Vitamin C is a substance that has been the subject of debate over the years because of its numerous documented uses. Benefits have been shown in some cases, from use as prevention and shortening the duration of colds to reviewing vitamin C and its effects on diseases such as cancer. Therefore, vitamin C has been studied to evaluate the different mechanisms of action of vitamin C in relation to cancer; even vitamin C has been used as monotherapy or in combination with chemotherapy to demonstrate or eliminate its role in cancer. The aim of this review is to show whether the effects of vitamin C are effective and whether it makes sense to use it as monotherapy or in combination with chemotherapy; and even more to confirm or deny its positive effect in cancer.

INTRODUCTION Pleural effusion is a pathology resulting from overproduction of pleural fluid and decreased absorption. Transudative pleural effusions are caused by general alterations in formation and absorption, as in the case of cirrhosis or heart failure. Exudative pleural effusions are usually caused by local alterations that affect physiology, such as pneumonia, neoplasms or pulmonary embolisms. The origin of the fluid in the present clinical case comes from the presence of an infectious process located in the sub-mandibular region, due to poor hygiene and oral care of the patient, which leads to bacterial pneumonia, which evolves into empyema. CLINICAL CASE The clinical case is presented of a 43 year old male patient, attended in a hospital in the Amazon, belonging to the province of Morona Santiago-Ecuador, with a personal history of chronic alcoholism; and the presentation of a picture of pain in the oral cavity of moderate intensity, associated with purulent secretion of moderate quantity, which evolves unfavourably with non-productive cough and pleuritic pain. Complementary studies were carried out which revealed the presence of pleural empyema and submandibular abscess. EVOLUTION The patient was treated with broad-spectrum antibiotic therapy, vasoactive support management due to the presence of septic shock and management of his dental problems. In addition, radiographic and tomographic images were taken to confirm the patients critical clinical condition. Subsequently, the patient decided to request medical discharge to go to another private health unit of greater complexity. CONCLUSIONS Neck abscesses are the result of dental disorders which, if not treated immediately, are a strong predisposing factor for infections in other regions of the body through dissemination, such as the lung, mediastinum and pericardium. The different causes of empyema are of vital importance, because diagnosing the possible aetiologies of empyema can lead to a correct and more targeted management and treatment of the cause. KEY WORDS: Empyema, Submandibular abscess, Pleural effusion

Introducción: la depresión es una enfermedad, con síntomas, tales como: estado de ánimo deprimido, pérdida de interés, cambios en el apetito, insomnio o hipersomnia; presentes durante más de dos semanas. Objetivo: examinar cómo se ha abordado y manejado a este tipo de pacientes, y la efectividad que presentan las terapias, tanto farmacológicas como no farmacológicas, basado en artículos de revisión de los últimos cinco años. Metodología: se realizó una búsqueda de un total de 43 artículos originales y de revisión, recolectados desde la base de datos Cochrane Library, PubMed y Google Scholar, con el término “Depresión”. Los documentos se encontraron en idioma español e inglés. Se excluyeron algunos artículos por falta de información actualizada y falta de relevancia para nuestra revisión bibliográfica. Resultados: existe un pilar fundamental para el tratamiento de la depresión, basado en terapias psicológicas (elemento primario y fundamental), farmacoterapia y como última línea, la terapia electroconvulsiva. Los fármacos que se utilizan en general son los inhibidores de la recaptura de serotonina y los inhibidores de la recaptura de serotonina y noradrenalina. Existen otras terapias como la acupuntura, musicoterapia, que han demostrado cierto beneficio. Conclusiones: a lo largo de este tiempo, se ha determinado que las modalidades diagnósticas actuales han permitido diagnosticar precozmente y a un mayor número de personas que sufren depresión, iniciando con psicoterapia, y administrando fármacos antidepresivos en falta de respuesta a la psicoterapia.

Introduction: Depression is a global health problem that has been increasing in recent years, but it is still underdiagnosed and it’s not taken seriously enough. For this reason, it is vital for health workers to know their correct diagnosis and treatment to prevent patients from reaching their worst outcome, which is suicide. Objective: To examine how these patients have been approached and managed, and the effectiveness of both pharmacological and non-pharmacological therapies, based on review articles from the last five years. Methodology: a total of 43 original and review articles, collected from the Cochrane Library, PubMed and Google Scholar databases, were searched for the term Depression. The documents were found in Spanish and English. Some articles were excluded due to lack of updated information and lack of relevance for our literature review. Results: there is a fundamental pillar for the treatment of depression, based on psychological therapies (primary and fundamental element), pharmacotherapy and, as a last line, electroconvulsive therapy. The drugs generally used are serotonin reuptake inhibitors and serotonin and noradrenaline reuptake inhibitors. There are other therapies such as acupuncture, music therapy, which have shown some benefit. Conclusions: throughout this time, it has been determined that current diagnostic modalities have made it possible to diagnose early and a greater number of people suffering from depression, starting with psychotherapy, and administering antidepressant drugs in the absence of response to psychotherapy. KEY WORDS: depression, dysthymia, psychotherapy, Serotonin Uptake Inhibitors, Serotonin and Norepinephrine Reuptake Inhibitors.

Introducción: la depresión es una enfermedad, con síntomas, tales como: estado de ánimo deprimido, pérdida de interés, cambios en el apetito, insomnio o hipersomnia; presentes durante más de dos semanas.   Objetivo: examinar cómo se ha abordado y manejado a este tipo de pacientes, y la efectividad que presentan las terapias, tanto farmacológicas como no farmacológicas, basado en artículos de revisión de los últimos cinco años.   Metodología: se realizó una búsqueda de un total de 43 artículos originales y de revisión, recolectados desde la base de datos Cochrane Library, PubMed y Google Scholar, con el término “Depresión”. Los documentos se encontraron en idioma español e inglés. Se excluyeron algunos artículos por falta de información actualizada y falta de relevancia para nuestra revisión bibliográfica.   Resultados: existe un pilar fundamental para el tratamiento de la depresión, basado en terapias psicológicas (elemento primario y fundamental), farmacoterapia y como última línea, la terapia electroconvulsiva. Los fármacos que se utilizan en general son los inhibidores de la recaptura de serotonina y los inhibidores de la recaptura de serotonina y noradrenalina. Existen otras terapias como la acupuntura, musicoterapia, que han demostrado cierto beneficio. Conclusiones: a lo largo de este tiempo, se ha determinado que las modalidades diagnósticas actuales han permitido diagnosticar precozmente y a un mayor número de personas que sufren depresión, iniciando con psicoterapia, y administrando fármacos antidepresivos en falta de respuesta a la psicoterapia.