Medicina

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    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 Gabriela
    Introduction: 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.
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    IMPLEMENTACIÓN DE NUEVAS TECNOLOGÍAS EN EL TRATAMIENTO DE QUEMADURAS PEDIÁTRICAS: UNA REVISIÓN NARRATIVA
    (2024-09-24) Balseca Artos, Eddy Efren; Fiallos Brito, Edisson Javier
    Burns 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.
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    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, Gabriela
    Pulmonary 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.
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    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 Mariana
    Coronaviruses 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.
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    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 Lourdes
    Objective: 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.
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    HEMOGLOBINA GLICOSILADA Y EL GRADO DE SARCOPENIA: UNA REVISIÓN SISTEMÁTICA
    (Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-06-10) Sacón Ayerbe, Camila Salomé; Cevallos Teneda, Andrea Carolina
    Type II diabetes mellitus (DM2) and sarcopenia are conditions with high prevalence and significant complications, making them important public health problems. This study is based on a systematic review of 12 original scientific articles published between January 2019 and June 2023, focusing on the relationship between DM2 and sarcopenia. The findings indicate an increasing prevalence of sarcopenia in patients with DM2, especially when glycemic control is inadequate. It was observed that glycosylated hemoglobin (HbA1c) levels above 8.5% are associated with an increased risk of developing sarcopenia. The studies reviewed also suggest that the most effective treatment to mitigate sarcopenia is a combination of endurance exercise and nutritional counseling. Although HbA1c is a useful indicator for monitoring glycemic control, it does not reflect daily fluctuations in glucose levels, which are also an important factor in the development of sarcopenia. The review concludes that early diagnosis and multidisciplinary intervention are crucial to prevent and treat sarcopenia in patients with DM2.
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    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 Carmen
    Introduction: 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.
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    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.
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    Hemofilia a y b: manejo del paciente con inhibidores
    (Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2022-11) Núñez Pérez, Eliana Alejandra; Naranjo Perugachi, Jeaneth del Carmen Dra.
    Hemophilia is an affection defined by a hereditary and congenital hemorrhagic alteration in which the blood does not coagulate properly, causing hemorrhages spontaneously or after witnessing an injury or surgical procedure, mainly manifested by mutations in the chromosome X, in which there is a decrease or absence of the activity of factors VIII or IX, within this pathology inhibitors can be produced, these being alloantibodies that act against coagulation factor VIII and IX, which are responsible for the suspension of bleeding, the presence of inhibitors can be suspected when the bleeding does not stop with the usual dose of treatment, which are the concentrates of said factors. In this review, sources that contain verified and real information were investigated in publications of scientific journals such as The New England Journal of Medicine, The official Journal of the World Federation of Hemophilia, Haematologica, WHO and databases such as Scopus, PubMed, The Cochrane, Google Scholar, Uptodate, BMC Medicine with a period of time between 2016 and 2021 in the Spanish and English languages. This pathology requires an interdisciplinary, complex and often costly management. Treatment depends on the location and severity of the bleeding, the titer and the characteristics of the inhibitor. Among the drugs used to manage this pathology are recombinant activated FVII rFVIIa, activated prothrombin complex concentrates (APCC) and the use of Rituximab and Emicizumab
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    Nefritis lúpica: actualización sobre el manejo deltratamiento a propósito de un caso
    (Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2022-10-01) Sierra Navarrete, Valeria Isabel; Suaste Pazmiño Dra. Esp., Kathya Verónica
    Lupus Nephritis is derived from Systemic Lupus Erythematosus, an autoimmune disease, whose chronicity dates back a long time under study, the same diseasecauses significant damage within the human body and much more when the person does not receive timely and adequate treatment. It is interesting to be able to determine the mechanisms by which the disease is produced as such and therefore, asin many diseases, a detailed anamnesis must be carried out, considering, among so many options, the appropriate treatment for a person considered as a world individually. It is reported that different medical specialties must be involved in the study of this disease, such as Nephrology, Internal Medicine, Pharmacology, among others. It is more prevalent in women than in men, having a ratio of 9:1 in current data worldwide. In the case of the black and Latin American and Asian race, it is said that it begins at very early ages. It is described that kidney involvement is a serious complication, being responsible for 70 to 80% of patients and that it can induce severe kidney failure within the population in 30 to 70%. It is advisable to take a kidney biopsy, which gives more reliable information on the damage that is taking place in the patient at that moment. Within the treatment it is said that mycophenolate and cyclophosphamide fail in up to 20%, as well as complement inhibitors, anticytokines and in cases stem cell transplantation.