Parise Vasco, Juan Marcos

Preferred name

Main Affiliation

Facultad de Ciencias de la Salud y Bienestar Humano

Ambato

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Higher-Protein Nutrition and Concurrent Exercise in Obesity: A Narrative Review of Body Composition, Metabolic Health, and Physical Function
(MDPI AG, 2026-07-11)
Reytor González, Claudia
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Loor-Cedeño, Andrés
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Gavilanes, Dolores Jima
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Matos, Andri
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Parise Vasco, Juan Marcos
Obesity care increasingly requires outcomes that extend beyond total body weight. Although weight reduction remains clinically meaningful, the scale alone does not indicate whether fat mass, lean tissue, muscle quality, strength, mobility, or physiological reserve have changed in a favorable direction. This narrative review examines the combined role of higher-protein dietary strategies and concurrent exercise in adults with obesity, with emphasis on body composition, metabolic health, and physical function. Higher-protein dietary strategies may support satiety, improve the tolerability of energy restriction in some patients, and attenuate lean-tissue loss during weight reduction, while evidence for superior long-term weight loss remains inconsistent. Exercise provides complementary stimuli to protein-focused nutrition: resistance training supports strength, muscle function, and lean-tissue preservation, while aerobic and interval-based training contribute to cardiorespiratory fitness, regional adiposity reduction, and selected cardiometabolic adaptations. Concurrent training offers a practical framework for integrating these stimuli, with value primarily as multidomain coverage rather than as evidence of universal superiority over other modalities. The main rationale for combining protein adequacy with exercise is preservation of usable physical function during weight loss, particularly in older adults, patients with sarcopenic-obesity risk, and individuals undergoing rapid pharmacological or surgical weight reduction. Overall, the available evidence is most consistent with viewing higher-protein nutrition and structured exercise as complementary strategies for improving the quality of weight loss, rather than as a single protocol for maximizing scale-weight reduction. Longer pragmatic trials are needed to clarify phenotype-specific responses, feasible protein targets, exercise progression, monitoring strategies, and functional outcomes. © 2026 by the authors.
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Reconstructing severe acute respiratory infection dynamics from ICD-10 hospital discharge data: a 10-year analysis of 11.2 million discharges in Ecuador, 2014–2023
(Frontiers Media SA, 2026-07-22)
Angamarca Iguago, Jaime
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Cagua Ordoñez, Jaen
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Parise Vasco, Juan Marcos
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Fuentes-Tumbaco, Natasha Bella
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Escobar-Naranjo, Mónica
Background – In many low- and middle-income countries, surveillance of severe acute respiratory infections (SARI) relies on administrative hospital data without virological confirmation, and its ability to capture epidemic dynamics and age-specific burden remains uncertain. Methods – We analyzed 11, 232, 698 hospital discharges recorded by Ecuador's National Institute of Statistics and Censuses between 2014 and 2023, identified SARI episodes using International Classification of Diseases, 10th Revision (ICD-10) codes under broad and length-of-stay–restricted case definitions, and incorporated a neonatal component that included perinatal respiratory codes for infants younger than 1 year. Serfling harmonic regression was used to estimate seasonal baselines and excess SARI admissions at national, provincial, and age-stratified levels. Results – Administrative data identified 538, 272 SARI discharges and revealed marked heterogeneity in incidence and case fatality across provinces and age groups. A previously unrecognized shift in ICD-10 coding from respiratory to perinatal chapters produced an apparent 99% decline in infant SARI after 2014; reclassifying perinatal respiratory codes restored stable high SARI rates in infants and increased their estimated burden by nearly ten-fold. Nationally, we identified 50 epidemic weeks with 77, 352 excess SARI discharges (95% CI 70, 030–85, 982), while the COVID-19 pandemic disrupted typical seasonality, reducing admissions but increasing mortality among older adults. Conclusions – Routinely collected hospital discharge data can reconstruct SARI epidemic dynamics and geographic disparities in the absence of virological surveillance, but are highly sensitive to coding practices. Incorporating neonatal perinatal respiratory codes into SARI definitions is essential to avoid underestimating infant burden and misinforming public health priorities. Copyright © 2026 Angamarca-Iguago, Cagua-Ordónez, Parise-Vasco, Fuentes-Tumbaco, Escobar-Naranjo, Reytor-González and Simancas-Racines.
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Perception, knowledge and attitudes of Ecuadorian dentists towards patients with molar incisor hypomineralization
(Frontiers Media SA, 2026-06-08)
Armas-Vega, Ana
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Parise Vasco, Juan Marcos
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Angamarca Iguago, Jaime
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Cagua Ordoñez, Jaen
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Ribadeneira-Morales, Jennifer
Background – Molar Incisor Hypomineralization (MIH) is one of the most prevalent enamel development defects in contemporary dental practice. Understanding perceptions, knowledge, and attitudes of professionals towards this condition is key to optimizing clinical protocols and improving therapeutic results. Objective – To evaluate the perception, knowledge and attitudes of Ecuadorian dentists about diagnosis and management of patients with MIH. Methods – A cross-sectional observational study was carried out using a self-administered survey of registered dentists in Ecuador. A validated 19-question questionnaire was applied that explored demographic characteristics, knowledge of etiology and prevalence, attitudes towards clinical management, and therapeutic choices. In addition, two clinical cases with photographic support were included to evaluate treatment decisions. The statistical analysis incorporated descriptive statistics, chi-square or Fisher's exact tests, and multivariate logistic regression models. Results – A total of 352 dentists participated, predominantly working in private practice (71.9%), particularly in general dentistry (61.1%). Most practitioners reported observing MIH monthly (45.7%) and perceived an increase in its occurrence (67.0%). Demarcated opacities were the most frequent clinical manifestation (93.2%), with antibiotics being the main reported etiological factor (31.8%). The frequency of observation varied significantly between specialties (p < 0.05). Management was considered difficult, with durability of restorations being the main concern. Glass ionomer (37.5–71.4%) was the primary therapeutic choice, followed by fluoride varnish (22.6–37.5%). In the multivariate logistic regression model, professionals with 6–10 years of experience showed significantly higher odds of adequate knowledge (adjusted OR = 2.23, 95% CI: 1.14–4.37, p = 0.019). No independent predictors of favorable attitude towards MIH management reached statistical significance after multivariate adjustment. Conclusions – MIH is recognized as a growing and complex problem. It is frequently observed with demarcated opacities as the predominant sign and antibiotics as the main etiological factor. Its management is challenging, and professional experience appears to influence clinical knowledge. Continuing education and the development of standardized clinical protocols are needed to strengthen professional competence in MIH management. © 2026 Armas-Vega, Parise-Vasco, Angamarca-Iguago, Cagua-Ordoñez, Reytor-González, Ribadeneira-Morales, Rösing, Noal and Simancas-Racines.
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Endodontic Retreatment Using Rotary System and Aesthetic Rehabilitation of a Deciduous Central Maxillary Incisor in a 5‐Year‐Old Child: A Case Report
(Wiley, 2026-01)
Domínguez-Gaibor, Esthefany
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Ribadeneira-Morales, Leslee
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Sempertegui, Paulina
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Parise Vasco, Juan Marcos
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Wesley, Hannah
Introduction Early childhood caries (ECC) affects the primary dentition of preschool children and can result in the need for pulp treatment. Endodontic retreatment in deciduous teeth is indicated when initial treatment fails, representing a conservative alternative to extraction. Objective This case describes pulp retreatment using a rotary system and complete aesthetic rehabilitation of the anterosuperior sector in a pediatric patient. Case Report A 5‐year‐old systemically healthy male patient attended the clinic with ECC affecting the maxillary central and lateral incisors. Clinical examination revealed a temporary dentition with bilateral Class I molar relationship. The left maxillary central incisor presented a previous deficient endodontic obturation with material extending only one‐third of the root length. The treatment plan included pulp retreatment of Tooth 61, fiberglass postplacement, and celluloid crowns on maxillary incisors, in addition to comprehensive oral cavity rehabilitation. Canal debonding was performed with K‐files, removing zinc oxide eugenol. Reinstrumentation was performed with Hedstrom File #30 and the U1 file rotary system (0.40 mm, torque 2.5 N·m, and 400 RPM), with a working length of 11.5 mm. An irrigation protocol was performed using physiological saline, as well as 2.5% and 5% sodium hypochlorite. Obturation was performed with Metapex. Subsequently, a fiberglass post cemented with RelyX dual and celluloid crown with Filtek Supreme resin were placed. One‐year follow‐up demonstrated an asymptomatic tooth, remaining in the mouth in favorable conditions with successful aesthetic and functional restoration. The mother and patient expressed high satisfaction with the outcome. Conclusion In this pediatric case, endodontic retreatment of a deciduous maxillary central incisor using a rotary system, combined with fiberglass post placement and celluloid crown rehabilitation, resulted in favorable clinical and radiographic outcomes at 12‐month follow‐up. Within the limitations of a single‐case report, these findings suggest that retreatment may be considered a viable conservative alternative to extraction in carefully selected clinical scenarios.
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Regional, altitudinal, and age-specific heterogeneity of bronchiolitis hospitalization seasonality in Ecuador, 2007–2024, and implications for RSV immunoprophylaxis timing
(Frontiers Media SA, 2026-08-03)
Angamarca Iguago, Jaime
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Cagua Ordoñez, Jaen
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Parise Vasco, Juan Marcos
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de Mora, Doménica
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Escobar-Naranjo, Mónica
Background – Acute bronchiolitis, mainly attributed to respiratory syncytial virus (RSV), is the leading cause of infant hospitalization for lower respiratory tract disease worldwide. Nirsevimab and maternal RSVpreF (Abrysvo) confer about 6 months of protection, so timing relative to the season affects their impact. Ecuador spans the equator from sea level to valleys above 4, 000 m and is considering introducing these products, yet lacks subnational evidence on the seasonality of bronchiolitis, altitudinal patterning, or post-pandemic stability. Methods – We conducted a national ecological time-series analysis of hospital discharges from the Ecuadorian Statistics Institute, 2007–2024 (19, 788, 097 discharges; 204 of 224 cantons had complete data and formed the analytic panel). The primary outcome was acute bronchiolitis (ICD-10 code J21) in children younger than 12 months (n = 23, 190 nationally; 22, 724 in the panel), with secondary outcomes across three RSV-relevant age bands, ICD-10 code J21 under 5 years, and two RSV-specific ICD-10 codes (J12.1 and J20.5; 2018–2024). K35 (appendicitis) was a negative control. Analyses combined circular seasonality metrics with block-bootstrap confidence intervals (CIs), year-by-year disaggregation, and complementary sensitivity analyses [Moving Epidemics Method (MEM), Bai–Perron breaks, and lagged climate correlations]. Results – The weighted circular peak month of infant bronchiolitis hospitalizations shifted after the pandemic in Costa (+2.16 months), Sierra (+1.22), and Amazonía (+1.91), attenuating with altitude from +2.19 months below 500 m to +0.88 at 1, 500–3, 000 m. Costa was stable across 2022–2024; Sierra and, more so, Amazonía varied widely year to year (Amazonía peak ranged March–July, n = 37–42/year), so the pooled estimate should be read with caution. The composite RSV-coded outcome tracked ICD-10 code J21's timing closely in Costa (0.15-month difference) and Sierra (0.40), supporting ICD-10 code J21 as a reasonable RSV proxy in both, and the three regional peaks now span 2 months. Conclusion – Bronchiolitis seasonality in Ecuador changed after the pandemic, most clearly and stably in Costa; Sierra showed a transient 2022 perturbation with partial reversion by 2023–2024, and Amazonía's estimates remained unstable and underpowered. As region-tailored estimates are less stable in Sierra and Amazonía than in Costa, a single national window (nirsevimab February–April; maternal RSVpreF for pregnancies expected to deliver January–May) is a more defensible starting point, pending confirmation from further seasons and, ideally, laboratory-confirmed surveillance. Copyright © 2026 Angamarca-Iguago, Cagua-Ordóñez, Parise-Vasco, de Mora, Escobar-Naranjo, Bruno and Simancas-Racines.
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Two-Stage Conservative Management of Mandibular Unicystic Ameloblastoma with an Intraluminal Pattern: A Case Report
(MDPI AG, 2026-08-17)
Chango-Chávez, Andrea
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Vizuete-Bolaños, Marco
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Paladines-Calle, Stephany
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Parise Vasco, Juan Marcos
Intraluminal unicystic ameloblastoma is characterized by tumor proliferation confined to the cystic lumen, without invasion of the supporting connective tissue, a feature that has led some authors to regard it as particularly suited to conservative surgical treatment. Objective: This study aims to describe the conservative two-stage management of a mandibular unicystic ameloblastoma with an intraluminal pattern, treated by decompression followed by enucleation with the aim of avoiding mandibular resection. Case Report: A 24-year-old female patient presented with a slight swelling in the right mandibular angle that had evolved over two years without prior treatment. Panoramic radiography revealed a well-defined radiolucent lesion extending from the mesial surface of the right mandibular second molar through the mandibular ramus to the ipsilateral coronoid process. Cone-beam computed tomography (CBCT) confirmed the lesion as a hypodense area measuring approximately 6 × 3.4 × 2.9 cm. A two-stage surgical approach was performed: the first stage consisted of an incisional biopsy and the placement of a decompression tube for six months; the second stage consisted of enucleation of the lesion. The definitive histopathological diagnosis was intraluminal unicystic ameloblastoma with a plexiform growth pattern. The surgical procedures were completed without preoperative, intraoperative, or postoperative complications. Follow-up evaluations were performed at 3 and 6 months and at 1 and 2 years after the initial surgical stage. Conclusions: At 24 months from the initiation of treatment, the outcome was favorable, with evidence of mandibular bone apposition and no signs of lesion recurrence. © 2026 by the authors.
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Temporal Dynamics of Innate Immune Activation and Viral Interference During Sequential Co-Infection with Influenza A Virus and SARS-CoV-2: Molecular Mechanisms, Clinical Evidence, and Therapeutic Implications
(MDPI AG, 2026-07-03)
Angamarca Iguago, Jaime
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Parise Vasco, Juan Marcos
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Reytor González, Claudia
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Cagua Ordoñez, Jaen
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Simancas Racines, Daniel
The concurrent circulation of influenza A virus (IAV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has unveiled complex host–pathogen interactions governed by temporal dynamics of innate immune activation. This narrative review synthesizes evidence from human air–liquid interface (ALI) epithelial models, animal studies (hamster, ferret), clinical cohorts, and randomized controlled trials (2015–2026) to delineate the molecular mechanisms underlying viral interference between these two major respiratory pathogens. Prior IAV infection induces a robust type I/III interferon (IFN) response and broad interferon-stimulated gene (ISG) upregulation that restricts subsequent SARS-CoV-2 replication within a critical 24–72 h temporal window. Conversely, SARS-CoV-2 employs a multi-layered immune evasion strategy that blunts IFN induction, providing minimal heterologous protection. Simultaneous co-infection tends to exacerbate disease severity. Host genetic determinants, including OAS1 and TLR7 variants, modulate interference capacity. Therapeutically, early pegylated IFN-λ shows clinical benefit, while experimental evidence from in vitro and animal models suggests oseltamivir may paradoxically reduce IAV-induced interference. These findings underscore the need for multi-pathogen diagnostics, temporally informed clinical decision-making, and IFN-based therapeutic strategies during co-circulation periods. © 2026 by the authors.
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Tuberculosis in prisons: an integrated prevention and care cascade for a persistent structural epidemic
(Frontiers Media SA, 2026-07-08)
Cagua Ordoñez, Jaen
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Parise Vasco, Juan Marcos
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Angamarca Iguago, Jaime
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Fuentes-Tumbaco, Natasha Bella
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Simancas Racines, Daniel
Tuberculosis (TB) remains disproportionately concentrated in prison populations worldwide, driven by overcrowding, poor ventilation, HIV co-infection, delayed diagnosis, treatment interruption, social vulnerability, and weak integration between correctional health services and national TB programs. This structured narrative review synthesizes current evidence across the prison TB prevention and care cascade, including screening, diagnosis, treatment, transmission reduction, TB/HIV integration, surveillance, and continuity after release. We conducted an expert-led narrative synthesis informed by systematic-review principles, distinguishing direct prison-specific evidence from mathematical modeling, policy guidance, systematic reviews, and indirect evidence from adjacent fields such as HIV care and TB infection treatment. Symptom screening alone has limited sensitivity in high-burden prisons. Digital chest radiography with computer-aided detection can improve case detection when linked to confirmatory molecular testing and treatment capacity. Xpert MTB/RIF or Ultra are central to rapid confirmation and rifampicin-resistance detection. Shorter rifamycin-based regimens for TB infection generally achieve higher completion than longer isoniazid-based regimens, while shorter all-oral MDR/RR-TB regimens may offer programmatic advantages but remain insufficiently studied in correctional settings. Ventilation improvement, safer spaces, peer-supported case detection, and integrated TB/HIV services are important components of transmission reduction. Decongestion may have substantial population-level impact, but this conclusion is supported mainly by mathematical modeling and should be interpreted as a projected effect rather than direct prison-specific causal evidence. Post-release continuity remains a major implementation gap, with limited direct evidence for active TB interventions. Sustainable prison TB control requires moving from isolated activities to an integrated, measurable prison–community cascade linking risk-adapted screening, rapid diagnosis, effective treatment, environmental controls, data systems, and confirmed linkage to community care after release. Copyright © 2026 Cagua-Ordoñez, Parise-Vasco, Angamarca-Iguago, Fuentes-Tumbaco and Simancas-Racines.
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Surgical excision of an infraorbital nerve schwannoma via a transconjunctival approach with lateral canthotomy: a case report
(Frontiers Media SA, 2026-08-03)
Panchi-Lasluisa, Jonathan Andrés
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Acuña-Peña, Virgen María
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Álvarez-Razo, Sebastián
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Parise Vasco, Juan Marcos
Schwannoma is a benign, encapsulated, slow-growing tumor that arises from Schwann cells. Approximately 25%–45% of extracranial schwannomas occur in the head and neck region, accounting for 1%–8% of all neoplasms. However, involvement of the infraorbital nerve is exceptionally rare. This report describes the surgical management of an infraorbital nerve schwannoma using a transconjunctival approach with lateral canthotomy, and documents the clinical, functional and aesthetic outcomes at 12 months. A 32-year-old woman with a history of hypochromic microcytic anemia presented with a progressively enlarging mass in the right infraorbital region that had been present for four years, associated with mild paresthesia in the nasolabial region. The main reason for consultation was aesthetic concern due to facial protrusion. Physical examination revealed a firm, painless subcutaneous mass without local inflammatory signs. Contrast-enhanced computed tomography revealed a solid, lobulated lesion measuring approximately 60 mm in maximum diameter in the right infraorbital region. Imaging features suggested an origin from the infraorbital foramen and involvement of the corresponding nerve; there was no evidence of osteolysis. Fine-needle aspiration cytology (FNAC) suggested a mesenchymal neoplasm. Surgical excision was performed under general anesthesia via a transconjunctival approach with lateral canthotomy. The infraorbital nerve was identified and preserved intraoperatively. Histopathological examination confirmed a schwannoma, showing spindle-shaped cells with Verocay bodies. The patient had a favorable clinical course. At the 12-month follow-up, facial symmetry and preserved sensory function were confirmed, as was the absence of recurrence. © 2026 Panchi-Lasluisa, Acuña-Peña, Álvarez-Razo and Parise-Vasco.
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CBCT-guided Caldwell–Luc management of a dentigerous cyst associated with an ectopic maxillary third molar in the maxillary sinus: a case report
(Frontiers Media SA, 2026-08-04)
Llanos-Arteaga, José Luis
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Delgado-Piedra, Daniel Andrés
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Llanos-Arteaga, Luis Alberto
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Llanos-Arteaga, Anderson Daniel
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Parise Vasco, Juan Marcos
A dentigerous cyst associated with an ectopic third molar in the maxillary sinus is an extremely rare pathological entity that poses diagnostic and therapeutic challenges. We report the case of a 22-year-old woman with a four-month history of chronic nasal congestion and postnasal drip sensation, without a relevant medical history. Cone-beam computed tomography (CBCT) confirmed a cystic lesion associated with an ectopic third molar, allowing accurate three-dimensional assessment for surgical planning, with partial involvement of the left maxillary antrum. Given the size and location of the lesion, complete cystic capsule enucleation and ectopic tooth odontectomy were performed using the Caldwell–Luc approach under local anesthesia. Histopathological examination confirmed the diagnosis of a dentigerous cyst. Clinical and imaging follow-up at six months showed complete resolution of sinonasal symptoms and no evidence of recurrence. This case highlights that the Caldwell–Luc approach guided by CBCT remains a viable and effective option for treating extensive odontogenic cystic lesions involving the maxillary sinus. © 2026 Llanos-Arteaga, Delgado-Piedra, Llanos-Arteaga, Llanos-Arteaga and Parise-Vasco.

Parise Vasco, Juan Marcos

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