CENTRO DE INVESTIGACIÓN DE EVIDENCIA, IMPLEMENTACIÓN Y TOMA DE DECISIONES EN SALUD
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Item type:Publication, 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) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, 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); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Perception, knowledge and attitudes of Ecuadorian dentists towards patients with molar incisor hypomineralization(Frontiers Media SA, 2026-06-08); ; ; Ribadeneira-Morales, JenniferBackground – 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. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Local thermal anomalies and the altitudinal rise of dengue hospitalisation rates in Ecuador, 2011–2024: a national ecological study(Frontiers Media SA, 2026-09-08); ; ; Introduction Dengue is expanding beyond its traditional lowland range as rising temperatures may enable Aedes aegypti establishment at progressively higher altitudes. Ecuador, spanning sea level to above 4500 m, offers a natural altitudinal experiment, yet hospital-based evidence on the thermal drivers of Andean dengue is lacking. Methods We conducted a national ecological time-series analysis at the canton level using Ecuador's hospital discharge registry (INEC) for 2011–2024, the period with standardised canton coding, identifying dengue hospitalisations by ICD-10 codes A90, A91 and A97. Monthly land surface temperature, precipitation and vegetation index were derived from MODIS and GPM products. A distributed lag non-linear model estimated the temperature–hospitalisation association; a quasi-Poisson model restricted to Andean cantons (≥1500 m), with canton, calendar-month and year fixed effects, tested whether thermal anomalies above each canton's 2007–2015 baseline were associated with hospitalisation rates. Results Among 74,601 dengue hospitalisations with a resolvable canton of residence (232 deaths; case fatality 0.31%), dengue was recorded in 68 cantons above 1500 m, including altitudes exceeding 3000 m. The national hospitalisation rate rose from 29.7 to 77.0 per 100,000 and the Andean rate approximately 7-fold (1.9 to 12.8). The minimum hospitalisation temperature was 18.4°C nationally and 18.9°C in Andean cantons. A +1°C anomaly versus zero was associated with a 1.07-fold increase in hospitalisation rates (95% CI 1.02–1.13; p = 0.012). Without canton fixed effects, the same contrast yielded 1.21 (1.07–1.36); the within-canton association fell to 1.04 (1.00–1.08) when the 2024 epidemic year was excluded. Discussion Positive deviations from local historical baselines, rather than absolute temperature, were associated with rising dengue hospitalisation rates among Andean residents, by a modest margin that depends materially on the 2023–2024 epidemic. In-hospital case fatality was nearly twice as high in low Andean cantons (0.62%, 95% CI 0.20–1.45; five deaths) as on the coast (0.33%), a non-significant difference that nonetheless supports strengthening dengue recognition in highland facilities. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Socioeconomic disparities and nutritional aging: how food insecurity and financial hardship accelerate health decline in older adults(Frontiers Media SA, 2026-06-08); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, 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); Wesley, HannahIntroduction 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. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, 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); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Personalized nutrition for healthy aging: precision diets based on genomic, metabolic, and microbiome profiles(Frontiers Media SA, 2026-08-05); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, 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); ; ; ; 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. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Associations of the exact-overlap Farm-to-Diet Coupling Index and production diversity with market dependence among smallholder farming households in Los Ríos, Ecuador: a cross-sectional study(Frontiers Media SA, 2026-09-08);
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