Ciencias de la Salud
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Item AVANCES EN LOS MÉTODOS SEROLÓGICOS Y MOLECULARES PARA EL DIAGNÓSTICO DE TUBERCULOSIS LATENTE(2025-02-25) Albán Balseca, Jessy Marianela; Galárraga, Pérez Edison Arturo; Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Laboratorio ClínicoIntroduction: tuberculosis (TB) is an infectious pathology of bacterial origin that is transmitted mainly by air. This disease is caused by Mycobacterium tuberculosis (MTB) and its main area of involvement is the lungs. Clinically, tuberculosis can manifest itself from a non-communicable and asymptomatic latent infection (LTBI) to a highly transmissible active disease. An essential aspect to obtain adequate control of the disease is the detection and diagnosis of both infectious and active cases, in order to interrupt the chain of TB transmission. Objectives: to evaluate the usefulness, efficacy and clinical accuracy of the serological and molecular methods currently used to detect latent tuberculosis. Methods: a bibliographic review was carried out using the PRISMA method. Clinical studies and systematic reviews were included, highlighting those with relevant information on the diagnostic advances used in laboratories for the detection of TB. Results: currently, the interferon gamma release assay (IGRA) and the tuberculin skin test (TST) are used to establish the diagnosis of TB. However, molecular tests such as GeneXpert MTB/RIF, LAMP, PCR have revolutionized the diagnosis of active tuberculosis by offering significant advances in terms of speed, accuracy and accessibility. Conclusions: tests for the diagnosis of tuberculosis include different traditional techniques such as microscopy and culture, as well as innovative molecular and immunodiagnostic tests. However, each of these strategies has its strengths and limitations, so this topic remains a necessary area of research to achieve the eradication of the disease.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 FACTORES DE RIESGOS DE CONTAGIO DE TUBERCULOSIS EN PERSONAS ADULTAS(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Enfermería, 2024-05-29) Velazque Coyachamin, Bethy Margoth; Moyano Calero, Willian EudrillirIntroduction: Tuberculosis is an infectious condition caused by the Mycobacterium tuberculosis bacterium, which has a main impact on the respiratory system. This disease can be transmitted relatively easily from one individual to another through the air, especially when a person with active tuberculosis coughs, expels phlegm or sneezes. Objective: This study focused on seeking relevant information on risk factors for tuberculosis infection in adults, to provide a deeper understanding of this disease and its determinants. Methodology: To achieve this objective, the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) were used, which consisted of carrying out a systematic review of the scientific literature, rigorously following the steps defined by PRISMA. Results: These revealed that socioeconomic factors such as low income and lack of formal education bring a higher risk of tuberculosis. Furthermore, it will be noted that cigarette smoking and drug use gave a significant risk of tuberculosis. In addition, there is evidence of an uneven geographic distribution of multidrug-resistant tuberculosis (MDRTB), as well as the importance of coinfection with HIV and comorbidities such as diabetes in the risk of tuberculosis. Conclusion: This study highlights the complexity of factors influencing tuberculosis in adults, as the interplay between medical, social, and environmental factors underscores the need for comprehensive, personalized approaches to disease prevention and treatment.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.