Browsing by Author "Estévez Abad, René Fernando"

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Anticuerpos monoclonales como tratamiento profiláctico en migraña refractaria. Revisión Bibliográfica
(Universidad de Cuenca, 2024-05-31) Idrovo Calle, María Daniela; Pérez Morales, Damaris Micaela; Estévez Abad, René Fernando
Background: Migraine is the most common form of headache and the main cause of medical consultation; patients who have not improved after receiving two or three preventive therapy regimens suffer from refractory migraine, causing disability with a negative impact on quality of life, social and intrafamilial relationships. It has been demonstrated that calcitonin gene-related peptide (CGRP) is elevated during migraine attacks, and its pharmacological reduction translates into significant clinical improvement; monoclonal antibodies have a specific mechanism of action on the CGRP pathway, these are Eptinezumab, Fremanezumab, Galcanezumab and Erenumab. Objective: to find evidence supporting the efficacy of the use of monoclonal antibodies in the prophylactic treatment of refractory migraine. Method: a systematic search of information was performed, to identify and evaluate academic articles related to the research topic, published between 2017 and 2022 in Spanish and English. Databases were used: Pubmed, Scielo, Scopus and Medscape. Results: reduction in the number of migraine days, symptomatology, polypharmacy and medication costs, improvement in quality of life with a reduction of more than 50% of MIDAS score, reduction of migraine attack progression, reduction of headache impact, all these results were sustained over time, indicating a high response rate to the use of monoclonal antibodies. Conclusions: the efficacy of monoclonal antibodies was determined by a response rate of >50%, reduction in clinical symptoms, reduction in the number of monthly migraine days, number of drugs and cost per patient, improvement in quality of life and a good safety profile due to the minimal presence of adverse effects.
Conocimientos y actitudes sobre eutanasia en médicos residentes y tratantes del Hospital José Carrasco Arteaga, Cuenca 2017
(2017) Berrezueta Pesantez, Roberto Carlos; Saquipay Zhagui, Jhony Fabrisio; Estévez Abad, René Fernando
Precedent: Until last year Colombia was the only country in Latin America where euthanasia was allowed (1), in January 2017 in Mexico City an article was approved that allows death with dignity and the possibility of patients to request euthanasia (2). In Ecuador, the practice of euthanasia is not considered to be a legally protected or legislated option; however, doctors and lawyers manifest that it is necessary to discuss the issue of the Right to a Dignified Death in Ecuador (3). Objectives: To determine the knowledge and attitudes regarding euthanasia manifested by medical residents and specialist doctors of the José Carrasco Arteaga Hospital in Cuenca in 2017. Methodology: A descriptive and transversal research was carried out in 188 medical residents and specialist doctors of the José Carrasco Arteaga Hospital. The information was collected in forms, the data were processed using the SPSS V.15 program. Which are presented in tables. Results: 53.2% of participants were aged 20-34, 53.7% were men; regarding religion, 78.7% are Catholics, 49.5% are resident physicians and 50.5% are medical doctors. A high degree of knowledge regarding euthanasia was observed, since 76.1% know its meaning, 81.9% of doctors agree with the practice of euthanasia, while 18.1% disagrees. Conclusions: There was a high level of knowledge and acceptance regarding euthanasia, however, knowledge gaps are also presented on important topics related to the objectives of euthanasia
Detección de frecuencia de depresión y comportamiento suicida en estudiantes de la Escuela de Medicina de la Universidad de Cuenca durante 2008-2009
(2009) Maldonado López, Carlos E.; Muñoz Vega, Pedro José; Patiño Alvarado, Juan Diego; Estévez Abad, René Fernando; Freire Solano, Eulalia del Carmen
Evaluación de las habilidades comunicacionales de los internos rotativos de la carrera de medicina mediante la aplicación de la Guía Calgary Cambridge. Cuenca 2018
(2019-04-30) Bermeo Ochoa, Paulina Daniela; Estévez Vélez, Andrea Fernanda; Estévez Abad, René Fernando; Parra Parra, Jorge Leonidas
Background: communicational skills are considered very important in the physician professional training; these skills are basic to establish a good doctor-patient relationship which will be helpful in the diagnosis and effective treatment. Objective: to evaluate the communicational skills of the medical school interns that work at Vicente Corral Moscoso Hospital. Methodology: we present an observational and descriptive study on medicine students finishing the career. The data obtained was admitted to the program IBM SPSS Statistics 24.0. For the analysis it was used measures of central tendency, frequency and chi squared test and subsequently showed in tables and graphics. Results: the mean age was 24,04 (± 1,154) years. The students belong to the three faculties of medicine in Cuenca. Most of participants where students of the University of Cuenca constituting 51% of the total and only 20% of them know the Calgary-Cambridge guide while just 19% chose to study Doctor-Patient Relationship as an elective subject. When we evaluated the communicational skills, we found that 90% of the students greet the patient, 89% show respect, whilst only 11% summarize the interview at the end of the session. The mean score of the students trained in medical communication was 13,79 (DS±2,323) whereas the score obtained by the ones who didn’t was 11,60 (DS±3,371) over 23. Conclusions: there is a deficit in the communicational abilities of the interns, in the current investigation we established different reasons to explain why, among which we highlight the lack of education of medical communication
Eventos cerebrovasculares hemorrágicos y su relación con la hipertensión arterial de casos diagnosticados en el Hospital Vicente Corral Moscoso durante los años 2015 a 2017. Cuenca 2019
(2019-04-16) Martínez Muñoz, María Emilia; Saquicili Castro, Fernando Santiago; Estévez Abad, René Fernando; Parra Parra, Jorge Leonidas
Hemorrhagic stroke is a public health problem that in this study occurs most frequently in the male sex, between the ages of 20 and 64 years. The main risk factor associated is arterial hypertension, especially in patients not fully controlled. Objective: To determine the frequency of hemorrhagic stroke and the relation with arterial hypertension in diagnosed cases in “Vicente Corral Moscoso Hospital”, during the 2015 - 2017 period. Methods and Material: This descriptive study is based on the search about the characteristics and control of arterial hypertension in 80 patients with hemorrhagic stroke admitted in “Vicente Corral Moscoso Hospital”, during the 2015 – 2017 period, through the revision of the clinical discharge record in medicine department during this period. Results: 80 patients showed hemorrhagic stroke; 52.2% male sex. 51.3% between ages 20 and 64 years; 50% with complete primary education level; 48,8% married. 61.2% (49 cases) had arterial hypertension, out of these 77,5% (38 patients) where previously diagnosed and 31,6% had pharmacological management; 26,5% with Losartan. Conclusions: In this study we found that arterial hypertension is the main factor risk associated with hemorrhagic stroke and is mainly common in patients without treatment. Furthermore, unmodifiable risk factors such as age and sex can increase the frequency of hemorrhagic stroke.
Frecuencia de crisis convulsivas en pacientes con trauma craneo encefalico ingresados en el Hospital Vicente Corral Moscoso, Cuenca 2013 - 2014
(2014) Mora Orellana, Estrella Janeth; Cajamarca Bermeo, Luis Raúl; Estévez Abad, René Fernando; García Alvear, Jorge Luis
Objective: To determinate the frequency of epileptic crisis in patients with TEC, who come to Vicente Corral Moscoso Hospital in the period 2012-2013 Method and Materials: This prospective, descriptive, study was conducted on patients who were attended or referred to the Regional Hospital “Vicente Corral Moscoso” of Cuenca for 3 months, based on the following judgment: patients after traumatic brain injury (TBI) with pathologies such as subdural hemorrhage, and intraparenchymal,subdural and epidural hematoma. The variables studied were: patient age, clinical presentation, type of injury, consciousness, the extension of injury visible with CT and report the same. It has been monitored the patients for 6 months for the occurrence and recurrence of seizures To survey the data, we used a Form filled by those who perform the thesis, once collected, the data were entered in Microsoft Excel version 2007 software, version 12.0.4518.1014, the data were summarized in tables and graphs for presentation and descriptive analysis Results: Patients with TBI who presented or were referred to the Hospital Vicente Corral Moscoso had a prevalence of 32% of posttraumatic seizures, 40% between 11 and 20 years, more common in males 25.81%. The most frequent lesion visible on TAC was epidural hematoma with 45% and a prevalence of post-TBI seizures of 16.13%. In this work, all cases with severe TBI had seizures post-TBI, whereas moderate and mild TBI showed only 9.8%. The immediate crisis was the most frequent with 29%. The 45.16% of patients have no symptoms after CT without major disability the 25.81%, and only 6.45% have severe disability according to the Rankin scale. Keywords: SEIZURES, BRAIN TRAUMA, BRAIN INJURY, HEAD TRAUMA, VICENTE CORRAL MOSCOSO HOSPITAL
Frecuencia de crisis convulsivas en pacientes con traumatismo craneoencefálico que acuden al Instituto Ecuatoriano de Seguridad Social, Cuenca 2012-2013
(2014) Arias Regalado, Johanna Estefanía; Barros Torres, José Roberto; Estévez Abad, René Fernando; García Alvear, Jorge Luis
One of the most common problems after traumatic brain injury are caseizures, early or late submission, which are the result of excessive neuronal discharge that may even lead to the development of post-traumatic epilepsy, psychosocial development and limiting economic sufferer . TARGET To determine the frequency of seizures in TBI patients who come to the Institute of Social Security, Cuenca 2012-2013. MATERIALS AND METHOD A prospective descriptive study was conducted in the period December 2012 -October 2013. The sample was representative, selected for 3 months based on the following criteria: patients after head trauma, presenting pathologies such as subdural hemorrhage, epidural and intraparenchymal, epidural hematoma and subdural; attending the Institute of Social Security; Forms were collected information: age, Glasgow, anticonvulsant therapy, trauma type, type of visible injury TAC . Patients were asked informed to track consent for 6 months, during which Forms onset seizures that were confirmed with a doctor's diagnosis was detected. The data was analyzed using Microsoft Excel 2007 software version 12.0.4518.1014, is represented by statistical tables and graphs. RESULTS: 28% prevalence of seizure onset was found post TEC. 60% was in the open trauma, most often between 0 to 10 years (10%) in males ( 32%). 27% had epidural and subdural hematoma. In severe TEC were 50%, 60% appeared in the immediate trauma period. 31% of patients who suffered TEC had mild disability, while 5 % died. KEYWORDS: SEIZURES; CEREBRAL TRAUMA; BRAIN INJURY; HEAD TRAUMA; JOSÈ CARRASCO ARTEAGA HOSPITAL; CUENCA-ECUADOR.
Frecuencia de síndrome burnout en internos rotativos de medicina que presenten depresión, Hospital José Carrasco Arteaga. Cuenca, 2020.
(Universidad de Cuenca, 2020-10-23) Alvarado Alvarado, Pedro Mateo; Robles Ordóñez, Andrés Fernando; Estévez Abad, René Fernando
BACKGROUND: depression is an entity of psychiatric and psychological nature, which can appear as a set of symptoms that affect mood, being a main reason for consultation in the psychiatrics’ area; generally, the appearance of these symptoms is related with strong work, physical, psychological and academic demands, which could be a trigger for Burnout Syndrome. GENERAL OBJECTIVE: to determine the frequency of Burnout Syndrome among students of the rotating medical internship who suffer depression at José Carrasco Arteaga Hospital. METHODOLOGY: cross-sectional descriptive study. The universe of the study were the rotating interns of the medical career, who work at José Carrasco Arteaga Hospital, corresponding to the cohort of September 2019. For this study, was applied an interview, a sociodemographic survey, the Hamilton test and the Maslach Burnout Inventory scale validated. Once the data collection was finished, the SPSS Statistics version 18 program was used for the statistical analysis of the results. RESULTS: 63.3% of the inmates are women, 77.2% are aged between 22-25 years, 88.6% live in urban areas and 60.8% come from Cuenca; 94.9% have a workload greater than 72 hours. 81.0% of the inmates have depression and 31.3% of these have Burnout Syndrome; 60.9% have a high level of emotional fatigue, 70.3% have a high level of depersonalization and 46.9% have a low level of personal fulfillment. There is no significant relationship between depression and burnout syndrome (p: 0.164). CONCLUSIONS: 81% of the inmates have depression, while about 30% have Burnout syndrome; however, there is no statistical association between these two. KEY WORDS: Medical students. Depression. Burnout syndrome.
Miotonía congénita de Becker, un reto diagnóstico. Caso clínico
(Universidad de Cuenca, 2024-07-05) Lamar Cueva, Camila Alejandra; Rodas Cordero, Mateo Sebastián; Estévez Abad, René Fernando
Becker's type myotonia congenita, an autosomal recessive non-dystrophic disorder belonging to chloride channelopathies, is caused by mutations in the CLCN1 gene. It is characterized by delayed relaxation of muscle fibers as opposed voluntary muscle contraction. The general objective of this study was to describe a clinical case of Becker's type myotonia congenita for a subsequent analysis and bibliographic search. The clinical case was that of a 10-years-old male with Becker's type myotonia congenital. Data collection was carried out conducting interview with the patient and his parents, physical examination and pre-existing studies. Discussion was based on supplementary bibliography selected by PRISMA, using PUBMED, SCIELO and SCIENCE DIRECT databases. The most relevant results of the case indicated that the characteristic symptom was the myotonic phenomenon in lower extremities which improved with repetitive movements. Creatine kinase remained at basal values, EMG myotonic discharges were found, and genetic sequencing confirmed variant c.180+3A>T p.? of the CLCN1 gene. The patient was treated with carbamazepine, reporting a favorable evolution. Accurate and early diagnosis is essential in this type of rare diseases that affect the quality of life, EMG and genetic tests are effective to diagnoses Becker's myotonia congenita.
Neurociencia, una aliada para mejorar la educación
(Universidad de Cuenca, 2023-07-14) González España, Wendy Carolina; Rojas Chuquiguanca, Dayana Thalia; Estévez Abad, René Fernando
Introduction: the dynamic post-COVID-19 era, driven by technological advancements and new realities, has spurred a multitude of social transformations. Education, as a fundamental sphere, has embraced innovative disciplines to enhance pedagogical strategies, among which educational neuroscience stands out. This field is of paramount importance for the future of healthcare professionals, equipping them with the necessary skills to thrive in an interconnected and ever-evolving world. Objectives: this study aims to gauge the knowledge of educational neuroscience among faculty members of the Medicine Career at the esteemed Faculty of Medical Sciences, University of Cuenca, from September 2022 to July 2023. Methods: A quantitative-descriptive study was conducted with a randomized sample of 149 teachers. A validated survey, customized for this research, was administered through the Google Forms platform. Results: The findings reveal a moderate level of knowledge and practices in educational neuroscience among the faculty (mean score of 0.837 for knowledge and 0.7128 for practices). Remarkably, 78.23% of teachers exhibited a significant acceptance of neuromyths. Notably, a statistically significant correlation was found between overall knowledge and the educational level of the respondents (p = 0.000). Conclusions: The majority of faculty members in the Medicine Career possess substantial knowledge and practices related to educational neuroscience. However, it is crucial to address the prevalence of false beliefs about learning among a notable proportion of educators. These findings emphasize the importance of continuous professional development and targeted training in educational neuroscience for educators.
Percepción de cumplimiento de los logros de aprendizaje referentes a destrezas y habilidades mediante E-learning por los estudiantes de noveno y décimo ciclo de la carrera de medicina de la Universidad de Cuenca durante marzo 2020 – marzo 2021 implementado por la pandemia de Covid-19, Cuenca-Ecuador
(Universidad de Cuenca, 2022-10-11) Cordero Matovelle, Pedro Andrés; Almeida Mendieta, Gustavo Andrés; Estévez Abad, René Fernando
BACKGROUND: as a result of the declaration of a pandemic emergency by the WHO in March 2020, the University of Cuenca in all of its faculties, including Medical School adopted e-learning as the principal teaching method Because of this change in the learning modality, the face-to-face practices carried out by the students in the various subjects were also suspended. This situation has caused several topics to be treated virtually and led to radical changes in the way in which medical skills were taught and the need to know how the situation influenced their learning was born. GENERAL OBJECTIVE: to determine the perception of learning practical skills and abilities through e-learning in Medicine students at the University of Cuenca who completed virtually the ninth and tenth cycle during the COVID-19 pandemic, based on the learning achievements contemplated in the syllables of the respective subjects. METHODOLOGY: this is a descriptive, cross-sectional study. The sample will include all the students of the Medicine career of the University of Cuenca who attended the ninth and tenth cycle under the modality virtual during the period March 2020-March 2021. To collect the data, a data collection form validated by the authors and the director of the project together with the Bioethics Committee of the University of Cuenca (see Annex 2) was used, given that there is no standardized questionnaire. The data will be processed through statistical systems SPSS, Excel and the Google Forms platform.RESULTS: up to 73.4%% of those surveyed stated that they always or partially had Internet connection and 69.8% of the participants stated that they knew the learning achievements of the practical skills contemplated within the ninth and tenth cycle syllables. The perception of e-learning compared to traditional education regarding the learning of practical skills is negative, up to 96.4% of the participants consider that practical skills are learned in a worse way in the virtual context. However, the average of all the accumulated answers showed that 67.22% perceived that they agree or totally agree to comply with the learning achievements that appear in the surveys.
Percepción de los graduados de la Carrera de Medicina de la Universidad de Cuenca 2003-2012, sobre la formación en la relación y comunicación médico-paciente
(2015) Solíz Carrión, Ana Denise; Vega Crespo, Bernardo José; Borja Robalino, Brigith Vanessa; Estévez Abad, René Fernando; Castro Calle, Fernando Eugenio
Objective. To identify the perception of the graduated doctors from Medical Faculty, regarding to their formation in the Relationship and Communication with patients. Design: It is a cross-sectional study Methodology: A survey to graduated doctors from Medical Faculty in the University of Cuenca was conducted. A database of the monitoring program for graduated people from Medicine School in the University of Cuenca, Azuay 2003-2012 was used. Results: A total of 208 surveys, 116 males with a 56% and 92 women with a 44%, aged between 23 and 42, all graduated people from Medicine School in the University of Cuenca from 2003 to 2013. The 98% are living in Ecuador. Regarding the perception of training in communication and doctor-patient relationship: to written communication, oral communication, delivering bad news, emotional relationship with patients and community participation: the perception is that their training was adequate, while it is appreciated as little suitable for handling conflict situations, as well as in the application of the informed consent.
Percepción sobre el perfil profesional de la carrera de medicina de la Facultad de Ciencias Médicas de la Universidad de Cuenca. 2013
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2014-12) Castro Calle, Fernando Eugenio; Solìz Carrión, Ana Dénise; Medina Rodríguez, María Elizabeth; Estévez Abad, René Fernando; Salazar Torres, Zoila Katherine; Dután Erraez, Hoger Gonzalo
Objective: To determine the criterion of graduate students of the School of Medicine and leaders of health institutions about the professional profile and competencies of graduate physician at the University of Cuenca Methods: A descriptive study was conducted with a sample of 310 physicians with no more than 10 years following graduation from the career and with the heads of health services regardless of their graduating year, who were given a survey to ascertain their views on the work performance against medical professionals profile offered by the Medicine School of the University of Cuenca. Results: From 310 surveys, 240 were applied to graduates of the Medical School and 70 were applied to the heads of health services, accounting for 77.5% and 22.5% of respondents, respectively. The average age of graduates was 29 years and the average age of the heads of health services was 44 years. As the years have passed from graduation until the survey was 4 years on average for graduates and 16.5 for departmental heads. In the perception of both groups on the level of university education are minor differences, with a positive balance on the criteria in the development of competencies placing in the categories of “Very Good” and “Good” when rating the various aspects of skills declaring graduate profile.
Prevalencia de la enfermedad cerebrovascular isquémica y factores asociados, según la clasificación TOAST, en el Hospital José Carrasco Arteaga del año 2013-2014
(2016) Salcedo Jaramillo, Jaime Fernando; Samaniego Pesántez, Darío Javier; Estévez Abad, René Fernando; Castro Calle, Fernando Eugenio
The Ischemic Stroke is one of the worldwide leading cause of causes of death. In spite of the increases rated in our country, still there’s a lack of epidemiological update data and their etiology base on “Trial of Org 10172 in Acute Stroke Treatment” (TOAST) classification for Ischemic Stroke. OBJECTIVE: Determine the predominance of the stroke as the classification TOAST and associate factors in the Hospital José Carrasco Arteaga of 2013 - 2014. METHODOLOGY: Transverse descriptive study, sample of 137 patients. It was used: frequencies, percentages and Odds Ratio (OR). RESULTS: The ischemic stroke get a prevalence of 54%, the major presentation was in the feminine sex (64,96%), 28,47% took place between 80 and 89 years old. Between the risk factors, the arterial hypertension prevailed in 64,23% (OR:3.5918), and the diabetes in 27,74% (OR:1,9840) of the cases. According to the TOAST classification, the types of ECV more prevalent were the stroke for indeterminate cause (normal studies) (28,46%), and the cardioembolic stroke (24,81%). CONCLUSIONES: The ischemic stroke get a prevalence of 539 cases per patients/year admit in the neurologic service in this institution, and in accordance with the classification TOAST were; the stroke for indeterminate cause by normal studies with 28,46%, followed by the cardioembolic stroke with 24,81%, the two variants of major presentation in this study. The Arterial Hypertension was the associate factor most prevalent with 64,23% (OR: 3,5918)
Prevalencia de las reacciones adversas del tratamiento farmacológico de la epilepsia en el Hospital José Carrasco Arteaga. Cuenca. Enero 2014 - diciembre 2017.
(2019-03-06) Faicán Auquilla, Kléver Leandro; Peralta Reinoso, Erika Yessenia; Estévez Abad, René Fernando; García Alvear, Jorge Luis
Introduction: Epilepsy is characterized by an abnormal, synchronous and excessive activity of the brain with presence of signs and symptoms transitory. Pharmacological treatment depend of the appearance of side effects to short, mid and long term. That’s why we conducted the present study of frequency and characteristics of the complications of carry through the pharmacological treatment of epilepsy at Jose Carrasco Arteaga Hospital. From january 2014 to december 2017. Materials and Methods: A descriptive, cross-sectional, retrospective study was carried out by observing clinical records of 393 patients in the area of Neurology of José Carrasco Arteaga Hospital. From january 2014 to december 2017. The results were obtained through a database in the statistical program SPSS version 24, through the frequency, percentage, mean, which were represented in tables and graphs. Results: Evidence showed that 58,02% of the total patients studied, present side effects to the medication. 72,81% presented neurological disorders, among the less frequent side effects are acute cutaneous erythema with 2,63%, libido decrease 0,88%, hydroelectrolytic disorder 1,32%, haematological disorders 1,32%. Finding predominance of male 52.9%. Conclusions: The Side effects of drug treatment occur with a prevalence of 42,2%, the initial pharmacological treatment being monotherapy base with 73.28%, neurological disorders have a higher frequency within the adverse effects of pharmacological treatment.
Prevalencia y factores asociados a la migraña en estudiantes de Medicina de la Universidad de Cuenca 2014
(2015) Naula Chimbo, María del Carmen; Novillo Cuenca, María Cristina; Estévez Abad, René Fernando; Sacoto Molina, Adrán Marcelo
General Objective: To determine the prevalence of migraine and associated risk factors in medical students at the University of Cuenca in 2014. Method: Analytical study with a sample of 340 randomly selected medical students, the presence of migraine based questionnaire determined ALCOI 95; analyzed their association with family history of migraine, history of ECT, nutritional characteristics and smoking, repeated academic year, insomnia, academic stress situations, contraceptive use and chronic diseases. Data were analyzed by SPSS statistical such as frequency and percentage, mean and standard deviation for the association chi square and ration of prevalence and p value with 95% confidence. Results: The prevalence of migraine was 22.1% (15.9% with aura and without aura 6.2%); the frequency of risk factors were: history of migraine in the family 35.9 stressful situations the most frequent or intense bad marks with scores of 5; statistically they associated with migraine family history of migraine RP 2.5 (1.6 to 3.7); personal history of TEC RP 1.7 (1.1 to 2.8); insomnia RP 1.5 (1-2.2) and chronic diseases 2.3 (1.1 to 4.8). Conclusions: The prevalence of migraine is high and is most frequently associated with non-modifiable factors. Subject headings: MIGRAINE DISORDERS, PREVALENCE RISK FACTORS, MEDICINE, QUESTIONNAIRE ALCOI 95.
Riesgo de demencia y factores asociados en adultos mayores, IESS, Cuenca 2009
(2010) Abambari Ortiz, Carlos Fabian; Atiencia Amaya, Richar Andrés; Arévalo Labanda, Cristhian; Estévez Abad, René Fernando; Morales Sanmartín, Jaime Rodrigo
Riesgo de demencia y factores asociados en adultos mayores, IESS, Cuenca 2009
(2009) Abambari Ortiz, Carlos Fabian; Atiencia Amaya, Richar Andrés; Arévalo Labanda, Cristhian; Estévez Abad, René Fernando
La Universidad y la ética, un compromiso
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2016-05) Estévez Abad, René Fernando
We propose to see again to the University of quality as an institution based on social fundaments, formed by people who seek the truth within the framework of morality and rigor, who are able to argue, discuss and deliberate, absent of dogmatism, immune to fundamentalism; with space for personal development within the framework of respect, recognition of skills and limits
Uso de cannabinoides en el tratamiento de la epilepsia refractaria. Revisión bibliográfica
(Universidad de Cuenca, 2024-06-03) Maldonado Armijos, Manuel Antonio; Peñafiel Zamora, Ivan Sebastian; Estévez Abad, René Fernando
Background: epilepsy is a frequent disease worldwide. In Ecuador, the incidence is 7 - 12 cases per 1000 inhabitants; 43% of them suffer a recurrence, and up to 20% of epilepsy cases develop refractory epilepsy. Therapeutic approach includes multiple therapeutic schemes; cannabinoids (CBD) are one of the emerging options. Objective: to describe the use of cannabinoids in the treatment of patients with refractory epilepsy. Methodology: a bibliographic review on the use of CBD to treat refractory epilepsy was carried out in scientific databases like PubMed, Cochrane Library and SpringerLink. Using keywords and mesh terms (in PubMed), an Excel database was created to remove duplicates and those that were not related to the topic or showed exclusion criteria. Results: 50 articles were used. CBD mechanism of action has its own objectives/targets like cannabinoid receptors; it modulates receptors like 5-HT and also decreases the hepatic metabolism of other antiepileptics by inhibition of cytochrome P450. It is indicated in patients over 1 year of age, in epileptic encephalopathies and another antiepileptic drug. CBD causes side effects (mild/moderate: hyporexia, somnolence, nausea, vomiting, and diarrhea) and some can be attributed to other concomitant antiepileptic drugs. Conclusions: the use of cannabinoids is indicated for the treatment of refractory epilepsy related to epileptic encephalopathy, as an adjuvant in other antiepileptic drugs. CBD has not shown significant benefits in other types of epilepsy. Each case should be analyzed individually to assess therapeutic benefits.