Lorenzo Hidalgo, Alejandro Ernesto

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Lorenzo Hidalgo, Alejandro Ernesto
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Ambato

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    Inclusive higher education for students with special educational needs: review of advances, challenges, and future directions
    (2026)
    Esparza Yánez, Wilmer  
    ;
    Lorenzo Hidalgo, Alejandro Ernesto  
    ;
    Camaño Carball, Lilian  
    ;
    Israel Vinueza-Fernández
    ;
    García Pérez, Dianet  
    Inclusive education (IE) in Higher Education (HE) has become a global priority, driven by the mandate of the United Nations Convention on the Rights of Persons with Disabilities (CRPD). However, the implementation remains uneven, characterized by fragmented institutional responses and conceptual ambiguities. This article presents an international, critical narrative review of the advances and persistent challenges concerning IE for Students with Special Educational Needs (SEN) and Students with Disabilities (SWDs). A narrative review was conducted on international peer-reviewed literature and policy documents published mainly between 2015 and 2025. The analysis is critically structured around six dimensions: (1) conceptualizations of SEN and disability; (2) characteristics and academic trajectories of SWDs; (3) institutional and pedagogical models; (4) the use of digital and assistive technologies; (5) legislative and policy frameworks; and (6) the economic and financial costs associated with inclusion. The review confirms a necessary paradigm shift from the reactive Medical Model to the proactive, Rights-Based Model. Universal Design for Learning (UDL) and innovative, student-centered pedagogies are crucial tools for systemic change, supported by the transformative potential of emerging technologies like AI and Virtual Reality for personalization. Despite these advances, a critical gap persists between policy and practice. Major challenges include the persistent lack of faculty readiness to implement UDL effectively, fragmented policy management, and inadequate financial models that treat inclusion as a cost rather than an investment. Achieving genuine equity in HE requires moving beyond minimal legal compliance toward an integrated, systemic commitment. Future research must focus on longitudinal studies measuring the impact of UDL on retention, efficacy of faculty training, and developing robust, bifurcated financial models. The ultimate success hinges on redesigning the educational environment—pedagogically, technologically, and financially—to establish diversity as the institutional norm.
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    Autoimmune Complications in Long COVID in a Patient with Hepatitis C
    (2026)
    Camaño Carball, Lilian  
    ;
    Núñez-Naranjo, Aracelly Fernanda  
    ;
    Lorenzo Hidalgo, Alejandro Ernesto  
    A significant percentage of patients, according to recent studies, report persistent clinical manifestations of COVID-19 beyond the acute phase. These symptoms extend between four and twelve weeks from the initial clinical presentation. This clinical study details the case of a 50-year-old female patient with a history of hepatitis C who developed COVID-19 and subsequently experienced a series of symptoms indicative of Post-COVID-19 Syndrome (Long COVID). The presented symptoms included fever, general malaise, anorexia, vomiting, diarrhea, sore throat, dry cough, severe headache, mucosal dryness, skin fold, muscle weakness in the lower limbs, conjunctival injection, and sudden visual loss in the left eye. She showed initial improvement and was discharged from the hospital; however, she developed fever, ageusia, dyspnea, positional tachycardia, palpitations, and retrosternal pain. Subsequent examinations revealed pericarditis and subacuteinflammatory demyelinating polyneuropathy, demonstrating the diverse and prolonged clinical course associated with Long COVID. Treatment with colchicine and NSAIDs resulted in clinical improvement, highlighting the challenges in managing and potential therapeutic approaches for patients with persistent COVID-19 symptoms. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2026.
      17
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    DOLOR PERSISTENTE EN ARTRITIS IDIOPÁTICA JUVENIL TRATADA CON BIOLÓGICOS: UNA REVISIÓN DE ALCANCE
    (CEIT S.A., 2026-07-29)
    Garzón-Nájera, Antonny
    ;
    Lorenzo Hidalgo, Alejandro Ernesto  
    ;
    Apráez-Núñez, Karla
    La artritis idiopática juvenil (AIJ) es la enfermedad reumática crónica más común en la infancia. Los agentes biológicos han mejorado notablemente el control de la actividad inflamatoria; sin embargo, muchos pacientes siguen reportando dolor pese a alcanzar remisión o baja actividad clínica. Este estudio buscó mapear la evidencia sobre mecanismos, evaluación y manejo del dolor persistente en pacientes con AIJ tratados con biológicos, mediante una búsqueda electrónica sin límite inferior de fecha y ejecutada hasta 2024, que identificó estudios elegibles publicados entre 2010 y 2022. Se realizó una revisión de alcance según las directrices PRISMA-ScR (Tricco et al., 2018), buscando en PubMed, Scopus, Web of Science, Cochrane Library y SciELO. Dieciocho estudios cumplieron los criterios de inclusión. Los hallazgos muestran que muchos pacientes en tratamiento biológico, en proporciones variables, siguen presentando dolor, fatiga o rigidez clínicamente relevantes, lo que evidencia una discordancia entre los marcadores objetivos de inflamación y la experiencia sintomática. Los mecanismos propuestos incluyen sensibilización central, componentes neuropáticos e influencias psicosociales. Entre los inhibidores del TNF-α, adalimumab ha reemplazado a etanercept como el agente de primera línea más prescrito en registros pediátricos recientes, con un perfil de seguridad favorable a largo plazo. Estos hallazgos respaldan reconocer el dolor persistente en la AIJ como un problema clínico independiente de la actividad inflamatoria, que requiere instrumentos validados y manejo multidisciplinario. La revisión también señala vacíos de conocimiento, en particular la falta de definiciones estandarizadas y biomarcadores predictivos, lo que orienta las prioridades de investigación futura.