Introduction: Due to its high nutritional composition, goat milk is a food source; however, when obtained by manual or mechanical milking, there is an elevated possibility of contamination by microorganisms harmful to health, as in the case of Staphylococcus aureus. Objective: To determine the frequency of Staphylococcus aureus in goat milk sold in markets in Cuenca - Ecuador. Methodology: Descriptive observational and cross-sectional study. A non-probabilistic convenience sampling was conducted to obtain sixty samples of raw goat milk. Results: Of the sixty samples collected, a frequency of Staphylococcus aureus of 65.0% was determined, showing the presence of these bacteria in raw goat milk. Conclusion: The frequency of Staphylococcus aureus was found in samples obtained from raw goat milk sold by street vendors, due to poor hygiene and poor milking procedures.

Introduction: Acute pancreatitis is an inflammation of the pancreas caused by the activation of its enzymes, this pathology presents several etiologies, the main ones being biliary obstruction, alcoholism, and hypertriglyceridemia. The diagnostic picture is based on three specific criteria: intense epigastric pain, serum amylase/lipase levels higher than three times their normal limit and imaging tests compatible with acute pancreatitis. The biochemical markers amylase, serum lipase, urinary amylase and urinary trypsinogen-2 help in the diagnosis, as each of them provide valuable information that contributes to a clear view of the pathology. So far, no molecular marker has been found that contributes significantly to the patient's evaluation, considering that for a correct diagnosis it is necessary to use imaging studies. Objective: Describe the biochemical and molecular markers for the diagnosis of acute pancreatitis. Methodology: Documentary, descriptive and retrospective study of current and updated studies. Conclusion: Acute pancreatitis if not diagnosed and treated in time can lead to systemic inflammation and death. The best biochemical markers for diagnosis are serum amylase and lipase since they have high sensitivity and specificity. For a correct diagnosis it is necessary to correlate serum amylase and lipase levels with symptoms, especially severe pain in the epigastrium, and necessarily with imaging tests.

Introduction.  Women who are pregnant are more likely to develop a more severe state of COVID-19 due to physiological changes that they experience unlike non-pregnant women, therefore the safety of the vaccines in this population is a concern despite that the World Health Organization and governments of different countries have allowed the application of the vaccines in pregnant women, information on the safety are diverse but not entirely reliable, even though certain studies have demonstrated that it is a safe strategy with high efficiency both at the maternal level and for the fetus against COVID-19, its long term evolution is still uncertain. Objective. To describe the effects of the vaccine against COVID-19 in pregnant women from a bibliographic review. Methodology. Bibliographic review where the PubMed database was used for articles in English and Spanish in the last three years using DeCS and MeSH terms as well as AND and OR booleans incorporating inclusion and exclusion criteria in order to have a more specific search. Results. It is evident that after the application of the vaccine against COVID-19, in addition to reducing the severity of the disease and the risk of hospitalization, there is a shared maternal-fetal protection that increases with booster doses, especially when it is applied before the last weeks of pregnancy. The most common side effects were fatigue, headache, myalgia, chills, nausea, vomiting, joint pain and fever. Regarding the most appropriate trimester for the application of the vaccine remains under debate. Conclusion. The vaccine against COVID-19 is effective for pregnant women to protect themselves against the severe form caused by COVID-19, the safety of the vaccines is evident as is the presence of side effects that can range from local to systemic.

Introduction. Erythema pernio is a condition that presents as an abnormal reaction to low temperatures, due to a prolonged vasoconstriction which leads to inflammation and hypoxemia of the vascular walls; it generally occurs in countries with very cold climates. The disease was first described by William Tomas in 1894 as "dermatitis hiemalis". The largest number of cases was reported during World War II. Objective. To know the main findings of the clinical evolution and diagnosis of chilblains, in order to serve as a contribution to the medical scientific community. Methodology.  A clinical case report was used in relation to chilblains, through the retrospective collection of information by accessing the clinical history by means of the patient's authorization through informed consent. A bibliographic review was included to corroborate the case information. Results. A 21-year-old female patient attended a Dermatology outpatient clinic where she reported recurrent dermatological manifestations on hands and feet for 5 years, after several treatments that she does not remember, she presented slight improvement and several episodes of remission and exacerbation. On physical examination she presents violaceous macules and erythematous papules of 1 mm over erythema, distributed bilaterally on distal phalanges of fingers and toes, while on the back of hands, palms and soles she presents scarce erythematous papules, some of them ulcerated.  Conclusion.  Being an infrequent disease in our environment, it is not usually diagnosed in a timely manner and therefore it is treated ineffectively, thus worsening the clinical pictures of patients and even putting their lives at risk. With the presentation of this case we hope to contribute to the scientific community to learn more about the management of pernio.

Introduction: Gastroesophageal reflux disease occurs due to the involvement of the cardia and the esophagus as a result of gastric content regurgitation. Its global prevalence ranges from 10% to 30% of the population. Within this group, approximately 30-40% show resistance to proton pump inhibitors treatment, while other pharmacological measures have proven ineffective. However, fundoplication, regardless of the surgical technique used, has been shown to be effective in the long term, reversing the damage and resolving symptoms. Methodology: Descriptive retrospective case presentation. Objective: To describe a clinical case of a patient with treatment-resistant GERD with Barrett's metaplasia, treated surgically with Nissen fundoplication. A 48-year-old female patient with a history of hiatal hernia presented with symptoms of epigastralgia, progressive dysphagia, and postprandial heartburn. Upper gastrointestinal endoscopy was performed, and upon macroscopic presence of metaplasia, a biopsy was performed, diagnosing Gastroesophageal reflux disease with Barrett's metaplasia. Treatment with proton pump inhibitors was initiated; however, no improvement in the epithelium was observed in the follow-up endoscopy, leading to the decision to perform surgical intervention using Nissen fundoplication as a definitive treatment. After one month, the patient showed positive progress, with a total improvement in her symptoms. Conclusion: Nissen fundoplication is established as a long-term therapeutic alternative with lower recurrence rates and complications compared to conventional medical treatment. However, further studies are still required to determine the optimal timing of this treatment. It is crucial to emphasize the importance of early intervention to prevent complications associated with GERD.

Open-angle glaucoma is the most common and prevalent ocular affectation in the world, this disease generally affects people over 40 years of age in 90% of the population. Glaucoma occurs when intraocular pressure is elevated because the duct becomes blocked and fluid cannot drain normally. This type of glaucomatous optic neuropathy is very silent and often does not present any sign or symptom that alerts patients, which is why it is extremely important to recognize this ocular pathology in its early stages, through a good diagnosis accompanied by a good ocular examination, in order to avoid complications, such as the gradual loss of sight on the side that is affected, since it is one of the main complications of this type of glaucoma. For this we are going to explain the importance of the benefit of early clinical management of open-angle glaucoma. For this, a non- experimental study will be carried out, of a narrative type of bibliographic review. The correct clinical management of patients suffering from this ophthalmopathy is important, since in this way it will be less complicated to treat it early, without it evolving and can generate or bring with it multiple affectations, which in the end will end up deteriorating the view of the patient and lifestyle as such. This is why it is of great importance to be able to diagnose this type of ocular involvement in a timely and early manner.

Introduction. Rapid maxillary expansion is one of the treatments indicated in cases of transverse constriction of the maxilla in order to improve orofacial functional and esthetic aspects. Objective. To carry out a review of the scientific literature on the efficacy of rapid maxillary expansion in patients with obstructive sleep apnea.  Methodology. A descriptive and critical literature review was performed through digital databases such as: PubMed, Scielo and Google Academic. Articles were included from March 2018 to February 2023 published in the following languages: Portuguese, English and Spanish. Results. A total of 29 articles were collected and the efficacy of rapid maxillary expansion as a treatment for sleep apnea was analyzed. Conclusion. We can conclude that most of the studies evaluated mention the existence of a notable positive change in obstructive sleep apnea syndrome after the application of treatments that expand the palatal bone, such as RME.

Introduction.  Currently, orthodontic treatments have evolved to meet both aesthetic and functional objectives, through technological and industrial development. Objective.  To compare the speed between lingual and labial appliances through a bibliographic review of the literature to know the differences and effectiveness of these two treatments. Methodology.  In this study, a bibliographic and documented review was carried out on the literature on lingual and labial orthodontics and the relationship with the speed, duration and time of treatment. Results. On the evaluation of the effectiveness and the total treatment time between labial and lingual appliances, it was shown that the procedures of these two appliances complemented each other. Conclusion.  It was possible to conclude that there is a disparity in the results of the articles analyzed in relation to the speed and time of treatment, both in lingual and labial dentistry. For this reason, it cannot be affirmed that there is a difference in efficacy, speed, time or duration between these two treatments.