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

Introduction: Beta-thalassemia major is a severe hereditary hemoglobinopathy caused by mutations in the HBB gene, which encodes the beta chain of hemoglobin. These mutations drastically reduce the production of functional hemoglobin, leading to severe chronic anemia. As an alternative to regular transfusion treatments, a promising gene therapy based on CRISPR/Cas9 technology has been investigated with the aim of correcting these mutations and offering a potential cure. Objective: Analyze the efficacy of the CRISPR/Cas9 technique as a therapeutic approach for beta-thalassemia major, highlighting its benefits and limitations. Methodology: A systematic review of studies published between 2020 and 2025 was conducted using the PRISMA methodology. Results: CRISPR/Cas9-based therapies in numerous studies primarily focused on editing the BCL11A gene, resulting in increased production of HbF. Additionally, other investigations targeted the β039 gene, achieving an increase in both HbF and HbA levels. Conclusion: Genetic therapy has shown effectiveness in more than 90% of patients with beta-thalassemia major, demonstrating that increased levels of HbF help patients achieve transfusion independence. However, certain limitations remain, such as the prohibitive cost and limited accessibility of treatment, particularly in regions with a high prevalence of the disease. General Area of Study: Clinical Laboratory. Specific area of study: Molecular biology. Type of study: Systematic bibliographic review.

Introduction. Metritis and endometritis in cows are considered a public health problem due to their high incidence and antimicrobial resistance, affecting both the loss of milk production and the decline in the percentage of pregnancies. This translates into economic losses that are detrimental to the purpose of dairy farming and cattle breeding. The most common treatments that have been applied are based on antibiotic therapy, but this article presents studies that provide viable alternatives to antibiotics for the treatment of metritis and endometritis in cows. We have described therapeutic alternatives such as: Nanotherapies, Phytotherapy, Hormonal Therapy, NSAIDs and Metabolic Therapy. With their respective comparative analyses in terms of feasibility, preventive actions, and application requirements. These alternative treatments may be the answer to the problem of antimicrobial resistance, improving animal health and welfare without neglecting economic performance in livestock systems. Objective. To evaluate alternative therapeutic methods for the control of endometris and metris in dairy cows. Methodology. Review and analysis of scientific literature, published in specialized journals and veterinary textbooks. Use of databases such as PubMed/MEDLINE, Scopus, SciELO and specific veterinary databases such as VetMed Resource. Search engines such as Google Scholar. Results: In the present bibliographic review, a set of alternative non-antibiotic therapeutic options that are effective and comparable with traditional antibiotic treatments can be appreciated. Their effectiveness ranges from 60% to 92% compared to 87% and 96% for antibiotics. Phytotherapeutic compounds, nanoparticles, metabolic therapies and anti-flammatory therapies stand out, valuing preventive treatments to reduce the incidence of metritis and endometritis. The results obtained give us understanding that these are viable options, despite the limitations in terms of the samples presented in the studies. Conclusion: In conclusion, these alternative treatments, such as phytotherapy, anti-inflammatory therapies, etc., have proven to be viable and promising therapeutic options due to their efficacy, availability and easy application, obtaining also additional beneficial results in preserving the uterine microbiota, improvement in milk production and reduction of pathologies after metritis and endometritis. Representing an effective response to antibiotic resistance, contributing to an improvement in the sustainability of bovine reproductive health. General Area of Study: Veterinary Medicine. Specific area of study: Gynecology. Type of study: Systematic bibliographic review

Introduction: Genu valgum is a common orthopedic disorder in children that can affect their mobility and quality of life if not accurately diagnosed and treated. In Latin America, the lack of unified criteria and organized information makes its management difficult, especially in Ecuador, where there is no updated review of age-specific treatments. Given the growing concern about children's musculoskeletal health and the inequality in access to specialized care, it is essential to compile and analyze the available evidence to optimize diagnosis and treatment, improve clinical practice and patients' quality of life, and avoid unnecessary interventions. Objective: To analyze the scientific information available on the treatments used for genu valgum in the pediatric population, evaluating their efficacy according to the different ages, in research conducted in the last five years. Method: A theoretical review was conducted through the PICOT strategy: using DeCS/MeSH terms in relevant health databases such as PubMed, Scopus, Google Scholar, Web of Science and Springer Link. Specific search strategies will be applied using keywords and MeSH (Medical Subject Headings) terms to identify relevant primary studies such as “Genu valgum,” “Child,” “Treatment” accompanied by Boolean operators such as ‘AND’ and “OR.” Results: Its origins can be congenital, nutritional, biomechanical or postural. To evaluate it, measurements such as the thiofemoral angle, intermalleolar and intercondylar distances, and radiographs are used. Treatment varies from physiotherapy and corrective exercises to surgery in severe cases. The benefits of early therapeutic programs to improve posture and function are also highlighted. Furthermore, the psychosocial impact of genu valgum is highlighted, affecting the self-esteem and social interaction of the child or adolescent. Conclusions: genu valgum represents more than a physical alteration; it is an indication of the organism that suggests the need for clinical, preventive, and empathic intervention. This analysis helps to deepen the understanding of the situation and paves the way for new therapeutic options, adapted and focused on the well-being of the child being in continuous evolution. General Area of Study: Medicine. Specific area of study: Pediatric Traumatology and Orthopedics. Type of study: Bibliographic review.

Introduction. Hormonal contraceptives are widely used worldwide due to their effectiveness in preventing unwanted pregnancies. In addition to their contraceptive function, these drugs offer multiple non-contraceptive benefits, such as regulating the menstrual cycle, reducing pain associated with dysmenorrhea, decreasing excessive menstrual bleeding, and treating acne and polycystic ovary syndrome. However, numerous studies have shown that their use can induce changes in hematological parameters, particularly in the red cell series and platelets. These modifications vary depending on the type of contraceptive, the route of administration, and the duration of treatment. Objective. To analyze the alterations in red blood cell parameters and platelet count associated with the use of diverse types of hormonal contraceptives in women. Methodology. An information search was conducted in various databases, including PubMed, Scopus, BVS, Cochrane Library, Elsevier, and books, considering studies published in both English and Spanish. Results. Combined oral contraceptives and quarterly progestogen-only injections are associated with clear increases in red blood cell count, hemoglobin, hematocrit, and platelet count. In contrast, transdermal patches, the vaginal ring, and the hormonal IUD maintain stable erythrocyte indices and platelet counts. Subdermal implants, on the other hand, do not usually alter these parameters initially, but prolonged use can cause irregular uterine bleeding, which over time leads to a decrease in red blood cell count, hematocrit, MCV, and MCH due to the progressive depletion of iron stores. Conclusion. The hematological effects of hormonal contraceptives vary according to their type and duration of use. While combined oral contraceptives and injectable progestogens promote an increase in erythrocyte and platelet parameters due to reduced menstrual bleeding and possible erythropoietic stimulation, chronic use of subdermal implants may induce changes consistent with iron deficiency. General field of study: Health Sciences Specific field of study: Clinical Laboratory Type of study: Narrative literature review.

Objective. To analyze the literature regarding enamel and dentin remineralization with biomimetic materials to understand their effectiveness and clinical applications. Methodology. Comprehensive research of scientific articles was conducted that included in vitro studies, systematic reviews, and meta-analyses published between 2019 and 2024. The databases consulted were Pubmed, Science Direct, and Springer Link and Google academic was used as a secondary search engine. Results. Despite all the promising studies, biomimetic strategies still face challenges in the field of dentistry. Conclusion. Biomimetic remineralization has evolved from an experimental concept to an emerging clinical reality, establishing P11-4 peptides, stabilized CPP-ACP dentifrices, and zinc-carbonate hydroxyapatite as viable therapeutic options for immediate implementation. The trend toward multifunctional materials combining remineralizing, antibacterial, and anti-adhesive properties represents a paradigmatic evolution that transcends traditional restorative approaches toward comprehensive tissue regeneration. Despite promising evidence, a critical gap persists between abundant laboratory research and limited clinical evidence requiring priority attention. Biomimetic remineralization possesses transformative potential to revolutionize preventive and therapeutic management of dental caries, transitioning toward a regenerative model that could significantly reduce the burden of oral disease at the population level. General Area of Study: Medicine. Specific area of study: Dentistry. Type of study: Systematic bibliographic review

Introduction: The composition of the intestinal microbiota is closely related to the modulation of immune system activity. However, alterations in this composition (dysbiosis) compromise biological functions and bacterial balance and are associated with pathologies such as obesity, cancer, inflammatory disorders, and even neurological conditions. In such cases, immunological markers allow for the evaluation of inflammatory processes and the functional state of microbiota. Objective: Describe the impact of immunological biomarkers on alterations of the intestinal microbiota through a literature review. Methodology: The information was gathered from studies published between 2020 and 2025. The search for articles was conducted in the scientific databases PubMed, Scopus, and Web of Science. Studies published in both Spanish and English were included. Results: Dysbiosis leads to an increase in opportunistic and pathogenic bacteria, triggering the host's immune response by stimulating the production of proinflammatory cytokines. Thus, IL-6, TNF-a, IL-1ß, IL-8, and fecal calprotectin were the most relevant immunological markers presented in this study, as they can assess mucosal damage and the progression of the inflammatory process. However, markers such as C-reactive protein, due to their lower specificity, have limited diagnostic value. Conclusion: This article summarizes the diagnostic value of immunological markers in microbial imbalance scenarios and their interaction with immune response activation associated with inflammatory disorders, infections, cancer, and neurological diseases. In this way, diagnostic tools are presented that offer new perspectives for the clinical management of patients. General Area of Study: Health Sciences Specific area of study: Clinical Laboratory Type of study: Narrative literature review

Introduction. Bone exostosis is a benign, multifactorial lesion that appears in various locations, sizes, and shapes. Despite being harmless, it may be a problem for patients with prosthetic needs. Objective. Analyze treatment options for patients with osseous exostoses requiring prosthetic care. Determine surgical considerations for managing maxillary or mandibular exostoses in prosthetic rehabilitation. Evaluate factors influencing the choice of prosthetic treatment in patients with exostoses. Methodology. A descriptive cross-sectional study was conducted using PubMed, Google Scholar, Scopus, and Cochrane to find relevant studies addressing prosthetic complications of OE. Results. A total of 34 articles were reviewed, offering alternatives to improve the quality of life in patients with prosthetic needs. Conclusion. Treatment should be individualized according to each patient’s clinical condition and specific needs. General Area of Study: Dentistry. Specific area of study: Oral Surgery, Prosthodontics. Type of study: Bibliography Review.

Introduction: Population aging is a global phenomenon that, in Ecuador, reflects a marked feminization, with a higher proportion of elderly women. Objective: Analyze the feminization of aging in Ecuador by exploring differences in life expectancy and quality of life between men and women. Methodology: A comprehensive literature review was conducted using major scientific databases and search platforms, such as PubMed, Google Scholar, Scopus, and ResearchGate. Results: Women have a longer life expectancy and at the same time face more challenges than men, including a higher prevalence of chronic diseases and conditions of psychosocial vulnerability. Conclusion: The literature review highlights the urgent need to develop public policies focused on improving the quality of life of older women, addressing both gender inequalities and the social and economic factors that affect their well-being in old age. General field of study: Medicine. Specific field of study: Geriatrics. Type of study: Systematic literature narrative.

Introducción. La hernia hiatal se define como un desplazamiento de las estructuras abdominales hacia el tórax a través del hiato esofágico, se clasifican en cuatro tipos según la relación anatómica entre el estómago y el hiato; su prevalencia es mayor en mujeres y ancianos, con frecuencia se asocia a obesidad y a factores genéticos. Comúnmente son asintomáticas, pero los pacientes pueden referir reflujo gastroesofágico, disnea o dolor torácico, siendo detectadas frecuentemente de manera incidental. La endoscopía digestiva alta es el método de diagnóstico principal, complementado por radiografías, esofagogramas y TAC; el tratamiento incluye manejo conservador o cirugía, siendo la Funduplicatura de Nissen uno de los procedimientos de elección debido a su eficacia valorada según la eliminación de los síntomas. Objetivo. Evaluar la efectividad de la funduplicatura de Nissen como tratamiento de elección en pacientes con diagnóstico de hernia hiatal refractaria al tratamiento conservador, analizando su impacto en la resolución del cuadro clínico a través de una revisión bibliográfica de la evidencia científica actualizada. Metodología. Se realizó una búsqueda en bases de datos científicas seleccionando artículos basados en confiabilidad, validez y relevancia clínica, priorizando publicaciones en inglés y español de los últimos 6 años, se eligieron 14 artículos de alto nivel de evidencia que cumplieron con los criterios establecidos. Resultados. La hernia de hiato ocurre cuando los cardias sobresalen a través del hiato esofágico, su diagnóstico suele ser incidental, destacándose la endoscopia y el esofagograma como herramientas principales. El tratamiento conservador con IBP es la terapia de primera línea para hernias tipo I, reservándose la cirugía para casos refractarios o graves; la funduplicatura de Nissen es el procedimiento quirúrgico más empleado por su alta efectividad, aunque existen otras técnicas como la de Tou - pet o Dor mismas que reducen las molestias postquirúrgicas como la disfagia, lo que implica un desafío al momento de elegir la técnica quirúrgica adecuada según el paciente. Conclusión. La hernia de hiato es una condición compleja que requiere diagnóstico oportuno para determinar el tratamiento adecuado, el manejo depende del tipo de hernia hiatal y su severidad, es así como las hernias Tipo I responden a tratamientos conservadores con IBP y cambios en el estilo de vida, mientras que las hernias Tipo II-IV suelen requerir cirugía. La funduplicatura de Nissen, realizada por laparoscopía, es el tratamiento quirúrgico más eficaz, aunque puede causar disfagia y distensión abdominal, por lo que importante valorar condiciones como la longitud del esfínter esofágico y el IMC, destacando la necesidad de personalizar el tratamiento para optimizar resultados y mejorar la calidad de vida del paciente. Área de estudio general: Medicina. Área de estudio específica: Cirugía general. Tipo de estudio:  Revisión Bibliográfica.

Introducción: NGAL es un biomarcador temprano para detectar daño renal tubular e insuficiencia renal precoz en pacientes con diabetes mellitus tipo 2 ya que su concentración sérica se eleva a las 2h del daño y precede 24h al incremento de la concentración sérica de creatinina, superando biomarcadores tradicionales como creatinina, microalbuminuria, albuminuria cistatina C y KIM-1, en sensibilidad (90 - 95%) y especificidad (90 – 95%). Objetivos: Analizar si la combinación de NGAL y otros biomarcadores (como KIM-1, microalbuminuria, cistatina C, etc.) mejora la precisión diagnóstica para la detección de daño tubular en pacientes con enfermedad glomerular. Metodología: Se realiza una revisión bibliográfica de tipo documental, con un enfoque descriptivo, no experimental y analítico mediante la utilización de criterios de inclusión y exclusión para aplicarlo a la metodología PRISMA. Resultados: NGAL es un biomarcador altamente sensible (90-95%) y específico (90-95%) para detectar insuficiencia renal en etapas tempranas incluso antes que biomarcadores tradicionales ya que se eleva entre las 2 y 6 horas tras de daño renal, muy útil en pacientes que presentan diabetes mellitus tipo II por su tendencia a desarrollar nefropatía diabética y aunque su costo es mayor su valor predictivo y preventivo lo justifica pudiendo medirse en distintas muestras como orina, suero, plasma e incluso líquido cefalorraquídeo. Conclusiones: Estudios muestran que los niveles altos de NGAL en orina y suero están asociados a un mayor riesgo de progresión de enfermedad renal crónica, inhibir esta proteína podría ser riesgoso ya que también tiene funciones protectoras en etapas tempranas del daño renal. NGAL es un biomarcador temprano y confiable presentando una alta sensibilidad y especificidad, pudiendo detectar daño renal incluso antes que biomarcadores tradicionales y útil en situaciones urgentes. El uso combinado de NGAL con otros marcadores como KIM-1, microalbuminuria y cistatina C mejora la detección de daño renal especialmente en enfermedad glomerular sin embargo NGAL destaca en la evaluación del daño tubular. Área de estudio general: Laboratorio Clínico. Área de estudio específica: Uroanálisis. Tipo de artículo: Revisión bibliográfica sistemática.