Medicina
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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 IDENTIFICACIÓN DE BIOMARCADORES PRECOCES PARA EL DIAGNÓSTICO DE ENDOMETRIOSIS(2025-06-13) Rodriguez Linares, Angie Ibeth; Bustillos Solorzano Marcos Edisson; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaEndometriosis is a progressive gynecological disease characterized by the migration of endometrial cells outside the uterus, associated with chronic inflammation and an uncertain pathogenesis. This study aimed to identify early biomarkers for the diagnosis of endometriosis through a systematic review of scientific literature. Following the PRISMA methodology, research questions were formulated focusing on immunological and angiogenesis aspects, the most relevant biomarkers under study, and the challenges in their validation. An exhaustive search was conducted in databases such as Scopus, PubMed, and Web of Science, covering publications from 2018 to 2024. The results show that although numerous potential biomarkers have been identified, including glycoproteins, inflammatory cytokines, oxidative stress markers, growth factors, autoantibodies, miRNAs, and lncRNAs, none have achieved adequate sensitivity and specificity for universal clinical use. The heterogeneity of the disease and variability in studies hinder the implementation of a single biomarker. However, the combination of multiple biomarkers could improve diagnostic accuracy. In conclusion, the identification of early biomarkers is essential to develop non invasive and effective diagnostic tools, transforming the clinical management of endometriosis, reducing the need for invasive procedures, and allowing personalized therapeutic interventions.Item AVANCES EN EL DIAGNÓSTICO Y TRATAMIENTO DE LA INFECCIÓN DEL TRACTO URINARIO EN PEDIATRÍA(2025-06-13) Barreros Lema, Edwin Esmith; Philco Toaza, Priscila Elizabeth; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaUrinary tract infection (UTI) is one of the most common bacterial infections in the pediatric population, especially in children under two years of age, Escherichia coli is the most common pathogen, responsible for the majority of cases. The high recurrence rate and potential for kidney damage underscore the importance of proper diagnosis and treatment. The objective of this scientific article is to identify recent advances in the diagnosis and treatment of urinary tract infection in children based on updated scientific evidence with the aim of improving clinical management in the pediatric population. A bibliographic review of the literature available in databases such as PubMed, Scopus and Web of Science was carried out; articles published between January 2019 and November 2024 that addressed the diagnosis, treatment and management of UTI in the pediatric population were included. The studies reviewed highlight the importance of early diagnosis through urine cultures and adaptation of treatment based on bacterial susceptibility. Advances include the use of fosfomycin, probiotics, and supplementation with vitamins D and C, all of which have shown promise in the prevention and treatment of UTIs. Additionally, new forms of intravesical therapy and the implementation of nutritional strategies to reduce infection recurrence are explored. It was concluded that the management of UTI in pediatrics has evolved, currently supplementation with micronutrients and probiotics are used as novel methods for the prevention of recurrent UTIs, while fosfomycin is presented as a viable option in cases of resistance to conventional antibiotics.Item DIAGNÓSTICO DE UN TUMOR XANTOASTROCITOMA PLEOMÓRFICO(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-07-04) García Amores, Arianna Gabriela; Lana Saavedra, Héctor EnriqueIntroduction: Xanthoastrocytoma Pleomorphic (XAP) is a rare and usually lowgrade brain tumor, which presents significant challenges in its diagnosis. This tumor is characterized by its clinical and pathological heterogeneity, making it a point of interest in the field of neurooncology. Objective: The aim of this research is to review and synthesize current diagnostic methodologies for Xanthoastrocytoma Pleomorphic, identifying the most effective techniques and emerging trends in its identification and classification. Methodology: An exhaustive search was conducted in databases such as PubMed, Scopus, and Web of Science, using keywords related to Xanthoastrocytoma Pleomorphic and its diagnosis. Articles in English and Spanish were included, from the year 2017 to 2023, selecting studies that provide data on clinical characteristics, diagnosis, treatment, and prognosis of XAP. Results: The reviewed studies indicate that magnetic resonance imaging (MRI) is the most important diagnostic tool for XAP, typically revealing a well-circumscribed lesion with enhancement after contrast administration. Biopsy and histopathological examination are crucial for definitive diagnosis, showing the presence of pleomorphic cells and areas of xanthomatization. Conclusion: The accurate diagnosis of XAP is based on a combination of clinical, radiological, and pathological features. Despite advances in imaging and pathology, definitive diagnosis still relies on histology. Understanding molecular characteristics may offer new insights for diagnosis and treatment.Item ENFERMEDAD RENAL POLIQUISTICA AUTOSÓMICA DOMINANTE: ACTUALIZACIÓN DIAGNÓSTICO Y TRATAMIENTO(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-06-10) Sáez Paredes, Diana Nathaly; Lituma Jumbo, Rosalina de LourdesObjective: This paper aims to consolidate and analyze the most recent data on the diagnosis and management of ADPKD, providing an updated synthesis to guide clinical practice and future research. Methodology: A thorough literature review was conducted, selecting studies, articles, and clinical guidelines published in the last decade. Inclusion criteria were based on clinical relevance, methodological quality, and the timeliness of the data. Non-peer-reviewed publications and those not contributing significant information to the central theme were excluded. Results: Advances in imaging have enhanced early detection and accurate assessment of the disease severity. Understanding the genetics and molecular biology of ADPKD has been crucial for the development of targeted therapies. Current treatments focus not only on delaying the progression of kidney disease but also on managing extrarenal manifestations and associated comorbidities. Conclusions: This pathology requires a multidisciplinary approach for its diagnosis and treatment. Advances in genomic and clinical research continue to improve the quality of life of affected patients. It is imperative for healthcare professionals to be up to date regarding recent developments to optimize clinical management and explore new avenues for research and therapeutic intervention.Item ACTUALIZACIÓN DE LA INFECCIÓN POR VIRUS DEL PAPILOMA HUMANO ASOCIADO A CÁNCER DE CUELLO UTERINO CON UN ENFOQUE EN EL DIAGNÓSTICO Y TRATAMIENTO(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-06-10) Oña Rodríguez, Tannia Maribel; Silva Acosta, Jissela Del CarmenIntroduction: Cervical cancer is one of the leading causes of death among women worldwide, and infection with the Human Papillomavirus (HPV) is a significant risk factor for its development. The aim of this review article is to update the knowledge on HPV infection and its association with cervical cancer, with a focus on diagnosis and treatment. Methodology: A systematic review of the literature was conducted using electronic databases such as PubMed, Scopus, and Web of Science. Studies published in English from 2015 to the present that addressed HPV infection and cervical cancer, with a focus on diagnosis and treatment, were included. Results: HPV infection is a significant risk factor for the development of cervical cancer. Diagnostic methods include cervical cytology, HPV testing, and colposcopy. Prevention of cervical cancer can be achieved through HPV vaccination and early detection via screening tests. Conclusions: HPV infection is a significant risk factor for the development of cervical cancer. Diagnostic methods and treatment options are available for the management of HPV infection and cervical cancer. Prevention of cervical cancer can be achieved through HPV vaccination and early detection via screening tests. It is important for healthcare professionals to be up-to-date on the latest recommendations for the prevention and management of cervical cancer.Item ESTRATEGIA DE DIFUSIÓN CIENTÍFICA DE RESULTADOS DE PROYECTOS DE INVESTIGACIÓN EN EJECUCIÓN DE LA CARRERA DE MEDICINA DE LA UTA(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-06-10) León Sánchez, José Andrés; Hernández Navarro, Elena VicentaIntroduction: The current hyperconnectivity, known as participatory culture, has promoted phenomena of scientific dissemination in the contemporary world, social networks have transformed the way of accessing and consuming information, forcing traditional media to assume the role of content creators, where scientific dissemination becomes the axis of the multidimensionality of scientific knowledge Objective: Design a Scientific Dissemination Strategy based on the results of the Research projects of the Medicine Career of the Technical University of Ambato Methodology: A theoretical systematization of the most creative and innovative processes related to the scientific dissemination process was developed, the historical-logical methods were applied, as well as the analysis and synthesis of the consulted literature, a methodological triangulation, data and analysis was established. of theories of the analyzed content, the data has been extracted by consulting the PUBMED and ISI WEB KNOWLEDGE databases Results: The dissemination of science must currently assume through the research experience itself, the so-called citizen science, a horizontal model of coexistence and participation, where society becomes the issuer and manager of scientific content, thanks to the acquisition of the relevant skills developed through scientific, media and digital literacy, this implies the involvement and learning of the latter in a process of transformation of roles, tasks and procedures, thanks to the digital context, with the aim of improving management of scientific information and the results of on going research projects Conclusions: The Scientific Dissemination Strategy took into account various phases for its development, articulated to three basic processes, the first the creation of a database for the collection of publications and preparation of reports, the second stimulating the creation of articulated products to scientific projects that respond to societal problems , and the third is integration into indexed databases , which guarantee the visibility of the scientific results developed in the Medicine CareerItem LA RABDOMIÓLISIS UN POTENCIAL RIESGO PARA LA FALLA RENAL EN EL SÍNDROME COMPARTIMENTAL(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-06-07) Bautista Simbaña, Bety Claudia; Lituma Jumbo, Rosalina de LourdesIntroduction: Rhabdomyolysis is a disorder characterized by the massive rupture of myocytes, leading to the release of myoglobin and other intracellular components into the bloodstream. This condition can have severe consequences, especially when combined with compartment syndrome. The purpose of this article is to examine the available literature on the relationship between rhabdomyolysis and renal injury in compartment syndrome. The methodology used in this literature review study consisted of conducting a comprehensive review of relevant scientific literature in electronic repositories and other relevant sources. Studies addressing aspects such as epidemiology, clinical manifestations, risk factors, diagnostic and therapeutic methods, and prognosis were included. The results obtained revealed that rhabdomyolysis is identified as a significant risk factor for the progression of renal injury in the context of compartment syndrome. Diagnostic methods involve assessing renal injury by detecting elevated levels of muscle enzymes and biomarkers, as well as imaging studies to evaluate the extent of muscle damage. Regarding treatment, the importance of aggressive rehydration and the prevention of acute renal injury is emphasized. In severe cases, renal replacement therapy may be necessary. In conclusion, rhabdomyolysis represents a potential risk for the development of renal injury in compartment syndrome, making early diagnosis and appropriate treatment essential for improving clinical outcomes.Item Diagnóstico y manejo terapéutico actualizado del aborto espontaneo recurrente(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2023-06-01) Yanchaliquin Paucar, Tamia Vanessa; Gavilanes Sáenz, Víctor Patricio Dr. Esp.Abstract: Recurrent miscarriage is the spontaneous loss in two or more consecutive pregnancies before 20 weeks of gestation, it must be confirmed by ultrasonographic ultrasound or histology studies. It is a multifactorial pathology, it is estimated that 1% to 2% of all women who manage to conceive a pregnancy suffer recurrent early losses within this percentage, 60% o f which produce endocrinological disorders, genetic, anatomical, immunological factors, the other The remaining 40% of cases are of idiopathic etiology. For several years, the treatment of first choice has been surgery with uterine vacuum aspiration, with a high success rate (97-99%). The clinical manifestations of spontaneous abortion include vaginal bleeding before 20 weeks, with or without abdominal pain, however, the gold standard used is ultrasound given its high specificity (97.6%), sensitivity (90%), and its costeffectiveness, defining spontaneous abortion, using cut-off criteria of MSD at ≥25 mm (without an obvious yolk sac) and CRL ≥7 mm (without fetal cardiac activity), patients with recurrent miscarriages, two-dimensional ultrasonography is recommended /three-dimensional echohysterography, especially if the cause of recurrence is suspected to be uterine defects or anomalies, new diagnostic alternatives such as antibody detection, hysteroscopy, embryoscopy, and biomarkers can also be used. For several years, the first-choice treatment has been vacuum aspiration surgery, with a high success rate (97-99%); however, this surgical technique is an invasive procedure and can cause short-term complications such as cervical injury, uterine perforation, excessive bleeding and pelvic infection, and longterm adhesion formation and risk of preterm delivery. In updated protocols therapeutic management includes levothyroxine, progesterone, folic acid, hCG, LMWH (low molecular weight heparin), LDA (low dose aspirin), VD3 (vitamin D3), intravenous immunoglobulin (IVg), psychotherapy, genetic counseling , patients with idiopathic recurrent spontaneous abortion are treated with anticoagulation, progesterone supplements and/or immunomodulatory agents, and surgicalxiii procedures are less invasive, have less risk of intrauterine adhesions, more cases of complete tissue removal.Item Manejo de coledocolitiasis mediante la colangiopancreatografía retrograda endoscópica (CPRE) en pacientes geriátricos: a propósito de un caso(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Carrera de Medicina, 2021-01-01) Beltrán López, Édison Gabriel; Yépez Yerovi, Fabian Eduardo Dr. Esp.Choledocholithiasis is considered the main cause of bile duct obstruction, it occurs in 5 to 10% of clinical patients with symptomatic cholelithiasis and in up to 18 to 33% of clinical patients with biliary pancreatitis. It is a frequent pathology that the general surgeon is faced with, although in the medical literature there are different tools for its diagnostic approach depending on whether the patient has a high or low probability of having it from the result of paraclinical studies (Hepatic profile and hepatobiliary ultrasound). These scales were developed to be applied in patients with or without gallbladder in situ, for an adequate diagnosis and therapeutic management. There are studies that have shown that the paraclinical laboratory and imaging results may have variations, which is why the feasibility of using the ASGE scale as predictors of choledocholithiasis in these patients has been proposed. Using this scale, it would help us to better determine the study of these cases, saving Hospital resources, by defining which patients benefit from extension studies such as cholangioresonance or ERCP, taking into account the possible complications associated with this procedure.