المؤلفون: Fornasini, Marco, Sisa, Ivan, Baldeon, Manuel E.

المصدر: Annals of Global Health; Vol. 89 No. 1 (2023); 26 ; Annals of Global Health; Vol. 89 Núm. 1 (2023); 26 ; 2214-9996

مصطلحات موضوعية: chronic noncommunicable diseases, COVID-19, Ecuador, mortality, cardiometabolic diseases

الوصف: Before the COVID-19 pandemic, chronic noncommunicable diseases (NCDs), represented a high burden for low and middle-income countries. Patients with NCDs are at higher risk of COVID-19 and suffer worse clinical outcomes. We present mortality trends for myocardial infarction (AMI), stroke, hypertension (HT), and type-2 diabetes mellitus (T2DM) from 2005 to 2021 in Ecuador. The greatest increase in mortality observed in the pandemic was in AMI, T2DM, and HT. Factors related to COVID-19, health services, and patients with NCDs could contribute to these important increases in mortality.

وصف الملف: application/pdf; application/xml

العلاقة: https://account.annalsofglobalhealth.org/index.php/up-j-agh/article/view/4021/3684Test; https://account.annalsofglobalhealth.org/index.php/up-j-agh/article/view/4021/3685Test; https://account.annalsofglobalhealth.org/index.php/up-j-agh/article/view/4021Test

الإتاحة: https://doi.org/10.5334/aogh.4021Test
https://account.annalsofglobalhealth.org/index.php/up-j-agh/article/view/4021Test

المؤلفون: Dueñas-Espín, Iván, Echeverría-Mora, María, Montenegro-Fárez, Camila, Baldeón, Manuel, Chantong Villacres, Luis, Espejo Cárdenas, Hugo, Fornasini, Marco, Ochoa Andrade, Miguel, Solís, Carlos

المساهمون: Soto, Alonso, Pontificia Universidad Católica del Ecuador

المصدر: PLOS ONE ; volume 18, issue 7, page e0288106 ; ISSN 1932-6203

الوصف: Objective To develop and validate a scoring system to predict mortality among hospitalized patients with COVID-19. Methods Retrospective cohort study. We analyzed 5,062 analyzed hospitalized patients with COVID-19 treated at two hospitals; one each in Quito and Guayaquil, from February to July 2020. We assessed predictors of mortality using survival analyses and Cox models. We randomly divided the database into two sets: (i) the derivation cohort (n = 2497) to identify predictors of mortality, and (ii) the validation cohort (n = 2565) to test the discriminative ability of a scoring system. After multivariate analyses, we used the final model’s β-coefficients to build the score. Statistical analyses involved the development of a Cox proportional hazards regression model, assessment of goodness of fit, discrimination, and calibration. Results There was a higher mortality risk for these factors: male sex [(hazard ratio (HR) = 1.32, 95% confidence interval (95% CI): 1.03–1.69], per each increase in a quartile of ages (HR = 1.44, 95% CI: 1.24–1.67) considering the younger group (17–44 years old) as the reference, presence of hypoxemia (HR = 1.40, 95% CI: 1.01–1.95), hypoglycemia and hospital hyperglycemia (HR = 1.99, 95% CI: 1.01–3.91, and HR = 1.27, 95% CI: 0.99–1.62, respectively) when compared with normoglycemia, an AST–ALT ratio >1 (HR = 1.55, 95% CI: 1.25–1.92), C-reactive protein level (CRP) of >10 mg/dL (HR = 1.49, 95% CI: 1.07–2.08), arterial pH <7.35 (HR = 1.39, 95% CI: 1.08–1.80) when compared with normal pH (7.35–7.45), and a white blood cell count >10 × 10 3 per μL (HR = 1.76, 95% CI: 1.35–2.29). We found a strong discriminative ability in the proposed score in the validation cohort [AUC of 0.876 (95% CI: 0.822–0.930)], moreover, a cutoff score ≥39 points demonstrates superior performance with a sensitivity of 93.10%, a specificity of 70.28%, and a correct classification rate of 72.66%. The LR+ (3.1328) and LR- (0.0981) values further support its efficacy in identifying high-risk patients. ...

الإتاحة: https://doi.org/10.1371/journal.pone.0288106Test

المؤلفون: Valencia-Espinoza, Evelyn, Cabezas, María del Carmen, Plaza, Andrea, García, Katherine, Calle, Carlos, Fornasini, Marco, Luna, José, Miño, Camila

المصدر: Medicine ; volume 102, issue 25, page e34082 ; ISSN 0025-7974

الوصف: The 2019 coronavirus disease (COVID-19) pandemic has affected different human populations since March 2020 and challenged healthcare systems, especially in chronic non-communicable diseases such as cancer. The present study aimed to evaluate the mortality, risk factors, and symptoms of cancer patients and control subjects, diagnosed with COVID-19 and admitted to intensive care unit (ICU). This retrospective, observational, non-randomized, controlled study of patients admitted to ICU was conducted between March and August 2020 in an Ecuadorian oncology center. Patient information collected from electronic medical records included sociodemographic information, clinical history, symptoms, laboratory test results, COVID-19 treatment, and discharge status. For patients with neoplasia, diagnosis, type, and status of cancer, as well as antineoplastic treatment received over the past month was also recorded. Descriptive statistics and multiple logistic regression were used to analyze the data. Statistical analysis was performed with SPSS (version 22.0) and R (version 4.1.3). In total, 79 adult COVID-19 patients were studied (40 with cancer and 39 controls). The total mean time until COVID-19 symptoms onset was 6.2 ± 3.5 days (5.3 ± 3.2 days in the cancer group vs 7.2 ± 3.6 days in the control group; P = .016) but no difference was observed in reported symptoms. All patients received an antibiotic treatment, but only 70% of the cancer group had antivirals ( P < .001). Cancer patients had lower hemoglobin levels than controls (10.7 ± 2.8 vs 13.3 ± 1.7 g/dL; P < .001). In terms of mortality, not statistically significance difference was reported between groups. The study showed that high ferritin (Absolute Odds Ratio of 3.9; 95% CI 1.1–14.6) and mechanical ventilation (Absolute Odds Ratio of 4.9; 95% CI 1.3–18.6) were independent COVID-19 mortality risk factors. COVID-19 infection did not represent an increased risk of mortality in cancer patients, but elevated ferritin levels and the need for mechanical ventilation ...

الإتاحة: https://doi.org/10.1097/md.0000000000034082Test

المؤلفون: Baldeon, Manuel, Cardenas, Paul, Prado-Vivar, Belen, Peña, Lizbeth, Arevalo, Valentina, Uchimaya, Mario, Edison, Arthur, Herrera, Alonso, Arturo, Linda, Fornasini, Marco

المصدر: Current Developments in Nutrition ; volume 7, page 101512 ; ISSN 2475-2991

مصطلحات موضوعية: Nutrition and Dietetics, Food Science, Medicine (miscellaneous)

الإتاحة: https://doi.org/10.1016/j.cdnut.2023.101512Test
https://api.elsevier.com/content/article/PII:S2475299123262149?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2475299123262149?httpAccept=text/plainTest

المؤلفون: Baldeon, Manuel E., Fornasini, Marco, Flores, Nancy, Merriam, Philip A., Rosal, Milagros C., Zevallos, Juan C., Ockene, Ira S.

المساهمون: Prevention Research Center, Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, Department of Medicine, Division of Cardiovascular Medicine

المصدر: Revista panamericana de salud publica = Pan American journal of public health ; 42 ; e139

مصطلحات موضوعية: Cardiovascular diseases, Ecuador, blood pressure, cholesterol, HDL, LDL, diabetes mellitus, type 2, health human resource training, Behavioral Medicine, Behavior and Behavior Mechanisms, Community Health and Preventive Medicine, Medical Education, Preventive Medicine, Primary Care, Public Health

الوصف: Objective: To assess the feasibility of implementing a physician-based, patient-centered counseling intervention model in Ecuador to improve the ability of primary care physicians (PCPs) to reduce cardiovascular disease (CVD) risk factors among patients. Methods: This was a randomized clinical trial conducted in primary care clinics in Quito in 2014 - 2016. Participants included 15 PCPs and their adult patients at high risk of developing type-2 diabetes. A physician-based and patient-centered counseling program was delivered to eight PCPs. Seven PCPs who did not receive the training comprised the control group. The patient experience was assessed by a patient exit interview (PEI). Assessment of the patient's anthropometrics, blood pressure, and blood biochemistry parameters were conducted. Changes within and between groups were estimated utilizing chi-square, ANOVA, paired t-tests, and coefficient with intervention. Results: A total of 197 patients participated, 113 in the intervention care group (ICG) and 84 in the usual care group (UCG); 99 patients (87.6%) in the ICG and 63 (75%) in the UCG completed the study. Counseling steps, measured by the PEI, were significantly higher in the ICG (8.9+/-1.6 versus 6.6+/-2.3; P = 0.001). Comparison of the estimated difference between the ICG and the UCG showed greater decreases in HbA1c and total cholesterol in the ICG. Within the ICG, there were significant improvements in weight, BMI, HbA1C, total cholesterol, and LDL-cholesterol. Conclusions: Training PCPs in a patient-centered behavioral intervention for CVD risk factor reduction is feasible and efficacious for reducing CVD risk factors in Ecuador. Developed and developing countries alike could benefit from such an intervention.

العلاقة: Link to Article in PubMed; Rev Panam Salud Publica. 2018 Sep 24;42:e139. doi:10.26633/RPSP.2018.139. eCollection 2018. Link to article on publisher's site; 1020-4989 (Linking); http://hdl.handle.net/20.500.14038/44543Test; https://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1138&context=prc_pubs&unstamped=1Test; https://escholarship.umassmed.edu/prc_pubs/138Test; prc_pubs/138

الإتاحة: https://doi.org/10.26633/RPSP.2018.139Test
https://doi.org/20.500.14038/44543Test
https://hdl.handle.net/20.500.14038/44543Test
https://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1138&context=prc_pubs&unstamped=1Test
https://escholarship.umassmed.edu/prc_pubs/138Test

المؤلفون: Baldeón, Manuel E., Maldonado, Augusto, Ochoa‐Andrade, Miguel, Largo, Carolina, Pesantez, Mónica, Herdoiza, Marco, Granja, Gerardo, Bonifaz, Marco, Espejo, Hugo, Mora, Francisco, Abril‐López, Patricio, Armijo, Lady Karen Robles, Pacheco, Verónica, Salazar, Rafael, Reinthaller, Steffy, Zertuche, Federico, Fornasini, Marco

المصدر: Transfusion Medicine ; volume 32, issue 2, page 153-161 ; ISSN 0958-7578 1365-3148

الوصف: Introduction South America is one of the regions most affected by the COVID‐19 pandemic. Specific and affordable treatments are needed to treat SARS‐CoV‐2 infection. Evidence regarding the use of convalescent plasma in COVID‐19 patients is still limited. We compared the safety and efficacy of COVID‐19‐convalescent plasma administration as a complement to standard treatment in the early management of patients with moderate SARS‐CoV‐2 infection. Methods We carried out a random double blinded, placebo‐controlled trial that compared standard treatment plus convalescent plasma (CP) or plus non‐convalescent plasma in the management of COVID‐19 patients. The main outcome was survival and secondary endpoints included: length of hospitalisation (LOH), days from treatment to discharge, time to clinical improvement or death within a 28‐day period, and adverse reactions to treatment. Results Administration of CP with antibodies against SARS‐CoV‐2 did not affect patient survival, RR = 1.003, 95% CI (0.3938, 2.555). These results led to terminate the RCT prematurely. However, early treatment of COVID‐19 patients with CP tended to decrease the LOH while the delay in CP treatment was associated with longer hospitalisation. In addition, delay in CP treatment negatively affected the recovery of the respiratory rate. Conclusion Use of CP for the treatment of COVID‐19 patients is safe and its early use can decrease the LOH and improve respiratory function. Early administration of antibody‐rich CP could contribute to decrease the negative impact of COVID‐19 pandemic in patients with impaired immune response.

الإتاحة: https://doi.org/10.1111/tme.12851Test

المؤلفون: B Martineau, Debora, Fornasini, Marco, Suarez, Daniela, Paz, Mario, Valarezo, Cinthia, Loor, Enrique, Guerrero, Marixa, E Baldeon, Manuel

الوصف: Supplementary document - Survey ...

العلاقة: https://dx.doi.org/10.2217/pmt-2023-0055Test

الإتاحة: https://doi.org/10.25402/fmc.2496776410.2217/pmt-2023-0055Test
https://tandf.figshare.com/articles/dataset/Epidemiology_of_non-oncological_high-impact_chronic_pain_in_Ecuadorian_adults_in_2022/24967764Test

المؤلفون: Martineau, Debora B, Fornasini, Marco, Suárez, Daniela, Paz, Mario, Valarezo, Cinthia, Loor, Enrique, Guerrero, Marixa, Baldeon, Manuel E

المصدر: Pain Management; Dec2023, Vol. 13 Issue 12, p689-699, 11p

المؤلفون: Baldeón, Manuel E., Felix, Camilo, Fornasini, Marco, Zertuche, Federico, Largo, Carolina, Paucar, María José, Ponce, Liz, Rangarajan, Sumathy, Yusuf, Salim, López-Jaramillo, Patricio

المساهمون: Bello-Chavolla, Omar Yaxmehen, universidad ute, population health research institute - phri

المصدر: PLOS ONE ; volume 16, issue 7, page e0254812 ; ISSN 1932-6203

الوصف: Metabolic syndrome (MetS) and type 2 diabetes (T2D) are metabolic alterations associated with high morbidity and mortality, particularly in low and middle-income countries. Diet has a significant impact on the risk to develop MetS and T2D; in this regard, consumption of fruits, vegetables, and protein rich foods (from plant and animals) are important to prevent and manage these pathologies. There are limited studies regarding the potential association between Andean foods rich in proteins and the presence of cardio-metabolic conditions in Ecuador. It is necessary to develop new low-cost, local-culturally acceptable strategies to reduce the burden of cardio-metabolic diseases. We describe the prevalence (baseline data) of MetS and T2D in the Ecuadorian cohort of the Prospective Urban and Rural Epidemiology (PURE) study and their potential association with the consumption of protein rich foods, including beef, white meat, dairy and legumes. In this cross-sectional study, we assessed 1,997 individuals aged 35–70 years (mean age 51 years, 72% women), included in the Ecuadorian cohort of the PURE study, from February to December 2018. The prevalence of MetS was 42% for male and 44% for female participants; the prevalence of T2D was 9% for male and 10% for female. Metabolic syndrome and T2D were more common in women older than 50 years of age with primary education or less, low economic income, and with obesity; MetS was more frequent in the rural area while T2D was more frequent in the urban area. Using logistic regression analysis, we observed a significant protective effect of higher consumption of dairy and legumes in the prevalence of MetS and T2D compared with low consumption. It will be important to develop policies for ample production and consumption of protein rich foods such as legumes and dairy, part of traditional diets, to reduce the burden of cardio-metabolic diseases.

الإتاحة: https://doi.org/10.1371/journal.pone.0254812Test

المؤلفون: Sisa, Ivan, Fornasini, Marco, Teran, Enrique

المصدر: The Lancet ; volume 398, issue 10307, page 1212-1213 ; ISSN 0140-6736

مصطلحات موضوعية: General Medicine

الإتاحة: https://doi.org/10.1016/s0140-6736Test(21)01605-6
https://api.elsevier.com/content/article/PII:S0140673621016056?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0140673621016056?httpAccept=text/plainTest