Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introduction: Acute mesenteric ischemia is defined as a disorder due to a deficit of oxygenation of the intestine due to thrombosis, embolism or spasm of the blood vessels that nourish it. Objective: Show a case of acute mesenteric ischemia as a clinical form of intestinal angina. Clinical Case: It was an 87-year-old male patient, with a history of high blood pressure, heart failure, ischemic heart disease and arrhythmias; who went to the emergency room for sudden abdominal pain, accompanied by nausea and vomiting. Signs of hypovolemic shock and acute mesenteric ischemia were found on physical examination. It was decided to perform emergency surgery, where mesenteric ischemia of the irrigation path of the superior mesenteric artery was found. Conclusions: Acute mesenteric ischemia poses a true diagnostic challenge for the general surgeon due to its unusual clinical presentation, turbulent progression, and high morbidity and mortality rates.

Introduction: Impacted permanent maxillary canines are common disorders in the orthodontist's clinical practice. Objective: To explain the importance of preventing impacted permanent maxillary canines from a science, technology, and society perspective. Methods: A literature review was conducted. The following databases were consulted: MEDLINE, PubMed, and SciELO, and the Google Scholar search engine. The terms "impacted tooth AND science"; "impacted tooth AND prevention"; and "impacted tooth AND technology" were used. The search focused primarily on articles published in the last 5 years, in English and Spanish. Sources that were not available in full text and opinion pieces were excluded. Forty-one articles were obtained, of which 34 were selected. Development: Impacted permanent maxillary canines are a health problem that affects children and adolescents and is frequently detected during adolescence. It causes masticatory and aesthetic impairment with psychological repercussions that influence the patient's social functioning. Scientific developments have clarified that it is multifactorial in origin, primarily associated with local, systemic, and genetic factors. Conclusions: Preventing this anomaly is important for the patient, the family, and society as a whole. Scientific and technical advances have enabled the development of tools such as predictive models, which, based on risk factors, determine the likelihood of retained teeth. This facilitates the implementation of preventive or interceptive treatments.

Introduction: Musculoskeletal conditions affect the health status of older adults. The presence of pain, mobility disorders, increased risk of falls, fractures and decreased functional capacity are some of its clinical characteristics and complications. Objective: Synthesize the therapeutic actions that allow the comprehensive treatment of musculoskeletal conditions in the elderly. Methods: A bibliographic review of updated information available in the Latindex, Scielo, Redalyc, Lilacs, Scopus, Web of Science, PubMed and Medline databases was carried out. 95 documents were identified, of which 31 were selected. Health descriptors (elderly, rheumatic diseases and rehabilitation) were used in English, Spanish and Portuguese. The use of Boolean operators allowed us to optimize the search results. Development: Osteoarthritis, osteoporosis, sarcopenia and rheumatoid arthritis were identified as the main musculoskeletal conditions that affect older adults and that generate pain, inflammation, stiffness, deformity, functional disability and dependency among other clinical manifestations. Therapeutic actions include the use of drugs, natural and traditional medicine, physical rehabilitation and adoption of healthy habits and lifestyles, with emphasis on exercise and adequate nutrition. Conclusions: The synthesis of the general aspects of the comprehensive treatment of musculoskeletal conditions in older adults includes the combination of pharmacological elements to minimize symptomatology and non-pharmacological elements aimed at promoting healthy habits and lifestyles; for its application, it must be adapted to the characteristics of the age and individualities of the patient.

Introduction: Linear nevus sebaceous syndrome is a rare neurocutaneous disease that results from genetic mosaicism with a dominant gene. It is characterized by a wide spectrum of anomalies with multisystem involvement; alterations of the central nervous system are the most frequent extracutaneous manifestations, with intellectual disability and epileptic seizures being the most common. Objective: To describe the clinical evolution, the results of complementary examinations and the response to anti-seizure treatment in two patients with linear sebaceous nevus syndrome. Case presentation: Case 1 was a 13-year-old male patient with linear Sebaceous Nevus on the face (midline and left hemiface), area of ​​midline alopecia, left microphthalmia and corneal opacity, and spastic quadriparesis. Debuted at three months old with West syndrome that evolved into Lennox-Gastaut Syndrome. Case 2 was a 19-year-old female patient with linear sebaceous nevus on the face (midline), craniosynostosis, dysmorphisms, focal epileptic seizures, and intellectual disability. Conclusions: It is a rare, underdiagnosed entity, with multisystem involvement; cause of drug-resistant epilepsy and intellectual disability. Its diagnosis and treatment must be individualized and requires interdisciplinary management.

Introduction: Academic performance is conceptualized as the value attributed to the learning outcomes of university students in a given subject area compared to the level of knowledge expected of their peers. It is determined by several factors, especially those related to the students themselves. Objective: To identify whether there is a relationship between sleep hours and academic performance in university students. Method: A descriptive and correlational study was conducted; the sample consisted of 235 students from a sample of 597 students from the Escuela Superior Politécnica de Chimborazo. The variables determined were the students' general characteristics, sleep hours, and academic performance. To analyze the relationship between sleep and performance, the Pearson correlation test was applied. Results: The average age was 23.51 years, with a predominance of students between 23 and 25 years old (51.49%) and females (67.66%). 34.89% of the students reported sleeping less than 4 hours, while 40.85% reported sleeping between 4 and 6 hours daily. Students with academic performance between 8.0 and 9.0 points predominated (48.51%), followed by the group of students who achieved less than 8.0 points in academic performance. Conclusions: A positive correlation was identified between the hours of sleep and the academic performance of university students, so sleep can be considered a factor that favors their academic performance.

Introduction: Biological therapy is one of the latest pharmacological innovations in therapeutic regimens for various conditions. Its benefits are indisputable; however, its costs, adverse events, and utilization profiles merit further analysis. Objective: To analyze the cost-benefit ratio of biological therapy as well as its current utilization profile. Development: A cost-benefit analysis of biological therapy was conducted, taking into account its main etiopathogenic mechanisms, adverse events, and economic costs. Its main indication profiles were also studied based on their pharmacokinetic characteristics and the feasibility of incorporating them into the basic medication regimens of public health institutions in Ecuador. Conclusions: Biological drugs offer advantages related to the selectivity of therapeutic targets and the control of the inflammatory process. However, their high cost, the high rate of serious adverse events, and access barriers pose significant challenges in terms of health equity and sustainability for the Ecuadorian health system.

Introduction: Brugada phenocopy is a medical condition that presents with an electrocardiographic pattern identical to Brugada syndrome, but is caused by various reversible external factors rather than genetic abnormalities. Objective: To present a clinical case linking the presence of a Brugada electrocardiographic pattern with ST-segment elevation myocardial infarction. Case Presentation: An 80-year-old patient presented with symptoms of chest pain and was diagnosed with acute myocardial infarction with ST-segment elevation. He progressed to cardiogenic shock, and an electrocardiogram revealed a Brugada type 1 pattern. Percutaneous transluminal angioplasty of the left anterior descending artery was performed, and coronary flow was successfully restored. Conclusions: Brugada phenocopy is an uncommon condition nowadays; its presentation in the course of an acute myocardial infarction is even more unusual. The correction of the underlying cause and the influence of each patient's personal history influence their prognosis.

Introduction: The Body Mass Index (BMI) is an indicator of risk of suffering from diseases associated with excess body fat. Objective: To evaluate the neural network as a predictor of BMI according to height and waist circumference. Methods: Analytical, and cross-sectional study of 2004 Venezuelan adults belonging to the Prevalence of Metabolic Syndrome study of the City of Maracaibo. The variables were BMI, height and waist circumference. Multilayer perceptron-type neural networks were used, evaluated using scatter-plots, receiver operating characteristic curve and classification tables. Results: For quantitative BMI, the relative error was 0.191 and 0.180 in training and testing, respectively. For BMI categories, the percentage of incorrect predictions in training and testing were 25.50% and 20.80%, respectively. The neural network developed to quantitatively predict the BMI from height and waist circumference had an R2 coefficient of 0.812 and qualitatively, an area under the curve of 0.968, 0.919, 0.844 and 0.950 for low weight, normal weight, overweight, and obesity, respectively. The neural network to predict BMI categories had percentages of correct predictions of 37.50%, 74%, 79.80% and 84.40% for underweight, normal weight, overweight, and obesity, respectively. Conclusions: The use of multilayer perceptron-type neural networks is efficient to predict the BMI quantitatively and qualitatively from height and waist circumference.

Introduction: Pulmonary tuberculosis is associated with symptoms, signs and radiological images similar to those of lung cancer; therefore, it can simulate a neoplasia. In the case of resistant bacteria and the lack of first-line drugs, combined treatments are used, which in many cases have no evidence of their effectiveness. Objective: To contrast the results of diagnostic investigations with the clinical manifestations in a patient with pulmonary and colon tuberculosis. Clinical Case: Patient with pulmonary tuberculosis, with risk factors, clinical and radiological manifestations of lung cancer; he was evaluated with this diagnosis until months later the bacilloscopy and biopsy confirmed the diagnosis. Exceptional treatment with first- and second-line drugs was indicated in the first phase. The patient evolved favorably. Conclusions: Pulmonary tuberculosis can go unnoticed, because it is asymptomatic or simulates a pulmonary neoplasia. Bacilloscopic examination is an essential tool for differential diagnosis and timely treatment, which in this case produced clinical-radiological and bacteriological improvement.

Lung ultrasound, especially POCUS (Point-Of-Care Ultrasound), has been shown to be more effective than traditional X-rays in diagnosing pneumonia in adults, mainly in emergency and intensive care settings. With a sensitivity of 92% and specificity of 94%, POCUS outperforms X-rays, which have a sensitivity and specificity of 75%. In addition, it is safe for pregnant women and speeds up management in critically ill patients. It can also differentiate between bacterial and viral pneumonia, guiding the use of antibiotics. Although it has anatomical limitations, only 8% of cases go undetected. In Peru, pneumonia cases increased in 2023, highlighting the importance of this technique in diagnosis and treatment.