Magazine of the Faculty of Medical Sciences of the University of Cuenca

Gorham-Stout disease. Case Report

Marco Fabricio Bombón Caizaluisa — 2025-08-04

Introduction: Gorham-Stout disease (GSD) is a pathology characterized by progressive destruction of bone tissue, which appears between the second and third decades of life. Currently, it presents a diagnostic challenge due to its low incidence and non-specific symptomatology. There is no specific treatment for this pathology, but it may include bisphosphonates, radiotherapy and in advanced cases, surgery.

Case report: a 37-year-old female patient, with no relevant pathological history, presented with chronic intermittent pain in the left hip of 8 months of evolution, exacerbated in the last weeks until it became constant and limiting. A simple anteroposterior (AP) radiography of the pelvis was performed, which showed: osteolytic lesion of the right iliopubic branch, left ilio and ischiopubic branches and in the symphysis pubis region. A simple computed axial tomography (CT) scan of the pelvis was also performed, which showed an extensive lytic lesion with irregular sclerotic borders, simple and contrasted magnetic resonance imaging (MRI) of the pelvis suggested increased inflammatory or vascular activity in the described areas. Finally, histopathological analysis of the incisional biopsy confirmed the presence of fibroangioblastic tissue, without neoplastic infiltration, cellular atypia; characteristic aspects of Gorham-Stout disease.

Conclusion: Gorham-Stout disease is a rare pathology, with low incidence and unknown etiology. The diagnosis requires a combination of clinical, imaging and histopathological aspects and its treatment is currently controversial and unspecific.

Spontaneous heterotopic pregnancy. Case Report

Jennifer Paola Pacheco Rodríguez — 2025-08-04

Introduction: a heterotopic pregnancy presents an intrauterine and an extra-uterine gestation. The problem arises when one pregnancy cannot develop outside the uterus, which can lead to severe complications and even death. The specific selection of this case report is motivated by daily practice, where timely action allows us to save the lives of pregnant women who are susceptible to this condition.

Clinical case: This is the case of a 33-year-old pregnant woman who presented to the emergency department of the Pablo Jaramillo Crespo Foundation Hospital in Cuenca, at 9 weeks' gestation of her second pregnancy. The patient presented with severe abdominal pain and vaginal bleeding. Ultrasound findings revealed a trabeculated isoechoic mass in the right ovary, as well as a viable fetus in the uterine cavity. The diagnosis was resolved by laparotomy, revealing a heterotopic pregnancy in the right adnexa; the intrauterine pregnancy was viable and reached term without complications.

Conclusion: in the present clinical case, reaching the correct diagnosis was very complex due to the low incidence. The imaging study was performed appropriately, despite the fact that it was operator-dependent. The surgical resolution path was taken in accordance with the capabilities and limitations of the surgical team. Once the acute extra-uterine pathology was detected and resolved, the intrauterine pregnancy came to term.

Analysis of communication through ImPACT in children with ASD. Case series

María de los Ángeles Sánchez León — 2025-08-04

Introduction: Autism Spectrum Disorder (ASD) affects children's communication and social skills to varying degrees, which significantly impacts their quality of life and their families. Despite advances in the treatment of this disorder, parent-mediated therapies, such as the Improving Parents as Communication Teachers (ImPACT) model, have not been sufficiently developed in our region.

Objective: to evaluate the results of the ImPACT model in the development of communication and social skills in children aged 3 to 6 years with autism spectrum disorder (ASD), supported by the active participation of parents in the intervention and treatment process.

Methodology: a quasi-experimental analysis was conducted to evaluate the communication of 5 children with ASD, aged 3 to 6 years, using the ImPACT model. For this purpose, the Preschool Language Scale-5 (PLS-5) and the Social Communication Checklist instruments were applied. Parents were trained to use strategies from the model in daily activities with their children.

Results: the results obtained showed significant improvements in several evaluated areas, which was confirmed by the Wilcoxon test. A significant change was observed in social participation with a p-value = 0.041, communication with a p-value = 0.043, the game with a p-value = 0.043 and in total intervention with a p-value = 0.043. However, imitation did not present a significant difference with a p-value = 0.109.

Conclusions: the study found that the ImPACT model, supported by active parental involvement, improves communication and social skills in children with ASD, although the improvement in imitation was less significant.

Cervical cancer and pregnancy. Case report

Patricio Edmundo Corral Domínguez — 2025-08-04

Introduction: Cervical cancer has an incidence of 1 in 1.000 pregnancies, a condition that raises uncertainties: when should chemotherapy be initiated, and how long should it be administered to minimize maternal-fetal complications? What is the best surgical treatment?

Clinical Case: A 30-year-old nulliparous patient was diagnosed at 14 weeks of pregnancy with squamous cell carcinoma of the cervix, clinical stage IIB. The patient began chemotherapy at 18 weeks, receiving 5 cycles. At 34 weeks, a cesarean section followed by a radical hysterectomy was performed. Pathology confirmed a 3 cm tumor with 2 out of 11 metastatic lymph nodes. Adjuvant treatment included chemo-radiotherapy and brachytherapy was applied. One year after surgery, both the patient and the baby are in excellent condition.

Conclusions: This case highlights the feasibility of active oncologic management during pregnancy, with chemotherapy in the second trimester and oncologic surgery after fetal viability, with favorable outcomes for both mother and fetus.

Saberes andinos en el vuelo del cóndor: hacia un diálogo horizontal con la ciencia

David Ricardo Achig-Balarezo — 2025-08-04

Se propone considerar principios y saberes de la cosmovisión andina sobre enfermedad desde su lenguaje en un primer momento de hermenéutica para luego dialogar de manera horizontal con la ciencia.

Prevalence of Carpal Tunnel Syndrome in the peeling area of the aquaculture industry at a shrimp packing plant in Ecuador

Adriana Stephania Lema Barragan — 2025-08-04

Introduction: Carpal Tunnel Syndrome (CTS) is one of the most common musculoskeletal disorders among workers performing repetitive tasks.

Objetive: to determine the prevalence of CTS in the peeling area of a shrimp packing plant in Ecuador, comparing with a less exposed control group (machine-sorting area).

Methodology: a cross-sectional analytical observational study was carried out, based on occupational medical records collected between January 2022 and June 2024. The total population included 194 female workers from the peeling area and 100 from the machine-sorting control area.

Results: the results showed that 20.6% of the workers in the peeling area presented CTS, compared to 8% in the control group. The most affected age group was 60 to 64 years, with the right hand being predominantly involved (82.5%). Most cases occurred among workers with 16 years of service. The statistical analysis yielded a Prevalence Odds Ratio (POR) of 2.99 (95% CI: 1.34–6.66), indicating that workers in the peeling area are nearly three times more likely to develop CTS than those in the control group.

Conclusions: it is concluded that there is a strong association between intensive work activity in the peeling area and the occurrence of CTS. The implementation of ergonomic preventive measures and longitudinal studies that include psychosocial factors are recommended to mitigate this condition and improve workers’ well-being.

Academic performance in the subject of Morphology 2 in the Medical career at the University of Cuenca, before, during, and after the COVID-19 pandemic

Fernando Eugenio Castro Calle — 2025-08-04

Introduction: It is important to reflect on how to teach or learn morphology; there are various methods and resources available for learning, all of which are part of in-person learning. In 2020 (the COVID-19 pandemic), the way of learning changed abruptly, shifting from traditional (in-person) methods to virtual learning. This undoubtedly impacted both learning and teaching, as well as summative assessments and, in this area, student passing or failing grades.

Objective: to determine the differences in academic performance in the subject Morphology 2, pre-pandemic, during the pandemic and post-pandemic, in the March-August academic cycles of the Medicine degree at the University of Cuenca, during the period 2019-2022.

Methodology: the anonymized database provided by the Vice Dean's office of the Faculty of Medical Sciences was used. Final grade and passing data for students from the academic cycles, March - August of the years 2019, 2020, and 2022 were selected. The data are presented in tables of frequencies, means, and standard deviations. For data analysis and to determine differences, the one-factor ANOVA test and the Bonferroni post hoc test were used.

Results: In the March–August 2020 academic cycle (the first pandemic academic cycle), the passing rate (98.6%) increased compared to other academic cycles. In the post-pandemic year, the passing rate decreased (88.7%), reaching a similar level to the pre-pandemic period (87%). The final grades for the pre-pandemic, pandemic, and post-pandemic academic years were 64.80, 74.55, and 69.43, respectively; the differences were statistically significant.

Conclusion: the performance of morphology students during the COVID-19 pandemic period was higher than in the pre- and post-pandemic cycles analyzed.

Neuroscience a tool to enhance education in the Medical career

Wendy Carolina Gonzalez España — 2025-08-04

Introduction: neuroscience has emerged as a key discipline for understanding learning processes, memory, and decision-making—fundamental aspects in the training of future healthcare professionals. This article explores how advances in neuroscience can be used as a pedagogical tool to optimize medical education, promoting more effective and personalized teaching methods.

Objective: to determine the level of knowledge about educational neuroscience among second- to fifth-year medical students at the Faculty of Medical Sciences of the University of Cuenca, from September 2023 to July 2024.

Methodology: a descriptive observational study was conducted with a total population of 548 students. A sample of 227 was calculated using Fisher’s formula, with 203 students voluntarily participating. Data were collected through a survey.

Results: there is a good level of perception in neuroeducational knowledge among students (4 points), a medium level of acceptance of neuromyths (3 points) and a medium level of application of neuroeducational practices (8 points).

Conclusions: the findings show that students have a good perception of neuroeducation, although there is also a broad acceptance of neuromyths, along with a high implementation of neuroeducational practices. These results highlight the importance of incorporating neuroeducation into academic programs to enhance educational quality, providing both teachers and students with essential neuroscientific tools.

Prevalence of cognitive impairment and associated factors in older adult residents of Hogar Cristo Rey

Esteban Fernando Aguirre Collahuazo — 2025-08-04

Introduction: cognitive impairment is one of the most prevalent conditions in older adults who are residing in care centers, impacting negatively in their quality of life and interfering with the performance of daily activities.

Objective: to determine the prevalence of cognitive impairment, and associated factors, in older adults at Hogar Cristo Rey.

Methodology: an analytical observational study was carried out with a sample of 87 older adults. A data collection form and Mini-Mental State Test (MMSE) were used. Data were analyzed using SPSS 25, Epi Info 7.2.6.0, and Microsoft Excel 2019. Data were also interpreted using percentages, frequencies, chi-square tests, and prevalence odds ratios (PORs) with 95% CI.

Results: the prevalence of cognitive impairment was 66.67%. A statistically significant association (p<0.05) was found between cognitive impairment and polypharmacy and physical activity; risk factors: female sex (RMP 4.061; 95% CI 1.580–10.440), and polypharmacy (RMP 2.676; 95% CI 1.293–8.425); protective factor: physical activity in severe impairment (RMP 0.164; 95% CI 0.031–0.867).

Conclusions: cognitive impairment is highly prevalent (66.67%) among older adults at Hogar Cristo Rey. Female sex and polypharmacy were identified as risk factors, while physical activity was found as a protective factor against severe impairment.