Ciencias de la Salud

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Start date: 2020Subject: search.filters.subject.ENFERMEDAD RENAL CRÓNICA

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    TRATAMIENTO ANTICOAGULANTE EN PACIENTES CON FIBRILACIÓN AURICULAR Y ENFERMEDAD RENAL CRÓNICA
    (2025-06-16) Oñate Gutiérrez, Alan Daniel; Sánchez Salazar, Nelly Alexandra; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de Medicina
    Introduction. Atrial fibrillation is the most common arrhythmia characterized by premature atrial beats, causing ineffective atrial contraction and promoting thrombus formation. It is associated with chronic kidney disease, where a prothrombotic and prohemorrhagic state coexists, further increasing thromboembolic risk. Treatment with oral anticoagulants is key to preventing thromboembolic events. Objective. To analyze the clinical benefit of oral anticoagulant therapy in patients with non-valvular AF and advanced CKD. Methodology. A bibliographic review was conducted in the MEDLINE/PubMed, Scopus, and ScienceDirect databases. The review included articles published in the last 5 years, open access, and in English or Spanish. Results. The reviewed studies indicate the need to properly stratify thromboembolic and hemorrhagic risk. DOACs are the anticoagulant therapy of choice over warfarin, except in moderate to severe mitral stenoses and in patients with mechanical prosthetic valves. The recommendations and evidence for advanced CKD and dialysis are unclear, especially when CrCl <15 ml/min. Furthermore, factors that could influence therapy, such as the presence of polypharmacy and the assessment of renal function, should be considered. Conclusion. The evidence does not suggest a benefit of oral anticoagulant therapy in preventing thromboembolism in patients with advanced CKD, and alternative non-pharmacological therapies could be chosen.
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    EFECTOS DEL EJERCICIO INTRADIALÍTICO SOBRE LA FUERZA MUSCULAR Y CAPACIDAD FÍSICA EN PACIENTES CON ENFERMEDAD RENAL CRÓNICA QUE RECIBEN HEMODIÁLISIS
    (2025-06-16) Armas Ingavélez, Melanie Samantha; Morales Solis, Jorge Marcelo; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de Medicina
    Introduction: patients with advanced stages of chronic kidney disease present a hypercatabolic state characterized by loss of body proteins, which has a negative impact on physical capacity and muscle strength, particularly in patients undergoing hemodialysis, leading to reduced quality of life and increased mortality. Exercise has been shown to improve muscle function in this population but remains underutilized due to safety concerns and lack of evidence. Methodology: we conducted a descriptive systematic review of cohort studies and randomized clinical trials published in the last 5 years in English or Spanish whose main intervention is intradialytic physical exercise was conducted. Results: thirteen studies were analyzed that described an improvement in physical and functional capacity of patients who were included in the intradialytic exercise groups, although changes regarding body composition were not significant. Conclusions: the implementation of structured and supervised exercise programs during hemodialysis can mitigate the adverse effects of prolonged inactivity, improve physical function, and ultimately improve the quality of life of CKD patients.
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    Musicoterapia y ansiedad en pacientes en hemodiálisis.
    (Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Centro de Posgrados, 2023-11-01) Avilés Peña, Daniel Armando Psicól; Vásquez de la Bandera Cabezas, Fabricio MSc