Facultad de Ciencias de la Salud y Bienestar Humano
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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 , Carlos Escalante , Gustavo Gómez-Tabares , Mónica Ñañez , Eliana Ojeda , Claudia Rey , Doris Rodríguez-Vidal , Marcio Alexandre H. Rodrigues , Carlos Salinas , Konstantinos Tserotas , María S. Vallejo , Calle Miñaca, Andrés , Maribel Dextre

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

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Body Composition Evaluation using Bioelectrical Impedance and its Impact on Academic Performance of Nursing Students

2023 , Romero Riaño, Paola , Camaño Carball, Lilian , Yánez-Rueda H. , Buele, Jorge

In the past, nutritional assessment relied on manual measurements that did not allow for the differentiation of body composition components. With technological advancements, the introduction of bioelectrical impedance has provided a more specific approach to obtaining results. This study aims to utilize this innovative method to assess the connection between body composition and academic performance in nursing students. The research focused on a representative sample of 89 participants, utilizing bioelectrical impedance to measure the primary bioelements of the human body. Strong and significant correlations were observed between height and weight, height and muscle mass, and muscle mass and weight. A moderate correlation was found between weight and fat, as well as significant weak correlations between age and fat, and between fat and body mass index. Additionally, a significant weak negative correlation was observed between height and fat. Of the participants, 42.2% of women and 48% of men were classified as overweight. However, the statistical analysis did not reveal significant correlations between academic performance and variables such as weight, muscle mass, fat, and body mass index. Based on this information, it was concluded that most students had a body mass index within the normal range, and no direct relationship between body composition and academic performance was identified. Continuous monitoring of overweight students using this technology is recommended to promote healthy nutritional practices. © 2023 IEEE.

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Time Series Analysis of Dengue, Zika, and Chikungunya in Ecuador: Emergence Patterns, Epidemiological Interactions, and Climate-Driven Dynamics (1988–2024)

2025 , Sánchez Redrobán, José , Carolina Álvarez Ramírez , Emilio Cevallos Carrillo , Juan Arias Salazar , César Barros Cevallos

Background: Ecuador presents a unique epidemiological laboratory for studying arboviral dynamics due to its diverse ecological zones and exposure to climatic variability. Methods: We conducted a comprehensive 36-year analysis (1988–2024) of dengue (DENV), Zika (ZIKV), and chikungunya (CHIKV) using national surveillance data from Ecuador’s Ministry of Public Health. Statistical analyses included time series decomposition, change-point detection, correlation analysis, and climate association studies. Results: Ecuador reported 387,543 arboviral cases, with dengue comprising 91.3% (353,782 cases). Dengue exhibited endemic–epidemic cycles with major peaks during El Niño events (1994: 10,247 cases; 2000: 22,937 cases; 2015: 42,483 cases; 2024: 23,156 cases through week 26). CHIKV emerged explosively in 2015 (29,124 cases, incidence 181.10 per 100,000), followed by ZIKV in 2016 (2947 cases). Both showed rapid decline post-epidemic. Severe dengue cases paradoxically decreased from 2–4% of total cases in early 2000s to <0.1% post-2016, suggesting immunological modulation. Cross-correlation analysis revealed significant associations between climatic indices and epidemic timing (r=0.67, p<0.001), particularly for the El Niño-Southern Oscillation. Conclusions: Arboviral diseases in Ecuador function as an integrated epidemiological system with evidence of viral interactions, cross-protective immunity, and strong climate forcing. These findings emphasize the need for integrated surveillance and adaptive control strategies.

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Grading the damage: Prognostic significance of diffuse axonal injury severity and hemorrhagic lesions in traumatic brain injury outcomes

2025 , Nanci Estefanía Bayas-Almeida , González Andrade, Fabricio

Background: Diffuse axonal injury (DAI) is a key determinant of prognosis in traumatic brain injury (TBI), yet the interaction between DAI severity and associated hemorrhagic lesions is not well defined, especially in low- and middle-income countries (LMICs). Methods: We conducted a retrospective cohort study of 283 adults with moderate-to-severe TBI admitted to a tertiary hospital in Ecuador (2019–2023). DAI severity was graded anatomically using CT or MRI, and patients were stratified by the presence of hemorrhagic lesions. Demographic, clinical, metabolic, and radiological variables were collected. Outcomes were evaluated at 6 months with the Glasgow Outcome Scale–Extended (GOS-E). Logistic and ordinal regression models identified predictors of mortality and disability. Results: Of 283 patients, 141 had isolated DAI and 142 had DAI with hemorrhage. Baseline demographics were similar. Patients with hemorrhagic lesions had lower median Glasgow Coma Scale scores (6 vs 9, p < 0.001), more frequent hyperglycemia (15.5 % vs 7.1 %, p = 0.045), and greater surgical needs (77.5 % vs 16.3 %, p < 0.001). Complications, including pneumonia and central nervous system infections, were more frequent in the hemorrhagic group (63.9 % vs 45.7 %, p < 0.001). At 6 months, functional outcomes were significantly worse with hemorrhage (median GOS-E 7 vs 8, p < 0.001). Multivariable regression identified Grade III DAI as the strongest predictor of mortality (OR 20.02, 95 % CI 7.99–50.15) and disability (OR 71.59, 95 % CI 23.11–221.77). Hemorrhagic lesions predicted poor functional recovery (OR 2.08, 95 % CI 1.24–3.48) but not mortality. Conclusions: DAI grading is the most powerful prognostic factor in severe TBI, while hemorrhagic lesions primarily worsen disability. In LMICs, CT-based assessment remains essential for prognostic stratification and guiding rehabilitation strategies.

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Aggression and violence in adolescents in the iberoamerican context, a systematic review

2022 , Javela, J.J. , Naranjo-Niño, B. , Ospina-Sánchez, D.J. , Bahamon, M , Cuesta-Guzmán, M. , Sánchez-Villegas, M. , Moreno-Londoño, H.

This research is a systematic review that uses the Prism method, searching different databases to systematically analyze studies related to aggression and violence in adolescents in Iberoamerica. Objective: The present study aims to systematically analyze studies related to aggression and violence in adolescents in Iberoamerica. Method: Research works were collected from a total of 5 databases. For the selection of the articles, keywords or search terms were entered, and inclusion and exclusion criteria were applied. After the complete reading, a total of 47 research studies were selected. Results: The country retrieved with the largest number of articles was Brazil with a total of 11 documents, followed by Spain with ten, and the United States with a total of eight documents. It was also found that the database with the largest number of articles retrieved was Scopus, with 21 papers equivalent to 44.7 % of the total documents retrieved, followed by Science Direct and SciELO, each with a percentage of 19.1 %, equivalent to 9 documents. © 2022 Academia Nacional de Medicina. All rights reserved.

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Severe menopausal symptoms linked to cognitive impairment: an exploratory study

2024 , Calle Miñaca, Andrés , Juan E. Blümel , Peter Chedraui , María S. Vallejo , Alejandra Belardo , Maribel Dextre , Alejandra Elizalde-Cremonte , Carlos Escalante , María T. Espinoza , Gustavo Gómez-Tabares , Álvaro Monterrosa-Castro , Mónica Ñañez , Eliana Ojeda , Claudia Rey , Doris Rodríguez , Marcio A. Rodrigues , Carlos Salinas , Konstantinos Tserotas , Sócrates Aedo

Objective To evaluate the association between menopausal symptoms and cognitive decline in postmenopausal women. Methods This was a subanalysis of a cross-sectional, observational study conducted among women attending gynecological consultations across nine Latin American countries. The survey involved late postmenopausal women who were asked to complete a general questionnaire and the Menopause Rating Scale (MRS) to assess menopausal symptoms, with the Montreal Cognitive Assessment used to evaluate cognitive function as an outcome. A Montreal Cognitive Assessment score of less than 21 was used to define women with mild cognitive impairment (MCI). Results The study included 1,287 postmenopausal women with a mean age of 55.5 years and a mean body mass index of 26.3 kg/m2. On average, participants had 13.8 years of education and 2.3 ± 1.8 children, with 72.8% reporting having a partner. Additionally, 36.7% ever used menopausal hormone therapy. Regarding lifestyle factors, 50.3% engaged in a sedentary lifestyle, whereas 70.5% had never smoked. 15.3% of women had MCI exhibited significantly more intense menopausal symptoms compared with those without MCI (MRS total score 15.24 ± 12.58 vs 10.53 ± 8.84, respectively, P < 0.001). Logistic regression analysis revealed a significant association between severe menopausal symptoms (MRS total score ≥14 points) and MCI (odds ratio [OR], 1.74; 95% CI, 1.25-2.42). Conversely, a lower body mass index (OR, 0.96; 95% CI, 0.95-0.98), sexual activity (OR, 0.70; 95% CI, 0.51-0.96), physical exercise (OR, 0.55; 95% CI, 0.39-0.76), menopausal hormone therapy use (OR, 0.36; 95% CI, 0.24-0.55), and higher educational level (OR, 0.31; 95% CI, 0.21-0.46) were associated with lower odds for MCI. Conclusion Severe menopausal symptoms in postmenopausal women were associated with cognitive impairment. This study highlights the intricate interplay between hormonal, lifestyle, and sociodemographic factors and cognitive health.

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SURROGATE MOTHERHOOD, QUESTIONS [MATERNIDAD SUBROGADA, CUESTIONAMIENTOS]

2023 , Carrillo A.F.

Currently, surrogate motherhood is configured as an assisted motherhood technique, which, in some societies, is accepted and regulated. However, its approval in other societies is still under debate, which is how this work proposes as a general objective Critically review the conception of the fundamental rights that are at stake in favor of the sons and daughters who were born by this technique. For this purpose, a qualitative approach has been used, since it responds to a descriptive investigation of the bibliographic review type, based on the following historical-logical, analytical-synthetic and inductive methods, which allow certain questions to be made regarding the rights of the fathers or mothers of those people who are born as a result of surrogate motherhood. Putting in this way to the public arena, a real, current and controversial situation, which should be better analyzed, to guarantee the fundamental rights of the parties that derive from human dignity. © 2023, University of Cienfuegos, Carlos Rafael Rodriguez. All rights reserved.

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Severe obesity and menopause symptoms are associated with cognitive impairment in postmenopausal women from Latin America

2025 , Juan Enrique Blümel , Maria Soledad Vallejo , Peter Chedraui , Socrates Aedo , Marcio Alexandre Hipolito Rodrigues , Carlos Salinas , Konstantinos Tserotas , Calle Miñaca, Andrés , Maribel Dextre , Alejandra Elizalde , Carlos Escalante Gomez , Gustavo Gómez-Tabares , Álvaro de Jesus Monterrosa-Castro , Maria T. Espinoza , Monica Ñañez , Eliana Ojeda , Claudia Rey , Doris Rodríguez-Vidal

Objective: This study aimed to evaluate the association between obesity and cognitive impairment. Methods: This study is a sub-analysis of an observational, cross-sectional study in nine Latin American counties. Sociodemographic, clinical and anthropometric data were collected, and cognition was assessed using the Montreal Cognitive Assessment (MoCA) tool in 722 postmenopausal women. Results: The mean age, body mass index (BMI) and years of education of the cohort were 56.9 years, 26.8 kg/m2 and 13.6 years, respectively. Women with cognitive impairment, compared to those without, had a higher BMI (27.8 ± 5.9 vs. 26.6 ± 4.9 kg/m2, p = 0.037), had more children (3.1 ± 2.4 vs. 2.5 ± 1.7, p = 0.023), experienced more severe menopausal symptoms (56.3% vs. 31.9%, p < 0.001) and presented more comorbidities (60.0% vs. 43.8%, p = 0.006). They also had fewer years of study (10.8 ± 5.1 vs. 13.9 ± 4.9 years, p = 0.001), were less physically active (35.0% vs. 49.1%, p = 0.018) and were less likely to use menopausal hormone therapy (MHT) (11.3% vs. 28.8%, p = 0.001). In binary logistic regression analysis, BMI ≥ 35.0 kg/m2 (odds ratio [OR] 2.27, 95% confidence interval [CI] 1.08–4.76) and severe menopausal symptoms (OR 2.10, 95% CI 1.29–3.43) were associated with cognitive impairment. In the model, factors related to lower risk were ever use of MHT (OR 0.44, 95% CI 0.21–0.92) and having more years of education (OR 0.38, 95% CI 0.20–0.64). Conclusion: Severe obesity and severe menopausal symptoms increased the risk of cognitive impairment in postmenopausal women, while higher education and ever use of MHT were protective factors.

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Unraveling the association between obesity and climacteric symptoms: a generalized structural equation modeling approach

2025 , Sócrates Aedo , Juan Enrique Blümel , María Soledad Vallejo , Claudia Rey , Marcio Alexandre Rodrigues , Doris Rodríguez-Vidal , Carlos Salinas , Konstantinos Tserotas , Calle Miñaca, Andrés , Maribel Dextre , Alejandra Elizalde , Carlos Escalante , María Teresa Espinoza , Gustavo Gómez-Tabares , Álvaro Monterrosa-Castro , Eliana Ojeda , Mónica Ñañez

Objective: To assess the direct and indirect associations between obesity and the severity of menopausal symptoms in postmenopausal women, considering related conditions such as chronic diseases and physical activity. Methods: This observational subanalysis utilized data from the REDLINC XII multinational study, which included 722 postmenopausal women aged 70 or younger from 9 Latin American countries. Menopausal symptoms were measured using the Menopause Rating Scale (MRS). Clinical, behavioral, and sociodemographic data were obtained through physician-administered surveys. Generalized Structural Equation Modeling was employed to examine the direct and indirect relationships between obesity, chronic cardiovascular and respiratory diseases, chronic hypertension, diabetes mellitus, and physical activity, and MRS scores. Odds ratios (ORs) were calculated to enhance interpretability. Results: A total of 722 participants were included. Obesity was directly associated with higher MRS scores (OR = 1.75). In addition, obesity exhibited indirect associations with MRS scores, with an odds ratio of 19.07, through chronic arterial hypertension, diabetes mellitus, physical inactivity, and chronic cardiovascular or respiratory diseases. The total association between obesity and MRS scores was reflected in an OR of 33.45. Furthermore, physical inactivity and the use of antidepressants were associated with greater symptom severity, whereas higher educational attainment, regular physical activity, and menopausal hormone therapy were associated with lower MRS scores. Conclusions: Obesity is strongly associated with more severe menopausal symptoms, both directly and through related chronic conditions and behavioral factors. Longitudinal studies are needed to establish temporal and causal inferences.

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Neurological dysfunction and exposure to agrotoxics [Disfunción neurológica y exposición a agrotóxicos]

2022 , Andrade-Mora D.S. , Celi-Simbaña S.S. , Celi-Simbaña K.P.

[No abstract available]

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