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    Dietary Diversity, Dietary Patterns, and Cardiometabolic Health in University Students: A Cross-Sectional Study
    (2026)
    Diana Fonseca-Pérez
    ;
    Ludwig Álvarez-Córdova
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    Cecilia Arteaga-Pazmiño
    ;
    Víctor Sierra-Nieto
    ;
    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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    Demographic, Functional, and Risk Factors Characterization in Ecuadorian Mestizo Patients With Microtia: A Retrospective Study
    (2024) ;
    Fausto Coello
    ;
    Ramiro López-Pulles
    ;
    Guillermo Fuenmayor
    ;
    Edwin Andrade
    Objective: This paper compares demographic, morphological, functional, and risk factors between isolated and familial forms of microtia in Ecuadorian mestizo patients. Methods: The authors did an epidemiological, and retrospective study with 112 patients divided into isolated microtia (n = 91) and familial microtia (n = 21). Patients with syndromic microtia were not included. Results: In isolated microtia, the mean age was 11.80 ± 16.9, and the most prevalent age group was from 5 to 9 years, with 45.0%; males were 58.2%, and 91.2% of patients were born in a city above 2500 meters about sea level. In familial microtia, the mean age was 15.57 ± 17.2. There were no statistically significant differences between the analyzed variables. In isolated microtia, 41.8% of patients had bilateral involvement, 40.7% had grade 1 microtia in the right ear (RE), and grade 1 in the left ear was 47.3%; external auditory canal atresia of RE was present in 62.6%, and in left ear in 31.6%. External auditory canal atresia sidedness was mostly unilateral in both groups. Most patients did not have tags or pits (78% and 81% in RE and 85.7% and 71.4%). Most patients had moderate hearing loss in both ears. Conclusion: The authors found an association between both microtia forms with external auditory canal atresia in RE; only 20% of patients had unilateral auricular tags or pits in both groups. The authors also found a high incidence (18.75%) of familial microtia, which suggests a distinct pathological genetic component than the more prevalent isolated cases. The authors found a high association of microtia cases from the Ecuadorian highlands above 2500 meters about sea level (over 90%). The presence of “social” intake of alcohol during pregnancy showed over twice the chance of having a child born with microtia.
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    Cancer Risk Due to Rheumatoid Arthritis in Older Adults in the Province of Pastaza
    (2025)
    Luis Enrique Naula Chuca
    ;
    ;
    Alexandra Monserrath Moya Carillo
    ;
    Mayra Lisseth Toaquiza Quinapallo
    The rheumatoid arthritis is a disease that increases the risk of developing certain types of cancer, such as lymphomas, leukemia, multiple myeloma and lung cancer affecting all people, regardless of sex, age or social status, but the population at greatest risk is the elderly, which is why we seek to learn about the disease and it’s about the disease and its affectations, as well as about its conventional and alternative and alternative treatment by means of natural products in areas of the Pastaza Province. The research was carried out bibliographic review using a descriptive and explanatory research method, based on a descriptive and explanatory method, based on relevant information from publications in magazines, scientific in journals, scientific articles, as well as a systematic review by describing the most describing the most relevant parts, analyzing and interpreting them. It was obtained that rheumatoid arthritis results showed that rheumatoid arthritis affects mostly women of 60 years of age or older in 69%, as well as 69%, as well as that anti-inflammatory medication should be prescribed according to the progression of the disease according to the progression of the disease, and the alternative of natural medications such as wine natural medicines as the wine therapy that contributes to the improvement of the patient. It is concluded that the older adult with rheumatoid arthritis has a better quality of life rheumatoid arthritis has a poor quality of life which leads to other psychosomatic diseases.
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    Impact of Delayed Trauma Unit Admission on Mortality and Disability in Traumatic Brain Injury Patients
    (2025)
    Julio Quispe-Alcocer
    ;
    Antonio Biroli
    ;
    Traumatic brain injury (TBI) remains a critical public health issue worldwide, with significant morbidity, mortality, and long-term disability. Timely transfer to a specialized trauma unit is crucial to improving outcomes, yet in resource-limited settings, delays often exceed recommended time frames. This study evaluates the impact of arrival time on mortality, disability, and clinical outcomes in Ecuadorian patients with TBI. A cross-sectional and observational study was conducted, analyzing 383 adult patients diagnosed with TBI. Patients were categorized into two cohorts: those who arrived at a specialized trauma unit within five hours post-injury and those who arrived between five and 24 h. Demographic, clinical, and radiological characteristics were analyzed, including Glasgow Coma Scale (GCS), Injury Severity Score (ISS), Marshall Scale classification, and presence of subarachnoid hemorrhage (SAH). Logistic regression models were used to identify predictors of mortality and disability. Longer transfer times were associated with increased mortality (3.34 times higher for ≥5 h, p < 0.05) and disability (2.92 times higher for ≥5 h, p < 0.05). Patients with Marshall Diffuse Injury III and IV had an 8.80- and 9.05-fold increased risk of mortality, respectively. SAH was an independent predictor of mortality (4.53 times higher), and GCS between 9–13 increased the likelihood of death by 6.49 times. Delayed transfers were associated with lower GCS at admission, longer ICU stays, and increased surgical complications. Although some survivors experienced improvement over time, disability in TBI can persist for many years or even lifelong, underscoring the burden of delayed trauma care. Despite delays, overall survival remained higher than reported in high-income countries, suggesting compensatory factors in hospital-based management. Delayed hospital arrival in TBI patients significantly increases mortality and disability. Early transfer within five hours is essential to reduce secondary brain injury and improve functional outcomes. Findings suggest that in resource-limited settings, optimizing pre-hospital care and transport efficiency is crucial to minimizing long-term disability.
      18
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    Aggression and violence in adolescents in the iberoamerican context, a systematic review
    (2022)
    Javela, J.J.
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    Naranjo-Niño, B.
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    Ospina-Sánchez, D.J.
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    Bahamon, M
    ;
    Cuesta-Guzmán, M.
    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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    Interpreting Resting Energy Expenditure in Critically Ill Patients with Obesity: Clinical Impact of Weight Adjustment
    (2026)
    Sebastián Chapela
    ;
    ; ;
    Daniel Tettamanti Miranda
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    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.
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    T he interplay between osteoarthritis and cardiovascular disease: shared pathophysiological mechanisms
    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
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    The role of negative affects as mediators in the relationship between stress and mental health in Ecuadorian adolescents
    (2023)
    Moreta-Herrera R.
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    Zumba-Tello D.
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    de Frutos-Lucas J.
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    Llerena-Freire S.
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    Salinas-Palma A.
    Background Stress and negative emotions have adverse consequences for the mental health of adolescents, an area that deserves further examination. These attributes are associated with each other and regularly interact in different ways. The way they exert an influence can be both direct and indirect, so the general objective is to elucidate the potential mediating effect of negative affects in the relationship between stress and mental health in Ecuadorian adolescents. participants and procedure An explanatory and mediation design based on structural equation modeling (SEM) was applied with 1154 high school students from Ecuador (67.7% women) aged 14 to 19 years (M = 15.69). results In our sample, the presence of stress and negative affect is moderate, while that of mental health problems is low. According to our final model, these variables covary with and influence each other in the following way: stress (X) has a direct effect on mental health (Y) and also an indirect effect mediated by negative affect (M). The structural regression model proposed explains 63.0% of the variance in mental health. conclusions Stress exerts a relevant impact on mental health, both through direct and indirect pathways. The indirect pathway, mediated by negative affect, opens the door to novel interventional strategies to foster mental health. © 2023 Termedia Publishing House Ltd.. All rights reserved
    Scopus© Citations 1  28
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    Natural Products Targeting Key Molecular Hallmarks in Gastric Cancer: Focus on Apoptosis, Inflammation, and Chemoresistance
    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.
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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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    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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