involved in its appearance are obesity, exposure to radiation, environmental factors, nutritional patterns and dietary patterns that according to the Spanish Society of Medical Oncology (SEOM) cancer can be prevented in 30 to 50% of cases if strategies are implemented to guide the eradication of these predisposing factors, so through research, preventive strategies were created that could reduce the risk of thyroid cancer. Conclusions: Thyroid cancer can be prevented in 30 to 50% of cases if strategies, policies or programs are implemented to guide the identification and eradication of predisposing factors. However, it should be clarified that the absence of cancer is not guaranteed, but it can help reduce the risk of developing it.
Siringomielia dorsal, a propósito de un caso
(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2023-07-06) Sánchez Mejía, Mirka Michelle; Acosta Gavilánez, Roberto Iván
Syringomyelia is a pathology characterized by the presence of a cyst inside the spinal cord. This pathology has an incidence of 8.4 new persons each year per 100,000 inhabitants. The average age of onset is approximately 30 years with an evolution period of 6 years. The following is the clinical case of a 64-year-old male patient with no clinical or surgical history of importance, who comes to the Emergency Department of Hospital General Ambato for paresthesia in lower limbs of progressive evolution, the physical examination shows an unstable gait with increased base of support, decreased strength, spastic paresthesia, inability to ambulation and standing, bilateral positive Babinski, bilateral patellar and bilateral Achilles hyperreflexia with sensitive level in T10. Simple magnetic resonance imaging of the dorsal spine was performed, showing an intramedullary cystic lesion extending from T2 to T9, reaching the diagnosis of Dorsal Syringomyelia not related to other anomalies such as Arnold Chiari Type I. Shunting of the syringoma to the subarachnoid space is a definitive surgical treatment, however, in some cases the procedure succeeds in reducing the size of the syringoma but does not produce any notable improvement in the patient's clinical condition.
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