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Objective To analyze the correlation between arm muscle area and handgrip strength among postmenopausal community dwelling low-income women in order to provide an easy anthropometric indicator to assess muscle mass quantity and quality.Methods This was a cross-sectional study involving postmenopausal women (n = 171) from three urban-marginal communities of Guayaquil, Ecuador. Corrected arm muscle area was calculated using the Frisancho formula. Dynapenia was defined as HGS < 16 kg. Spearman’s correlation coefficient was calculated at a 5% significance level to test the correlation between corrected arm muscle area and handgrip strength.Results Median (interquartile range: IQR) age of the sample was 72.0 years (17.0). The median of corrected arm muscle area was 34.8 cm2 (20.7). The overall prevalence of dynapenia was 57.9% (n = 99). There was a significant decreasing trend with age regarding all anthropometric characteristics and handgrip strength, as well as a higher prevalence of dynapenia with age. For the whole sample, a statistically significant positive correlation was found between corrected arm muscle area and handgrip strength [r = 0.267; p

AbstractObjective To evaluate the possible association between thyroid function within the euthyroid range and musculoskeletal parameters as well as body composition in a sample of postmenopausal women.Methods This cross-sectional study included 96 postmenopausal women with serum thyroid-stimulating hormone (TSH) within the normal laboratory reference range. Fasting venous blood samples were obtained for biochemical/hormonal assessment. Bone status and body composition were measured using Dual Energy X-ray absorptiometry (DXA). Physical activity was quantified using the International Physical Activity Questionnaire (IPAQ) index.Results Serum TSH correlated with handgrip strength (HGS, r-coefficient = 0.233, p = .025), and total body bone mineral density (BMD) T-score values (r-coefficient = 0.321, p = .003). HGS measures were associated with BMD (r-coefficient = 0.415, p

Objective To assess menopausal symptoms and determine awareness of menopausal related information in mid-aged women.Methods This was a cross-sectional study in which 140 women aged 40 to 60 years from Guayaquil, Ecuador were surveyed with the short 10-item Cervantes Scale (CS-10) and a questionnaire containing personal data and questions assessing awareness of menopause related information.Results The mean age of the sample was 48.0 ± 5.6 years. More than half of surveyed women had low education and non-urban residency, none were on menopausal hormone therapy, 33.6% had hypertension, 35% were postmenopausal, 78.6% had an increased body mass index (overweight/obese) and 92.9% had abdominal obesity (waist > 88 cm). The average CS-10 score was 15.3 ± 9.0 with a median of 14.0. The three most frequent menopausal symptoms were muscle-joint pain (75.0%), changes in skin texture (74.3%) and vaginal dryness (71.4%). Regarding awareness of information related to the menopause, it was found that 98.6% of women had no idea about what the menopause is and the average age of its onset. Interestingly, although 61.4% knew that during the menopause there is weight gain, 57.9% were sedentary. Married, postmenopausal, older and less educated women presented higher mean total CS-10 scores. Contrarily, those with less awareness of menopause related information present lower scores.Conclusion In this low-income mid-aged female sample there was a high rate of non-awareness regarding information related to the menopause, including an unhealthy cardiometabolic profile. There is a need for educational programs aimed to increase awareness in this high-risk population in relation to the surveyed aspects in order to improve their health status and prevent chronic conditions.

AbstractObesity is not a choice or a result of lack of willpower, but a multifactorial, chronic, progressive, and relapsing disease. During menopause, hormonal and body composition changes lead to greater visceral adiposity, that aggravates women’s health at a cardiometabolic, mechanic and mental level. Adiposity has been identified as an important modifier of reproductive hormones. During female midlife, obesity has been associated with menstrual cycle alterations (anovulatory cycles ending with abnormal bleedings), menopausal symptoms including hot flashes, poor quality of sleep, aches and joint pain, genitourinary symptoms, and reduced quality of life. However, the relationships between weight, the menopausal process, aging, and hormone levels remain poorly understood. Women with obesity have an increased risk of thromboembolic disease when using menopause hormone therapy (MHT), and it is probably the main medical condition to prescribe or not MHT. However, this risk depends on the route and type of MHT. The use of estrogen-only or combined transdermal MHT does not increase the risk of a thrombotic event in women with obesity.

Insulin autoimmune syndrome or Hirata's disease is a rare condition characterized by hypoglycemia associated with endogenous autoimmune hyperinsulinism. This report concerns the case of a 28-year-old Latin American woman with Graves' disease who developed insulin autoimmune syndrome and then subsequently became pregnant. She displayed symptoms related to severe hypoglycemia due to hyperinsulinemia, elevated C-peptide, and anti-insulin antibodies. Prior to pregnancy she was treated with corticosteroids and had ablative treatment with iodine-131. During follow-up of both conditions, the patient became pregnant, and clinically and biochemically hyperthyroid, for which total thyroidectomy was performed during the second trimester of pregnancy. Anti-insulin antibodies, blood glucose, and C-peptide remained normal throughout pregnancy. At 40 weeks of gestation she gave birth to a healthy female newborn with normal blood glucose values. Molecular genetic analysis determined the following genotypes: HLA-DRB1*03:01 / HLA-DRB1*04:01 in the mother; and HLA-DRB1*04:01 / HLA-DRB1*08:02 in the daughter. Because some HLA-DRB1*04 alleles are associated with susceptibility to insulin autoimmune syndrome induced by environmental factors, the patient was advised regarding the future use of drugs with a sulfhydryl group and possible triggering factors for insulin autoimmune syndrome. At 6-month follow-up the daughter presented normal growth and development, as well as normal plasma glucose values, and this remained the case at five-year follow-up.

AbstractObjective To explore the association between anxiety and frailty in community-dwelling postmenopausal women.Methods This was a cross-sectional study in which 390 postmenopausal women (aged 60–83 years) who were attending a comprehensive care program were surveyed between January 2018 and February 2020. Each participant was administered a validated Spanish version of the Hospital Anxiety and Depression Scale (HADS) to assess their anxiety status. Those scoring 8 or higher on the anxiety subscale of the HADS were indicative of anxiety. The assessment of frailty utilized the Fried’s phenotype, with a diagnosis of frailty established if the participant met at least three out of the five criteria. Factors associated with frailty were analyzed using multivariate logistic regression.Results The mean age of participants was 70.08 years, with an average of 12.58 ± 3.19 years since menopause. Frailty was diagnosed in 43.85% of the total series, while anxiety was present in 41.08%, rising to 69.59% in participants with frailty. Neither body mass index, years since menopause, educational level, economic status, nor smoking habit demonstrated significant associations with frailty. Upon multivariate analysis, anxiety (OR 8.56), multimorbidity (OR 2.18), and age (OR 2.73) emerged as independently associated with frailty (p

Objective: To determine the prevalence of menopausal symptoms and factors related to severity in mid-aged women.Methods: Cross-sectional study in which 216 urban-living women from Asunción-Paraguay (40–60 years) were surveyed with the 10 item Cervantes Scale (CS-10) and a general questionnaire (personal and partner data).Results: Median (interquartile range [IQR]) age of the sample was 48 [9] years, 48.1% were postmenopausal, 8.8% used menopausal hormone therapy, 39.4% psychotropic drugs, 43.5% had hypertension, 6.5% diabetes, 51.9% abdominal obesity, and 89.3% had a partner (n = 193). A history of sexual abuse was present in 2.8%. Median total CS-10 score was 8.5 [9.75]. Overall, 93.3% (180/193) of women having a partner were sexually active, with a median coital frequency of 8 times per month. According to the CS-10, the three most prevalent menopausal symptoms were: aching in muscles and/or joints (70.8%), anxiety and nervousness (70.8%) and hot flashes/night sweats (54.2%). Factors associated with higher CS-10 scores were: female age and educational level, marital status, menopausal status, and marital sexual aspects. Partner educational level was inversely correlated (rho Spearman coefficient) with CS-10 total scores. However, multiple linear regression analysis found that higher total CS-10 scores (more severe menopausal symptoms) negatively correlated to coital frequency and positively correlated with peri- and postmenopausal status, parity, sedentary lifestyle and a history of sexual abuse.Conclusion: Menopausal symptoms in this mid-aged urban female Paraguayan sample were related to hormonal, sexual and other female aspects.

Objective: This systematic review and meta-analysis aimed at summarizing the evidence concerning circulating asprosin, and related endocrine and metabolites in women with and without the polycystic ovary syndrome (PCOS).Method: We performed a comprehensive literature search in Pubmed, Web of Science, Scielo, and Chinese National Knowledge Infrastructure for studies published until May 20, 2022, that evaluated circulating asprosin levels in women with and without PCOS, regardless of language. The quality of studies was assessed with the Newcastle-Ottawa Scale. Random-effects models were used to estimate mean differences (MD) or standardized MD (SMD) and their 95% confidence interval (CI).Results: We evaluated eight studies reporting 1,050 PCOS cases and 796 controls of reproductive age. Participants with PCOS were younger (MD = −2.40 years, 95% CI −2.46 to −2.33), with higher values of asprosin (SMD = 2.57, 95% CI 1.64–3.50), insulin (SMD = 2.73, 95% CI 1.18–4.28), homeostatic model assessment of insulin resistance (SMD = 2.70, 95% CI 0.85–4.55), luteinizing hormone (SMD = 2.33, 95% CI 0.60–4.06), total testosterone (SMD = 4.06, 95% CI 1.89–6.22), dehydroepiandrosterone sulfate (SMD = 2.38, 95% CI 0.37–4.40), and triglycerides (SMD = 1.20, 95% CI 0.13 to 2.27). Moreover, PCOS women had lower circulating levels of sex hormone-binding globulin (SMD = −3.36, 95% CI −4.92 to −1.80), and high-density lipoprotein-cholesterol (SMD = −0.85, 95% CI −1.69 to −0.01); with no significant differences observed for glucose, total cholesterol, and low-density lipoprotein-cholesterol levels.Conclusion: Circulating asprosin levels were significantly higher in women with PCOS as compared to those without the syndrome.

Abstract Background Previous studies have indicated an association between oral hypofunction and frailty in community-dwelling older adults. However, this issue has not been evaluated in institutionalized older patients. We aimed to determine the prevalence of physical frailty in this particularly vulnerable group and evaluate its association with oral hypofunction, analyzing possible differences by gender. Methods This cross-sectional study was conducted in private and public care homes in Guayaquil (Ecuador) from January 2018 until December 2019. Participants were classified as robust, pre-frail, and frail according to the Fried's frailty phenotype. Oral hypofunction was defined as the presence of at least three positive items in the following list: poor oral hygiene, oral dryness, reduced occlusal force, decreased masticatory function, and deterioration of swallowing function. The relationships between frailty and oral hypofunction were analyzed using logistic regression models for the whole sample and stratified by gender. Statistical analyses were performed using STATA 15.0 software (Stata Corp. LP, College Station, TX, USA). Results Among the 589 participants analyzed (65% women), the median age was 72 years (interquartile range: 66–82). Pre-frailty and frailty were presented in 66.7% and 28.9% of them respectively. Weakness was the most frequent item (84.6%). There was a significant relationship between frailty and oral hypofunction in women. In the overall sample, the frequency of frailty was 2.06 times higher (95% CI 1.30–3.29) in patients with oral hypofunction, and this association was maintained in women (ORa: 2.18; 95% CI 1.21–3.94). Reduced occlusal force and decreased swallowing function were items significantly associated with the presence of frailty (ORa: 1.95; 95% CI 1.18–3.22 and ORa: 2.11; 95% CI 1.39–3.19, respectively). Conclusion The prevalence of frailty and pre-frailty was high among institutionalized older people and was associated with the presence of hypofunction, especially in women. Decreased swallowing function was the most strongly item associated with frailty.

Background: Clitoromegaly is often a sign of androgen excess; however, non-hormonal causes must be ruled out. We report the case of an adolescent with isolated clitoromegaly without clinical or biochemical evidence of hyperandrogenism. Case: A 16-year-old female was referred due to a clitoromegaly of 12 months of evolution. Examination of the pubic region revealed normal female genitalia with an enlarged clitoris, 4 cm long and 2.5 cm wide. The clitoris was painless, soft on palpation, and mobile over deeper layers. There were no signs of virilization, and the patient did not report dysuria or difficulties with sexual intercourse. Her medical record was also unremarkable, with no female circumcision, family history of birth defects, or genital abnormalities. Hormone profile blood tests were normal. Pelvic ultrasound examination was normal, but a high-resolution scan with a linear transducer confirmed the presence of a cyst, lying anterior to the clitoral body and glans. The cyst was surgically removed with special care to preserve the clitoral neurovasculature. The pathological report disclosed an epidermoid clitoral cyst. The patient described emotional well-being, satisfactory sexual function, and no discomfort after a year of follow-up. Conclusion: Epidermal clitoral cysts represent an unusual cause of clitoromegaly. These cysts should be ruled out as a differential diagnosis after an exhaustive semiological and endocrinological examination.

Abstract Background The use of information and communication technologies (ICTs) provide the tools for enabling fast and reliable real-time communications, as well as the transfer of information between dental professionals and their patients. However, little is known about the frequency and preference of ICTs among Latin-American dentists. Our study aims to fill this gap by assessing different aspects related to ICTs, mainly the frequency of use, perceptions, and barriers among Ecuadorian dentists. Methods An anonymous, cross-sectional survey-based study was conducted among 342 Ecuadorian dentists. The final questionnaire included 13 items related to the frequency of use, perceptions, and barriers of ICTs. Bivariate analysis was performed by using chi-squared testing to explore the association between the independent variables and the intended use of ICTs, as well as to characterize the perceptions and barriers related to ICTs. Results In general, most participants reported the use of ICTs to communicate with colleagues (99.7%), and patients (96.2%), while only 63.5% reported using ICTs to obtain academic information in their daily practice. WhatsApp was rated as the most used ICT for communicating with colleagues and patients. A majority of participants considered that ICTs can be useful for facilitating continuing dental education (92.1%), searching new work opportunities (91.5%), promoting health (90.1%), working with colleagues and other health professionals (91.2%), promoting their professional services (90.6%), and for resolving clinical cases (87.7%). On the subject of barriers, privacy and security concerns about personal and/or patient information was the biggest concern among dentists (65%), followed by lack of time to learn how to use and/or use ICTs (48%), lack of mobile internet access (28.1%), and lack of internet access at work (24.9%). Conclusion In our study, we found that Ecuadorian dentists had a high usage rate of ICTs, mainly for communicating with other colleagues and patients, while the academic use of technology remains a comparatively underused application. Most of the participants surveyed had a positive perception towards ICTs, while privacy and security concerns were identified as the main barrier. Older age was associated with a less favourable perception toward ICTs, as well as an increased likelihood of reporting barriers related to the use of technology.

Ivan Cherrez-Ojeda,1,2 Emanuel Vanegas,1,2 Miguel Felix,1,2 Valeria L Mata,1,2 Fanny M Jiménez,1,2 Mabel Sanchez,3,4 Daniel Simancas-Racines,5 Sofia Cherrez,6 Antonio WD Gavilanes,7,8 Johannes Eschrich,2 Peter Chedraui9,10 1Universidad Espíritu Santo, Samborondón, Ecuador; 2Respira Lab Research Group, Guayaquil, Ecuador; 3Universidad Laica Eloy Alfaro, Manabí, Ecuador; 4Universidad Estatal Del Sur Del Manabí, Manabí, Ecuador; 5Centro De Investigación En Salud Pública y Epidemiología Clínica, Facultad De Ciencias De La Salud Eugenio Espejo, Universidad Tecnológica Equinoccial, Quito, Ecuador; 6School of Medicine, University of Heidelberg, Heidelberg, Germany; 7Department of Pediatrics, Maastricht University Medical Center, Maastricht, the Netherlands; 8School of Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands; 9Instituto De Investigación e Innovación En Salud Integral, Facultad De Ciencias Médicas, Universidad Católica De Santiago De Guayaquil, Guayaquil, Ecuador; 10Facultad De Ciencias De La Salud, Universidad Católica “Nuestra Señora De La Asunción”, Asunción, ParaguayCorrespondence: Ivan Cherrez-OjedaUniversidad Espíritu Santo, Km. 2.5 Vía La Puntilla, Samborondón 0901-952, EcuadorTel +593 4511455Email ivancherrez@gmail.comObjective: In recent years, the use of information and communication technologies (ICTs) has increased in various sectors, among which the healthcare service is no exception. However, studies have mostly focused on the use of ICTs among patients with chronic diseases, with few reports on the advantages and barriers of these technologies among physicians, particularly in Latin America. We designed this study to fill in the gap, as an objective assessment of the frequency of use, perceptions, and barriers of ICTs among physicians remains crucial for a successful implementation of these technologies into the mainstream medical practice.Methods: We conducted an anonymous cross-sectional survey-based study in 640 Ecuadorian physicians. The survey used consisted of 13 items and evaluated the frequency of use, perceptions, and barriers of ICTs among physicians. Chi-square tests for goodness of fit and independence were performed, whilst Phi coefficient was interpreted to assess the strength of associations. Fisher exact test was performed when required.Results: Over 90% of physicians reported the use of ICTs to message other colleagues and patients (p=0.000). While 89.5% of physicians used social media to interact with other colleagues, only 58.1% used them to interact with patients (p=0.000). Most participants reported the use of ICTs to search for academic information (p=0.000). Moreover, more than 80.0% agree that ICTs may be used to promote health and medical services, search new job opportunities, get involved in research projects and promote teamwork with colleagues. However, 83.6% of physicians expressed concerns about privacy and patient confidentiality, while 53.8% stated that they lacked the time to use ICTs.Conclusion: High usage of ICTs was found among Ecuadorian physicians. Younger physicians, with less postgraduate years, and non-specialists were more likely to have a positive perception toward ICTs. Privacy and patient confidentiality, followed by time management, were the most reported barriers in our study.Keywords: eHealth, social media, web 2.0, medical informatics, public health

Ivan Chérrez-Ojeda,1,2 Emanuel Vanegas,1,2 Miguel Felix,1,2 Valeria L Mata,1,2 Antonio WD Gavilanes,3,4 Peter Chedraui5,61Universidad Espíritu Santo, Samborondón, Ecuador; 2Respiralab Research Group, Guayaquil, Ecuador; 3Department of Pediatrics, Maastricht University Medical Center, Maastricht, the Netherlands; 4School of Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands; 5Instituto De Investigación E Innovación En Salud Integral, Facultad De Ciencias Médicas, Universidad Católica De Santiago De Guayaquil, Guayaquil, Ecuador; 6Facultad De Ciencias De La Salud, Universidad Católica “Nuestra Señora De La Asunción”, Asunción, ParaguayObjectives: This study was designed to assess the use and preferences for information and communication technologies (ICTs) among patients with hypertension in Ecuador.Methods: We conducted an anonymous cross-sectional study during 2018, in which 207 patients with hypertension were surveyed using an adapted version of the Michigan questionnaire. The survey included 16 questions in total, in which patients were asked to quantify their use for each ICT, and their interest in using ICTs to receive information and communicate with health care providers. Adjusted binomial and multinomial regression analyses were performed.Results: Of the surveyed population, 74.9% of patients reported owning a smartphone, while 79.2% of responders reported having access to the internet. In general, web-based internet (53.7%) remains the main source for obtaining information related to hypertension, followed by YouTube (39.5%) and Facebook (30.2%). WhatsApp and Facebook were rated with the highest interest for receiving and asking health-related information. Older age and lower educational levels were consistently associated with less interest and usage for most ICTs.Conclusions: The widespread use of ICTs opens new possibilities for improving the care of patients with hypertension through self-management education strategies. Further studies should be conducted to demonstrate how to develop and promote interventions through ICTs more effectively, based on the studied patterns of use and preferences of ICTs for specific patients.Keywords: information and communication technology, social media, hypertension, self-management, Latin America

The purpose of this review was to assess recent evidence regarding the effects of low vitamin D levels on some highly prevalent clinical conditions of postmenopausal women. We reviewed and selected recent literature regarding menopause-related conditions associated with vitamin D deficiency and interventions to manage them. Low circulating 25-hydroxyvitamin D (25(OH)D) levels related to menopause are linked to diet, lifestyle, changes in body composition, insulin sensitivity, and reduced physical activity. Vitamin D supplementation increases serum 25(OH)D levels while normalizing parathyroid hormone and bone markers, and in women with serum 25(OH)D levels below 10 ng/ml supplementation may improve bone mineral density. Low vitamin D status has been associated with the metabolic syndrome, high triglyceride levels, and low high-density lipoprotein cholesterol levels. When compared with placebo, vitamin D supplementation may lower the risk of the metabolic syndrome, hypertriglyceridemia, and hyperglycemia. There is an inverse relationship between fat mass and serum 25(OH)D levels and, therefore, the dosage of supplementation should be adjusted according to the body mass index. Although vitamin D supplementation may improve glucose metabolism in prediabetic subjects, data regarding muscle strength are conflictive. There is evidence that vitamin D over-treatment, to reach extremely high circulating 25(OH)D levels, does not result in better clinical outcomes. The identification and treatment of vitamin D deficiency in postmenopausal women may improve their general health and health outcomes. Vitamin D supplementation should preferably be based on the use of either cholecalciferol or calcifediol.

ObjectivesThe aim of the present study was to assess the frequency of use, and preferences regarding information and communication technologies (ICTs) among Ecuadorian patients with chronic kidney disease (CKD) undergoing hemodialysis.MethodsWe conducted an anonymous cross-sectional survey-based study from January 2016 to April 2017, involving 393 patients with end-stage renal disease from 9 hemodialysis centers, in which they rated their use and preferences of various ICTs through a modified version of the Michigan Questionnaire. The questionnaire collected information regarding demographics, patients' interest in obtaining health-related information through ICTs, and interest in using ICTs as a potential way to communicate with their healthcare providers. A chi-square test for association and adjusted regression analyses were performed.ResultsAmong all patients who participated, 64.3% reported owning a cellphone, with less than a third reporting active Internet connection. The most used ICT for obtaining information about CKD and/or hemodialysis was web-based Internet, followed by YouTube. SMS was rated the highest to receive and seek health-related information, followed by Facebook. Younger age and higher levels of education were associated with a higher overall usage of ICTs. Finally, more than half of the patients reported interest in using WhatsApp for communicating with their healthcare providers.ConclusionsUnderstanding the preferences of ICTs among patients with CKD undergoing hemodialysis could help to improve their outcomes through the potential uses and benefits of ICTs. Further research is needed to assess their role in improving the care of patients with chronic diseases.

Objetivos: Conocer la incidencia de fracturas de cadera en Ecuador en el 2016, determinando si hubo variaciones por región geográfica, residencia o estacionalidad. Materiales y métodos: Estudio epidemiológico, descriptivo y retrospectivo. Se utilizó el Anuario de Egresos Hospitalarios de Ecuador para determinar el número de personas de 60 ó más años hospitalizadas con fractura de cadera desde el 1 de enero hasta el 31 de diciembre de 2016. Para calcular la incidencia por 100.000 habitantes/año se utilizó como denominador la proyección poblacional ecuatoriana de la Comisión Económica para América Latina y el Caribe (CEPAL) para el año 2016. Se calculó la incidencia estandarizada por edad por el método directo usando 2 poblaciones de referencia: 1) la de 60 ó más años para América Latina elaboradas por el Centro Latinoamericano y Caribeño de Demografía (CELADE) en 2016; y 2) con la población de Ecuador del año 2010. Resultados: Un total de 2.054 personas fueron hospitalizadas con diagnóstico de fractura de cadera (1.470 mujeres y 584 hombres) en el 2016. La incidencia anual cruda fue de 123 casos por 100.000 habitantes/año (74,6 por 100.000 hombres/año y 165,8 por 100.000 mujeres/año). La incidencia ajustada por edad aumentó exponencialmente con la edad en ambos sexos, y en mayor magnitud en las mujeres. La incidencia estandarizada con la población de América Latina fue de 165,4 y 80,1 por 100.000/año, en mujeres y hombres respectivamente. La mortalidad intrahospitalaria fue 5,1% y 3,8% en mujeres y hombres, respectivamente. Conclusiones: La incidencia de fracturas de cadera es mayor en mujeres que en hombres, existiendo un aumento exponencial con la edad, siendo más evidente después de los 80 años. No hubo diferencias por región geográfica. En comparación con países desarrollados y otros países de América Latina la incidencia de fracturas de cadera fue más baja en Ecuador.

Priscila E Parra-Pingel,1,2 Luis A Quisiguiña-Avellán,1,2 Luis Hidalgo,1,2 Peter Chedraui,1,2 Faustino R Pérez-López3 1High Risk Pregnancy Labor and Delivery Unit, Enrique C. Sotomayor Obstetrics and Gynecology Hospital Guayaquil, 2Institute of Biomedicine, Research Area for Women’s Health, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador; 3Department of Obstetrics and Gynecology, Hospital Universitario Lozano Blesa, Facultad de Medicina Universidad de Zaragoza, Zaragoza, Spain Background: Adolescent mothers are at higher risk for preeclampsia, but the effect of their age on the outcome of the pregnancy complication is not clear.Objective: To describe maternal and neonatal outcomes among singleton adolescent pregnancies complicated with severe preeclampsia in a low-income-setting hospital and compare results according to age.Materials and methods: Maternal and neonatal outcomes of 213 adolescent mothers complicated with severe preeclampsia delivering at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital (Guayaquil, Ecuador) were analyzed and compared according to their age (16 or less years, n=82 vs 17–19 years, n=131).Results: Cesarean section rate was high in both studied groups; otherwise, obstetrical outcome did not differ and there were no maternal deaths or severe complications. Neonatal outcome was adverse in the two groups evidenced by high rates of preterm birth, small-for-gestational-age and low-birth-weight infants, low first-minute Apgar scores and admissions to neonatal intensive care; however, it was not significantly different between the analyzed groups. There were no neonatal deaths among mothers aged 16 or less and 4 in the group aged 17–19 years. This was, however, not significant (p=0.30).Conclusion: Pregnancy outcome in this adolescent population with severe preeclampsia was similarly adverse, independent of maternal age. Keywords: preeclampsia, adolescents, Ecuador, neonatal, maternal, outcome

Background. Advances in information and communication technologies (ICTs) represent a growing platform for the expansion of healthcare related services, but there is little information on how generational differences might account for distinct patterns of use and interest for ICTs. Our study aims to achieve a better understanding on how generational cohorts might influence the use and preferences for ICTs among patients with obstructive lung diseases in Latin America. Materials and Methods. We conducted an anonymous cross-sectional survey-based study, involving 968 patients with obstructive lung diseases (OLD) in Latin America. Patients rated their frequency of use and preferences of ICTs through a modified version of the Michigan Questionnaire. Chi-square test for association and adjusted regression analyses were performed. Results. Of all, 63.6% of participants had Internet access. Younger generations, in particular Generation Z and Millennials, had the highest rate of Internet access and smartphone ownership, as well as of overall frequency of ICT use. Web-based Internet was found to be the main source to seek information about the disease (36.9%) across all generational cohorts. Generation Z and Millennials presented the highest odds to be interested in using Twitter (OR 31.79 and 8.86) for receiving health-related information, and email (OR 4.87 and 4.86) as the preferred way to ask physicians information related to their disease through ICTs. Conclusion. Generational cohorts influence the use and preferences for ICTs among patients with obstructive lung diseases. Younger generational cohorts were associated with higher access to the Internet and smartphone ownership, as well as higher interest for using ICTs to receive and ask for health-related information.

Somatosensory evoked potentials (SSEPs) are a valuable tool to assess functional integrity of the somatosensory pathways and for the prediction of sensorimotor outcome in perinatal injuries, such as perinatal hypoxia-ischemia (HI). In the present research, we studied the translational potential of SSEPs together with sensory function in the male adult rat with perinatal HI compared to the male healthy adult rat. Both somatosensory response and evoked potential were measured at 10-11 months after global perinatal HI. Clear evoked potentials were obtained, but there were no group differences in the amplitude or latency of the evoked potentials of the preceding sensory response. The bilateral tactile stimulation test was also normal in both groups. This lack of effect may be ascribed to the late age-of-testing and functional recovery of the rats.

Faustino R Pérez-López1,2, José J Tobajas1,3, Peter Chedraui41Department of Obstetrics and Gynecology, Facultad de Medicina, Universidad de Zaragoza; 2Hospital Clínico Lozano Blesa; 3Hospital Universitario Miguel Servet, Zaragoza, Spain; 4Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, EcuadorAbstract: Female genital Actinomyces infection is relatively rare, although strongly related to long-lasting intrauterine contraceptive device (IUD) application. An infective pathway has been postulated extending upward from the female perineum to the vagina and cervix. The traumatic effect of the device and a prior infection may contribute to the Actinomyces infection in the female genitalia. This disease is characterized by local swelling, suppuration, abscess formation, tissue fibrosis, tubal-ovarian mass and fistula formation. The infection spreads by contiguity often mimicking the characteristics of a malignant neoplastic process. Currently there is no consensus regarding diagnosis and screening tests, although there seems to be agreement in relation to IUD type, duration, and sexual behavior as major risk factors.Keywords: contraception, intrauterine contraceptive device, pelvic actinomycosis, sexuality

Introducción. Pocos estudios han comparado el impacto del climaterio en la calidad de vida (CV) en diferentes etnias latinoamericanas. Objetivo: Evaluar la CV en mujeres postmenopáusicas colombianas de tres etnias distintas. Material y método: Estudio descriptivo transversal que incluyó mujeres sanas entre 40 y 59 años de edad, pertenecientes a las etnias hispánicas, indígenas y negras. La población evaluada hace parte del Estudio Calidad de Vida en la Menopausia y Etnias Colombianas (Cavimec). El instrumento utilizado para valorar CV fue el Menopause Rating Scale. Resultados: Se estudiaron 579 mujeres postmenopáusicas, 153 hispánicas, 295 indígenas y 131 afrodescendientes. Las hispánicas tenían en promedio 55,3 (DE 3,3) años de edad, 6,4 (DE 3,5) años de escolaridad y habían presentado su menopausia a los 48,3 (DE 2,5) años. Comparadas con las hispánicas, las indígenas tenían una edad similar, menor escolaridad (2,2 [DE 1,8] años, p

Introducción: Es diferente la prevalencia y la severidad delos síntomas relacionados con la menopausia cuando seevalúan diferentes grupos étnicos o poblacionales. Se haseñalado que las mujeres de raza negra pueden tenermayor riesgo de oleadas de calor que las mujeres caucási-cas. Objetivos: Evaluar la frecuencia y severidad desíntomas menopáusicos entre mujeres afro descendientescolombianas. Método: Estudio transversal, parte delproyecto CAVIMEC (Calidad de vida en la menopausia yetnias colombianas), realizado en mujeres afro descendien-tes colombianas entre 40 y 59 años. Fueron evaluadas conMenopause Ranting Scale (MRS) para establecer lafrecuencia e intensidad de síntomas menopáusicos.Resultados: 201 mujeres afro descendientes colombianasfueron incluidas. La edad promedio fue de 47.2±5.2 años,estando el 43% en premenopausia, 18% en perimenopausiay 38% en postmenopausia; el tiempo promedio desde laúltima regla fue de 3.2±2.7 años y con edad promedio de lamenopausia fue 45.9±4.8 años; el 50% de las pacientes conmenopausia natural. La mitad de las participantes manifestótener síntomas de menopausia, siendo moderados en el28% y severos o muy severos en el 9%. El 77% presentasíntomas musculares o articulares, 54% oleadas de calor,64% irritabilidad y 16% problemas vesicales. La puntuaciónde MRS fue: dimensión somático-vegetativa 5.0±3.3,psicológica 4.8±3.3 y global 10.6±6.3. Conclusión: Enmujeres afro descendientes colombianas se observaelevada puntuación en la escala MRS, dada por una elevadapresencia de síntomas somático-vegetativos y psicológicos.La puntuación observada supera significativamente la deotras poblaciones tomadas como referente.