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Apoyo político y microplanificación como factores de éxito para una campaña de vacunación de seguimiento de alta calidad, Ecuador, 2023
(Pan American Health Organization, 2025-04-09)
Gabriela Aguinaga-Romero
;
Cristina Jacome
;
Jonathan Márquez
;
Jackeline Pinos
;
Ania Carmenates
Objective. To describe the results, achievements, and lessons learned through administrative coverage and rapid monitoring of a follow-up vaccination campaign, in the context of political prioritization and micro-planning as determining factors in the different stages of follow-up campaigns, and the application of these good practices to strengthen the National Immunization Program. Method. This is a special descriptive epidemiological report on a high-quality follow-up vaccination campaign in Ecuador. The sources of information used were: population estimates from the 2010 and 2022 censuses carried out by the National Institute of Statistics and Census; calculation of the susceptible cohort for vaccination with the bivalent vaccine (measles and rubella) and with the oral and injectable polio vaccines; definition of vaccination strategies and tactics, and vaccine scheduling by type and age group; and macro- and micro-planning instruments generated at the local level, which involve quantitative variables related to human, material, logistic, and financial resources. Achievement of high-quality criteria and indicators for follow-up vaccination campaigns were also assessed, including effectiveness, homogeneity, timeliness, simultaneity, efficiency, and rapid monitoring. Results. The micro-planning process was fully implemented nationwide in 95% of health facilities (1879) four weeks prior to implementation of the follow-up campaign. High-quality follow-up was conducted over 14 weeks: 3 395 716 children aged 1-12 years were vaccinated and 99% administrative coverage was achieved, with 71% of provinces (17) reaching ≥95% coverage. In the remaining 29% of provinces (7), coverage rates were between 90% and 94%, with a total of 5 556 128 doses of bivalent vaccine and oral or injectable polio vaccine. Based on the quality criteria, the country achieved 95% of the targeted results. Conclusions. Political support and prioritization, together with the implementation of high-quality micro-planning of the follow-up vaccination campaign generated at the local level, enabled the achievement of targets and results at ≥95% coverage. This is an innovative and successful public health experience that has strengthened the National Immunization Program in Ecuador and other countries in the Region of the Americas. Local health teams conducted micro-planning adapted to the local context, using the methodology and instruments to identify areas of responsibility in orderly, systematic intramural and extramural vaccination campaigns.
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Management of Maxillary Incisors With Middle‐Third Root Perforation: A Case Report
(Wiley, 2024-01)
Daysi Morocho-Monteros
;
María José Masson-Palacios
;
Juan Marcos Parise-Vasco
;
Sivakumar Nuvvula
Root canal perforations are frequent but critical complications in endodontic treatments, which can pose a risk of irreversible damage to the affected tooth. These perforations typically occur during root canal preparation or endodontic post placement, presenting significant therapeutic challenges. The main objective in the management of such complications is to seal the perforation, thus preventing bacterial invasion and tooth loss. This report details the case of a 70‐year‐old patient with a perforation in the palatal wall of the middle root section of tooth #11. The treatment approach involved magnification techniques and the application of a bioactive material known as Biodentine. This case underscores the critical role of accurate radiographic evaluation and the use of biocompatible materials in the management of root perforations. Despite inherent challenges, proper diagnosis and planning, combined with appropriate techniques and materials, can lead to satisfactory results, effectively preserving the structure of the tooth.
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Late complication due to rhinoplasty with non-absorbable tension threads: A case report
(Elsevier BV, 2025-07)
Yekaterina Altuna-Roshkova
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VILLARREAL ORTIZ, GHISLAYNE DANIELA
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Diana Villarroel-Mosquera
;
Jaime Angamarca-Iguago
;
Juan Marcos Parise-Vasco
Introduction: Rhinomodeling is a minimally invasive aesthetic procedure that offers quick recovery and lower costs compared to surgical rhinoplasty. However, the use of non-absorbable tension threads can lead to late complications requiring surgical intervention. Case presentation: A 27-year-old female patient underwent rhinomodeling with non-absorbable tension threads ten years ago. She presented with nasal asymmetry, respiratory difficulty, and a foreign body sensation in the left nasal cavity. Clinical examination revealed left-sided laterorhinia, asymmetric nasal cavities, and a protruding tension thread. An open rhinoseptoplasty was performed, revealing thread extrusion, granuloma formation, and partial rupture of the right alar cartilage. The thread was removed, and structural correction was performed with septoplasty and cartilage grafting. Discussion: Unlike absorbable threads, which degrade within months, non-absorbable threads can cause late complications requiring surgical removal. Conclusion: This case highlights a late complication of rhinomodeling, previously described but underreported, requiring surgical intervention ten years later. Open rhinoseptoplasty successfully restored nasal function and aesthetics, emphasizing the importance of long-term follow-up and professional expertise.
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Quality Assessment of Clinical Practice Guidelines for the Management and Surgical Treatment of Female Stress Urinary Incontinence
(Wiley, 2025-01-10)
Mario Vásquez-Peralta
;
Alison Simancas-Racines
;
Juan Marcos Parise-Vasco
;
Camila Montesinos-Guevara
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SIMANCAS RACINES, DANIEL ALEJANDRO
Clinical practice guidelines (CPGs) are tools developed to support evidence‐based decision making in healthcare. However, despite the availability of CPGs for the surgical management of female stress urinary incontinence (FSUI), their methodological quality has not been evaluated. The aim of this study was to assess the methodological quality of published guidelines for the surgical management of FSUI using the AGREE II tool. A systematic search of CPGs published between 2017 and 2023 was performed in databases including MEDLINE/PubMed, LILACS, Scopus, and Trip Medical Database. Data extraction and guideline selection were performed independently by two reviewers, as was the assessment using the AGREE II instrument. Of 1459 initial records, six guidelines met the eligibility criteria. The scores for each domain evaluated were as follows: scope and purpose (45.83%; SD: 22.69), stakeholder participation (30.56%; SD: 29.03), development (48.56%; SD: 30.42), presentation clarity (58.80%; SD: 22.25), applicability (24.04%; SD: 26.36), and editorial independence (44.87%; SD: 32.88). One of the six included CPGs was rated as high quality and recommended for clinical practice. Three CPGs with modifications were recommended because there were still areas that needed improvement to enhance their quality, and two CPGs were not recommended for clinical practice because the six domains evaluated scored below 60%. According to these findings, it is essential that new CPGs developed for the surgical management of FSUI adhere to greater methodological rigor to ensure that recommendations are based on the best available evidence. Furthermore, guidelines should take into account patient values and clinical expertise to improve and facilitate effective healthcare decision making.
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Effectiveness and Safety of Preoperative Nutritional Interventions on Surgical Outcomes in Patients Undergoing Metabolic and Bariatric Surgery: A Systematic Review and Meta-Analysis
(MDPI AG, 2025-04-30)
Simancas-racines Daniel
;
Reytor-gonzález Claudia
;
Juan Marcos Parise-Vasco
;
Jaime Angamarca-Iguago
;
Eloisa Garcia-Velasquez
Background: Preoperative nutritional interventions, including low-calorie diets (LCDs) and very low-calorie diets (VLCDs), are commonly implemented in metabolic and bariatric surgery. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of preoperative dietary interventions in patients undergoing bariatric surgery, with primary outcomes including perioperative complications, operative time, and length of hospital stay. Methods: A systematic review and meta-analysis were conducted, including studies that compared LCD and VLCD with regular diets in adults undergoing bariatric surgery. The primary outcomes assessed were perioperative complications, operative time, and length of hospital stay. Random- and fixed effects models were used for quantitative synthesis. Risk of bias was evaluated using the Cochrane Risk of Bias tool and ROBINS-I, while the certainty of evidence was assessed using the GRADE approach. Results: Eight trials comprising 1197 patients were included in the meta-analysis. VLCDs were associated with a significant reduction in perioperative complications (OR 0.59; 95% CI: 0.37–0.94; p = 0.03), whereas LCDs showed no significant effect on complications (OR 1.64; 95% CI: 0.71–3.78; p = 0.25). No significant reduction in operative time was observed (MD −2.64 min; 95% CI: −6.01 to 0.73; p = 0.12). Hospital stay was slightly reduced (MD −0.17 days; p = 0.0001), though the clinical significance remains uncertain. The certainty of evidence was low, primarily due to the risk of bias and small sample sizes. Conclusions: VLCDs may lower the risk of perioperative complications, while LCDs do not appear to provide this benefit. However, the evidence is limited by methodological heterogeneity and low certainty. Further high-quality studies are needed to establish optimal preoperative nutritional protocols.

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