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

Introduction: Marfan Syndrome and hypomelanosis of Ito are low-incidence diseases that share clinical and genetic elements.Objective: To demonstrate the importance of periodic follow-up of patients with dysmorphia for the diagnosis of Marfan syndrome and hypomelanosis of Ito.Case presentation: A 13-year-old male adolescent is presented. In the first years of life, he was diagnosed with multiple dysmorphia, conductive hearing loss, and dilation of the cardiovascular ventricular system. After falling ill with COVID-19, his mother was concerned with the fact that he sometimes reported shortness of breath, so he came to the doctor. On physical examination, he was found to have a macular, achromatic pattern that follows the path of Blaschko's lines, striae on the back and hips, tall stature, double ear canal and poorly developed auricle, pectum excavatum, dolichostenomelia, positive Walker Murdoch and Gowers signs, joint hyperlaxity, flat feet, and dorsolumbar scoliosis. These manifestations led to the diagnosis of Marfan syndrome and hypomelanosis of Ito, which were subsequently confirmed by karyotyping.Conclusions: Marfan syndrome and hypomelanosis of Ito are rare entities in which clinical suspicion due to the presence of multiple dysmorphisms and periodic monitoring allow for early diagnosis.

Introduction: Adolescence represents an essential stage in the physical and physiological development of people, in which nutritional status plays a fundamental role.Objective: To determine the relationship between aerobic physical effort and body composition in male adolescents from the urban area of the city of Riobamba, Ecuador.Material and Methods: A cross-sectional correlation study was developed in 110 adolescents selected through non-probabilistic convenience sampling. Data on body composition and heart rates were collected for subsequent analysis in the JAMOVI statistical program.Results: Body composition indicators were found mostly normal for age with good and very good recovery when analyzing aerobic physical effort. A statistically significant difference was evident in FC3 in the BMI and total body fat variables. The group that was normal according to BMI had a higher HR when compared to the group with excess BMI. Likewise, the heart rate was higher in adolescents with high body fat as opposed to the group that had normal body fat.Conclusions: A statistically significant negative relationship was obtained between muscle mass and HR1; that is, as the adolescent's muscle mass increases, the resting heart rate decreases. These results allow us to establish individualized nutrition and physical activity interventions for adequate recovery after exercise or physical activity.

Introduction: In the current context, where health systems face significant pressures arising from demographic changes, the increase in chronic diseases and social inequalities, health promotion, with the use of social marketing and asset mapping, is emerging as a key resource to address these challenges.Objective: To analyze the integration of social marketing and asset mapping as strategic tools in the promotion of community health.Material and Methods: A review study was conducted. The sources consulted included scientific databases, documentary repositories and full texts from 2019 to 2024, which were selected using keywords. Structured search strategies were used. Of 82 documents reviewed, 50 were selected for analysis and 28 were included for their relevance and quality.Development: By interweaving community health promotion with social marketing and asset mapping strategies, a holistic approach is created that not only seeks to prevent disease, but also to empower communities to take control of their own well-being. This integrated model allows for a more adaptive and equitable response to diverse health challenges.Conclusions: Community health promotion faces a variety of challenges ranging from cultural and economic barriers to technological and political constraints. Overcoming these obstacles requires a comprehensive approach that combines awareness raising, intersectoral collaboration, technological innovation, and political commitment. Social marketing and asset mapping represent essential tools in community health promotion.

Introduction: The development of clinical skills is crucial in medical education and therefore, depending on academic interests, the teacher must develop teaching strategies that contribute to a constructive and developing learning experience. For a dentist, it is vital to correctly interpret x-rays and detect defects in the images.Objective: To explore students' criteria on the design, content and impact of an educational multimedia on the academic results of the Imaging subject in the Dentistry degree.Material and Methods: A non-experimental, cross-sectional, descriptive and mixed-type research was carried out in the Dentistry degree of the Faculty of Health Sciences of the National University of Chimborazo. The research consisted of two stages: technical-didactic evaluation of the multimedia and effectiveness and impact on the learning results of the students. To obtain the information, surveys for the students were designed.Results: The criteria of the students were considered generally favorable during the application of the multimedia. Specifically, they highlighted the sufficiency of quality activity to assess learning and the flexibility that multimedia allows for the pace of learning. The impact evaluation showed that the tool was highly effective in the teaching-learning process of the subject since it promoted the academic results of the participating students.Conclusions: The study highlights the effectiveness of an educational multimedia tool in the teaching-learning process in the Imaging subject in the Dentistry degree. The results indicate that this strategy not only favors a more flexible learning experience adapted to the pace of the students, but also contributes significantly to improving academic results. These findings underline the importance of integrating innovative technologies in medical education to enhance the development of essential skills.

Introduction: Recent studies have shown the potential of large language models in medical education. However, there is limited information regarding their capabilities in the subjects of Biochemistry, Metabolism, and Nutrition, especially in open-source models or those other than ChatGPT. Objective: To evaluate the capabilities of the open-source large language model Llama 3.1 70B-Instruct in the subjects of Biochemistry, Metabolism, and Nutrition. Material and Methods: An Observational study with an exploratory, mixed-methods design was conducted using two groups of evaluators, one of which was external to the research. The researchers assessed 264 questions, while the external evaluators examined a stratified random sample of 72 questions by topic. A 5-point Likert scale was used for evaluation, with RStudio for statistical analysis and Zotero for reference management. Results: Both evaluator groups reported similar results, with a consensus rating of 4.75 for the tool. Its highest performance was observed in Metabolism and Nutrition, scoring 4.8, while in Biochemistry it scored 4.7. Some areas demonstrated shortcomings. The explanations provided by the tool were clear and useful, showing a strong ability to explain abstract concepts. Conclusions: The results were favorable. However, further comprehensive studies of large language models in these and other subjects of medical education are essential. Only through continued research we can better guide students on optimal use and benefits.

Introduction: In the midst of the rise of the knowledge society and in the face of a progressively digitalized educational system, achieving the digital competence of health sciences teachers is crucial.Objective: To examine the results of the evaluation of the massive open online course (MOOC) “Facebook in Medical Education”, aimed at health sciences teachers, from the perception of its participants.Material and Method: In the period June, 2023 - February, 2024, a study was developed with a quantitative approach and an ex-post-facto non-experimental design. Research strategy was divided into 8 stages: determination of training needs, selection of the methodology or model for instructional design, MOOC design, management, infrastructure review and analysis of the quality of the proposal, course implementation on the platform, evaluation of the MOOC, processing and analysis of information and preparation of a course evaluation report.Results: Although many pedagogical, functional and technological aspects are revealed through research and critical reflection on their practice by teachers, facilitators, technical team and administrator, supported by student feedback; specially, course administrators must investigate the technical, organizational and curricular difficulties that may arise during their development and encourage the use of interaction tools, so that the technological context of the MOOC itself favors its correct functioning.Conclusions: The factors analyzed exceeded the average established in the scale used. Therefore, it can be considered a quality MOOC, with a low dropout rate and a satisfactory percentage of passes.

Introduction: Tests for screening and diagnosis of prediabetes based on plasma glycaemia have low reproducibility, which affects their precision, reliability and increases costs for the health system. Objective: To identify clinical or humoral factors associated with the reproducibility of fasting blood glucose in the prediabetes range, in the context of preventive medical examinations. Material and Methods: Cross-sectional study in 69 patients without a history of diabetes and with fasting blood glucose between 5.6 - 6.9 mmol/L. Medical history, demographic and anthropometric variables, HbA1c and glucose tolerance test (GTT) were recorded. The correlation between fasting blood glucose, GTT and HbA1c was analyzed using Pearson's correlation coefficient, and the OR for hyperglycemia reproduced according to risk factors was calculated. Biochemical parameters were compared between patients with and without reproduced hyperglycemia. Results: The correlations of fasting blood glucose with HbA1c, 0h-GTT blood glucose and 2h-GTT blood glucose were weak and positive. The best correlation was obtained between the two GTT blood glucose values (p 0.549; sig 0.000). No diabetes risk variable behaved as a risk factor for reproduced hyperglycemia. Patients with reproduced hyperglycemia had significantly higher fasting blood glucose than those without it (6.23 ± 0.31 vs. 5.99 ± 0.35 mmol/L). Conclusions: Fasting blood glucose showed low reproducibility in the context of preventive examinations. Only the highest blood glucose values were associated with reproduced hyperglycemia. No clinical variable was identified as a risk factor for reproduced hyperglycemia.

Introduction: Cirrhotic cardiomyopathy is an underestimated cardiovascular complication in patients with advanced liver cirrhosis. Its clinical recognition is limited due to its silent presentation and the lack of standardized diagnostic criteria. Objective: To review the pathophysiological mechanisms, clinical manifestations, diagnosis, and epidemiology of cirrhotic cardiomyopathy, highlighting its impact on morbidity and mortality in patients with cirrhosis. Material and Methods: A narrative review of the scientific literature was conducted, consulting databases such as PubMed, LILACS, Hinari, and Google Scholar. Thirty-four articles published between 2020 and 2025 were selected, prioritizing systematic reviews, original studies, and full-text articles relevant to the study objectives. Results: Cirrhotic cardiomyopathy is characterized by diastolic and systolic dysfunction, abnormal stress response, and electrophysiological abnormalities, in the absence of evident structural heart disease. Its pathophysiology involves sympathetic hyperactivity, autonomic dysfunction, systemic inflammation, oxidative stress, and hormonal alterations. Its estimated prevalence ranges between 40% and 70% in patients with advanced cirrhosis, especially in liver transplant candidates. The diagnosis is based on echocardiography, biomarkers, and functional testing, although inconsistencies persist among the criteria used in clinical practice. Conclusion: Cirrhotic cardiomyopathy represents a diagnostic challenge with significant prognostic implications. Its timely identification and comprehensive evaluation can improve clinical outcomes, particularly in the context of liver transplantation. Greater diagnostic standardization and clinical validation of new criteria are required.

Introduction: Human immunodeficiency virus (HIV) infection continues to represent a priority challenge in global public health. Among its multiple clinical manifestations, precursor oral lesions are early indicators of immunological deterioration and disease progression. In Ecuador, where the number of HIV cases has increased in the last decade, the study of oral manifestations offers a valuable tool for early detection. Objective: To identify and analyze the most common oral lesions in patients with a positive HIV serological diagnosis in the province of Tungurahua, Ecuador. Material and Methods: A cross-sectional, descriptive, and prospective study was conducted at the Ambato Provincial Teaching Hospital. A total of 121 adult individuals, which were divided into HIV-positive patients, healthy high-risk (HR) patients, and healthy individuals were included. Data collection was based on medical records and oral examinations, and statistical analysis was carried out using SPSS v. 23.0 with Chi-square, Risk Ratio (RR), and 95% confidence intervals. Results: In HIV-positive patients, the main oral conditions were dental caries (64.4%), periodontal disease (46.7%), and oral candidiasis (37.8%). Oral hyperpigmentation (28.9%) and xerostomia (20.0%) were also common. Periodontal disease, oral candidiasis, and oral hyperpigmentation showed a statistically significant association with HIV infection. Conclusions: Precursor oral lesions are relevant clinical manifestations in people living with HIV, associated with greater immunological impairment. Their early detection should be systematically integrated into comprehensive medical care to optimize timely diagnosis and patient prognosis.