Ciencias de la Salud
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Item VIRUS DEL PAPILOMA HUMANO COMO FACTOR ETIOPATOGÉNICO EN EL DESARROLLO DE CÁNCER ORO FARÍNGEO: REVISIÓN BIBLIOGRÁFICA(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-06-10) Tixe Toalombo, Paulina Alejandra; Naranjo Naranjo, Doris EsthelaHuman Papillomavirus (HPV) has been identified as a significant etiological factor in the development of oropharyngeal cancer, particularly squamous cell carcinoma. The objective of this review was to evaluate the relationship between HPV infection, the incidence, progression and prognosis of oropharyngeal cancer. Methodology: An exhaustive literature review was carried out in databases such as PubMed, Scopus and Google Scholar, using keywords related to HPV and oropharyngeal cancer. Studies were included from 2019 to 2023, covering clinical investigations, epidemiological analyzes and reviews. Studies revealed that HPV, especially serotype 16, is associated with an increase in the incidence of oropharyngeal cancer, mainly affecting younger patients and with fewer traditional risk factors. HPV-positive patients had a better prognosis and survival compared to HPV-negative patients. The review also highlighted the importance of vaccination as a preventive strategy. HPV is a key etiopathogenic factor in oropharyngeal cancer, with significant implications for the prognosis and clinical management of the disease. Vaccination emerges as a crucial tool in prevention. However, there is a need to improve vaccination rates and early detection to effectively combat the disease.Item ASPECTOS BIOÉTICOS DE LA LIMITACIÓN DEL ESFUERZO TERAPÉUTICO EN LA UNIDAD DE CUIDADOS INTENSIVOS(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Enfermería, 2024-05-28) Calero Calero, Karina Margarita; Guarate Coronado, Yeisy CristinaIntroduction: The care provided in the intensive care unit has recognized significant scenarios regarding the provision of activities focused on prolonging life, however, decision-making should be considered under bioethical criteria governed by the participation of the user and family. Methodology: A descriptivedocumentary review was carried out based on the analysis of scientific data registered in Scielo, PubMed and bibliographic managers linked to the research topic, using PRISMA diagram, search equations such as "Ethics AND Limitation of Therapeutic Effort" OR Intensive Care Unit. Results: We found 30 articles which allowed us to know the bioethical aspects of the limitation of therapeutic effort within the intensive care unit. Conclusion: The application of the limitation of therapeutic effort within the intensive care unit is still controversial due to the legal repercussions that this implies, however, the health professional has the necessary training in the bioethical field to make a pertinent judgment regarding the development of restrictive measures for futility or non-beneficenceItem Eficacia pronóstica de la relación plaquetas / linfocitos y la relación neutrófilos / linfocitos en pacientes con cáncer gástrico(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Laboratorio Clínico, 2023-03-01) López Altamirano, Joselyn Macarena; Rosero Freire, Daniela Alexandra Lic. Mg.Cancer is the main cause of death before age 70. Gastric cancer (GC) is responsible for 1 in 13 deaths worldwide and is predominant in men. Inflammation is closely related to cancer, as it activates differentblood cells such as neutrophils, lymphocytes, platelets, etc. A bibliographic review was carried out to collect and analyze studies concerning the prognostic efficacy of neutrophil/lymphocyte ratio (NLR) andplatelet/lymphocyte ratio (PLR) in patients with gastric cancer. Upon analysis, several studies indicatedthat elevated values of both NLR and PLR show poor prognosis. However, we suggest that more research is needed to obtain cutoff values according to GC staging, in order to bea helpful tool in GC diagnosis and prognosisItem “Mielinolisis pontina secundaria a traumatismo craneoencefálico severo(Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2018-05-01) Gavilanes Acosta, Daisy Maribel; López Ulloa, Mario Orlando Dr. Esp.Deaths to traumatic brain injury are still among the main causes of mortality and disability, with the affections of the nervous system and hemorrhagic shock becoming its main contributors. The patient with traumatic brain injury (TCE) is forming a complicated group of patients that can present different types of brain injury, as a result of a closed lesion or an open lesion. TCEs are more frequent in males in all age groups. The causes of the TCE are related to the age of the subjects who suffer them, thus, falls are the most frequent etiology and traffic accidents correspond to the second cause in frequency. The central pontine myelinolysis is a rare pathology, characterized by a neurological alteration of undetermined etiology linked to various conditions such as serious diseases, in more than 50% of cases manifested in patients with chronic diseases with malnutrition or hydroelectrolytic disorders, being frequent, when Sodium levels rise too fast. The damage basically consists of the destruction of the myelin sheaths, leaving the cylinders undamaged, affecting part or the entire base of the protuberance symmetrically. There are a variable percentage of patients in brain death situations who have developed diabetes insipidus. To continue the clinical case is about a male patient of 14 years of age, who while doing extreme sports (Downhill), without a helmet, he suffers a fall of his bicycle in motion, with displacement of approximately 2 meters and frontal impact of his skull against a rocky surface (stones), then ECU 911 transfers him to the Pediatric Emergency Service of the IESS Ambato General Hospital. On physical examination, the positive: the patient with a tendency to sleep, disoriented, with pain, Glasgow Scale: 13/15 (O: 3, V: 4, M: 6). Head: evident hematoma in the frontal region, with left palpebral edema, localized ecchymosis, palpable bone crax in the frontal region, pupils: mydriatic, hyporeactive. CT was performed immediately, showing a fracture line at the level of the frontal bone, extending from the frontoparietal suture to the left orbit, with signs of an epidural hematoma, deciding to admit it for hospital management because he has a severe traumatic brain injury. Neurosurgery is consulted, they indicate that at the moment he does not require surgical resolution, so he decides clinical management, with advanced airway management, sedoanalgesia and later is admitted to the Intensive Care Unit Evolution in the ICU: Hemodynamically unstable, brain MRI is performed where it is evident: signs of pontine myelinolysis, results of examinations are obtained revealing the following: hypernatremia + low density + low urinary sodium + urinary hypoosmolarity + plasma hyperosmolarity related to Diabetes Insipid Central, with poor clinical evolution, he does not respond to treatment and he dies.