Ciencias de la Salud
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Item PROTEÍNA ACIDA FIBRILAR GLIAL EN SANGRE COMO MÉTODO DIAGNÓSTICO DE TRAUMATISMO CRANEOENCEFÁLICO: UNA REVISIÓN SISTEMÁTICA Y METAANÁLISIS(2025-06-18) Riofrío Ponce, Edison Joshua; Salazar Garcés, Luis Fabián; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaIntroduction: traumatic brain injury (TBI) is a leading cause of morbidity and mortality worldwide. Glial fibrillary acidic protein (GFAP) has been proposed as a blood-based diagnostic biomarker for TBI, but its clinical utility remains uncertain. This meta-analysis assessed the diagnostic accuracy of GFAP in identifying TBI. Method: a systematic search was conducted in biomedical databases for studies published between 2019 and 2024. Clinical trials with adequate sample sizes and standardized GFAP detection methods were included. Sensitivity, specificity, and predictive values were analyzed using statistical models to evaluate diagnostic accuracy. Results: seven studies with a total of 3 209 patients were included. The overall sensitivity of GFAP was 0,91 (95 % CI: 0,83–0,96), demonstrating a high capacity to detect TBI. However, specificity was moderate (0,61, 95 % CI: 0,48–0,73), indicating a higher rate of false positives. The summary ROC curve confirmed a good general diagnostic performance but highlighted limitations in differentiating TBI from other neurological conditions. Conclusions: GFAP exhibited high sensitivity as a diagnostic biomarker for TBI, making it a useful tool for early detection. However, its low specificity suggests the need for combination with other biomarkers to improve diagnostic accuracy.Item IDENTIFICACIÓN DE BIOMARCADORES PRECOCES PARA EL DIAGNÓSTICO DE ENDOMETRIOSIS(2025-06-13) Rodriguez Linares, Angie Ibeth; Bustillos Solorzano Marcos Edisson; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaEndometriosis is a progressive gynecological disease characterized by the migration of endometrial cells outside the uterus, associated with chronic inflammation and an uncertain pathogenesis. This study aimed to identify early biomarkers for the diagnosis of endometriosis through a systematic review of scientific literature. Following the PRISMA methodology, research questions were formulated focusing on immunological and angiogenesis aspects, the most relevant biomarkers under study, and the challenges in their validation. An exhaustive search was conducted in databases such as Scopus, PubMed, and Web of Science, covering publications from 2018 to 2024. The results show that although numerous potential biomarkers have been identified, including glycoproteins, inflammatory cytokines, oxidative stress markers, growth factors, autoantibodies, miRNAs, and lncRNAs, none have achieved adequate sensitivity and specificity for universal clinical use. The heterogeneity of the disease and variability in studies hinder the implementation of a single biomarker. However, the combination of multiple biomarkers could improve diagnostic accuracy. In conclusion, the identification of early biomarkers is essential to develop non invasive and effective diagnostic tools, transforming the clinical management of endometriosis, reducing the need for invasive procedures, and allowing personalized therapeutic interventions.Item AVANCES EN EL DIAGNÓSTICO Y TRATAMIENTO DE LA INFECCIÓN DEL TRACTO URINARIO EN PEDIATRÍA(2025-06-13) Barreros Lema, Edwin Esmith; Philco Toaza, Priscila Elizabeth; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de MedicinaUrinary tract infection (UTI) is one of the most common bacterial infections in the pediatric population, especially in children under two years of age, Escherichia coli is the most common pathogen, responsible for the majority of cases. The high recurrence rate and potential for kidney damage underscore the importance of proper diagnosis and treatment. The objective of this scientific article is to identify recent advances in the diagnosis and treatment of urinary tract infection in children based on updated scientific evidence with the aim of improving clinical management in the pediatric population. A bibliographic review of the literature available in databases such as PubMed, Scopus and Web of Science was carried out; articles published between January 2019 and November 2024 that addressed the diagnosis, treatment and management of UTI in the pediatric population were included. The studies reviewed highlight the importance of early diagnosis through urine cultures and adaptation of treatment based on bacterial susceptibility. Advances include the use of fosfomycin, probiotics, and supplementation with vitamins D and C, all of which have shown promise in the prevention and treatment of UTIs. Additionally, new forms of intravesical therapy and the implementation of nutritional strategies to reduce infection recurrence are explored. It was concluded that the management of UTI in pediatrics has evolved, currently supplementation with micronutrients and probiotics are used as novel methods for the prevention of recurrent UTIs, while fosfomycin is presented as a viable option in cases of resistance to conventional antibiotics.Item Estrategia pedagógica y didáctica para la presentación y discusión de Casos Clínicos sobre el Cáncer de Mama, por los Internos Rotativos de la Carrera de Medicina en el Servicio de Medicina Interna del Hospital Docente Ambato(2025-04-02) Freire Montesdeoca, Juan Gabriel; Acosta Acosta, Josué; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Centro de PosgradosIntroduction: Breast cancer represents one of the leading causes of morbidity and mortality among women worldwide. The training of rotating medical interns is crucial for developing clinical competencies. Objective: The objective of this study is to propose a pedagogical and didactic strategy to improve the understanding and clinical management of breast cancer among rotating medical interns in the Internal Medicine Service at the Ambato Teaching Hospital. This strategy aims to promote active learning and critical reflection through the presentation and discussion of clinical cases in the Internal Medicine Service at the Ambato Teaching Hospital. Methodology: An explanatory, experimental, and prospective study design with deliberate intervention was carried out. This included the selection of representative breast cancer cases. Presentation sessions were conducted, during which interns presented the background, diagnosis, and treatment of the cases. Subsequently, a space for group discussion was facilitated, guided by a specialized faculty member. Results: The results showed a significant increase in the interns' understanding of the diagnostic and therapeutic aspects of breast cancer. Surveys indicated that 85% of the interns considered that the methodology used enhanced their learning and enabled them to address patient care more effectively. Conclusions: The design of a pedagogical and didactic strategy focused on the presentation and discussion of breast cancer clinical cases is effective in enhancing the training of medical interns. This methodology not only improves their understanding of the disease but also strengthens their clinical competencies.Item DIVERSIDAD GENÉTICA DE BLASTOCYSTIS SPP: ACTUALIZACIÓN SOBRE SU VIRULENCIA Y PATOGENICIDAD(2025-02-25) Olmos Almachi, Omar Fernando; Yauli Flores, Carlos Fernando; Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Laboratorio ClínicoBlastocystis spp. is an intestinal parasite with broad genetic diversity, highlighting four subtypes related to gastrointestinal and extraintestinal symptomatology: ST1, ST2, ST3, and ST4. Multiple studies describe the mechanisms of virulence, pathogenicity, and resistance that debate its controversial commensalism: immune evasion by sIgA degradation, cell damage mediated by cysteine proteases, and resistance to chemical/pharmacological agents. The article compiles updated information on the abovementioned mechanisms, genotypes, and diagnostic methods. Understanding the biological behavior of this protozoan is necessary to improve the diagnostic and therapeutic approach: molecular characterization and implementation of cellular assays that evaluate the activity of Blastocystis spp. Subtypes in the human intestinal tract may contribute to understanding their pathogenic activity.Item COINCIDENCIAS DEL DIAGNÓSTICO DEL GÉNERO STREPTOCOCCUS ENTRE MÉTODO MANUAL Y EL MÉTODO AUTOMATIZADO EN EL LABORATORIO AUTOMATIZADO ZAMORA(Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Centro de Posgrados, 2024-10-01) Zamora Sánchez, María Cristina; Guangasig Toapanta, Víctor HernánThe genus Streptococcus sp. They are gram positive cocci; these bacteria grow in chains or pairs which are oxidase and catalase negative. Among the groups that cause disease in humans are the most frequent such as Streptococcus pyogenes (group A) produces tonsillitis and impetigo, Streptococcus pneumoniae is the cause. Of the majority of pneumonias acquired in the community, Streptococcus viridans and its groups are the cause of dental abscesses, within the subgenus is Streptococcus mutas the main agent that causes dental cavities and without forgetting that it causes endocarditis is a common pathogen that causes severe and potentially complicated infections with the possibility of generating serious sequelae, hence the importance of rapid, accurate and timely identification. In this context, it is essential to evaluate the available diagnostic methodologies to determine their relative effectiveness. In particular, the performance of the manual method should be compared with the Vitek 2 Compact automated system, in order to evaluate the concordance between both approaches in the identification of Streptococcus sp. The objective of this study is To evaluate the agreement of the diagnosis of Streptococcus sp. between the manual method and the automated method in the Zamora Automated Clinical Laboratory in the period July and May 2023-2024. The methodology used for this study was Quantitative, non-experimental, observational, descriptive study with verification of coincidences in diagnostic tests for the identification of 100 culture samples with growth for Streptococcus sp. in two laboratories, verification of coincidences in diagnostic tests for identification in 100 culture samples with growth for Streptococcus sp. in two laboratories, using conventional and automated methods (Vitek 2 Compact). To obtain results, tests were carried out to Differentiation tests were performed, obtaining 100% negative catalase, 100% alpha hemolysis, 100% resistant bacitracin, 94% resistant optochin. The identification of pathogens of the genus Streptococcus sp. was carried out using two different methods: one manual and the other automated. The manual method, revealed the following proportions: 94% corresponded to Streptococcus of the viridans group, 6% to S. pneumoniae, and 0% to S. pyogenes. On the other hand, the automated method provide results with 89% of S. viridans, 6% of S. pneumoniae and 0% of S. pyogenes. These findings show a slight discrepancy in the proportion of S. viridans identified by both methods, while the identities of S. pneumoniae and S. pyogenes remained constant between the two analytical approaches. The kappa index determined a concordance of 1 (almost perfect) according to the table between both methods for the identification of S. pneumoniae and 0.635 (considerable for identifying S. viridans. Based on these findings, a proposal was designed for the improvement of diagnostic skills according to the results obtained, the identification of the Streptococcus sp. by the manual method compared to the automated methodology (Vitek 2 Compact), presents high concordance, especially with S. pneumoniae. Strategies must be reviewed and implemented to improve the identification of this pathogen in laboratories how is the implementation of the automated equipment since it has a better identification in the subgenera of the viridans group which are of clinical interest in the dental areaItem Caracterización de bacterias multidrogoresistentes en infecciones urinarias de mujeres embarazadas(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de posgrados, 2024-09-01) Sánchez Tite, Viviana Paulina Licenciada.; Salazar Garcés Licenciada. Magister., Dolores KrupskayaUrinary Tract Infection (UTI), is a term used to indicate the growth of pathogenic microorganisms present in the urinary system, capable of producing functional and morphological alterations. Multidrug-resistant bacteria (MDR) are microorganisms that have acquired the ability to resist the action of several antibiotics, complicating their treatment. In pregnant women, urinary tract infections are common due to hormonal changes and the pressure of the uterus on the bladder, which prevents proper urine drainage and greatly facilitates the proliferation of pathogens. By carrying out an exhaustive characterization of the multidrug-resistant bacteria present in urinary infections of pregnant women attending clinical laboratory Tecnoanálisis aims to identify the most frequent microorganisms responsible for this type of infections and different resistances originated in this environment for it, the present study was a non experimental cross-sectional, descriptive and observational study with a quantitative approach, as it identified the different bacteria that cause urinary tract infections in pregnant women. Cultures that had a positive growth and met the characteristics for the study were used where different bacteria were isolated as Escherichia coli presented a higher percentage followed by Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Enterobacter cloacae and Streptococcus agalactiae in the lowest percentage. Concluding that the development of gram-negative bacilli microorganisms predominates, while a minimal percentage corresponded to gram-positive bacteria, the analysis carried out showed that there is a high resistance for more than one antibiotic such as Ampicillin, Trimetropin/sulfamethoxazole, nitrofurantoin, amoxacillin+ clavulanic acid, ampicillin/sulbactam, with respect to multidrug resistance bacteria interpretation protocol, was based on the gestational age and results obtained from the samples processed in this research, taking into account natural and acquired resistance in a schematic form for easy interpretation by the beneficiaries.Item Coincidencias en la detección de toxoplasma gondii entre el método inmunocromatográfico y el método elisa en mujeres embarazadas atendidas en el hospital general Alfredo Noboa Montenegro.(Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Centro de posgrados, 2024-09-01) Guzmán Arellano, Maryori Tatiana Licenciada; Ana Gabriela. Bioquímica Farmacéutica Magister, Pacha JaraToxoplasma gondii is an obligate intracellular parasite that represents a challenge for public health due to its ability to infect humans and animals, without necessarily showing clinical manifestations. It is considered a Group 2 risk agent, that is, moderate individual risk and low community risk. However, it has a great impact on populations with compromised immune systems because it has the ability to damage the central nervous system. Pregnant women are among the vulnerable groups, as they can have significant complications, such as neurological, visual, and auditory disorders, and even the death of the newborn. This work focused on analyzing the coincidences in the detection of Toxoplasma gondii between the immunochromatographic method and ELISA in pregnant patients treated at the Alfredo Noboa Montenegro General Hospital. The study was carried out using a non experimental cross-sectional and correlational design, with a quantitative approach. The results indicated that the sample presented a balanced distribution in terms of age, with a predominant concentration of low results in the ELISA IgG and IgM tests, and a moderate dispersion around the mean value. The IgG immunochromatography test showed a clear and adequate interpretation, while the IgM revealed a low prevalence of positive results, suggesting the need for further evaluation for indeterminate cases. Although the IgM immunochromatography test presents higher sensitivity, the IgM ELISA presented a greater consistency in the reporting of results. The statistical analysis did not show significant differences between the Immunochromatography and ELISA tests, suggesting a similar capacity to detect positive and negative cases. In conclusion, the results obtained from the comparison between the Immunochromatography and ELISA tests for the detection of Toxoplasma gondii suggest that both methodologies present a similar capacity to identify positive and negative cases in the analyzed sampleItem BIOMARCADORES DE DIAGNÓSTICO EN MASTOCITOSIS(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Laboratorio Clínico, 2024-08-05) Núñez Reyes, Viviana Estephania; Proaño Pérez, María ElizabethIntroduction: mastocytosis is a rare disease triggered by the KIT D816V mutation that increases the proliferation and survival of mast cells in several organs. Mast cells have crucial receptors such as KIT, TLR, complement (C5aR, C3aR), MHCI, MHCII, MRGPRX , and FcεRI that allow them to activate and degranulate in innate and adaptive immune responses. The prevalence of mastocytosis is 10 cases per 10,000 individuals worldwide and is classified into cutaneous and systemic mastocytosis, affecting both children and adults. Objective: characterize the specific biomarkers crucial for the prognosis, diagnosis, and monitoring of Mastocytosis. Method: a bibliographic review was conducted by searching information in databases such as Pubmed, ScienceDirect, and Google Scholar from March to May 2024, including a total of 35 English articles published in the last 10 years and several published before 2019 that contributed relevant information to the topic. Results: it has been determined that prognostic biomarkers help identify severe forms of the disease. Meanwhile, diagnostic and follow-up biomarkers are utilized to confirm the disease and evaluate its progression and treatment effectiveness. Additionally, it has been demonstrated that biomarkers can determine the risk of anaphylaxis, as well as the subtypes of mastocytosis. Conclusion: biomarkers for the prognosis of mastocytosis, such as basal serum tryptase (BST) and hereditary α-tryptasemia (HαT) were characterized. In addition, diagnostic and monitoring biomarkers such as the KID D816V mutation, analysis of extracellular vesicles (EVs), CD25+/CD2+/CD30+, MITF, miRNAs, LBP, CXCL7, TGF-β1, PDGFRβ, IL-6, leukotrienes, prostaglandin, histamine, and IgE.Item DIAGNÓSTICO DE UN TUMOR XANTOASTROCITOMA PLEOMÓRFICO(Universidad Técnica de Ambato/ Facultad de Ciencias de Salud /Carrera de Medicina, 2024-07-04) García Amores, Arianna Gabriela; Lana Saavedra, Héctor EnriqueIntroduction: Xanthoastrocytoma Pleomorphic (XAP) is a rare and usually lowgrade brain tumor, which presents significant challenges in its diagnosis. This tumor is characterized by its clinical and pathological heterogeneity, making it a point of interest in the field of neurooncology. Objective: The aim of this research is to review and synthesize current diagnostic methodologies for Xanthoastrocytoma Pleomorphic, identifying the most effective techniques and emerging trends in its identification and classification. Methodology: An exhaustive search was conducted in databases such as PubMed, Scopus, and Web of Science, using keywords related to Xanthoastrocytoma Pleomorphic and its diagnosis. Articles in English and Spanish were included, from the year 2017 to 2023, selecting studies that provide data on clinical characteristics, diagnosis, treatment, and prognosis of XAP. Results: The reviewed studies indicate that magnetic resonance imaging (MRI) is the most important diagnostic tool for XAP, typically revealing a well-circumscribed lesion with enhancement after contrast administration. Biopsy and histopathological examination are crucial for definitive diagnosis, showing the presence of pleomorphic cells and areas of xanthomatization. Conclusion: The accurate diagnosis of XAP is based on a combination of clinical, radiological, and pathological features. Despite advances in imaging and pathology, definitive diagnosis still relies on histology. Understanding molecular characteristics may offer new insights for diagnosis and treatment.
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