Facultad de Ciencias de la Salud y Bienestar Humano

Parent Organisation

Universidad Indoamérica

Now showing 1 - 10 of 85

Some of the metrics are blocked by your
consent settings
Risk Factors Associated with Hyporesponsiveness to Erythropoietin in Chronic Kidney Disease Patients on Hemodialysis Who Present Anemia: A Multicenter Case-Control Study
(2025)
Carlos Perez Tulcanaza
;
André Benítez-Baldassari
;
Andrea Banegas-Sarmiento
;
Sánchez Redrobán, José
Background: Anemia represents a significant complication in patients with advanced chronic kidney disease (CKD) on hemodialysis, primarily caused by reduced renal erythropoietin production. Despite erythropoiesis-stimulating agents (ESAs) being the cornerstone of treatment, hyporesponsiveness to these agents remains a clinical challenge with implications for patient outcomes. Objective: To identify and quantify risk factors associated with hyporesponsiveness to erythropoietin in patients with CKD on hemodialysis who present with anemia. Methods: This multicenter case–control study analyzed data from 784 hemodialysis patients receiving erythropoietin therapy across six dialysis centers in Ecuador between January and December 2019. Hyporesponsiveness was defined as requiring ≥ 200 IU/kg/week of erythropoietin alfa for ≥3 consecutive months to maintain target hemoglobin levels (10–12 g/dL). Demographic, clinical, and laboratory parameters were compared between hyporesponsive cases (n = 123) and responsive controls (n = 661). Bivariate and multivariate logistic regression analyses were performed to identify independent risk factors. Results: The prevalence of erythropoietin hyporesponsiveness was 15.69%. A multivariate analysis identified female sex (adjusted OR = 1.96; 95% CI: 1.20–3.20; p < 0.001), age < 50 years (adjusted OR = 4.25; 95% CI: 2.42–7.47; p < 0.001), serum albumin < 4.0 g/dL (adjusted OR = 10.53; 95% CI: 6.53–16.98; p < 0.001), ferritin ≥ 800 ng/mL (adjusted OR = 7.28; 95% CI: 4.22–12.57; p < 0.001), transferrin saturation < 20% (adjusted OR = 9.27; 95% CI: 5.47–15.69; p < 0.001), parathyroid hormone ≥ 500 pg/mL (adjusted OR = 1.89; 95% CI: 1.16–3.09; p = 0.011), and use of renin–angiotensin system blockers (adjusted OR = 2.25; 95% CI: 1.36–3.71; p = 0.002) as independent risk factors for erythropoietin hyporesponsiveness. Conclusions: Multiple demographic, clinical, and laboratory factors independently contribute to erythropoietin hyporesponsiveness in hemodialysis patients. Identification of these risk factors may guide clinicians in developing individualized treatment approaches, optimizing erythropoietin dosing, and implementing targeted interventions to improve anemia management in this vulnerable population.
36
Some of the metrics are blocked by your
consent settings
Hot flashes: a potential marker of deterioration of health-related quality of life
(2026)
Juan E. Blümel
;
María S. Vallejo
;
Peter Chedraui
;
Eugenio Arteaga
;
Félix Ayala
Objective: Hot flashes are among the most common symptoms of the menopausal transition and have traditionally been considered benign and self-limiting. However, increasing evidence suggests that they may indicate broader neurovascular and inflammatory dysregulation linked to reproductive aging. The possible effect of hot flush severity on health-related quality of life (HRQoL) remains inadequately studied, particularly in Latin American populations. This study aimed to examine the association between hot flash severity and HRQoL in middle-aged women using validated tools and a large, multicenter sample. Method: A cross-sectional study was conducted between June 2024 and January 2025 in 30 healthcare centers across 12 Latin American countries. A total of 3523 women aged 40–60 years were assessed using the Menopause Rating Scale (MRS) to evaluate vasomotor symptoms and the Short Form-36 Health Survey (SF-36) to measure HRQoL. Multivariable logistic regression models were utilized to estimate the association between hot flush severity and low HRQoL, adjusting for sociodemographic, behavioral and clinical covariates. Results: Increasing severity of hot flushes was significantly associated with lower HRQoL scores across all SF-36 domains. In the logistic regression analysis, mild hot flushes (MRS item 1 score = 1) were associated with increased odds of impaired HRQoL (odds ratio [OR] 1.29; 95% confidence interval [CI]: 1.08–1.55), whereas very severe symptoms (MRS item 1 score = 4) demonstrated a substantially stronger association (OR 4.10; 95% CI: 2.93–5.74). Additional factors significantly associated with lower HRQoL included physical inactivity, the presence of comorbidities, obesity, current use of psychotropic medication, age ≥50 years and having two or more children. Conclusion: Hot flush severity is a strong and independent determinant of HRQoL in midlife women. These findings underscore the need for systematic assessment and targeted management of vasomotor symptoms in routine care, supporting the hypothesis that hot flashes may be a clinical marker of systemic aging. © 2026 International Menopause Society.
14
Some of the metrics are blocked by your
consent settings
Sleep disorders and menopausal symptoms: a Latin American perspective on postmenopausal health
(2025)
Eugenio E. Arteaga
;
Juan E. Blümel
;
María S. Vallejo
;
Carlos Salinas
;
Konstantinos Tserotas
Objective: This cross-sectional, observational study, conducted in nine Latin American countries, aimed to examine the association between hot flashes and insomnia, and whether the severity of vasomotor symptoms (VMS) correlates with sleep disturbances. Method: The study collected sociodemographic and clinical data, and evaluated the presence of sleep disorders using Jenkin’s Sleep Scale (JSS-4) and menopausal symptoms using the Menopause Rating Scale (MRS) questionnaire. Results: The study included 1185 postmenopausal women with average age 56.9 ± 5.7 years, body mass index (BMI) of 26.5 ± 5.2 kg/m² and 8.6 ± 6.4 years since menopause. Overall, 20.6% reported sleep disturbances. Compared to those without sleep problems, affected women had longer postmenopausal duration (12 ± 9.0 vs. 10.8 ± 7.8, p < 0.03), had higher BMI (27.9 ± 5.6 vs. 26.1 ± 5.0, p < 0.001), were more often smokers and homemakers, and had more comorbidities. They were also less likely to have a partner or have used menopausal hormone therapy. Sleep disturbances increased proportionally with VMS severity (p < 0.01). In multivariate analysis, sleep disorders were associated with VMS (odds ratio [OR] 4.47), psychotropic use (OR 1.84), obesity (OR 1.45) and comorbidities (OR 1.45). Conclusion: Women with VMS were more likely to experience sleep disorders and this effect was proportional to the magnitude of the hot flashes. The study also presents several factors associated with sleep disorders in postmenopausal women that should be considered to help prevent these disturbances.
14
Some of the metrics are blocked by your
consent settings
Natural Products Targeting Key Molecular Hallmarks in Gastric Cancer: Focus on Apoptosis, Inflammation, and Chemoresistance
(2026)
Simancas Racines, Daniel
;
Cagua Ordoñez, Jaen
;
Angamarca Iguago, Jaime
;
Parise Vasco, Juan Marcos
;
Reytor González, Claudia
Natural products have emerged as promising multi-target agents for addressing the complex biology of gastric cancer, a malignancy characterized by marked molecular heterogeneity, late clinical presentation, and frequent resistance to systemic therapies. This narrative synthesis integrates primarily preclinical evidence, with emerging clinical data, on how naturally derived compounds modulate three central molecular processes that drive gastric tumor progression and therapeutic failure: evasion of programmed cell death, persistent tumor-promoting inflammation, and chemoresistance. Compounds such as curcumin, resveratrol, berberine, ginsenosides, quercetin, and epigallocatechin gallate restore apoptotic competence by shifting the balance between pro-survival and pro-death proteins, destabilizing mitochondrial membranes, promoting cytochrome c release, and activating caspase-dependent pathways. These agents also exert potent anti-inflammatory effects by inhibiting nuclear factor kappa B and signal transducer and activator of transcription signaling, suppressing pro-inflammatory cytokine production, reducing cyclooxygenase activity, and modulating the tumor microenvironment through changes in immune cell behavior. In parallel, multiple natural compounds function as chemo-sensitizers by inhibiting drug efflux transporters, reversing epithelial–mesenchymal transition, attenuating cancer stem cell-associated traits, and suppressing pro-survival signaling pathways that sustain resistance. Collectively, these mechanistic actions highlight the capacity of natural products to simultaneously target interconnected hallmarks of gastric cancer biology. Ongoing advances in formulation strategies may help overcome pharmacokinetic limitations; however, rigorous biomarker-guided studies and well-designed clinical trials remain essential to define the translational relevance of these compounds.
12
Some of the metrics are blocked by your
consent settings
T he interplay between osteoarthritis and cardiovascular disease: shared pathophysiological mechanisms
(2026)
Jaya Larraga, Lorena Paola
The relationship between osteoarthritis (OA) and cardiovascular disease (CVD) is complex. Epidemiologically, both OA and CVD have displayed rising trends in the last decades, largely attributed to consistent increases in the prevalence of overlapping risk factors. Furthermore, subjects with OA appear to have a greater cardiovascular risk. As a result, these conditions are associated with a significant burden for public health systems. Both OA and CVD have traditionally been studied as distinct conditions, yet growing epidemiological and molecular evidence suggests these two highly prevalent chronic diseases are linked not merely by shared risk factors such as aging, obe-sity, and sedentary lifestyle, but also by deeply interconnected biological mechanisms. In ensemble, a plethora of pathophysiologic phenomena, such as chronic inflammation, oxidative stress, adipokine dysregulation, endothelial dysfunction, and extracellular matrix remodeling form a complex and overlapping network of processes that can jointly drive both articular degradation and vascular injury. Bridging the gap between musculoskeletal and cardiovascular research offers the promise of innovative therapies and integrated care strategies that can improve both mobility and longevity for millions of patients worldwide by improving clinical outcomes of both OA and CVD. In this narrative review, we revise the pathophysiological interconnections between OA and CVD. © 2026, Venezuelan Society of Pharmacology and Clinical and Therapeutic Pharmacology. All rights reserved.
4
Some of the metrics are blocked by your
consent settings
Interpreting Resting Energy Expenditure in Critically Ill Patients with Obesity: Clinical Impact of Weight Adjustment
(2026)
Sebastián Chapela
;
Cagua Ordoñez, Jaen
;
Parise Vasco, Juan Marcos
;
Daniel Tettamanti Miranda
;
Claudia Kecskes
Accurately estimating resting energy expenditure (REE) in critically ill obese patients remains a significant clinical challenge, as predictive equations are consistently inadequate. Metabolic heterogeneity across obesity classes and the role of substrate utilization are insufficiently characterized. Objective: To evaluate the impact of different weight-normalization methods on the interpretation of REE and to identify independent metabolic determinants of weight-adjusted energy expenditure in critically ill patients with obesity. Methods: Bicentric cross-sectional study of 148 critically ill adults with obesity undergoing indirect calorimetry. REE normalized by actual body weight (REE/kg), ideal body weight (REE/IBW), and adjusted body weight (REE/AdjBW) was calculated. Multivariable models with robust standard errors (HC3), stratified analyses by obesity class (I–III) with a Chow test, and internal validation were performed using 10-fold cross-validation and bootstrap resampling (1000 iterations). Results: Absolute REE did not differ significantly between BMI categories (p = 0.679), while REE/kg progressively decreased from normal weight (27.8 kcal/kg/day) to class III obesity (16.9 kcal/kg/day; p < 0.001). The respiratory quotient (RQ) emerged as the most robust independent correlate of adjusted REE (β = −13 to −15 kcal·kg−1·day−1; p < 0.001), whereas clinical severity scores (SOFA, APACHE II) and comorbidity (Charlson) did not show significant associations. Stratified analyses revealed significant structural heterogeneity between obesity classes (F = 4.545, p = 0.0001), with no significant predictors identified in class III obesity, likely reflecting limited statistical power in this subgroup. Conclusions: Normalizing REE using different weight indices fundamentally alters its metabolic interpretation. RQ surpasses traditional clinical scores as a correlate of adjusted REE, consistent with a phenotype of metabolic inflexibility. The heterogeneity between obesity classes underscores the need for individualized indirect calorimetry rather than reliance on predictive equations.
12
Some of the metrics are blocked by your
consent settings
Alcohol and Substance Use After Bariatric Surgery: Nutritional Risks and Clinical Implications in Long-Term Postoperative Care
(2026)
Martín Campuzano-Donoso
;
Reytor González, Claudia
;
Gerardo Sarno
;
Martha Montalvan
;
Luigi Barrea
Metabolic and bariatric surgery (MBS) has evolved into a highly effective neurohormonal intervention for severe obesity; however, it introduces unique long-term vulnerabilities, particularly regarding alcohol (AUD) and substance use disorders (SUD). This review synthesizes the epidemiological, pharmacokinetic, and neurobiological drivers of postoperative substance misuse. Procedures like Roux-en-Y gastric bypass (RYGB) radically alter ethanol metabolism, eliminating first-pass metabolism and accelerating gastric emptying, while simultaneously recalibrating reward pathways, creating a “reward gap” that facilitates addiction transfer. These physiological shifts exacerbate critical micronutrient deficiencies (thiamine, B12, iron), increase the risk of post-bariatric hypoglycemia, and correlate with higher rates of liver cirrhosis and suicide. Furthermore, substance use is a primary driver of suboptimal weight loss trajectories and weight regain. Mitigation requires a lifelong, multidisciplinary framework involving preoperative risk stratification, validated screening (e.g., AUDIT-C), and targeted nutritional supplementation to safeguard the long-term metabolic and psychological benefits of MBS.
6
Some of the metrics are blocked by your
consent settings
Sleep disturbances are associated with cognitive impairment in postmenopausal women
(2025)
Álvaro Monterrosa-Castro
;
Peter Chedraui
;
Juan E. Blümel
;
Alejandra Elizalde-Cremonte
;
María T. Espinoza
To evaluate the association between severe sleep problems and mild cognitive impairment (MCI) in postmenopausal women, we conducted a sub-analysis of a cross-sectional, multinational investigation between January and November 2023 among postmenopausal women younger than 70 years attending gynecological consultations in nine Latin American countries. MCI was assessed using the Montreal Cognitive Assessment (MoCA) tool, and severe sleep problems were evaluated with two validated instruments: the third question of the Menopause Rating Scale (MRS, score ≥3) and the Jenkins Sleep Scale (JSS, total score ≥12). Two adjusted logistic regression models were used to examine the association between the two measures of severe sleep problems and MCI, adjusting for relevant covariates. The analysis included 1,185 postmenopausal women with a mean age of 56.9 years. Severe sleep problems were significantly more frequent among women with MCI compared to those without MCI, whether assessed by the MRS (28.3 percent vs. 16.6 percent) or the JSS (31.6 percent vs. 18.4 percent; both p <.001). In adjusted regression models, severe sleep problems remained independently associated with MCI (MRS: aOR = 1.81, 95 percent CI: 1.26–2.60; JSS: aOR = 1.88, 95 percent CI: 1.31–2.69). Additional factors associated with a higher likelihood of MCI included physical inactivity and greater parity, while ever-use of menopausal hormone therapy and higher educational attainment were associated with a reduced likelihood of MCI. In this sample of postmenopausal Latin American women, severe sleep problems were associated with a higher likelihood of MCI, and factors such as physical inactivity, educational attainment, parity, and ever use of menopausal hormone therapy were also independently related to this condition
20
Some of the metrics are blocked by your
consent settings
Single vs. Dual Agonist Pharmacotherapy for Managing Insufficient Weight Loss and Weight Regain Following Metabolic and Bariatric Surgery: A Comparative Review
(2026)
Reytor González, Claudia
;
Martín Campuzano-Donoso
;
Gerardo Sarno
;
Martha Montalvan
;
Raquel Horowitz
Weight management after metabolic and bariatric surgery remains a persistent clinical challenge, particularly when patients experience insufficient weight loss or progressive weight regain following the postoperative nadir. In recent years, pharmacological therapies targeting gut-derived hormones have reshaped the therapeutic approach, offering nonsurgical strategies that directly influence appetite regulation, satiety, and energy balance. Single agonists acting on the glucagon-like peptide one receptor have demonstrated meaningful reductions in body weight among postoperative patients, while dual agonists that target both the glucagon-like peptide one receptor and the glucose-dependent insulinotropic polypeptide receptor have shown even greater weight reduction in early studies, suggesting enhanced therapeutic potential. These benefits, however, must be interpreted within the unique anatomical, nutritional, and behavioral context of individuals who have undergone metabolic and bariatric procedures, as they are inherently at higher risk for micronutrient deficiencies, gastrointestinal intolerance, and maladaptive eating patterns. Successful treatment requires a balanced integration of pharmacotherapy, individualized nutritional guidance, psychological support, and a patient-centered model of long-term care. Although emerging evidence is promising, dedicated clinical trials are still needed to directly compare the efficacy, safety, and sustainability of single versus dual agonist therapies in postoperative populations. Furthermore, culturally sensitive dietary strategies and shared decision-making processes are essential to enhance adherence, optimize long-term outcomes, and ensure equitable access to treatment. Ultimately, these therapies represent a significant advance in addressing postoperative weight challenges, but their full potential will rely on comprehensive, multidisciplinary frameworks that support both biological and behavioral aspects of chronic weight management.
7
Some of the metrics are blocked by your
consent settings
Integral communication on city-brands making: Contributions, strains and challenges [Comunicación integral en construcción de marcas ciudad: Aportes, tensiones y desafíos]
(2017)
Navas J.S.G.
;
Gonzalez, J.
The following qualitative work analyzes the relationship between integrated communication and the construction of city brands from the very perspective of the professionals of communication, who allocate different meanings to this process. The construction of city brands is challenging. There has been an investigation coming from the tensions and challenges that arise from the construction and management of a city brand. Furthermore, a research was carried out through open interviews and discussion groups, this technique allowed to frame historically and socially the professional experiences and the collective construction of a dialogue. Additionally, based on a thematic and content analysis, the textual data was organized and analyzed, this process allowed to created categories and a referential framework that places the purpose of the study. In conclusion, a renaissance figure in communication vanishes before the active participation of all the communication professionals, who ought to work in an integrated, inclusive and collaborative processes beyond the commercial and tourist point, thus, a real change and transformation of a city could be seen from inside and out.
26

Facultad de Ciencias de la Salud y Bienestar Humano

Filters

Settings

Sort By

Results per page