Medicina
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Item ASOCIACIÓN ENTRE LA COMPOSICIÓN DE LA MICROBIOTA INTESTINAL: RELACIÓN CON LA ENFERMEDAD CELIACA Y DESNUTRICIÓN(2025-06-19) Maridueña Paredes, Lizbeth Sarahi; Torres Torres, Johny Mauricio; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaThe aim was to determine the association between the composition of the intestinal microbiota and its relationship with celiac disease and malnutrition. A systematic review was carried out following the PRISMA guidelines, using databases such as PubMed, Dialnet, Google Scholar, SciELO and Elsevier. Studies published between 2020 and 2024 in Spanish and English, which analysed the composition of the intestinal microbiota in patients with celiac disease, were included. The selection of studies was carried out through a threephase process: review of titles and abstracts, evaluation of the full text and final data extraction. The results revealed an intestinal dysbiosis characterised by a significant reduction in beneficial bacteria (Bifidobacterium and Lactobacillus) and an increase in potentially pathogenic bacteria (Bacteroides and Escherichia coli). These microbial alterations are not only a consequence of celiac disease, but play a fundamental role in its development. Microbial changes were identified up to 18 months before clinical manifestation, suggesting their potential as an early biomarker. Factors such as antibiotic use, birth route and type of feeding significantly influence the composition of the microbiota. In conclusion, the intestinal microbiota plays a crucial role in the pathogenesis of celiac disease and malnutrition. Microbial alterations compromise nutrient absorption, modify the immune response and affect intestinal permeability. Emerging therapeutic strategies focus on microbiota modulation through probiotics, prebiotics and fecal microbiota transplantation, representing a promising approach for the management of these conditions.Item Desnutrición Infantil Marasmo y Kwashiorkor(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Barrionuevo Marín, Michel Estefany; Lucero Jácome, Martha Cecilia Dra. Esp.Protein-energy malnutrition (PEM) is a multisystem disease, which affects all organs and systems of the human being. It’s produced by a drastic, acute or chronic decrease in the availability of nutrients either due to insufficient food intake, inadequate absorption, excessive loss of intake or the combination of two or more of the aforementioned factors. PEM is the most notorious nutritional disease in third world countries due to its high prevalence and its relationship with mortality statistics. It’s also linked to the deterioration of physical growth, as well as poor social and economic development. Infantile malnutrition is a difficult problem to eradicate. One of the most important phases in the life of human beings takes place from when the baby is in the womb up until the child reaches five years of age. What happens at this stage could have irreversible physical physical and mental effects on a person’s development. If there is one thing in the fight against infantile malnutrition and poverty, that is to guarantee that children under the age of three receive adequate nutrition because this is the most critical stage in their psychological and physical development. That could be by Etiology: Primary: When it originates from an insufficient intake of nutrients. Secondary: When it’s caused by an underlying disease which leads to an inadequate ingestion or absorption of nutrients; for example, repeated episodes of diarrhea or infections of the respiratory ways; or the excessive utilization of nutrients. The terms marasmus and kwashiorkor according to clinical terms are used to describe advanced or third grade protein-calorie malnutrition. Marasmus is characterized by loss of muscle mass and depletion of body fat; while kwashiorkor is characterized by a marked normal or increased muscular atrophy with normal or excess body fat and the presence of peripheral oedema. In a high percentage of cases malnutrition is caused by low ingestion of nutrients, which is not enough to cover the body requirements. Adding to them at any time infection increases the severity of this case.Item Sìndrome de Niño Maltratado por Negligencia como causa de Desnutriciòn Crónica Severa(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Yauli Santos, Mayra Alexandra; Alulema Velasco Dr. Esp., César AugustoThe next case involves a male patient, 4 years, 11 months, preschool, born and resident in Ambato- Ambatillo product of sixth deed, pregnancy poorly controlled well tolerated, home birth, crying immediately, feeding exclusively breastfed until 6 months , complete for age immunizations, pondo growth suitable estatural through 11 months as reported mother, hospitalized at 11 months of age by EDA + subsequent dehydration to which child has chronic weight progressive loss and whose control and monitoring is performed in Subcentro Health of Ambatillo. He goes first referred to Subcentro of Health for Congenital Heart Disease and Pulmonary Hypertension Severa, physical examination patient with syndromic appearance, body , senile appearance, cachexia, chest with medial deformation protruding, clubbed with distal cyanosis, muscle hypertrophy, adipose panicle decreased universal respect bag Bichart, dental caries, psychomotor retaraso, blow heart III / IV audibly machinery in all foci, patient remains hospitalized for 10 days receiving medical care and nurses, nutrition education to the mother, valued by services Dentistry, Psychology, Social Work, Legal, is discharged for outpatient follow-up stable and weight gain.Item Retinoblastoma más Desnutrición en Paciente Pediátrico(Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-10-01) Panimboza Guamán, Inés Paulina; Nájera Rodríguez, Cecilia Isabel Dra.This paper aims to document and analyze the vital and chronic risk to suffer from retinoblastoma, common in less industrialized countries economically poor and in rural areas, the etiology is not known but the possible influence of genetic, nutritional factors is postulated and environmental. There are two forms of the disease: hereditary and sporadic. The first is rarer, with an autosomal dominant inheritance pattern, commonly seen in young children and may be bilateral. The sporadic form is unilateral and the mutation found only in the neoplastic cells. 2 forms affect weight and height, interfering with the growth of children in early stages of development. Then the case of a 7 months old, born and resident in the Canton Arajuno located in a rural area of the province of Pastaza, born at home, the product of the second pregnancy without prenatal checkups, family history is as follows: 3 year old sibling diagnosed with retinoblastoma treatment, the patient is taken by her mother to Sub health center thermal rise unquantified where prescribe antipyretic (Paracetamol) without finding improvement also redness of right eye output yellowish discharge, edema palpebral, hyporexia and general decay so goes the Hospital General Puyo where we value: Ophthalmologist and pediatrician, decide to enter the area of Pediatrics with diagnosis of pre-septal cellulitis versus orbital cellulitis right eye more Malnutrition Grade II, perform laboratory tests and suspicion of ocular neoplastic disease: Computed tomography (CT) is paranasal sinuses and orbit ultrasound eye finding echogenic mass with irregular contours, measures 19 mm in length that moves the eyeball medially, these findings justify performing CT multidetector simple orbits and contrasted it suggests describing and right diagnosis of retinoblastoma. The patient remained hospitalized for nine days in treatment with antibiotics (Tobramycin, Ampicillin + Sulbactam, Metronidazole) for 7 days and its nutritional treatment for malnourished and at recommended doses required for age. The clinical course of acute infectious process was favorable but limited response capacity of retinoblastoma transfer to more complex Hospital decided, getting outpatient appointment for Ophthalmology at Children's Hospital Baca Ortiz.