Nursing strategies for the prevention of urinary tract infections caused by Escherichia coli in pregnant women in Ecuador

Introduction. Urinary tract infections (UTIs) occur due to the invasion of microorganisms that multiply in the urinary tract and adjoining organs, causing infectious processes that threaten health, especially during pregnancy where vaginal pH and hormonal changes are factors that favor the arrival of germs to the genital area from other nearby areas, such as Escherichia coli, a microorganism that migrates from the rectum to the female urinary tract.  Objective. The present work has the need to describe strategies applicable by the nursing professional to prevent urinary tract infections triggered by Escherichia coli in pregnant women. Methodology. Several bibliographic analyses of the following journals were conducted: Dialnet, SciELO, Scopus, PubMed, among others; and university repositories. To identify the studies, Boolean operators "AND" and "OR" were used combined with key terms Escherichia coli-pregnancy, urinary tract infections-Ecuador. We searched for full-text articles, undergraduate papers, and clinical practice guidelines from the years 2020-2024, with estimates of research published in the years 2013, 2017-2019. Results. Ecuador has a deficient protocol for the prevention of UTIs in pregnant women with basic measures that include health promotion and specific protection activities, conducted from the first level of care. Conclusion. The reduction in the prevalence of UTIs in Ecuador means constant updating and commitment of the professional to provide information on hygiene and eating habits, such as complying with biosecurity measures before direct care and providing timely chemical prophylaxis with antibiotics. General area of study: Nursing Specific area of study: Gynecological-obstetric nursing. Type of Study: Bibliographic review.

Nhaylett Yoskyra Zurita Barrios, Danny Josué Cedeño Tomalá, Luis Joel Alvarez Izquierdo , Martha Rosario Baque Ortega, Manuel Adolfo González Correa , Estefanía Peña Valdano

6-23

Relationship between tonsil size and dental arch form. a literature review

Introduction. A set of structures forms the stomatognathic system. Each of them plays a fundamental role in the fulfillment of functions and esthetics of individuals. Thus, health personnel must be aware of the anatomy and function of each structure comprising the stomatognathic system, its configuration, dental occlusion, shape of the dental arches, and how these structures are subjected to significant transformations during life. It should be considered that dental occlusion is determined by bone growth, neuromuscular maturity, and dental development, which represent a possible etiological factor in dysfunctional pathology. Objective. To identify the relationship between the size of the tonsils and the shape of the dental arches. Methods. A descriptive study was conducted through a literature review in Google Scholar, SciELO, PubMed, Elsevier, and ScienceDirect databases. The inclusion criteria were clinical trials, systematic reviews, literature reviews, and articles published in the last five years in English and Spanish. Exclusion criteria were syndromic or surgically treated patients. Results. A meaningful relationship is described between the size of the tonsils and the shape of the arches, thus modifying the patients' occlusion. Conclusion. The shape of the dental arches is fundamental to understand the alterations that affect occlusion and respiration. Habits such as mouth breathing and conditions such as nasal obstruction, hyperplasia of the tonsils influence these alterations, causing breathing difficulties. Recognizing these interrelationships is essential to effectively treat respiratory and occlusal disorders.

Erika Carolina Tapia Vásquez , María Isabel Cabrera Padrón

24-41

Identification of musculoskeletal injuries in health and industrial safety personnel

Background: The study of musculoskeletal injuries in health personnel and industrial safety is crucial because it allows determining their impact, consequences and preventive measures to be applied. Objective: identify musculoskeletal injuries in industrial health and safety personnel. Methodology: quantitative approach, cross-sectional design, whose sample was made up of 46 participants, to whom the survey was applied (data collection technique) using a questionnaire (data collection instrument) comprised of 11 items, the analysis of which was carried out with the support of Microsoft Excel. Results: 61% of respondents were female, while 39% were male; most respondents (52%) experience pain or discomfort 1-2 times a week, lasting more than 3 hours (37%), and the pain usually occurs in the morning (46%) and is categorized as moderate by 41% of respondents. Regarding the impact of pain on the work capacity of health personnel, it is evident that 43% claim that it affects them occasionally, while 24% mention that it frequently or rarely affects them and 9% say that it never impacts their work capacity; the anatomical region most affected by pain or discomfort is the cervical area (30%), followed by the cervicolumbar (22%), while the most common type of injury is muscle strain and contracture, both with 30%. Conclusion: Respondents experience pain or discomfort 1-2 times per week, lasting more than 3 hours and generally occurring in the morning. The most affected anatomical region is the cervical area, followed by the cervicolumbar area. General area of ​​study: health & wellness. Specific study area: occupational medicine and occupational health. Type of study: original.

Alexandra Natividad Monar Mora, Eugenia Cecilia Malquin Vinueza, Janeth Fernanda Jiménez Rey

57-72

Postsurgical comparison between a linear flap and a triangular flap in lower third molar surgery. Literature review

Introduction. The extraction of lower third molars is a frequent intervention in the practice of oral and maxillofacial surgery. A crucial aspect of the procedure's success is the proper design of the mucoperiosteal flap, which determines optimal exposure, surgical access, and postoperative recovery with minimal complications. Among the most used techniques are linear and triangular flaps, generating a debate about which offers better results. Objective. The purpose of this study is to rigorously compare these two techniques for lower third molar surgery. Methodology. Using the PRISMA methodology, 17 studies that evaluated the use of both types of flaps were reviewed from several databases. Results. The review results showed various findings: some studies found no significant differences between the two flap types, while others highlighted specific advantages for each. Based on the findings, the triangular mucoperiosteal flap is associated with reduced postoperative pain, less incidence of lockjaw, and lower risk of surgical wound dehiscence. On the other hand, the linear flap could contribute to a decrease in inflammation and ecchymosis after surgery. Conclusion. In conclusion, linear and triangular flaps are viable and practical options for extracting lower third molars. The choice between both will depend on the individualized evaluation of the patient, the complexity of the case, and the surgeon's experience, seeking to optimize results and minimize postoperative complications.

Jorge Luis Hurtado Carrión, Felipe Rafael Calle Jara

73-101

Informed consent in medical practice and clinical research

Introduction. Informed consent is a fundamental pillar in medical practice and clinical research, evolving from a paternalistic model to one that emphasizes patient autonomy and shared decision making. Over time, the importance of ensuring that patients and clinical trial participants fully understand the procedures, risks, and benefits has been recognized as essential to protect their rights and ensure ethical treatment. Objective. The aim of this article is to conduct a review of the literature on informed consent in medical practice and clinical research, identifying advances, challenges, and associated ethical considerations, to provide a comprehensive and up-to-date understanding of its status and application in different contexts. Methodology. he methodology of the review was based on a systematic search for studies in academic databases such as PubMed, Scopus, and Web of Science. Articles addressing informed consent in medical and clinical research contexts, published in the last 10 years, were included. The selected studies were critically appraised to identify biases and extract relevant issues, such as patients' understanding of consent, cultural barriers, and the influence of technological innovations. Results. The results of the review revealed that, despite advances in the conceptualization of informed consent, significant challenges persist in its implementation. These include limited understanding by patients and participants, communication barriers, and cultural differences that complicate the consent process. The need for technological tools and ongoing training for professionals is highlighted, as well as cultural adaptation of the consent process to improve its effectiveness and respect the rights of individuals. Conclusion. Informed consent in medical practice and clinical research is a cornerstone, its importance cannot be underestimated, because as medicine and research continue to evolve, so must the practice of informed consent, adapting to modern technologies, ethical challenges, and the changing needs of patients and participants. General Area of Study: Medicine. Specific Area of Study: Bioethics and Medical Ethics. Type of study: Original articles.

Rita Elizabeth Velastegui Hernández, Ana Elizabeth Tagua Moyolema, Viviana Estefania Barrionuevo Torres, Christian Vicente Sogso Chano, Bryan Nicolás Vargas Ortiz, Rommel Santiago Velastegui Hernández

102-117

Evaluation of the effectiveness of behavioral scales in pediatric dentistry: a literature review

Introduction: Behavior rating scales are fundamental tools in pediatric dentistry. They evaluate children's anxiety and behavior during dental treatment. Identifying and effectively managing these factors are crucial for treatment success and patient satisfaction. Objective: To evaluate the effectiveness of various behavioral rating scales in pediatric dentistry. Methodology: A group of 50 studies on the use of different behavioral rating scales in children during dental procedures were reviewed and analyzed. Among the scales evaluated are the Frankl Behavior Rating Scale, Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), and Venham Anxiety and Behavioral Rating Scale. Studies were selected based on their use of these tools to measure anxiety and behavior and their reported reliability and validity. Results: The Frankl and CFSS-DS behavioral scales demonstrated high reliability and effectiveness in assessing anxiety and dental behavior in children. These scales support the application of additional techniques, such as intranasal sedation and music therapy, which significantly improve cooperation and reduce anxiety. Studies indicated that age, previous experiences, and parenting style influence anxiety levels and behavior during dental treatments. Conclusion: Behavior scales are effective tools for evaluating and managing anxiety and behavior in pediatric dentistry. Their use allows for personalization of interventions and improves the results of dental treatment in children. General area of study: Dentistry. Specific area of study: Pediatric dentistry. Type of study: Literature review.

María Belén Orellana Calderón, María de Lourdes Cedillo Armijos

118-141

Subclinical hypothyroidism as the main thyroid function disorder in outpatients treated at a primary-level laboratory, Riobamba - Ecuador

Introduction: Thyroid function disorders occur when the thyroid gland (small butterfly-shaped gland) does not produce adequate amounts of thyroid hormones. Likewise, it occurs when an abnormal growth progresses and forms a lump or nodule. This affects a variety of metabolic processes, influencing the concentration and activity of various enzymes, substrates, vitamins, and mineral metabolism. Objective: The objective of this work is to categorize the different disorders of thyroid function, to determine their prevalence depending on age and sex, through an analysis of laboratory results performed on outpatients treated in a first-class laboratory. level in the city of Riobamba during the year 2022. Methodology: A retrospective, descriptive and quantitative approach was used, with a design based on secondary sources. The results of thyroid tests such as Triiodothyronine (T3), Thyroxine (T4) and Thyrotropin (TSH) were tabulated and analyzed in relation to the established reference values, considering the age and sex of the patients. The sample included 460 results from outpatients treated at the first-level laboratory in Riobamba during 2022. The prevalence of thyroid disorders was categorized to evaluate its association with demographic variables, identifying the most significant risk factors. Results: The analysis revealed that 192 patients with some thyroid pathologies were registered, of which 130 women and 62 men presented some type of thyroid disorder. It could be observed that the most prevalent thyroid disease was subclinical hypothyroidism, widely followed by primary hypothyroidism, closely followed by subclinical hyperthyroidism, and finally by non-thyroidal disease and primary hyperthyroidism, respectively. Conclusion: The study did not find a significant difference in thyroid tests between males and females. Nor was a significant difference found in thyroid tests between young patients and older adult patients. Subclinical hypothyroidism was the most common disorder, suggesting the need for additional research to explore the underlying causes of the high prevalence of thyroid disorders in this region, including longitudinal studies to evaluate the evolution of these pathologies and the effectiveness of specific therapeutic interventions.

Grace Emperatriz Urgilés Ibarra, Vinicio Estuardo Santillán Rodríguez

142-163