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Miguel Felix,1,2 Carlos Vera Paz,1,2 Valeria L Mata,1,2 Emanuel Vanegas,1,2 Désirée Larenas-Linnemann,3 Nelson A Rosario,4 Jose Letort,5 Ivan Cherrez-Ojeda1,2 1Universidad Espíritu Santo, Samborondón, Ecuador; 2RespiraLab Research Group, Guayaquil, Ecuador; 3Investigational Center, Medica Sur Clinical Foundation and Hospital, Mexico City, Mexico; 4Departamento de Pediatria, Universidade Federal do Parana, Curitiba, Brazil; 5Departamento de Otorrinolaringología, Hospital, Quito, EcuadorCorrespondence: Ivan Cherrez-OjedaUniversidad Espíritu Santo, Km. 2.5 Vía La Puntilla, Samborondón 0901-952, EcuadorTel +593 4511455Email ivancherrez@gmail.comObjective: Allergic rhinitis (AR) represents a large burden to the healthcare system due to its high prevalence and impact on patients’ lives. Despite the existence of evidence-based guidelines, some studies have found that physicians do not always follow the latest recommendations. The aim of our study was to determine how Ecuadorian otorhinolaryngologists (ENTs) perceive some epidemiological aspects related to AR, as well as their preferences for managing the disease.Methods: We conducted an observational, survey-based cross-sectional study, among 116 Ecuadorian ENTs. The survey used was adapted from a previous publication and consisted of 30 multiple choice questions, concerning several topics of AR. Descriptive statistics (frequency, and standard deviation) were performed for clinical and demographic variables.Results: A total of 116 Ecuadorian ENTs completed the survey. Of them, 62.9% were male, with an average age of 42 years (SD ± 11.58). Computed tomography (CT) scan and nasal cytology were selected as the main diagnostic tests for AR by 62/91 (68.1%) and 45/91 (49.5%) of participants, respectively. Moreover, only 12/116 (10.3%) of participants performed skin prick tests (SPT). Allergen immunotherapy (AIT) was performed by 37/107 (36.4%) of participants.Conclusion: In general, most participants agreed that the prevalence of AR appears to be increasing, with increased exposure to allergens, irritants, and pollutants as the main probable cause. Children and adolescents were accounted as the group most affected by AR, with sinusitis and asthma identified as the most frequent comorbidities. Finally, we found unmet needs in the diagnostic and management of AR that should be addressed among Ecuadorian ENTs, in particular the high use of CT scans as part of routine evaluations, as well as the low use of allergen immunotherapy.Keywords: allergic rhinitis, Ecuador, epidemiology, Latin America, management

Ivan Cherrez-Ojeda,1,2 Emanuel Vanegas,1,2 Miguel Felix,1,2 Sofia Cherrez,2,3 Delia Suárez-Almendariz,4 Johana Ponton,5 Vladimir Preciado,6 Edgar Ollague-Cordova,7 Enrique Loayza5 1Universidad Espíritu Santo, Samborondón, Ecuador; 2Respiralab Research Group, Guayaquil, Ecuador; 3School of Medicine, University of Heidelberg, Heidelberg, Germany; 4Departamento de Dermatología, Honorable Cuerpo Consular de Damas, Durán, Ecuador; 5Departamento de Dermatología, Hospital Luis Vernaza, Guayaquil, Ecuador; 6Área de Fototerapia, Hospital Luis Vernaza, Guayaquil, Ecuador; 7Clínica Dermatológica Ollague, Guayaquil, EcuadorCorrespondence: Ivan Cherrez-OjedaUniversidad Espíritu Santo, Km. 2.5 vía La Puntilla, Samborondón 0901-952, EcuadorTel +5934511455Email ivancherrez@gmail.comObjective: We designed this study to determine the frequency of alexithymia in Ecuadorian patients with psoriasis, as well as possible associations between demographic factors, disease severity, and treatment adherence.Methods: A cross-sectional study involving 99 Ecuadorian patients with psoriasis was conducted. Multinomial logistic regressions were performed to ascertain whether age, gender, educational level, years with disease, psoriasis area and severity index (PASI) scores, and treatment adherence categories are prediction factors in patients with psoriasis to present alexithymia, possible alexithymia or no alexithymia.Results: A total of 99 patients participated in the study with a gender distribution of 57.6% male, and an average age and years with disease of 48.3 and 7.4, respectively. Out of all patients, 33.3% presented alexithymia, and 22.2% possible alexithymia, as assessed by the Toronto Alexithymia Scale (TAS-20). The multiple regression model statistically significantly predicted the TAS-20 score from age, gender, educational level, years with psoriasis, PASI score and level of adherence F (7,88) = 4.171, p = 0.001, adj. R2= 0.189. Only having the highest educational level added statistical significance to the prediction of having a lower TAS-20 score, whilst the remainder variables did not.Conclusion: We found a similar proportion of alexithymia, as well of average TAS-20 scores among Ecuadorian patients with psoriasis in comparison to previous studies. Only having the highest educational level was found to decrease the TAS-20 score. Age, gender, years with psoriasis, PASI score and level of adherence were not identified as factors that influence the TAS-20 score.Keywords: Alexithymia, psoriasis, Latin America, treatment adherence

Ivan Cherrez-Ojeda,1,2 Mark Haddad,3 Carlos Vera Paz,1,2 Jose Alejandro Valdevila Figueira,4 Justo Fabelo Roche,5 Carlos Orellana Román,4 Serguei Iglesias Moré,5 Miguel Felix,1,2 Emanuel Vanegas,1,2 Geovanny Efraín Alvarado-Villa1 1Universidad Espíritu Santo, Samborondón, Ecuador; 2Respiralab Research Group, Guayaquil, Ecuador; 3Centre for Mental Health Research, School of Health Sciences, City University London, London, UK; 4Instituto de Neurociencias, Guayaquil, Ecuador; 5Universidad de Ciencias Médicas de la Habana, Habana, CubaCorrespondence: Ivan Cherrez-OjedaUniversidad Espíritu Santo, Km. 2.5 Vía La Puntilla, Samborondón 0901-952, EcuadorTel +5934511455Email ivancherrez@gmail.comPurpose: The aim of the study was to develop and validate a Spanish version of the Revised Depression Attitude Questionnaire (R-DAQ).Methods: The R-DAQ was used as a baseline for the study. It was translated and tested to ensure the instrument was appropriate for the target population. 537 Ecuadorian healthcare professionals completed the revised Spanish version of the R-DAQ (SR-DAQ). Statistical and exploratory factor analyses were performed to examine construct validity, internal consistency, readability and floor and ceiling effects.Results: Three factors were obtained: “Professional confidence in depression care”; “Therapeutic optimism about depression”; and “Generalist perspective about depression occurrence, recognition, and management”. The internal consistency of the SR-DAQ was determined by means of Cronbach’s α coefficient, with values ranging between 0.61–0.8. The correlations with the English version reflected adequate validity. The model explained 39% of the variance. Subsequent analysis with a sample restricted to those who had received training in depression produced a model that explained 42% of the variance.Conclusion: The SR-DAQ meets the psychometric requirements for measuring depression attitude in a Spanish-speaking population and shows adequate internal consistency and validity.Keywords: attitudes, depression, Latin America, psychometric properties, validation