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 100 AÑOS DESPUÉS DE LA BCG, VACUNAS VIVAS ATENUADAS FRENTE A LA TUBERCULOSIS(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-09-24) Freire-Bravo, Milena Thais; Echeverría Valencia, Gabriela FernandaBackground: For more than a century, the BCG vaccine, derived from an attenuated strain of Mycobacterium bovis known as bacillus Calmette-Guérin, has been used to prevent tuberculosis (TB). Despite its widespread use, the effectiveness of the BCG vaccine is variable, and its protection is transitory. Objective: To compile information on the feasibility and effectiveness of new live attenuated vaccines as alternatives to the BCG vaccine in the prevention of tuberculosis. Methods: A bibliographic review of descriptive scope was carried out, using articles specialized in medical, nursing and epidemiology topics from the last two years (2022-2023), the search was carried out autonomously in various databases. Results: In clinical trials and preclinical studies, various live attenuated, inactivated and subunit/adjuvant vaccines have shown potential to improve immunogenicity and protection against tuberculosis. Vaccines such as MTBVAC and RUTI are in different phases of clinical development, while others, such as M72/AS01E and H56, are in advanced phases of testing. Conclusions: The invasion of M. tuberculosis can culminate in bacillary dissemination to other vital organs; it is crucial to develop more effective vaccines for adults and optimize vaccine combinations, addressing the genetic variability of the strains and immunological differences between populations. Currently, research into vaccines against tuberculosis reflects notable progress and an increasingly deep understanding of immunological interactions.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 Osteomielitis tuberculosa del cráneo, a propósito de un caso(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Carrera de Medicina, 2022-10-13) Silva Poaquiza, Violeta Alexandra; Andrade Alban, Noemí RocíoTuberculosis today continues to be a global health problem with high rates of morbidity and mortality, tuberculous osteomyelitis is one of the forms of presentation of extrapulmonary tuberculosis, skull involvement is rare even in endemic areas of tuberculosis, with an approximate incidence from 0.2 to 1.3% of the total cases of skeletal tuberculosis. The most common route of dissemination is hematogenous, from a primary pulmonary focus or by direct inoculation of the bacteria in the affected site; The clinical presentation is similar to other pathologies, but more frequently there is pain, local inflammation and suppuration of the affected site. Early treatment leads to a lower probability of complications at the neurological level, which is why it is important to propose accurate diagnostic methods and adequate therapy. A case of a 45-year-old male patient with a surgical history of craniotomy 6 years ago due to cranioencephalic trauma presents an open wound in the left parietal region with seropurulent fluid and erythematous edges. A sample of the wound secretion is taken, and a computerized axial tomography is requested in the that a lytic image is evident that affects the left parietal bone without alteration of the brain parenchyma in addition to simple and contrast-enhanced nuclear magnetic resonance with diffusion in which a fistula of the scalp is reflected without communication with the endocranial cavity the report of the secretion is positive for acid-fast bacilli, so antituberculous therapy was instituted. A descriptive investigation of a case of tuberculous osteomyelitis of the skull was carried out. To support the information, existing literature on the subject was reviewed in scientific bases such as PubMed, The Cochrane, Intramed, Medline, Scopus, ScieELO, Medigraphic, with a literature cut-off point. than 5 years old, except in cases where the information was essential, it was considered literature of greater antiquity. Due to the low incidence of cases of tuberculous osteomyelitis of the skull and the low relevance given to the subject, it was decided to carry out the report of this case for knowledge of the diagnosis and treatment of this pathology and its consideration for similar cases in the future.Item “Influencia de la tuberculosis pulmonar en la calidad de vida de los pacientes atendidos en el área de salud N.- 2 período enero - diciembre 2013”.(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2014-11-01) Carrillo Cunalata, Doris Marisol; Changoluisa Paredes, Edgar Ramiro Dr.Through the history of pulmonary tuberculosis has been considered a high-risk condition for life, although in Ecuador has only been handled medically , in order to manage the patient medically , controlling management treatment, more still has neglected the psychological level , which is involved in the quality of life of sufferers , affecting their health and changing sociability; However with technological advances has managed to find new treatments that have become more bearable lifestyle of patients affected by tuberculosis , within this research study is an analysis of the disease is detailed , the procedures used in the treatment so general and specifically the relationship between the disease and the quality of life of patients treated at this clinic in 2013 , through the implementation of a survey data could be obtained once we tabulated validate the hypothesis which has been the starting point for establishing the final proposal under the criteria of the development of a protocol for the treatment and improving lifestyle of patients with pulmonary tuberculosis.Item “Estudio de la incidencia de pacientes con multirresistencia al tratamiento antifimico para la tuberculosis y sus factores de riesgo, en el período 2006- abril 2010 en la provincia de Cotopaxi”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2010-10-25) Jordán Arias, Jacqueline Alexandra; Salas, Fernando Dr.The present study had as object know the patients' incident with multirresistencia to the treatment antifimico for the tuberculosis and his factors of risk, in Cotopaxi' Province from 2006 from April, 2010. It is an analytical retrospective study of cases and controls, the sample was taken of all the patients registered in the quarterly reports of the DPSC-EPIDEMIOLOGIA who are in the Headquarters of Health of Cotopaxi, being that these were or being under treatment and who have presented multirresistencia the same one, this way to manage to eradicate the principal factors that they interfere on having created multirresistencia. The present investigation has vital importance because the tuberculosis, his implications and repercussions with regard to the multiresistance, up to the current importance, have not been exhaustively investigated in our way, in such a way that the relation was investigated between the levels of the variables. x For the control methodological tools were in use since they are the controls, and the utilization of quarterly reports and clinical histories of the patients for the summary of the information. The results were analyzed by tables to validate his significancia and to guarantee the reliability of the same ones. Being like that that we have a sample of 479 patients of which they are new cases 418 and cases before treated 61casos for what takes as point of analysis the above mentioned finding as determinant that the patients with multirresistencia are classified as "others", inside which I determine 15 patients' cases with resistance to the treatment antifimico checking across the review of the clinical histories that 4 patients were monoresistant, 10 patients MDR (multidrogoresistentes) and 1 patients Poliresistente, analyzing that of the total of resistant patients 2 died.Item “Evaluación de la estrategia dots y su relación con la captación de sintomáticos respiratorios, por parte del personal de salud del área n°1 de Ambato, provincia de Tungurahua”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2010-09-01) Carrasco Calle, Rodolfo Salomón; Dra. Naranjo, JannethItem Tuberculosis Peritoneal(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-11-01) Gavilanes Paredes, María Cristina; Loaiza Merino, Iván PatricioDr. ESP.Peritoneal tuberculosis generally occurs as a secondary infection of a primary disseminated pulmonary infection. The clinical case can mimic a carcinomatosis due to its vague symptoms and unspecified signs, like abdominal pain of unknown etiology, ascites and fever. Male patient of 22 years of age, admitted for presenting ascites, weight loss, with adenosine-deaminase (ADA) 90,8 U/L and CA 125 of 681,3 U/mL. The peri-operative findings include ascetic fluid of about 4000cc, presence of multiple peritoneal and visceral infiltrates that appear as carcinomatosis, liver with multiple nodules, the anatomopathological study refers to abdominal tuberculosis. The diagnosis is performed through laboratory studies, anatomopathological study and through the culture of peritoneal fluid. With the diagnosis of peritoneal tuberculosis the patient was seen by the service of Infectology, he was later refered to health center number 1, where he will get a check up and treatment.Item “Influencia de los conocimientos del personal de salud en la calidad de las muestras de baciloscopias tomadas en pacientes perteneciente al área no.-2 en el período marzo – junio del 2.010”(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2010-10-01) Carrasco Paredes, Delia María; Aguilar, Aida Dra.