Neuroendoscopic septostomy in unilateral and bilateral ventricular hydrocephalus.

This study describes the results of septostomy (SPT) in terms of success and analysis of follow-up in a series of pediatric patients diagnosed with unilateral ventricular hydrocephalus (UHV) and biventricular hydrocephalus (BVH). A total of 29 pediatric patients diagnosed with UVH or BVH were included in this study. In UVH, a neuroendoscopic SPT was performed (sometimes accompanied by NEFPFMO). In those diagnosed with BVH, an SPT combined with VPS was carried out. Demographic, etiological, clinical, and diagnostic variables and percentage of treatment success were collected. SPT was successful during follow-up when no VPS was required in UVH and only unilateral VPS was implanted in BVH. At the time of surgery, 16 patients needed a ventriculoperitoneal shunt. The first SPT was successful in 22 patients, requiring a second surgery in 7 patients, from the oncology group diagnosed with BHV. The surgical management of UVH and BVH still has some disclosure points to be reviewed. However, SPT seems to be a secure, non-traumatic, and efficient procedure

Los nuevos discursos, normativas y prácticas sobre educación superior en la República del Ecuador: los énfasis en investigación e innovación

El presente trabajo trata sobre las etapas de desarrollo de la educación superior en la República del Ecuador, con énfasis en su período más reciente de desarrollo y orientando el foco de atención fundamental a las condiciones que se han desarrollado en los últimos dos lustros para hacer avanzar la investigación e innovación universitarias.Para su desarrollo los autores recurren a aspectos del discurso que se ha elaborado en las estructuras gubernamentales y del ámbito académico, elementos de la normativa que se ha establecido, así como a aspectos prácticos que ya evidencian el desarrollo de la actividad científica e innovativa en las universidades ecuatorianas.Puede afirmarse que el objetivo del presente artículo es ofrecer una panorámica del desarrollo de la educación superior en las universidades ecuatorianas, con énfasis en su función de investigación e innovación

Gestión e impacto de las investigaciones universitarias: pensando caminos para UNIANDES

Las universidades viven tiempos de cambios, asociados a demandas muy exigentes de los entornos socioeconómicos y culturales. Entre sus recursos, es hoy la investigación quien mejor puede apoyar su adaptabilidad y dotarle de creciente aceptación. Pero esta es una actividad de enorme complejidad en su organización y dirección, y para la que se requieren elevadas inversiones en talento humano y recursos financieros. Este es un panorama que involucra ya a las universidades ecuatorianas, lo cual convierte a la búsqueda de nuevas oportunidades para desarrollar la investigación científica universitaria en tarea de prioridad. El presente trabajo se ajusta a ese tipo de propósitos en lo referente a la UNIANDES y su función de investigación. Su objetivo es valorar la situación actual de la organización, dirección e impactos de la actividad de investigación de esta institución y contribuir a identificar caminos apropiados para su fortalecimiento institucional. En su desarrollo se ha optado por una lógica que comprende el análisis de referentes históricos y teóricos de la gestión e impactos de la investigación universitaria, su utilización para adelantar algunos elementos de diagnóstico situacional respecto a la investigación en UNIANDES y el planteamiento de una incipiente proyección en favor de comenzar a delinear una mejoría en sus impactos

Modelo para el desarrollo de la investigación e innovación en la Universidad Regional Autónoma de los Andes (UNIANDES, República del Ecuador)

Las universidades viven tiempos de cambios, con demandas exigentes de los entornos socioeconómicos y culturales. Entre sus recursos, es hoy la investigación quien mejor puede apoyar su adaptabilidad y aceptación. Pero esta es una actividad de enorme complejidad en su organización y dirección, y se requieren elevadas inversiones en talento humano y recursos financieros. Este panorama involucra ya a las universidades ecuatorianas, lo cual convierte a la búsqueda de nuevas oportunidades para la investigación científica en tarea de prioridad.El presente trabajo se enmarca en el campo de las Ciencias de la Educación, en particular en la subdisciplina de Gestión de la Educación. Su objetivo es: Proponer un modelo para propiciar el desarrollo de la función de investigación en la Universidad Regional Autónoma de Los Andes (UNIANDES).El modelo se estructura en torno a cuatro dimensiones básicas: 1) la formación de capacidad pre-innovativa universitaria; 2) la gestión de proyectos de investigación; 3) la gestión de información de apoyo a la investigación; y 4) la transferencia de conocimientos y tecnologías universidad – sociedad. También se incorpora una referencia al proceso de implementación de este modelo para el contexto de UNIANDES, evidenciando resultados parciales que constituyen una respuesta al llamado de la UNESCO en el sentido de que “los establecimientos de enseñanza superior deberían adoptar para su actividad de investigación conceptos y prácticas con una perspectiva de futuro que responda a las necesidades de sus entornos” (UNESCO, 1998, Citado por Tunnerman, 2010:34)

Potential research ethics violations against an indigenous tribe in Ecuador: a mixed methods approach

BACKGROUND: Biomedical and ethnographic studies among indigenous people are common practice in health and geographical research. Prior health research misconduct has been documented, particularly when obtaining genetic material. The objective of this study was to crossmatch previously published data with the perceptions of the Waorani peoples about the trading of their genetic material and other biological samples.METHODS: We conducted a mixed methods study design using a tailored 15-item questionnaire in 72 participants and in-depth interviews in 55 participants belonging to 20 Waorani communities about their experiences and perceptions of participating in biomedical research projects. Additionally, we conducted a systematic review of the literature in order to crossmatch the published results of studies stating the approval of an ethics committee and individual consent within their work.RESULTS: A total of 40 men (60%) and 32 women (40%), with a mean age of 57 ± 15 years agreed to be interviewed for inclusion. Five main categories around the violation of good clinical practices were identified, concerning the obtention of blood samples from a recently contacted Waorani native community within the Amazonian region of Ecuador. These themes are related to the lack of adequate communication between community members and researchers as well as the voluntariness to participate in health research. Additionally, over 40 years, a total of 38 manuscripts related to the use of biological samples in Waorani indigenous people were published. The majority of the studies (68%) did not state within their article obtaining research ethics board approval, and 71% did not report obtaining the informed consent of the participants prior to the execution of the project.CONCLUSION: Clinical Research on the Waorani community in the Ecuadorian Amazon basin has been performed on several occasions. Unfortunately, the majority of these projects did not follow the appropriate ethical and professional standards in either reporting the results or fulfilling them. The results of our investigation suggest that biological material, including genetic material, has been used by researchers globally, with some omitting the minimum information required to guarantee transparency and good clinical practices. We highlight the importance of stating ethics within research to avoid breaches in research transparency.</p

Thyroid Cancer in Ecuador, a 16 years population-based analysis (2001–2016)

Abstract Background Thyroid cancer is the most frequent endocrine neoplasia worldwide. Information from Andean countries is scarce. In Ecuador there is no reports available of the epidemiology of this type of cancer. The aim of this study is to present the epidemiology and the burden of disease of thyroid cancer. Methods This is a cross-sectional population-based analysis of thyroid cancer epidemiology in Ecuador from 2001 to 2016. The variables studied were the overall mortality rate, socio-demographics characteristics of the hospitalized patients, geographical trends and the burden of thyroid cancer in Ecuador. All the data was obtained from the official records reported by the Ministry of Public Health’s and retrieved from the public databases of the Vital Statistics Deaths and Births Databases and the National Institute of Census and Statistics (INEC). Results In Ecuador, over a period of 16 years from 2001 to 2016 a total of 23,632 hospital admissions were reported, which caused 1539 deaths due thyroid cancer. Data demonstrated an annual mean of 1477 cases, which caused 96 deaths per year in average. The annual incidence fluctuated from 3 in 2001 to 22 in 2016 per 100,000 inhabitants. Women were 5 times more likely than men to have thyroid cancer. The average length of stay for both sexes were 4 days. The mortality attributable to thyroid cancer represent less than 0.3% of all cancer deaths. Conclusion Ecuador has one of the highest rates of thyroid cancer in Latin America, ranking first among women in Latin America. Although this cancer is frequent, mortality rate is relatively low. As this is the first national report of thyroid cancer in the country, a further analysis of the pathological variants and the grading of this neoplasia is needed

Behavioral and sociodemographic predictors of anxiety and depression in patients under epidemiological surveillance for COVID-19 in Ecuador.

Ecuador has been one of the most affected countries by the Corona Virus Disease 19 (COVID-19) pandemic, by April 2020 this country presented the highest rates of mortality in Latin America. The purpose of the present study was to identify behaviors during confinement and sociodemographic variables associated with the mental health status of confirmed or suspected COVID-19 patients who were part of the epidemiological surveillance program in Ecuador that included mandatory confinement and self-isolation. A cross-sectional study was performed from March 22th to April 18th, 2020 using an online survey. The survey collected socio-demographic information and severity of depressive symptoms using the Patient Health Questionnaire-9 and anxiety symptoms through the Generalized Anxiety Disorder-7. A total of 759 patients completed the questionnaire, 20.3% presented moderate to severe symptoms of depression and 22.5% moderate to severe symptoms of anxiety. Being a woman and from the Coastal region were risk factors. Exercising, maintaining daily routines, and keeping informed about the COVID-19 but limiting to an hour was associated with better mental health. Regression analysis indicated that the mentioned behaviors explained approximately 17% of the variance for depression sum scores and 11.8% of the variance for anxiety sum scores while controlling for gender and region. Understanding the association between sociodemographic variables and psychological states in patients with COVID-19 is relevant to tackle future public mental health problems and to implement health policies that are intended to palliate further psychiatric complications. Promotion of modifiable behaviors such as exercising, maintaining daily routines, and keeping informed about the COVID-19 but limiting to less than an hour is recommended

15q Duplication Syndrome: Report on the First Patient from Ecuador with an Unusual Clinical Presentation

Background. The 15q11.1-13.1 duplication, also known as Dup15q syndrome, is a rare congenital disease affecting 1 in 30,000 to 1 in 60,000 children worldwide. This condition is characterized by the presence of at least one extra copy of genetical material within the Prader-Willi/Angelman Critical Region (PWACR) of the referred 15q11.2-q13.1 chromosome. Case Report. Our study presents the clinical and genetical features of the first patient with a denovo 15q11.2 interstitial duplication on the maternal allele (inv Dup15q) that mimics a milder Prader-Willi syndrome probably due to an atypical disruption of the SNHG14 gene. Methylation-specific MLPA analysis has confirmed the presence of a very unlikely duplication that lies between breakpoint 1 (BP1) and the middle of BP2 and BP3 (BP3). This atypical alteration might be linked to the milder patient’s clinical phenotype. Conclusions. This is the first Dup15q patient reported in Ecuador and of the very few in South America. This aberration has never been described in a patient with Dup15q, and the unusual clinical presentation is probably due to the atypical distal breakpoint occurring within the gene SNHG14 which lies between BP2 and BP3 and does not therefore contain the whole PWACR. If the duplication disrupted the gene, then it is possible that it is the cause of, or contributing to, the patient’s clinical phenotype