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  • 1
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    Detección serológica del Virus Papiloma Humano en mujeres mayores de 20 años. Caso sector “Gary Esparza”, Babahoyo, Ecuador // Serological detection of human papilloma virus in women over 20 years. “Gary Esparza” sector, Babahoyo, Ecuador
    Universidad Estatal de Milagro (UNEMI) ; 2017
    In:  CIENCIA UNEMI Vol. 10, No. 23 ( 2017-10-04), p. 112-115
    Details
    In: CIENCIA UNEMI, Universidad Estatal de Milagro (UNEMI), Vol. 10, No. 23 ( 2017-10-04), p. 112-115
    Abstract: El Virus del Papiloma Humano (HPV) tiene un genoma ADN bicatenario perteneciente a la familia de los Papovaviridae, tiene capacidad oncogénica en una variedad de mamíferos, en especial el hombre, en el que se conoce más de 200 serotipos y representa una de las enfermedades de transmisión sexual más común, por su relación de patogenia oncológica. Se clasifica en tipos de alto y bajo riesgo oncológico (IARC), también se ha descrito otros tipos de infecciones como las orofaríngeas y amigdalitis. El objetivo de este estudio fue determinar el cribado de detección de anticuerpos IgG contra los genotipos 6, 11, 16 y 18 del virus mencionado, mediante la técnica serológica de Microelisa. Mediante un estudio descriptivo, prospectivo y transversal, realizado en el primer semestre del año 2015 en el Sector Gary Esparza del cantón Babahoyo, provincia de Los Ríos, Ecuador, de un universo de 250 habitantes se tomaron muestras sanguíneas a 97 mujeres mayores de 20 años y determinó 8 casos positivos (8.25%), con ello se estableció el primer diagnóstico serológico en el país, lo que constituye una herramienta de detección preliminar o screening de un gran número de muestras. ABSTRACT The Human Papilloma Virus (HPV) is a virus that has a double-stranded DNA genome belonging to the Papovaviridae family. It has oncogenic ability in a variety of mammals, especially man, in which more than 200 serotypes are known and represents one of the most common sexually transmitted diseases because of its relation to oncological pathogenesis.  It is classified into high and low cancer types (IARC), other types of infections such as oropharyngeal and tonsillitis have also been described. The objective of this study was to determine the screening of IgG antibodies against Human Papilloma Virus genotypes 6, 11, 16 and 18 using the Microelisa serological technique. A descriptive, prospective and cross-sectional study was carried out during the first semester of 2015 in the Gary Esparza Sector of Babahoyo, Los Ríos province, with a population of 250 habitants. Blood samples were taken from 97 women with 20 years old, being determined 8 positive cases (8.25%), establishing the first serological diagnosis in the country, which is a tool for preliminary screening or screening of a large number of samples.
    Type of Medium: Online Resource
    ISSN: 2528-7737 , 1390-4272
    URL: Article
    DOI: 10.29076/issn.2528-7737vol10iss23.2017pp112-115p
    Language: Unknown
    Publisher: Universidad Estatal de Milagro (UNEMI)
    Publication Date: 2017
    detail.hit.zdb_id: 2903413-9
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  • 2
    Online Resource
    Online Resource
    Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
    Oxford University Press (OUP) ; 2023
    In:  British Journal of Surgery Vol. 110, No. 7 ( 2023-06-12), p. 804-817
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 110, No. 7 ( 2023-06-12), p. 804-817
    Abstract: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1093/bjs/znad092
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2006309-X
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  • 3
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    Online Resource
    THU519 Large Congenital Facial Teratoma: A Case Report
    The Endocrine Society ; 2023
    In:  Journal of the Endocrine Society Vol. 7, No. Supplement_1 ( 2023-10-05)
    Details
    In: Journal of the Endocrine Society, The Endocrine Society, Vol. 7, No. Supplement_1 ( 2023-10-05)
    Abstract: Disclosure: A.P. Solis Pazmiño: None. C. Pazmino-Chavez: None. V. Solano: None. C. Garcia: None. Background: Craniocervical teratomas are congenital tumors that arise from the endoderm, mesoderm, and ectoderm germ cell layers. In order to have adequate and prompt management for better outcomes, information about its clinical manifestations and prenatal assessment must be widely disseminated because it can cause death in neonatal patients. The purpose of this case report is to deepen understanding of craniocervical teratoma because there is a dearth of information on the subject. Clinical case: A boy infant was brought in with a significant right mass that had existed from birth. He was delivered by cesarean section at the 38th week of gestation by a 26-year-old primiparous female with one living and healthy child. An extended facial appendage measuring 54 x 23 x 49 mm (L x B x W), with a capacity of 32 mL, was seen during prenatal ultrasonography (Figure 1a). On color Doppler imaging, the appendage was shown as a smoothing, hypodense cystic lesion without any vascularity to be concerned about (Figure 1b). The patient underwent an elective cesarean section at term, the pregnancy developed normally overall, and the newborn was delivered in generally healthy condition. The youngster does not experience pain, have trouble opening his lips, have trouble hearing, or have any other neurological deficits, according to the child’s parents. At the time of examination, the mass measured approximately 6.5 cm by 5 cm by 4 cm in the lateral half of the face (Figure 2) and extended superiorly to the right pterygoid region to the sub-maxillary ipsilateral side. Clinical lessons: Although craniocervical teratoma incidence is low, it is important to identify the appendage on neonatal ultrasound to plan correct management ahead of the baby’s delivery. Additionally, using the 3D-printed model makes it easier to organize the surgery and reduces blood loss while debulking. Presentation: Thursday, June 15, 2023
    Type of Medium: Online Resource
    ISSN: 2472-1972
    URL: Article
    DOI: 10.1210/jendso/bvad114.2147
    Language: English
    Publisher: The Endocrine Society
    Publication Date: 2023
    detail.hit.zdb_id: 2881023-5
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  • 4
    Online Resource
    Online Resource
    Prospective observational cohort study on grading the severity of postoperative complications in global surgery research
    Oxford University Press (OUP) ; 2019
    In:  British Journal of Surgery Vol. 106, No. 2 ( 2019-01-08), p. e73-e80
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 106, No. 2 ( 2019-01-08), p. e73-e80
    Abstract: The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1002/bjs.11025
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2006309-X
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  • 5
    Online Resource
    Online Resource
    Effective interventions in preventing gestational diabetes mellitus: A systematic review and meta-analysis
    Springer Science and Business Media LLC ; 2024
    In:  Communications Medicine Vol. 4, No. 1 ( 2024-04-20)
    Details
    In: Communications Medicine, Springer Science and Business Media LLC, Vol. 4, No. 1 ( 2024-04-20)
    Abstract: Lifestyle choices, metformin, and dietary supplements may prevent GDM, but the effect of intervention characteristics has not been identified. This review evaluated intervention characteristics to inform the implementation of GDM prevention interventions. Methods Ovid, MEDLINE/PubMed, and EMBASE databases were searched. The Template for Intervention Description and Replication (TIDieR) framework was used to examine intervention characteristics ( who, what, when, where, and how ). Subgroup analysis was performed by intervention characteristics. Results 116 studies involving 40,940 participants are included. Group-based physical activity interventions (RR 0.66; 95% CI 0.46, 0.95) reduce the incidence of GDM compared with individual or mixed (individual and group) delivery format (subgroup p -value = 0.04). Physical activity interventions delivered at healthcare facilities reduce the risk of GDM (RR 0.59; 95% CI 0.49, 0.72) compared with home-based interventions (subgroup p -value = 0.03). No other intervention characteristics impact the effectiveness of all other interventions. Conclusions Dietary, physical activity, diet plus physical activity, metformin, and myoinositol interventions reduce the incidence of GDM compared with control interventions. Group and healthcare facility-based physical activity interventions show better effectiveness in preventing GDM than individual and community-based interventions. Other intervention characteristics (e.g. utilization of e-health) don’t impact the effectiveness of lifestyle interventions, and thus, interventions may require consideration of the local context.
    Type of Medium: Online Resource
    ISSN: 2730-664X
    URL: Article
    DOI: 10.1038/s43856-024-00491-1
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2024
    detail.hit.zdb_id: 3096949-9
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  • 6
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    Online Resource
    The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis
    Elsevier BV ; 2018
    In:  British Journal of Anaesthesia Vol. 120, No. 1 ( 2018-01), p. 146-155
    Details
    In: British Journal of Anaesthesia, Elsevier BV, Vol. 120, No. 1 ( 2018-01), p. 146-155
    Type of Medium: Online Resource
    ISSN: 0007-0912
    URL: Article
    DOI: 10.1016/j.bja.2017.08.002
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2018
    detail.hit.zdb_id: 2011968-9
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  • 7
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    Online Resource
    Participant characteristics in the prevention of gestational diabetes as evidence for precision medicine: a systematic review and meta-analysis
    Springer Science and Business Media LLC ; 2023
    In:  Communications Medicine Vol. 3, No. 1 ( 2023-10-05)
    Details
    In: Communications Medicine, Springer Science and Business Media LLC, Vol. 3, No. 1 ( 2023-10-05)
    Abstract: Precision prevention involves using the unique characteristics of a particular group to determine their responses to preventive interventions. This study aimed to systematically evaluate the participant characteristics associated with responses to interventions in gestational diabetes mellitus (GDM) prevention. Methods We searched MEDLINE, EMBASE, and Pubmed to identify lifestyle (diet, physical activity, or both), metformin, myoinositol/inositol and probiotics interventions of GDM prevention published up to May 24, 2022. Results From 10347 studies, 116 studies ( n  = 40940 women) are included. Physical activity results in greater GDM reduction in participants with a normal body mass index (BMI) at baseline compared to obese BMI (risk ratio, 95% confidence interval: 0.06 [0.03, 0.14] vs 0.68 [0.26, 1.60] ). Combined diet and physical activity interventions result in greater GDM reduction in participants without polycystic ovary syndrome (PCOS) than those with PCOS (0.62 [0.47, 0.82] vs 1.12 [0.78–1.61] ) and in those without a history of GDM than those with unspecified GDM history (0.62 [0.47, 0.81] vs 0.85 [0.76, 0.95] ). Metformin interventions are more effective in participants with PCOS than those with unspecified status (0.38 [0.19, 0.74] vs 0.59 [0.25, 1.43] ), or when commenced preconception than during pregnancy (0.21 [0.11, 0.40] vs 1.15 [0.86–1.55] ). Parity, history of having a large-for-gestational-age infant or family history of diabetes have no effect on intervention responses. Conclusions GDM prevention through metformin or lifestyle differs according to some individual characteristics. Future research should include trials commencing preconception and provide results disaggregated by a priori defined participant characteristics including social and environmental factors, clinical traits, and other novel risk factors to predict GDM prevention through interventions.
    Type of Medium: Online Resource
    ISSN: 2730-664X
    URL: Article
    DOI: 10.1038/s43856-023-00366-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 3096949-9
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  • 8
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    Online Resource
    Disease-modifying therapies and features linked to treatment response in type 1 diabetes prevention: a systematic review
    Springer Science and Business Media LLC ; 2023
    In:  Communications Medicine Vol. 3, No. 1 ( 2023-10-05)
    Details
    In: Communications Medicine, Springer Science and Business Media LLC, Vol. 3, No. 1 ( 2023-10-05)
    Abstract: Type 1 diabetes (T1D) results from immune-mediated destruction of insulin-producing beta cells. Prevention efforts have focused on immune modulation and supporting beta cell health before or around diagnosis; however, heterogeneity in disease progression and therapy response has limited translation to clinical practice, highlighting the need for precision medicine approaches to T1D disease modification. Methods To understand the state of knowledge in this area, we performed a systematic review of randomized-controlled trials with $$\ge$$ ≥ 50 participants cataloged in PubMed or Embase from the past 25 years testing T1D disease-modifying therapies and/or identifying features linked to treatment response, analyzing bias using a Cochrane-risk-of-bias instrument. Results We identify and summarize 75 manuscripts, 15 describing 11 prevention trials for individuals with increased risk for T1D, and 60 describing treatments aimed at preventing beta cell loss at disease onset. Seventeen interventions, mostly immunotherapies, show benefit compared to placebo (only two prior to T1D onset). Fifty-seven studies employ precision analyses to assess features linked to treatment response. Age, beta cell function measures, and immune phenotypes are most frequently tested. However, analyses are typically not prespecified, with inconsistent methods of reporting, and tend to report positive findings. Conclusions While the quality of prevention and intervention trials is overall high, the low quality of precision analyses makes it difficult to draw meaningful conclusions that inform clinical practice. To facilitate precision medicine approaches to T1D prevention, considerations for future precision studies include the incorporation of uniform outcome measures, reproducible biomarkers, and prespecified, fully powered precision analyses into future trial design.
    Type of Medium: Online Resource
    ISSN: 2730-664X
    URL: Article
    DOI: 10.1038/s43856-023-00357-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 3096949-9
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  • 9
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    Online Resource
    Índices de disnea de Borg y MRC percibida en pacientes COVID-19 persistente con hipertensión pulmonar
    Instituto de Altos Estudios Dr. Arnoldo Gabaldon ; 2021
    In:  Boletín de Malariología y Salud Ambiental Vol. 61, No. ee2 ( 2021), p. 70-77
    Details
    In: Boletín de Malariología y Salud Ambiental, Instituto de Altos Estudios Dr. Arnoldo Gabaldon, Vol. 61, No. ee2 ( 2021), p. 70-77
    Abstract: El SARS-CoV-2 causante de la enfermedad COVID-19, clínicamente se oscila desde episodios leves seudogripales a otros graves e incluso potencialmente mortales, sobre todo, debido a la insuficiencia respiratoria aguda, independientemente de la gravedad se puede superar el curso agudo, sin embargo, la persistencia de síntomas o complejo sintomático multiorgánico, denominado COVID persistente. Dentro de estos síntomas persistente esta la dificultad respiratoria. Se realizó un estudio descriptivo, observacional y transversal en 29 personas diagnosticadas de COVID-19 persistente más comorbilidad hipertensión pulmonar, entre 2019 y 2021. Se aplicaron las escalas de disnea de Borg en reposo y por prueba de esfuerzo (Prueba de la caminata en 6; y la escala de disnea del Medical Research Council. IFB B categorizan entre 0 y 2 y R2 alto (0,7993) explica la percepción de malestar respiratorio que aparece con niveles de actividad que normalmente no causan este tipo de malestar (actividad diaria), y puede ponderarse por el nivel de actividad necesario para que se desencadene. Ambas escalas tienen validez, fiabilidad, especificidad, sensibilidad y valor predictivo para el uso que se ha establecido, de fácil uso y compresión.
    Type of Medium: Online Resource
    ISSN: 1690-4648
    URL: Article
    DOI: 10.52808/bmsa.7e5.61e2.008
    Language: Unknown
    Publisher: Instituto de Altos Estudios Dr. Arnoldo Gabaldon
    Publication Date: 2021
    detail.hit.zdb_id: 2675744-8
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  • 10
    Online Resource
    Online Resource
    Precision gestational diabetes treatment: a systematic review and meta-analyses
    Springer Science and Business Media LLC ; 2023
    In:  Communications Medicine Vol. 3, No. 1 ( 2023-10-05)
    Details
    In: Communications Medicine, Springer Science and Business Media LLC, Vol. 3, No. 1 ( 2023-10-05)
    Abstract: Gestational Diabetes Mellitus (GDM) affects approximately 1 in 7 pregnancies globally. It is associated with short- and long-term risks for both mother and baby. Therefore, optimizing treatment to effectively treat the condition has wide-ranging beneficial effects. However, despite the known heterogeneity in GDM, treatment guidelines and approaches are generally standardized. We hypothesized that a precision medicine approach could be a tool for risk-stratification of women to streamline successful GDM management. With the relatively short timeframe available to treat GDM, commencing effective therapy earlier, with more rapid normalization of hyperglycaemia, could have benefits for both mother and fetus. Methods We conducted two systematic reviews, to identify precision markers that may predict effective lifestyle and pharmacological interventions. Results There was a paucity of studies examining precision lifestyle-based interventions for GDM highlighting the pressing need for further research in this area. We found a number of precision markers identified from routine clinical measures that may enable earlier identification of those requiring escalation of pharmacological therapy (to metformin, sulphonylureas or insulin). This included previous history of GDM, Body Mass Index and blood glucose concentrations at diagnosis. Conclusions Clinical measurements at diagnosis could potentially be used as precision markers in the treatment of GDM. Whether there are other sensitive markers that could be identified using more complex individual-level data, such as omics, and if these can feasibly be implemented in clinical practice remains unknown. These will be important to consider in future studies.
    Type of Medium: Online Resource
    ISSN: 2730-664X
    URL: Article
    DOI: 10.1038/s43856-023-00371-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 3096949-9
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