Introduction: Rheumatoid Arthritis and Ankylosing Spondylitis are autoimmune diseases, mediated by the activation of CD4+ T cells and characterized by high levels of molecules associated whit inflammation. The altered peptide ligand use constitutes an attractive therapy for the treatment of Rheumatoid Arthritis and Ankylosing Spondylitis. Jusvinza has as active ingredient a modified peptide derived from the autoantigen called 60kDa stress shock protein. Preclinical studies and clinic research results in Rheumatoid Arthritis and COVID-19 have demonstrated that Jusvinza has anti-inflammatory activity; and is able to induce mechanisms associated with the immunologic homeostasis restauration. Objective: To describe the safety, clinical evolution, as well as the variations of molecules associated with inflammation in patients with Rheumatoid Arthritis and Ankylosing Spondylitis, treated with Jusvinza in a new treatment schedule. Presentation of cases: Three patients were included, who were treated with Jusvinza for three months: two patients with Rheumatoid Arthritis and a patient with Ankylosing Spondylitis. Blood samples were taken before treatment and every 30 days after finished it, for the quantification of cytokines levels, anti-cyclic citrullinated peptide antibodies and rheumatoid factor. The patients showed evidence of clinic improvement, associated with the decrease of cytokine levels. In addition, the antibody levels decreased during Jusvinza treatment. Conclusions: Jusvinza's new therapeutic scheme induced clinical improvement in patients, associated with the decrease in proinflammatory cytokines levels. These results demonstrate the potential of Jusvinza for Rheumatoid Arthritis and Ankylosing Spondylitis.
The training process for the investigative function of the health professional. The Faculty of Medical Sciences "Miguel Enr & iacute;quez" has identified, through observation, analysis of documents, unstructured group interview and the own experience of its teachers, deficiencies in the direction of the teaching-educational process in Research Methodology, so it became necessary the educational research project: Management of the teaching-educational process of the Research Methodology in Medical Sciences, that is being developed with the scientific problem of how to contribute to the improvement of the direction of that process. Consequently, this article aims to explain the essential relationships between the constructs: training, investigative function, investigative approach and macro investigative skills, in the undergraduate and postgraduate training process for that function, considered as a platform for the occupations of the professional .These relationships were evidenced from the systematization of the foundations of the object of studies and the operational conceptualization of the dependent variable, from its theoretical and methodological links.
Introduction: independent work is an important way to achieve the capacity for cognitive independence necessary in the comprehensive training of students, which guarantees their full integration into today's knowledge society. Objective: to evaluate the use of independent work as a component of the teaching-learning process in the subjects of the 5th year of the Medicine degree at the "Miguel Enr & iacute;quez" Faculty of Sciences. Method: descriptive, observational, cross-sectional study, with the application of theoretical, empirical and descriptive statistical methods, carried out in the period from January to April of the 2024 academic year. The sample was randomly selected, consisting of 15 teachers and 40 students. Results: independent work was frequently used by teachers in the subjects, mostly linked to tasks of the profession, applying interdisciplinarity and with instructions to the student for their development and motivation. Both teachers and students consider that this teaching method is important in the comprehensive training of the student. Conclusions: the methodological work of the year group must be aimed at promoting the student's role and encouraging his cognitive independence, through adequate guidance, execution and control of the different teaching tasks and due demand from the teachers.
Introduction: Rheumatoid arthritis is a chronic and debilitating disease characterized by inflammation of the joints, it can have a significant impact on patients' quality of life. Objective: Determine the usefulness of the initial Gamma-Glutamyl-Transferase measurement and its relationship with the prediction of disease activity in patients with rheumatoid arthritis at the Teodoro Maldonado Carbo Hospital in Ecuador. Method: A quantitative, cross-sectional study was carried out. The population was 1254 patients and the sample was 294 patients. Initial and final measurement of the disease activity index and Gamma-Glutamyl-Transferase values were performed. The medical records were reviewed. Results: The mean disease activity index at the beginning was 10.12 points, while at the end it was 8.41 points; The initial GGT had an average of 44.21 and the final one of 38.37. There was a positive linear relationship (Pearson's correlation coefficient = 0.454 and p = 0.000) between the initial disease activity index and the initial GGT and between the final disease activity index and the final GGT (Pearson's correlation coefficient = 0.518 and p= 0.000). Conclusions: The relationship between GGT and rheumatoid arthritis activity may have important clinical implications. Determination of baseline GGT may help identify patients with rheumatoid arthritis who are at increased risk of complications.
Macrophage activation syndrome is known as a form of secondary hemophagocytic lymphohistiocytosis, related to autoimmune diseases. The objective of this research was to present a case of a patient with MAS, addressing the diagnostic process, the close relationship with rheumatic diseases, its follow-up and treatment. We present an 11-year-old female patient with a history of rheumatic fever, and a diagnosis of macrophage activation syndrome secondary to systemic lupus erythematosus at onset. In the treatment of the patient, high-dose steroids and immunosuppressants were used, with which clinical and humoral improvement was obtained, achieving the patient's discharge. macrophage activation syndrome remains an entity with high mortality, with the potential to cause multi-organ dysfunction, which is strongly related to various rheumatic diseases, so it is imperative that it is considered and diagnosed early in order to reduce mortality and contribute to increasing knowledge and its treatment.
A 55-year-old male patient was admitted to the Miguel Enriquez Clinical Surgical Teaching Hospital in Havana due to acute decline. The attending physicians performed clinical procedures, including an x-ray, which showed homogeneous opacity of the lower 2/3 of the right lung field due to pleural effusion; this coincides with the anamnesis performed by the clinicians. The extended cytological study showed abundant histiocytes, lymphocytes and reactive mesothelial cells and the presence of two isolated niches suspicious of malignancy, at which point a progressive cytological study was suggested.
Introduction: Rheumatoid arthritis has a universal distribution, its prevalence varies between 0.5 to 2 % in the general population and, globally, it has been estimated at 1 %. Objective: To characterize the population of patients suffering from rheumatoid arthritis, according to epidemiological, clinical and humoral particularities. Method: An observational, descriptive and cross-sectional study was carried out on 50 patients with a diagnosis of rheumatoid arthritis, in the Rheumatology clinic, in the province of Santiago de Cuba, in the period from May 2021 to May 2023. In the analysis Statistically, absolute frequency and percentage were used for qualitative variables. The Fisher-Irving test of exact probabilities was applied to identify statistically significant associations between selected qualitative criteria, with a confidence level of 95 %. Results: The age group of 45 to 64 years of age and the female sex predominated for 70.0 % and 82.0 %, respectively. The rheumatoid factor was positive in 84.0 % of the patients, and no significant statistical association was found between the rheumatoid factor result and the presence of arthritis in the wrist, metacarpophalangeal, and proximal interphalangeal joints. Conclusions: Female subjects predominate, in intermediate and advanced ages of life; and the frequency of bilateral arthritic damage in the wrist, metacarpophalangeal, and proximal interphalangeal joints is not related to rheumatoid factor positivity.
Introduction: Health-related quality of life is a subjective and multidimensional variable that is essential in the management of chronic diseases such as rheumatoid arthritis. Objective: To evaluate health-related quality of life in patients with rheumatoid arthritis treated with the drug called Jusvinza in combination with methotrexate. Method: An observational, descriptive study was carried out in the period between September 2019- May 2021 at the Reference Center for Rheumatic Diseases. HDCQ "October 10". 88 patients were included, HRQoL was evaluated through the QoL-RA questionnaire. Clinical variables were evaluated at time 0 (initial evaluation) and at 48 weeks. To describe the relationship between the average QoL RA score with the DAS 28 and the HAQ CU, the Pearson correlation was used. Results: Female patients, between 36 and 55 years of age, predominated. In the initial evaluation, the global mean of the QoL-RA was 3.75, indicating a poor quality of life. The lowest average value was for the parameter physical ability, which was 1.89. In the final evaluation, the mean value of the QoL-RA was 9.66, corresponding to a good quality of life. The highest score was obtained in the parameter personal health, with a value of 9.73. Improvement was observed in all aspects of the quality of life questionnaire. Statistical evidence demonstrated the relationship between overall quality of life and the clinical variables evaluated. Conclusions: An improvement in health-related quality of life was demonstrated in patients with Rheumatoid Arthritis treated with Jusvinza in combination with methotrexate, reinforcing the immunoregulatory effect of Jusvinza.
Rheumatoid arthritis is a chronic, systemic inflammatory disease that can cause destruction and ankylosis of the joints and extra-articular manifestations, which in its progressive course can cause functional disability, constituting one of the main causes of disability and morbidity. Patients with this disease treated with Jusvinza accredit the future possibility for the insertion of the drug as a first line of treatment in Cuba. This article presents an opinion of the researchers in relation to the different experiences that are had with its usefulness, in monotherapy and combined with methotrexate.
81-year-old woman, who after suffering a fall at the residence, suffered a fracture of her right femur. She arrives at the hospital referred from another hospital center to be evaluated and the protocol established for this type of emergency is followed. Finally, he is admitted to the Traumatology Service to proceed with the scheduled surgery. Placing a cable-ready system on her as she wears an ipsilateral hip and knee prosthesis.
Introduction: Meaningful learning constitutes a methodological tool that promotes a series of advantages in the teachers and students in whom it is implemented. Its implementation is significant to raise the quality of the educational teaching process. Objective: Describe the advantages of meaningful learning from the point of view of teachers and university students. Methods: A basic, non-experimental and descriptive research was carried out that included 23 teachers and 87 university students to know their opinion on the advantages offered by meaningful learning and the level of knowledge about its basic elements. A small survey was administered to each participant that allowed obtaining the necessary information to fulfill the proposed objective. Results: there was a predominance of female teachers (69.57%) and students of the same sex (60.92%). 34.78% of the teachers reported more than 10 years of teaching experience. The generation of research skills was the advantage of meaningful learning most mentioned by teachers (82.61%) and students (83.91%). A predominance of the medium level of knowledge on significant learning was identified in the teachers (56.52%) and the low level of knowledge (58.62%) in the students. Conclusions: Despite adequately recognizing the advantages that meaningful learning provides for teachers and students; Both groups must continue working and training to improve the level of knowledge about the general elements of this academic activity, in order to guarantee its adequate implementation.
Systemic lupus erythematosus is an autoimmune disease characterized by multiple pathogenic autoantibodies such as anti-DNA (nephritis), anticardiolipin (thrombosis) and antiRo (atrioventricular block). Numerous genetic and environmental factors intervene in the specific etiology of systemic lupus erythematosus. Hepatitis C Virus (HCV) and Hepatitis B Virus (HBV) may represent a chronic stimulus for B cell expansion in patients with systemic lupus erythematosus. Few studies have been published on the prevalence of HCV and HBV in subjects with lupus. While some studies find a high prevalence, others do not confirm them. There are data that indicate that the occurrence of HBsAg and HCV antibody is not increased in patients with lupus, compared to a control group from the same geographic area. Two patients are presented with a diagnosis of systemic lupus erythematosus and presence of positive hepatitis B and C viruses by third generation UMELISA (R) technique.
The rise of digital platforms in higher education has conditioned the development and implementation of active learning methodologies in the general university context. However, its use brings new challenges and future perspectives that must be properly analyzed and implemented. These include the self-preparation of teachers and students in the management of the platforms, as well as guaranteeing technological resources that allow access to the platforms and the implementation of the methodologies. There is a direct relationship between both elements, since each one benefits from the application of the other. The objective of this research is to describe the advantages of the use of digital platforms and active learning methodologies in higher education, focusing on its challenges and future perspectives. Elements related to the advantages of the use of digital platforms and active learning methodologies in higher education and the challenges and future perspectives for the consolidation of the use of virtual platforms and active learning methodologies in higher education were addressed. It is concluded that digital platforms and active learning methodologies provide advantages for both the teacher and the student. The consolidation of knowledge with optimization of the time dedicated to study constitutes decisive advantages. Both resources face current risks and future perspectives that will guarantee the continuity of quality higher education.
The epidemiological situation generated by the COVID-19 pandemic caused a deep economic and social crisis in Ecuador, which increased in cantons whose economic activity depended on tourism or other spheres that were highly affected during this period. The Guano canton, in the Chimborazo province, suffered the onslaught of COVID-19, affecting its main economic spheres: tourism, agricultural and craft activity. Despite having passed the worst years of the disease, an economic reactivation that allows us to approach pre-pandemic living standards has not yet been achieved. The objective of this research is to expose the importance of the use of neuroeconomics and the study of neuroemotions in promoting a rapid economic reactivation in the Guano canton after the COVID-19 pandemic. For this, a basic, non-experimental and descriptive research was carried out in which the conceptual elements of neuroeconomics and neuroemotions are exposed. As main results, the approach to the advantages that the study and implementation of these branches of science can represent to enhance economic reactivation can also be presented. It is concluded that the application of neuroeconomics and the study of neuroemotions can provide a series of data that would be used to draw up strategies for optimizing resources and generating opportunities that will favor the economic reactivation of the Guano canton.
Public purchases constitute the basis of support for activities carried out in the health service in Ecuador. They constitute a complex process that cannot be found except in loopholes that can be used by different people for profit, which exposes the presence of manifestations of corruption. The audit is a control process that allows minimizing the aforementioned gaps and thus limits the presence of events considered as an expression of corruption. The objective of this investigation is to expose the importance of auditing public procurement processes in Ecuadorian health units in order to make this process transparent and avoid expressions of corruption. In this basic, non-experimental and descriptive research, the elements related to the importance of the audit as a control process for public purchases in Ecuadorian health units are exposed, highlighting its role in the prevention and identification of expressions of corruption; Only in this way can the quality of health services in the country be improved. It is concluded that auditing public purchases in the health sector in Ecuador constitutes an expression of control over inadequate attitudes that, in addition to tarnishing the image of the system, undermines the quality of care and the population's satisfaction with the service provided.
Rheumatic diseases constitute a group of conditions that are characterized by affecting different organs and organ systems of the human body, with emphasis on respiratory and cardiovascular involvement; The expression of the sustained inflammatory process generates complications that cause different degrees of disability and affect the perception of healthrelated quality of life. Pulmonary rehabilitation may constitute a therapeutic alternative in patients with rheumatic disease and cardiovascular compromise. The objective of the present investigation was to expose the advantages that pulmonary rehabilitation provides in patients with RD and cardiovascular compromise; For this, a basic, descriptive and transversal research was carried out with the purpose of revealing the main elements that distinguish respiratory rehabilitation in patients with rheumatic disease and cardiovascular compromise. The main results were the main respiratory and cardiovascular complications that can occur in these patients, as well as elements related to the advantages and methods related to respiratory rehabilitation that make it possible to consider it as part of the therapeutic scheme in these conditions. It is concluded that respiratory rehabilitation contributes significantly to minimizing the expression of the damage generated by the inflammatory process in the cardiovascular and respiratory system. The advantages are related to the decrease in ventilatory restriction and gas exchange; as well as the improvement of the frequency and force of cardiac contraction.
Inflammatory bowel diseases are a frequent cause of attendance at a medical consultation and the generation of functional disability and alterations in patients' perception of quality of life. The inflammatory process is the final result of the combination of a series of events that include different organs, substances, chemical mediators and organ systems of the human body. Although it is true that it is considered a defense mechanism of the body against the invasion of different germs, its increased or maintained expression causes negative effects for the proper functioning of the human body. Physiologically there must be a balance between the production of pro-inflammatory and anti-inflammatory substances. The production of these substances occurs in different systems, including the digestive system. The intestinal flora is a set of microorganisms that fulfill different functions in the mucosa of the digestive tract; Alterations in the intestinal microbiota have been identified as a factor that determines the presence of a local and systemic inflammatory process. The objective of this research was to expose the role that alterations in the intestinal microbiota play in the appearance and perpetuation of inflammatory bowel disease. The humoral and chemical alterations that are generated in the presence of microbiota alterations are described and how these can induce a local and systemic inflammatory process. It is concluded that inflammatory bowel diseases can have a better clinical evolution if an adequate composition of the intestinal microbiota is guaranteed.
Introduction: Rheumatic diseases are characterized by the presence of a local and systemic inflammatory process that conditions articular and extra -articular manifestations; Within the latter, one of the least studied are the genitourinary manifestations. Objective: To point out the genitourinary manifestations that most frequently occur in patients with rheumatic diseases. Methodology: basic study, with non -experimental, descriptive, retrospective and cross-sectional design. The universe consisted of 147 patients with a confirmed diagnosis of rheumatic diseases treated in the outpatient service of the Hospital Andino de Chimborazo in the period January -August 2023. Results: Average age of 53.69 years, predominance of patients between 50 and 59 years (31.97%), female (77.55%) and with evolution time between 1 and 5 years (57.83%). 64.62% of patients reported genitourinary manifestations, vulvovaginitis (41.30%), urethritis (17.39%) and cystitis (15.21%) were the most frequently presented. Conclusions: Genitourinary manifestations, despite their high percentage of appearance, constitute an underdiagnosed and underestimated group of conditions in patients with RD; The inflammatory process seems to be the main etiopathogenic agent that generates the appearance of these clinical manifestations.
Osteoarthritis is considered a degenerative and chronic disease characterized by the decrease or loss of articular cartilage, associated with bone remodeling and different degrees of inflammation. As a disease, it affects the perception of quality of life and the functional capacity of patients. Early identification of risk factors for the disease is vital to delay its onset or reduce the intensity of its clinical expression. Although it is true that it is a disease associated with the aging process, the onset of clinical manifestations is expressed earlier and earlier. Images of patients under 45 years of age showing joint degenerative signs compatible with the diagnosis of osteoarthritis are presented. Diagnosis and treatment in these cases constitutes a challenge for health professionals in order to preserve joint function and guarantee the functional capacity of the patient.
