Reytor González, Claudia

Preferred name

Main Affiliation

Facultad de Ciencias de la Salud y Bienestar Humano

Ambato

Scopus Author ID

59139226400

Now showing 1 - 10 of 31

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From remote screening to precision prevention: responsible multimodal AI for risk prediction and equitable oral healthcare
(Frontiers Media SA, 2026-07-24)
Iglesias-Pérez, Heydi Daniela
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Gallo-Sánchez, Maria Emilia
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López-Loachamin, Ariel Sebastián
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Paccha-Melgar, Daniela Alejandra
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Rivadeneira-Ahuilar, Julio Damián
Artificial intelligence (AI) applications in oral healthcare have expanded considerably over the past decade. Deep-learning systems now report diagnostic performance exceeding 0.85 sensitivity and 0.90 specificity for several image-based tasks, with the highest pooled estimates reported in AI-assisted clinical photography for oral cancer and oral potentially malignant disorder (OPMD) detection (diagnostic odds ratio 68.4; AUC 0.938). These figures, however, mask three translational gaps. First, many studies often carry high risk of bias, lack external validation, and rest on heterogeneous reference standards. Second, datasets often provide limited demographic reporting, leaving uncertainty about model performance in the populations most likely to benefit from remote screening. Third, teledentistry and mHealth tools have outpaced the regulatory, validation, and fairness-auditing, and clinical-integration frameworks required for safe deployment. Preventive value emerges most clearly when AI is embedded in multimodal systems, such as imaging, sensors, behavioural feedback, clinician support rather than evaluated as an isolated classifier. Progress will be defined less by additional accuracy gains and more by external validation in diverse populations, transparent demographic reporting, equity-focused evaluation, and integration into prevention-oriented care pathways. © 2026 Iglesias-Pérez, Gallo-Sánchez, López-Loachamin, Paccha-Melgar, Rivadeneira-Ahuilar, Luna-Ponce, Gallo-Achig, Pillajo-Villalba, Campuzano-Donoso and Reytor-González.
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Nutrition-First Support for GLP-1 and Dual Incretin Therapy in Obesity: A Practical Framework for Dietary Management, Symptom Tolerability, and Long-Term Weight Maintenance
(MDPI AG, 2026-05-29)
Zambrano-Villacres, Raynier
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Campuzano-Donoso, Martín
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Reytor González, Claudia
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Rossetti, Gianluca
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Cobellis, Luigi
Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonists have transformed obesity treatment, producing substantial weight loss during active therapy. However, real-world effectiveness may be limited by gastrointestinal adverse events, reduced dietary intake, fat-free mass loss as part of total weight reduction, and weight regain after discontinuation. Methods: This narrative review synthesizes current pharmacological, nutritional, gastrointestinal, body-composition, and implementation evidence to propose an evidence-informed nutrition-first framework for patients receiving incretin-based therapy for obesity. Results: We translate pharmacologic mechanisms into practical dietary strategies, including protein prioritization, structured meal patterns, hydration and fiber management, symptom-targeted interventions, resistance-training support, and maintenance planning. Because direct trials of structured nutrition interventions in GLP-1RA- or dual incretin-treated populations remain limited, several recommendations are extrapolated from the broader obesity, caloric restriction, body-composition, gastrointestinal, and expert-consensus literature. Conclusions: Integrating structured nutrition care into pharmacotherapy pathways may help address meal-related symptom burden, support protein and fluid adequacy, identify patients at higher nutritional or body-composition risk, and prepare patients for long-term weight-management behaviors. Embedding practical nutrition management within multidisciplinary obesity care may help translate pharmacologic efficacy into durable, patient-centered 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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Socioeconomic disparities and nutritional aging: how food insecurity and financial hardship accelerate health decline in older adults
(Frontiers Media SA, 2026-06-08)
Reytor González, Claudia
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Campuzano-Donoso, Martín
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Román-Galeano, Náthaly-Mercedes
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Castano Jimenez, Janeth
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Paz-Yépez, Carolina
This narrative review examines how socioeconomic disparities accelerate health decline in older adults. As the global population ages, older age represents a major risk factor for chronic diseases, frailty, and disability, particularly in socially disadvantaged groups. While adequate nutrition is essential to healthy aging, approximately 28% of the global population experiences moderate or severe food insecurity, with older adults disproportionately affected in resource-limited settings. Food insecurity and financial hardship are consistently associated with poorer diet quality, including lower Healthy Eating Index scores (e.g., ~51 vs. >57 in food-secure peers), and increased risk of adverse outcomes such as sarcopenia, frailty, and cognitive decline. Notably, food-insecure older adults are also more likely to experience overweight or obesity (OR ≈ 1.29), reflecting reliance on energy-dense, nutrient-poor diets. These disparities are shaped by structural and socioeconomic factors, including low income, limited education, inadequate social safety nets, and inequitable neighborhood food environments. Addressing these challenges requires a shift from individual-level interventions to systemic, interdisciplinary, and culturally-tailored approaches. Copyright © 2026 Reytor-González, Campuzano-Donoso, Román-Galeano, Castano Jimenez, Paz-Yépez, Montalvan and Simancas-Racines.
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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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Hot flashes: a potential marker of deterioration of health-related quality of life
(2026)
Juan E. Blümel
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María S. Vallejo
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Peter Chedraui
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Eugenio Arteaga
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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.
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Dietary Diversity, Dietary Patterns, and Cardiometabolic Health in University Students: A Cross-Sectional Study
(2026)
Diana Fonseca-Pérez
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Ludwig Álvarez-Córdova
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Cecilia Arteaga-Pazmiño
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Víctor Sierra-Nieto
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Cagua Ordoñez, Jaen
Cardiometabolic risk is increasingly observed in young adults, particularly during university years, and is not limited to individuals with elevated body mass index. Emerging evidence highlights the presence of normal weight obesity—characterized by excess adiposity and unfavorable body composition despite normal BMI—which may confer early metabolic vulnerability. Dietary diversity is often promoted as a marker of dietary adequacy; however, its relationship with adiposity, body composition, and muscular health remains inconsistent, particularly in Latin American populations. Moreover, few studies have directly contrasted dietary diversity indicators with empirically derived dietary patterns in relation to cardiometabolic and functional outcomes. Objective: To examine the associations between dietary diversity, dietary patterns, and indicators of adiposity, muscular strength, and relative muscle mass in Ecuadorian university students. Methods: A cross-sectional study was conducted among 349 undergraduate students aged 18–26 years enrolled in health sciences programs in Ecuador. Dietary intake was assessed using a validated food frequency questionnaire. Dietary diversity was quantified using the Food and Agriculture Organization’s Individual Dietary Diversity Score, while dietary patterns were identified through principal component analysis followed by k-means clustering. Outcomes included excess body weight, relative muscle mass assessed by bioelectrical impedance analysis, and handgrip strength. Multivariable Poisson and linear regression models were fitted, adjusting for age, sex, academic program, physical activity level, and pre-existing conditions. Results: Despite their young age and low prevalence of diagnosed disease, approximately one-third of the participants exhibited markers of early cardiometabolic risk, including excess body weight and central adiposity. Higher dietary diversity was independently associated with a higher prevalence of excess body weight (adjusted prevalence ratio per one-unit increase in IDDS: 1.17; 95% CI: 1.06–1.30) and with greater relative muscle mass (adjusted β = 0.13; 95% CI: 0.05–0.22), whereas no association was observed with handgrip strength. In contrast, dietary patterns derived from multivariate analysis showed no significant associations with adiposity, muscular strength, or relative muscle mass after adjustment. Conclusions: In this young adult population, dietary diversity captured aspects of overall dietary exposure associated with both increased adiposity and greater lean mass, but not with muscular strength. Empirically derived dietary patterns demonstrated limited discriminatory capacity, likely reflecting dietary homogeneity within the cohort. These findings indicate that dietary diversity alone does not necessarily reflect diet quality and underscore the importance of interpreting diversity metrics alongside indicators of food quality, energy density, and body composition when evaluating early cardiometabolic risk in contemporary food environments.
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Alcohol and Substance Use After Bariatric Surgery: Nutritional Risks and Clinical Implications in Long-Term Postoperative Care
(2026)
Martín Campuzano-Donoso
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Reytor González, Claudia
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Gerardo Sarno
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Martha Montalvan
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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.
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Endometriosis as a Systemic and Complex Disease: Toward Phenotype-Based Classification and Personalized Therapy
(2026)
Simancas Racines, Daniel
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Emilia Jiménez-Flores
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Martha Montalvan
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Raquel Horowitz
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Valeria Araujo
Endometriosis is traditionally conceptualized as a pelvic lesion–centered disease; however, mounting evidence indicates it is a chronic, systemic, and multifactorial inflammatory disorder. This review examines the molecular dialog between ectopic endometrial tissue, the immune system, and peripheral organs, highlighting mechanisms that underlie disease chronicity, symptom variability, and therapeutic resistance. Ectopic endometrium exhibits distinct transcriptomic and epigenetic signatures, disrupted hormonal signaling, and a pro-inflammatory microenvironment characterized by inflammatory mediators, prostaglandins, and matrix metalloproteinases. Immune-endometrial crosstalk fosters immune evasion through altered cytokine profiles, extracellular vesicles, immune checkpoint molecules, and immunomodulatory microRNAs, enabling lesion persistence. Beyond the pelvis, systemic low-grade inflammation, circulating cytokines, and microRNAs reflect a molecular spillover that contributes to chronic pain, fatigue, hypothalamic–pituitary–adrenal axis dysregulation, and emerging gut–endometrium interactions. Furthermore, circulating biomarkers—including microRNAs, lncRNAs, extracellular vesicles, and proteomic signatures—offer potential for early diagnosis, patient stratification, and monitoring of therapeutic responses. Conventional hormonal therapies demonstrate limited efficacy, whereas novel molecular targets and delivery systems, including angiogenesis inhibitors, immune modulators, epigenetic regulators, and nanotherapeutics, show promise for precision intervention. A systems medicine framework, integrating multi-omics analyses and network-based approaches, supports reconceptualizing endometriosis as a systemic inflammatory condition with gynecologic manifestations. This perspective emphasizes the need for interdisciplinary collaboration to advance diagnostics, therapeutics, and individualized patient care, ultimately moving beyond a lesion-centered paradigm toward a molecularly informed, holistic understanding of endometriosis.
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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
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Martín Campuzano-Donoso
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Gerardo Sarno
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Martha Montalvan
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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.
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Reytor González, Claudia

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