Kartagener Syndrome is characterized by Chronic Sinusitis, Bronchiectasis and Situs Inversus, the etiology of this condition is an inherited defect that develops during the embryogenic period that involves alterations in ciliar motility, due to its difficult diagnosis and its infrequency, there is not enough information in Ecuadorian population, because to technological limitations and the difficult management, we consider important the review of this clinical case, due to its difficult diagnosis and its infrequency, there is not enough information in Ecuadorian population, because to technological limitations and the difficult management, we consider important the review of this clinical case. 

Introduction: Janus kinase (JAK)-targeted therapy has become a promising approach in the treatment of some autoimmune rheumatological pathologies, including A.R, ankylosing spondylitis, psoriatic arthritis, etc. Objective: To evaluate the role of Janus kinase therapies in the treatment of autoimmune rheumatological diseases and to understand the mechanism of action of these therapies. Methodology: A collection of information from scientific journals was used, using library research tools, databases and search engines.  Results: Janus kinase-targeted therapies have been shown to be safe and effective in the treatment of rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus and vasculitis. Monitoring of patients during treatment is recommended. Conclusion: Clinical studies have demonstrated that these drugs are safe and effective in these diseases and show promising results in other autoimmune diseases as well. However, further research is essential to determine long-term efficacy and safety.

Introduction: Ureteropelvic stenosis is a narrowing at the level of the junction of the renal pelvis with the ureter which prevents the passage of urine and its expulsion, thus causing secondary hydronephrosis. There are several etiologies such as intrinsic or congenital and acquired, where congenital ones are most often observed. It causes clinical manifestations such as pain, hematuria, urinary tract infections to repeat and secondary to this, hematuria. The diagnosis can be prenatal with the help of ultrasound, in addition to more specific tests such as cystourethrography, diuretic renography, among others described later. Objectives: General: To prepare an updated bibliographic review article on the treatment of ureteropelvic stenosis and hydronephrosis. Specifics: Determine the most common etiologies of ureteropelvic stenosis and hydronephrosis. To know the clinical picture and complementary examinations associated with ureteropelvic stenosis and hydronephrosis. Provide a tool for early diagnosis of ureteropelvic stenosis. Describe proper management of ureteropelvic stenosis as required by the patient. Methodology: Using databases such as PUBMED, UpToDate, PMC, ELSEVIER, The Cochrane Library Plus, NCBI conducted an exhaustive search of scientific articles for the development of a descriptive study through a systematic updated bibliographic review. Results: The main findings show that there is greater efficacy of minimally invasive pieloplasty with a 7% failure rate, open pieloplasty 9% and endopielotomy 15%. Conclusions: Ureteropelvic stenosis is usually caused by congenital etiology. Nursing patients with this pathology are usually asymptomatic, since over time this problem has its solution, however, if there is no resolution after 18 months, there will be manifestations such as abdominal pain, there may be the presence of abdominal masses, hematuria. Surgical intervention is the gold standard for the treatment of this pathology.

In Latin America, the study of dementia with endogenously validated scales is a challenge, being recurrent to study the necessary parameters for a possible adaptation and validation for Ecuador. Introduction. In Latin America, specifically in Ecuador, the study of dementia with endogenously validated scales is a challenge, being necessary to include poverty, cultural barriers, socioeconomic vulnerabilities; as indicators to be considered for the development of a scale to measure dementia in the region, a situation that helps to overcome existing challenges for clinical treatment more effectively.  Objective. General To review the scientific evidence on the psychometric properties of the evaluation scale on knowledge of dementia. Specific. SO1. Describe the validation or adaptation of the dementia knowledge assessment scale internationally. SO2. Verify the adjustment indices of the evaluation scale on knowledge of dementia. Methodology. A systematic review of the scientific literature related to the study was carried out. The PRISMA procedure was used for the development of this process. Search strategies. Results. The first step was to formulate the research topic and objectives, and then to establish the inclusion and exclusion criteria; the information was then searched in scientific databases for its selection and analysis to provide answers to the objectives. Conclusion. The research raised in the discussion, shows the need to validate the scales on dementia to the context of a country, as this helps to promote greater reliability in data collection, being also considerable, to implement a statistical analysis to verify the internal reliability of the items, taking into account the linguistic review because they are in order with the semantics of a culture, demonstrating the need in Ecuador, to adapt the scales to the reality of Ecuadorian society.

Introduction.  Cerebral intraparenchymal hemorrhage is focal bleeding from a blood vessel into the brain parenchyma, being hypertension one of its main causes. Objective. To analyze the causes, signs and symptoms, diagnosis, and treatment of cerebral intraparenchymal hemorrhage through the description of a clinical case. Methodology. The clinical case study is of a retrospective descriptive type, as a technique used for the collection of information will be done by reviewing the clinical history and for the description of the pathology will be through the collection of articles extracted from recognized databases such as: OPS/OMS, Pubmed, Medigraphic, Dialnet, Elsevier, Scielo. Results. The bibliographic analysis and the description of the clinical case show that arterial hypertension is the main cause of cerebral intraparenchymal hemorrhage. Conclusion.  The expectation of the following research work is to describe the main causes, signs and symptoms, diagnosis and treatment of cerebral intraparenchymal hemorrhage and to acquire new knowledge about this disease.

Objective is to determine the effect of fasting time on pre and postsurgical glucose levels in mixed breed canines 4 to 16 kg, submitted to OVH of until 15 minutes, with Alpha Trak2 strips in the Municipal clinic in the city of Ibarra on July 2022. The methodology of the research was quantitative of the descriptive experimental type. We proceeded with an evaluation of the individual classified by the American Society of anesthesiologists (ASA) scale. An initial taking of glucose in venous blood was carried out with the subject in fasting, which proved its normality to enter each study group. If it was normoglycemic or even hyperglycemic, they were classified in 3 study groups (4, 8 and 12 hours of fasting) comprised by 21 specimens each. Once admitted, a pre-surgical sample was taken and another 2 hours post-surgical the data was collected and grouped by treatment. This correlated the post-surgical symptomatology with the changes in the glucose levels and the fasting times. The population for this study were healthy, canine females from the municipal clinic that came for sterilization services. The sample treatment 63 females of 4+ months in the facilities of the clinic Animal Vet SAS were analyzed with resulting data. The analysis of variance ANOVA of 2 factors and the qualitative variables were performed with Chi-square, using Infostat. In the results between the 3 study groups there is a statistically irrelevant difference in the pre-surgical glucose variable p= 0.052 and in the post-surgical glucose p= 0.719 with the same result. The post-surgical glucose, in all cases, was always higher than the pre-surgical glucose and the symptomatology remained relatively constant in the 3 fasting groups. Conclusion. There is no significant relevance between fasting times, nor any risk of hypoglycemia. A metabolic stress was generated in all cases that induced hyperglycemia due to the surgical procedure itself, with similar post-surgical symptoms in all groups.  Area of study: veterinary medicine, animal health, urban wildlife management.

Introduction.  Dermatomyositis (DM) is a rare chronic autoimmune disease with primary features of symmetrical proximal muscle weakness and skin involvement with differentiated skin lesions and a clinically heterogeneous constellation of systemic manifestations that may affect other organs mainly heart, lung, and digestive system. In the absence of characteristic dermatological findings or myopathy, DM can be difficult to diagnose; therefore, due to its low incidence and the complexity of its diagnosis, it is a topic of interest to motivate other colleagues in the health area to approach this pathology. Objective. To analyze the current scientific evidence of dermatomyositis and to elaborate a detailed review of the pathology. Methodology.  The present work is a systematic review of the existing literature, of publications in scientific journals compiling information from the databases of Medline, Intra Med, PubMed, The Cochrane, SciELO and other journals with quality scientific evidence in which descriptors such as: Dermatomyositis, paraneoplastic syndrome, cancer are used. The records range between 30 and 50, after the combination of the different keywords with date restriction within the last five years, in Spanish and English. Results. Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of systemic acquired diseases characterized by chronic progressive muscle weakness and an inflammatory cellular infiltrate in skeletal muscle. In this group, polymyositis (PM), dermatomyositis (DM) and inclusion body myositis (IBM) are the most frequent diseases. Diagnosis is based on the cutaneous manifestations of the disease and the degree of muscle involvement, and when there is doubt in the diagnosis, electromyography or skin and muscle biopsy may be used. The goals of treatment of dermatomyositis include improving physical function and preventing the development of disability. Treatment should be instituted early and requires a team approach involving physical therapist, dermatologist, and family physician. Involvement of other specialists may be necessary, depending on the manifestations of the disease. Conclusion. The diagnosis of dermatomyositis is given largely by the clinical manifestations of the disease, but in certain cases it represents a diagnostic challenge in patients who suffer from it in the absence of cutaneous manifestations, requiring complementary studies such as skin biopsy, electromyography and even muscle biopsy. Dermatomyositis is an autoimmune disease that generally appears as a paraneoplastic syndrome associated with an underlying malignant neoplasm in a subgroup of patients. Because of this, comprehensive management and timely diagnosis is necessary to prevent possible complications. The goals of dermatomyositis treatment include improving physical function and avoiding the development of disability. Among the therapeutic options that help to control this disease, we find pharmacological therapies such as the use of systemic corticosteroids, immunoglobulins, monoclonal antibodies and immunomodulators.

Introduction: the early non-invasive identification of significant liver fibrosis remains a scientific and clinical challenge. One question is the discriminating capacity of the antibody against the Hepatitis B surface antigen on significant liver fibrosis in patients with chronic hepatitis B virus infection. Objectives: to evaluate the diagnostic and predictive value of surface antigen antibody on significant liver fibrosis in chronic hepatitis B virus infection. Methodology: An observational and cross-sectional study was conducted including fifteen patients infested chronically with hepatitis B virus with significant liver fibrosis and forty-three control subjects without significant liver fibrosis. Platelet count, antibody levels versus surface antigen, surface antigen, aspartate-aminotransferase, and alanine-aminotransferase were measured by automated methods, according to the manufacturer's instructions. The APRI and FIB-4 liver fibrosis indices were calculated according to the recommended formula. Significant liver fibrosis was considered when the FIB-4 and/or APRI indices were equal to or greater than 1.45 and 0.5, respectively. The SPSS statistical package, version 18.0, was used to analyze the results. Results: serum levels of antibody against surface antigen were found as an independent predictor (multiple regression; OR= 0.680; p= 0.021) and good discriminant (AUROC=0.876; p=0.000) of significant liver fibrosis. The cut-off points of 4.9 mIU/ml for this antibody showed 100% and 72.1% sensitivity and diagnostic specificity, respectively, and positive likelihood ratio of 3.58. Conclusions:  the serum level of the antibody against the surface antigen showed diagnostic capacity and predictive value on the significant ongoing liver fibrosis of chronic hepatitis B virus infection. Serum levels of surface antigen less than 4.9 mIU/ml suggest significant liver fibrosis during chronic hepatitis B virus infection. The cut-off points 4.25 mIU/ml showed the highest percentage of diagnostic accuracy (88%).          

Introduction: the timely detection of Hepatic Fibrosis in people with chronic infection by Hepatitis B virus through non-invasive biomarkers remains a scientific problem. The Anti-Surface Antigen antibody is a specific biomarker of the hepatitis B virus associated with infection control, whose relationship with liver fibrosis in these people has not been completely clarified in Grenada. Objective: to evaluate the relationship between serum levels of anti-Hepatitis B virus surface antigen antibody and APRI and IFF-4 liver fibrosis indices. Methodology: a cross-sectional study was conducted including twenty patients chronically infected with the Hepatitis B virus and twenty-three healthy volunteers vaccinated against it. The study was conducted from July to November 2018. The following were considered as exclusion criteria: positive results of serological tests for human immunodeficiency virus and Hepatitis C; as well as other causes of chronic liver disease. The levels of platelets, surface antigen, surface antigen and serum activity of Aspartate Aminotransferase and Alanine Aminotransferase, were measured in automated equipment according to the manufacturer's instructions. The FIB-4 and APRI liver fibrosis indices were calculated according to the recommended formulas. The SSPS program, version 18.0, was used to analyze the results. Results: serum levels of Anti-Surface Antigen showed negative correlation with the index of liver fibrosis FIB-4 in the group of patients (Spearman's Rho = (-) 0, 539; p = 0, 014). Conclusions: serum levels of the antibody against the surface antigen were negatively associated with liver fibrosis in patients chronically infected with the Hepatitis B virus studied.

Introduction: Asthma management has among its objectives to control symptoms and risk factors. 20% of adult patients and less than 5% of children with asthma suffer from severe asthma. Skin puncture tests are part of the etiological diagnosis of this disease. Polysensitization and the intensity of sensitization in asthmatic patients are elements to be evaluated in skin puncture tests. Objective: To identify in the bibliography consulted if polysensitization and the intensity of sensitization, evaluated through puncture skin tests, using mite extracts, were considered risk factors in the development of severe asthma. Method: A bibliographic search was conducted in the journals related to the topic to be investigated, during the year 2020. The journals that were at the time of the study in the top fifty positions of the scimago ranking were selected. Results: In the reviewed articles, polysensitization and the intensity of sensitization are not described as risk factors in severe asthma, but they do refer to dust mites as a risk factor related to the severity of symptoms and as a triggering factor for asthma and allergic reactions in patients with asthma. Conclusion: There is a gap in knowledge regarding the subject to be investigated.