Medicina
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Item LA SUSCEPTIBILIDAD DE LOS PACIENTES DIABÉTICOS FRENTE A LA TUBERCULOSIS, UN ENFOQUE DESDE LA PERSPECTIVA INMUNOLÓGICA(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-09-25) Paredes Aguirre, Wendy Valeria; Echeverria Valencia, Gabriela FernandaIntroduction: The interaction between diabetes and tuberculosis represents a topic of growing medical and public health interest. Both conditions, persistent and significant globally, impact millions of individuals. Diabetes mellitus, characterized by chronic hyperglycemia due to insufficient insulin production or resistance to this hormone, has seen an increase in prevalence. On the other hand, tuberculosis, caused by Mycobacterium tuberculosis (Mtb), remains one of the leading infectious causes of morbidity and mortality worldwide. Objective: To highlight the susceptibility of diabetic patients to tuberculosis from an immunological perspective. Methodology: The approach included a comprehensive literature review using high-impact databases such as PubMed, Google Scholar, and other relevant sources in the field. Results: Diabetic patients exhibit an altered immune response characterized by compromised macrophage and T-cell function, and a reduction in the production of antimicrobial peptides. These factors contribute to a higher bacterial load and a favorable environment for the proliferation of Mycobacterium tuberculosis. Conclusions: Diabetes mellitus intensifies susceptibility to tuberculosis through multiple immunological dysfunctions. It is essential to integrate glycemic management and immunological surveillance in the treatment of diabetic patients with tuberculosis to improve clinical outcomes and reduce the incidence of the disease.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 EFECTO CARDIOMETABÓLICO DE LOS INHIBIDORES DEL COTRANSPORTADOR DE SODIO Y GLUCOSA TIPO 2(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-06-10) Olmedo Muñoz, Melissa Belén; Recalde Navarrete, Ricardo JavierType 2 diabetes mellitus has emerged as a leading cause of premature death and a growing threat to the healthcare system due to the high costs of medical care in the context of cardiovascular complications. We conducted a systematic electronic search of clinical trials published from 2015 to January 2023 in PubMed, Scopus, Web of Science, and ScieLO databases, which evaluated the efficacy and safety of the use of sodium-glucose cotransporter type 2 inhibitors in patients with type 2 diabetes mellitus and established cardiovascular disease on standard therapy and their cost-effectiveness observing significantly lower rates of acute myocardial infarction, stroke, cardiovascular death and hospitalization due to heart failure when the study drugs were added to standard therapy. In addition, it was shown that the reduction in cardiovascular clinical events offset the cost of type 2 sodiumglucose cotransporter inhibitors, resulting in a cost-effective use of health care resources.Item IMPACTO METABÓ LICO DE LOS PESTICIDAS EN EL DESARROLLO DE OBESIDAD Y DIABETES(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-06-07) Barona Freire, Selene Isabel; Recalde Navarrete, Ricardo JavierIntroduction: Obesity and type 2 diabetes mellitus (T2DM) represent chronic patholog ic a l entities with increasing global incidence, whose etiology is multifactorial, ranging from lifestyle to environmental factors. Among the latter, exposure to pesticides has aroused notable scientific interest, suggesting a potential association with metabolic alterations. Objective: To evaluate the available evidence in the scientific literature regarding the metabolic impact of pesticides on the developm ent of obesity and T2DM. Methodology: A comprehensive literature review was conducted, selecting observati on a l studies, clinical trials, and meta-analyses from biomedical databases up to the year 2023. Inclusion criteria comprised studies in humans and animal models evaluating the effect of pesticide exposure on metabolic parameters related to obesity and T2DM. Results: Synthesis of the evidence indicated that pesticide exposure is associated with endocrine disruption, promoting adipogenesis and insulin resistance. Epidemiolog ic a l analyses correlate the presence of pesticide residues with increases in the prevalence of obesity and T2DM. Animal models support these findings, showing alterations in lipid and carbohydrate metabolism following pesticide exposure. Conclusions: Pesticides emerge as significant environmental risk factors for metabol i c dysfunction, enhancing the development of obesity and T2DM. This association highligh ts the need to establish stricter regulatory policies and develop intervention strategies to minimize pesticide exposure in at-risk populations.Item Hipoglucemia en pacientes diabéticos en tratamiento con glibenclamida(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Carrera de Medicina, 2022-10-24) Rodríguez Meza, José Andrés; Morales Solís, Jorge MarceloGlibenclamide is a potent hypoglycemic agent that helps to maintain lower serum glucose levels in diabetics, which may confer a higher risk of hypoglycemia as an acute complication than with the use of other oral hypoglycemic agents, such as metformin. The purpose of this review is to collect and to summarize updated information on the mechanism of hypoglycemia in diabetic patients during treatment with glibenclamide, the risk factors that predispose diabetic patients to suffer hypoglycemia, and the frequency with which hypoglycemia may occur as adverse reaction during treatment of diabetes. Its mechanism of action consists of the inhibition of ATP-dependent potassium channels in the beta cells of the pancreas, where it stimulates the secretion of insulin by these cells. As its function is independent of serum glucose levels, hypoglycemia frequently manifests as an adverse effect of its administration. The effect of the drug is enhanced in cases such as patients with long-standing diabetes or comorbidities like kidney failure, the use of high doses or the use of other drugs that enhance its effect. Even though the use of glibenclamide as a cause of hypoglycemia is predicted to be underestimated, it is predicted that approximately 1 in 5 patients treated with this drug may experience hypoglycemia during the diabetes therapy. This factor directly influences the quality of life of the diabetic patient, as well as their adherence to hypoglycemic treatment, who chooses to abandon this medication or request a change in the scheme and the drug of choice for their therapy.Item “Tratamiento quirúrgico y clínico y su incidencia en pacientes con pie diabético en el área de medicina interna del hospital provincial general docente Ambato en el período enero- diciembre 2009”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2010-03-01) Pérez Ortiz, Jadira Alexandra; Dr. Bolívar Guerrero