Facultad de Odontología
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Item type:Publication, El triple brote en Ecuador: entre la sindemia y la infodemia(2025) ;SIMANCAS RACINES, DANIEL ALEJANDRO ;REYTOR GONZÁLEZ, CLAUDIA MARÍACAGUA ORDONEZ, JAEN CARLOSBrotes simultáneos de tosferina, fiebre amarilla y leptospirosis en zonas rurales y amazónicas del Ecuador evidenciaron una combinación crítica de factores estructurales y sanitarios. La baja cobertura de vacunación, la escasez de servicios básicos, la pobreza, la desnutrición infantil y la limitada capacidad de vigilancia epidemiológica contribuyeron a una mayor carga de enfermedad. Estos eventos, potenciados por una infodemia marcada por desinformación y alarma social, configuraron una sindemia con consecuencias desproporcionadas en poblaciones vulnerables. Ante este escenario, resultan prioritarias acciones integradas que fortalezcan el primer nivel de atención, promuevan la comunicación en salud adaptada al contexto y garanticen condiciones dignas de vida como ejes fundamentales de una respuesta sindémica integral, equitativa y resiliente. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Food insecurity and sociodemographic factors in Latin America during the COVID-19 pandemic(Pan American Health Organization, 2018) ;Novoa Sanzana Stephanie ;Moya Valero José ;MOREJÓN TERÁN, YADIRA ALEJANDRACastillo-bellot IsraelObjective. To understand the association of food insecurity with sociodemographic factors in a sample population in Latin America during the COVID-19 pandemic. Methods. This was a multicenter cross-sectional study conducted in 10 countries in Latin America using an online survey through various digital platforms from October 14, 2020 to February 15, 2021. Statistical analysis of data was performed by applying descriptive statistics, chi-square test, and logistic regression analysis. Results. Of a total of 6 357 surveys, 58.2% of respondents experienced food security, 29.3% were slightly food insecure, 9.2% were moderately food insecure, and 3.3% were severely food insecure. Concerning the association food insecurity and sociodemographic variables, there is a significant association in the variables studied, including area of residence, education level, occupation, number of persons in the household, household with children younger than 10 years of age, and socioeconomic level. Conclusions. These findings indicate that sociodemographic factors associated with food insecurity during the COVID-19 pandemic in Latin America were rural residence; complete and incomplete basic and secondary schooling; occupation (homemaker, unemployed, and self-employed); low, medium-low, and medium socioeconomic level; household with more than four persons; and household with children younger than 10 years of age.Scopus© Citations 13 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Plant Biodiversity Knowledge Varies by Gender in Sustainable Amazonian Agricultural Systems Called Chacras(MDPI AG, 2019-08-04); ;Míriam Hernández del Barco ;José Blanco-Salas ;Carlos E. Cerón-MartínezTrinidad Ruiz-Téllez<jats:p>Chacras, which are Amazonian agricultural systems, are examples of traditional agricultural management that are sustainable. They are also characteristic of the identities of different ethnographic groups in tropical America. However, information regarding the botanical characterization of chacras is scant. In tropical rural communities, there is a gender bias hypothesis that makes women potential reservoirs of traditional chacras plant knowledge. We present an experimental study in order to demonstrate if this knowledge difference really exists and to plan accordingly. We performed workshops in an isolated Kichwa community from Amazonian Ecuador. We calculated the cultural signififcance index (CSI) for 97 local flora plants. Our results revealed statistically significant differences. They were coherent with the Kichwa worldview and the structure of their society. We concluded that gender perspective must be taken into account in biodiversity conservation programs, such as, for example, those to implement the resilient agricultural practices of tropical contexts promoted by The United Nations Sustainable Development Goal 2 (SGD2).</jats:p>Scopus© Citations 16 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Drug treatments for covid-19: living systematic review and network meta-analysis(BMJ, 2020-07-30) ;Reed AC Siemieniuk ;Jessica J Bartoszko ;Dena Zeraatkar ;Elena KumAnila Qasim<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Objective</jats:title> <jats:p>To compare the effects of treatments for coronavirus disease 2019 (covid-19).</jats:p> </jats:sec> <jats:sec> <jats:title>Design</jats:title> <jats:p>Living systematic review and network meta-analysis.</jats:p> </jats:sec> <jats:sec> <jats:title>Data sources</jats:title> <jats:p>WHO covid-19 database, a comprehensive multilingual source of global covid-19 literature, up to 3 December 2021 and six additional Chinese databases up to 20 February 2021. Studies identified as of 1 December 2021 were included in the analysis.</jats:p> </jats:sec> <jats:sec> <jats:title>Study selection</jats:title> <jats:p>Randomised clinical trials in which people with suspected, probable, or confirmed covid-19 were randomised to drug treatment or to standard care or placebo. Pairs of reviewers independently screened potentially eligible articles.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>After duplicate data abstraction, a bayesian network meta-analysis was conducted. Risk of bias of the included studies was assessed using a modification of the Cochrane risk of bias 2.0 tool, and the certainty of the evidence using the grading of recommendations assessment, development, and evaluation (GRADE) approach. For each outcome, interventions were classified in groups from the most to the least beneficial or harmful following GRADE guidance.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>463 trials enrolling 166 581 patients were included; 267 (57.7%) trials and 89 814 (53.9%) patients are new from the previous iteration; 265 (57.2%) trials evaluating treatments with at least 100 patients or 20 events met the threshold for inclusion in the analyses. Compared with standard care, three drugs reduced mortality in patients with mostly severe disease with at least moderate certainty: systemic corticosteroids (risk difference 23 fewer per 1000 patients, 95% credible interval 40 fewer to 7 fewer, moderate certainty), interleukin-6 receptor antagonists when given with corticosteroids (23 fewer per 1000, 36 fewer to 7 fewer, moderate certainty), and Janus kinase inhibitors (44 fewer per 1000, 64 fewer to 20 fewer, high certainty). Compared with standard care, two drugs probably reduce hospital admission in patients with non-severe disease: nirmatrelvir/ritonavir (36 fewer per 1000, 41 fewer to 26 fewer, moderate certainty) and molnupiravir (19 fewer per 1000, 29 fewer to 5 fewer, moderate certainty). Remdesivir may reduce hospital admission (29 fewer per 1000, 40 fewer to 6 fewer, low certainty). Only molnupiravir had at least moderate quality evidence of a reduction in time to symptom resolution (3.3 days fewer, 4.8 fewer to 1.6 fewer, moderate certainty); several others showed a possible benefit. Several drugs may increase the risk of adverse effects leading to drug discontinuation; hydroxychloroquine probably increases the risk of mechanical ventilation (moderate certainty).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Corticosteroids, interleukin-6 receptor antagonists, and Janus kinase inhibitors probably reduce mortality and confer other important benefits in patients with severe covid-19. Molnupiravir and nirmatrelvir/ritonavir probably reduce admission to hospital in patients with non-severe covid-19.</jats:p> </jats:sec> <jats:sec> <jats:title>Systematic review registration</jats:title> <jats:p>This review was not registered. The protocol is publicly available in the supplementary material.</jats:p> </jats:sec> <jats:sec> <jats:title>Readers’ note</jats:title> <jats:p> This article is a living systematic review that will be updated to reflect emerging evidence. Updates may occur for up to two years from the date of original publication. This is the fifth version of the original article published on 30 July 2020 ( <jats:italic>BMJ</jats:italic> 2020;370:m2980), and previous versions can be found as data supplements. When citing this paper please consider adding the version number and date of access for clarity. </jats:p> </jats:sec>Scopus© Citations 685 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Effects of Preoperative Exercise Interventions in Patients Undergoing Metabolic and Bariatric Surgery: A Systematic Review and Meta-Analysis(MDPI AG, 2025-09-01) ;SIMANCAS RACINES, DANIEL ALEJANDRO ;PARISE VASCO, JUAN MARCOS ;ANGAMARCA IGUAGO, JAIME WLADIMIR ;Ashley Carolina Cuzco MaciasCarlos SoriaBackground: Obesity affects over one billion people globally. Bariatric surgery is the most effective long-term intervention for severe obesity. However, postoperative outcomes can vary considerably, with such factors as baseline fitness and cardiorespiratory reserve influencing surgical outcomes. This systematic review aimed to evaluate the effects of preoperative exercise or physical activity, compared to standard care or no intervention, on preoperative fitness parameters and perioperative surgical outcomes in adults with obesity undergoing metabolic and bariatric surgery. Methods: A systematic review was conducted in accordance with the recommendations of the Cochrane Handbook and the PRISMA guidelines. Randomized controlled trials, non-randomized controlled trials, and cohort studies with control groups evaluating preoperative exercise interventions were included. Two independent reviewers conducted study selection, data extraction, and risk of bias assessment using Cochrane tools. Meta-analyses were performed using random effects models, with standardized mean differences calculated for continuous outcomes. Evidence certainty was assessed using the GRADE approach. Results: A total of 15 studies, including 1378 participants, were identified for qualitative synthesis, with 12 contributing data for quantitative meta-analysis. Preoperative exercise interventions significantly improved six-minute walk test distance (SMD 2.01; 95% CI: 0.51 to 3.50; p = 0.009) and VO2 peak (SMD 1.02; 95% CI: 0.52 to 1.51; p < 0.0001). BMI reduction was significant (SMD −0.96; 95% CI: −1.75 to −0.16; p = 0.02), while weight change was not statistically significant (SMD −0.81; 95% CI: −1.72 to 0.09; p = 0.08). One study reported a reduction in hospital length of stay of 0.64 days (95% CI: −0.86 to −0.42; p < 0.00001). Evidence certainty was rated as very low to low across all outcomes. Conclusions: Preoperative exercise interventions have been shown to significantly improve cardiorespiratory fitness in bariatric surgery candidates, with large effect sizes for functional capacity measures. Despite the low certainty of the evidence, these findings suggest that supervised exercise programs should be incorporated into the preoperative care of bariatric surgery patients.Scopus© Citations 2 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Adenomatoid odontogenic tumor in an unusual posterior maxillary location: a rare case report in a young male(Frontiers Media SA, 2025-12-17) ;GONZÁLEZ CALZADA, NATALIA ;Estefanía Chávez-Mestanza ;Náthaly Mercedes Román-Galeano ;Claudia Reytor-GonzálezDaniel Simancas-RacinesThe adenomatoid odontogenic tumor is a rare benign epithelial odontogenic neoplasm that most frequently affects young women and typically occurs in the anterior maxilla. Its presentation in the posterior maxilla, especially in male patients, is uncommon and can create diagnostic challenges. This case describes a large posterior maxillary adenomatoid odontogenic tumor in a 16-year-old male who presented with a one-year history of progressive, painless swelling of the right cheek. Clinical examination revealed facial asymmetry, obliteration of the right nasolabial fold, and intraoral swelling extending from tooth 1.5 to the posterior maxilla. Panoramic radiography and computed tomography showed a multilocular radiolucent lesion with a “soap bubble” appearance, internal calcifications, and displacement of tooth 1.8 toward the floor of the right orbit, which remained intact. The lesion caused root resorption of adjacent teeth and extensive destruction of the maxillary bone. Surgical treatment consisted of enucleation and extraction of teeth 1.5–1.8, followed by histopathological confirmation of adenomatoid odontogenic tumor. Due to the degree of bone involvement, a subsequent wide resection of critical maxillofacial structures was necessary. Postoperative follow-up at five months showed no recurrence but significant residual anatomical changes. This case emphasizes the importance of including adenomatoid odontogenic tumor in the differential diagnosis of posterior maxillary lesions in male patients, and the need for careful surgical planning, histopathological confirmation, and long-term follow-up. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Self-Reported Prevalence of Chronic Non-Communicable Diseases Concerning Socioeconomic and Educational Factors: Analysis of the PURE-Ecuador Cohort(Ubiquity Press, Ltd., 2025-03-13); ; ;Michelle Vega ;Katherine AndrangoSelena AndrangoBackground: The changing epidemiological landscape, marked by the increasing prominence of Non-Communicable Chronic Diseases (NCDs), underscores the need for studies that identify and analyze these conditions and their associated risk factors. This secondary analysis aims to describe the association between socioeconomic and educational characteristics and the prevalence of self-reported NCDs among participants in the PURE-Ecuador cohort in urban and rural populations of the Metropolitan District of Quito (MDQ), Ecuador. Methods: This secondary analysis is part of the Prospective Urban Rural Epidemiological (PURE) study. Data were collected from February to December 2018, including 2028 participants aged 35 to 70 years from different urban and rural areas of the MDQ. Data collection utilized standardized questionnaires administered in face-to-face interviews. Pearson’s chi-square tests and multivariate logistic regression were used to assess associations. Results: The self-reported prevalence of hypertension was 16.2%, rising to 32.7% in individuals over 60 years old. The prevalence of diabetes mellitus was 6.7%, coronary heart disease 1.3%, stroke 1.6%, heart failure 1.3%, COPD 0.4%, asthma 1.3%, and cancer 1.9%. Multimorbidity affected 5.9% of participants, with the highest rates in obese and older individuals (≥60 years). Adherence to medications was high for hypertension and diabetes mellitus but varied substantially between communities. Conclusions: The secondary analysis revealed significant disparities in the prevalence and management of NCDs in MDQ. The prevalence of self-reported NCDs in Quito, Ecuador, is significantly associated with age and body mass index (BMI). Older individuals, particularly those over 60 years, and obese participants demonstrated higher rates of NCDs and multimorbidity. While socioeconomic factors such as education and income showed some associations with NCD prevalence, these were less pronounced after adjusting for other variables. These findings highlight the importance of age-specific and obesity-focused interventions in addressing the burden of NCDs in this population.Scopus© Citations 3 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Orthopedic Management of a Class III Malocclusion With Deep Anterior Crossbite and Transverse Discrepancy: A Case Report(Wiley, 2025-10-11) ;César Sebastián Arcos-López ;Marco González; ;PARISE VASCO, JUAN MARCOSNihat KılıçClass III malocclusion is a dentoskeletal condition characterized by altered relationships between bones, teeth, and muscular structures. Sagittal and transversal maxillary deficiency is one of the most common patterns, negatively affecting facial esthetics and the psychosocial well‐being of the patient. This case report describes an 11‐year‐old male patient with Class III skeletal malocclusion, a deep anterior crossbite, and a transverse discrepancy. Orthodontic treatment was performed with a mini‐implant assisted rapid palatal expansion (MARPE 2S), anchored in the maxilla with two mini‐implants, combined with four additional components: two for a face mask and two for the Ertty Gap III protocol, as well as a lip bumper with flanges for 5/16 heavy intermaxillary elastics in Class III mechanics for 24 h a day, attached to a soldered lingual arch. The combination of these orthopedic devices synergistically improved expansion and anteroposterior changes, resulting in significant functional, esthetic, and psychological improvements for the patient. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Interleukin-receptor antagonist and tumour necrosis factor inhibitors for the primary and secondary prevention of atherosclerotic cardiovascular diseases(Wiley, 2024-09-19) ;MARTI CARVAJAL, ARTURO JOSE ;Mario A Gemmato-Valecillos ;Diana Monge Martín ;Mark DayerEduardo Alegría-BarreroBackground: Atherosclerotic cardiovascular disease (ACVD) is worsened by chronic inflammatory diseases. Interleukin receptor antagonists (IL-RAs) and tumour necrosis factor-alpha (TNF) inhibitors have been studied to see if they can prevent cardiovascular events. Objectives: The purpose of this study was to assess the clinical benefits and harms of IL-RAs and TNF inhibitors in the primary and secondary prevention of ACVD. Search methods: The Cochrane Heart Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE (including In-Process & Other Non-Indexed Citations), Ovid Embase, EBSCO CINAHL plus, and clinical trial registries for ongoing and unpublished studies were searched in February 2024. The reference lists of relevant studies, reviews, meta-analyses and health technology reports were searched to identify additional studies. No limitations on language, date of publication or study type were set. Selection criteria: RCTs that recruited people with and without pre-existing ACVD, comparing IL-RAs or TNF inhibitors versus placebo or usual care, were selected. The primary outcomes considered were all-cause mortality, myocardial infarction, unstable angina, and adverse events. Data collection and analysis: Two or more review authors, working independently at each step, selected studies, extracted data, assessed the risk of bias and used GRADE to judge the certainty of evidence. Main results: We included 58 RCTs (22,053 participants; 21,308 analysed), comparing medication efficacy with placebo or usual care. Thirty-four trials focused on primary prevention and 24 on secondary prevention. The interventions included IL-1 RAs (anakinra, canakinumab), IL-6 RA (tocilizumab), TNF-inhibitors (etanercept, infliximab) compared with placebo or usual care. The certainty of evidence was low to very low due to biases and imprecision; all trials had a high risk of bias. Primary prevention: IL-1 RAs The evidence is very uncertain about the effects of the intervention on all-cause mortality(RR 0.33, 95% CI 0.01 to 7.58, 1 trial), myocardial infarction (RR 0.71, 95% CI 0.04 to 12.48, I² = 39%, 2 trials), unstable angina (RR 0.24, 95% CI 0.03 to 2.11, I² = 0%, 2 trials), stroke (RR 2.42, 95% CI 0.12 to 50.15; 1 trial), adverse events (RR 0.85, 95% CI 0.59 to 1.22, I² = 54%, 3 trials), or infection (rate ratio 0.84, 95% 0.55 to 1.29, I² = 0%, 4 trials). Evidence is very uncertain about whether anakinra and cankinumab may reduce heart failure (RR 0.21, 95% CI 0.05 to 0.94, I² = 0%, 3 trials). Peripheral vascular disease (PVD) was not reported as an outcome. IL-6 RAs The evidence is very uncertain about the effects of the intervention on all-cause mortality (RR 0.68, 95% CI 0.12 to 3.74, I² = 30%, 3 trials), myocardial infarction (RR 0.27, 95% CI 0.04 to1.68, I² = 0%, 3 trials), heart failure (RR 1.02, 95% CI 0.11 to 9.63, I² = 0%, 2 trials), PVD (RR 2.94, 95% CI 0.12 to 71.47, 1 trial), stroke (RR 0.34, 95% CI 0.01 to 8.14, 1 trial), or any infection (rate ratio 1.10, 95% CI: 0.88 to 1.37, I2 = 18%, 5 trials). Adverse events may increase (RR 1.13, 95% CI 1.04 to 1.23, I² = 33%, 5 trials). No trial assessed unstable angina. TNF inhibitors The evidence is very uncertain about the effects of the intervention on all-cause mortality (RR 1.78, 95% CI 0.63 to 4.99, I² = 10%, 3 trials), myocardial infarction (RR 2.61, 95% CI 0.11 to 62.26, 1 trial), stroke (RR 0.46, 95% CI 0.08 to 2.80, I² = 0%; 3 trials), heart failure (RR 0.85, 95% CI 0.06 to 12.76, 1 trial). Adverse events may increase (RR 1.13, 95% CI 1.01 to 1.25, I² = 51%, 13 trials). No trial assessed unstable angina or PVD. Secondary prevention: IL-1 RAs The evidence is very uncertain about the effects of the intervention on all-cause mortality (RR 0.94, 95% CI 0.84 to 1.06, I² = 0%, 8 trials), unstable angina (RR 0.88, 95% CI 0.65 to 1.19, I² = 0%, 3 trials), PVD (RR 0.85, 95% CI 0.19 to 3.73, I² = 38%, 3 trials), stroke (RR 0.94, 95% CI 0.74 to 1.2, I² = 0%; 7 trials), heart failure (RR 0.91, 95% 0.5 to 1.65, I² = 0%; 7 trials), or adverse events (RR 0.92, 95% CI 0.78 to 1.09, I² = 3%, 4 trials). There may be little to no difference between the groups in myocardial infarction (RR 0.88, 95% CI 0.0.75 to 1.04, I² = 0%, 6 trials). IL6-RAs The evidence is very uncertain about the effects of the intervention on all-cause mortality (RR 1.09, 95% CI 0.61 to 1.96, I² = 0%, 2 trials), myocardial infarction (RR 0.46, 95% CI 0.07 to 3.04, I² = 45%, 3 trials), unstable angina (RR 0.33, 95% CI 0.01 to 8.02, 1 trial), stroke (RR 1.03, 95% CI 0.07 to 16.25, 1 trial), adverse events (RR 0.89, 95% CI 0.76 to 1.05, I² = 0%, 2 trials), or any infection (rate ratio 0.66, 95% CI 0.32 to 1.36, I² = 0%, 4 trials). No trial assessed PVD or heart failure. TNF inhibitors The evidence is very uncertain about the effect of the intervention on all-cause mortality (RR 1.16, 95% CI 0.69 to 1.95, I² = 47%, 5 trials), heart failure (RR 0.92, 95% 0.75 to 1.14, I² = 0%, 4 trials), or adverse events (RR 1.15, 95% CI 0.84 to 1.56, I² = 32%, 2 trials). No trial assessed myocardial infarction, unstable angina, PVD or stroke. Adverse events may be underestimated and benefits inflated due to inadequate reporting. Authors' conclusions: This Cochrane review assessed the benefits and harms of using interleukin-receptor antagonists and tumour necrosis factor inhibitors for primary and secondary prevention of atherosclerotic diseases compared with placebo or usual care. However, the evidence for the predetermined outcomes was deemed low or very low certainty, so there is still a need to determine whether these interventions provide clinical benefits or cause harm from this perspective. In summary, the different biases and imprecision in the included studies limit their external validity and represent a limitation to determining the effectiveness of the intervention for both primary and secondary prevention of ACVD.Scopus© Citations 6 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Interleukin-receptor antagonist and tumor necrosis factor inhibitors for the primary and secondary prevention of atherosclerotic cardiovascular diseases(Wiley, 2021-09-08) ;Arturo J Martí-Carvajal ;Juan Bautista De Sanctis ;Mark Dayer ;Cristina Elena Martí-AmaristaEduardo AlegríaScopus© Citations 2
