Medicina
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Item TRATAMIENTO DE LA LUMBALGIA CON EL BLOQUEO DE LA ARTICULACIÒN FACETARIA LUMBAR. REVISIÒN BIBLIOGRÀFICA(2025-06-16) Yugcha Quiquintuña, Dennis Omar; Acosta Gavilanez, Roberto Iván; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaLow back pain is one of the main causes of disability worldwide, significantly affecting the quality of life of those who suffer from it. Lumbar facet block has emerged as a therapeutic option for the management of chronic pain associated with this syndrome. The objective of this review was to analyze the treatment of low back pain by blocking the lumbar facet joint, examining its efficacy in patients with low back pain. A narrative literature review was carried out in the main databases, selecting studies published between 2013 and 2023 that evaluated the efficacy of facet block. The results showed that lumbar facet block was effective in reducing pain, with significant improvements in patients' functionality, however, the duration of relief is longer in patients without major structural changes in the spine. In conclusion, lumbar facet block has been established as an effective therapeutic option for the treatment of chronic low back pain, providing a significant reduction in pain and improvement in patient functionality. The technique can be useful both in the short and long term, although the duration of relief varies according to individual characteristics.Item EPIDERMÓLISIS AMPOLLOSA: TRATAMIENTO INNOVADOR CON CÉLULAS MADRE, UNA REVISIÓN SISTEMÁTICA(2025-06-16) Zurita Delgado, Katherine Michelle; Recalde Navarrete, Ricardo Javier; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaIntroduction: epidermolysis bullosa is a set of genetic disorders that originate from modifications in certain skin proteins that alter the union and structure of the dermis and epidermis. Clinically, it manifests itself through blisters. However, these lesions can spread to other areas. areas of the body, thus causing the appearance of chronic wounds. The conventional treatment of Epidermolysis Bullosa has not been shown to improve the long-term quality of life of those who suffer from it, which is why researchers propose new therapies that allow improvements in the quality of life of patients, being one of the most promising, the use of stem cells. Methods: randomized clinical trials were selected that evaluated the efficacy and safety of stem cell treatment in patients with Epidermolysis bullosa compared to usual therapy and its cost-effectiveness. Results: based on the selected articles, several variables were measured. Four articles demonstrated the effectiveness of stem cell treatment compared to conventional treatment; two articles measured the economic considerations and access to this new treatment; four articles compared the benefits and disadvantages of using stem cells in patients with Epidermolysis bullosa; and finally, five articles demonstrated the impact that stem cells have in improving the quality of life of patients with Epidermolysis bullosa who undergo this type of therapy. Conclusions: at a global level, the effectiveness of the use of stem cells opens a promising research perspective that seeks to benefit the most vulnerable population affected by this disease, since it plays a key role in the significant reduction of blistering lesions, this represents a positive advance. in the management of the disease, as well as the improvement in its biological, psychological and social sphere, allowing an early introduction to daily activities, generating significant savings of resources for caregivers and for the State. Because, in Latin America, to date there is little research in this area, it should be considered a very promising line of research in the field of Dermatology. Similar situation in the case of Ecuador, where since there are no statistics on patients with this disease, nor data that contribute to the treatment of this vulnerable group, these investigations will provide a solid basis for researchers to adopt this new therapy.Item ACTUALIZACIÓN DE LA REVISIÓN BIBLIOGRÁFICA DE LA INMUNOTERAPIA EN LEUCEMIA MIELOIDE AGUDA(2025-06-16) Peñafiel Canseco Fabian Alejandro; Cruz Castillo Yessenia Magaly; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaIntroduction: Acute myeloid leukaemia (AML) is a haematological disease characterised by uncontrolled proliferation of immature cells in the bone marrow, interfering with normal blood cell production. Despite advances in chemotherapy and bone marrow transplantation, relapse and mortality rates remain high. In this context, immunotherapies have emerged as an innovative and promising strategy. Aims: This article aims to describe therapeutic advances in immunotherapy for AML, analysing the clinical outcomes and survival rates of these patients treated with immunotherapy. Material and methods: A literature review was carried out including articles from the last 5 years retrieved from scientific databases such as Scopus, PubMed, Science Direct and Springer. Scientific articles referring patients with other types of leukaemia and which have been treated with phytotherapy and gene therapies were excluded.Keywords: acute myeloid leukaemia; treatment; immunotherapy. Results: Different immunotherapy strategies have been reviewed including monoclonal antibodies, immune checkpoint inhibitors, CAR-T cells and therapeutic vaccines that aim to boost the immune system's ability to identify and destroy leukaemic cells, reducing side effects compared to conventional treatments. Conclusions: Against a backdrop of hope and challenges, immunotherapy is emerging as a revolutionary tool that could redefine AML treatment and significantly improve clinical outcomes.Item SECUELAS EN PACIENTES POST INFECCIÓN POR COVID 19, UN COMPARATIVO ANTES Y DESPUÉS DE LA VACUNACIÓN(2025-06-16) Capuz Diaz Edwin Santiago; Romo López Ángel Geovanny; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaThe coronavirus outbreak in 2019, reported in the city of Wuhan, Hubei province in China, caused by a type-2 severe acute respiratory syndrome virus, leading to a global declaration as a pandemic in 2020, a fatality rate of 1% to 3% of the population affected, mainly older adults, is estimated worldwide, adding those people who had some type of comorbidity such as Diabetes, High blood pressure, cardiovascular disease and some type of disease. of Cancer. On February 29, 2020, the Ministry of Public Health of Ecuador confirmed the first case of COVID 19 in the city of Guayaquil, however this would only be the beginning of an unimaginable outbreak of infections in said city and at the country level, had a great global impact since until August 28, 2022 we had a report of 598 million confirmed cases and a total of 6.4 million deaths globally. Causes acute respiratory syndrome in the initial stages, but over time the presence of digestive, renal, hepatic, cardiovascular and neurological disorders has been observed in different stages, whether acute, subacute and chronic. In 2021, tests and studies were already being carried out for the viability of immunization at a global level, but this did not guarantee 100% immunity since 60% of people could be infected again given the characteristics of the mutation.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 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 GabrielaIntroduction: 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.Item IMPLEMENTACIÓN DE NUEVAS TECNOLOGÍAS EN EL TRATAMIENTO DE QUEMADURAS PEDIÁTRICAS: UNA REVISIÓN NARRATIVA(2024-09-24) Balseca Artos, Eddy Efren; Fiallos Brito, Edisson JavierBurns in children and adults exhibit pathophysiological differences derived from the anatomical and physiological characteristics of each age group, which is why burns are serious and require immediate medical attention. Calculating accurate total burned area is crucial, however, current methods such as the Lund and Browder table, the rule of nine, or two-dimensional plots are subject to inter-rater variation and severely overestimate the burned area. An inaccurate estimate of the extent of the burn generates unnecessary transfers to burn centers, fluid overload, increased hospital stay, and medium and long-term sequelae. To address these challenges, a series of applications for mobile phones and artificial intelligence have been evaluated, as well as the implementation of virtual reality, the use of skin substitutes and bioactive therapies that allow reducing costs in the hospital area. The development and implementation of therapeutic tools exemplifies how medicine is evolving; however, it is important to highlight the need to extend research in this field to optimize prognosis and quality of life.Item NUEVAS ESTRATEGIAS FARMACOLÓGICAS Y SU MECANISMO DE ACCIÓN EN EL TRATAMIENTO DE LA TB PULMONAR(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-09-24) Caicedo Lozada, Andrés Sebastián; Echeverría Valencia, GabrielaPulmonary TB (PTB), caused by the bacillus Mycobacterium tuberculosis (Mtb), is one of the most prevalent and deadly infectious diseases worldwide. With approximately a quarter of the global population affected, TB stands as one of the leading causes of mortality within the spectrum of infectious diseases. Given this reality, there is an urgent need to explore and analyze new strategies that offer hope in the fight against this disease. This article aims to provide an analytical review of emerging strategies in the treatment of TB. To achieve this objective, a comprehensive review methodology has been adopted, encompassing a wide range of recent bibliographic sources, including academic research and specialized literature. The purpose is to compile and synthesize the most significant and up-todate contributions in the field, thus providing a clear and current overview of advances in the fight against TB. The article is structured into key sections that cover an introduction to the basic concepts of PTB, examining the epidemiology and interaction between Mtb and the host immune response, focusing on the formation of granulomas. Additionally, the pharmacodynamics and conventional treatments are analyzed, along with a critical study on drug resistance. It concludes by highlighting the need for innovation and personalization in treatments to address drug resistance, offering a comprehensive view of the current challenges and solutions in the management of TB.Item TRATAMIENTOS APLICADOS EN PACIENTES POR INFECCIÓN DE COVID-19 CON DIABETES MELLITUS TIPO 2(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-06-10) Sánchez Jácome, Gissela de los Ángeles; Freire Montesdeoca, Jessica MarianaCoronaviruses are RNA viruses that cause different types of respiratory illnesses. At the end of 2019, a new coronavirus was identified and declared a pandemic on March 11, 2020. There is the development of diabetes in patients with SARS-CoV-2, so it is possible that it could cause alterations in glucose metabolism leading to the development of diabetes mellitus. The objectives of article to carry out a bibliographic review of the treatments applied in patients infected with Covid-19 and who have type 2 diabetes mellitus as their underlying pathology. The results this investigation all the articles analyzed describe the use of metformin, insulin and corticosteroids as the mainstay of treatment, accompanied by patient education and communication between health personnel and the patient. Conclusion treatment is based on the patient's usual medication, but with slight adjustments depending on glucose control. Different treatments have also been described such as incretins, ACE inhibitors, chloroquine and hydroxychloroquine and SGLT2 inhibitors among others that have acted in different ways to control this pathology.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.