University of Guayaquil
  • Guayaquil, Ecuador
Recent publications
Background High blood pressure is a prevalent condition in patients with chronic kidney disease on hemodialysis. Adequate control of high blood pressure is essential to reducing deaths in this group. The present study aimed to observe mortality prospectively in a group of patients in hemodialysis and hemodiafiltration programs in whom the use of antihypertensives was optimized with the point-of-care dry weight (POC-DW) technique. Methods The present observational, prospective study was carried out at the Pafram hemodiafiltration unit in Morona Santiago, Ecuador, and the hemodialysis unit of the Fundación Renal del Ecuador in Guayaquil, Ecuador, from August 2019 to December 2023. Patients who were receiving hemodiafiltration were included. Weight was optimized with POC-DW for eight weeks. In Group 1, patients whose use of antihypertensive drugs was not required to control systolic blood pressure with a value less than 150 mmHg predialysis, less than 130 mmHg postdialysis, and a peridialytic blood pressure (defined as post-HD minus pre-HD SBP) between 0 and − 20 mmHg were analyzed. In Group 2, patients who required antihypertensive drugs for not meeting the aims of systolic blood pressure were included. The variables included clinical, demographic, mortality, description of the treatment, and routine laboratory tests in dialysis programs. The sample was nonprobabilistic. Survival analysis was performed for the study groups. The log-rank test (Mantel-Cox) was used for survival comparisons. Results The study included 106 patients. Optimal blood pressure control without antihypertensive treatment was achieved in 52 patients (49.1%) (Group 1). In 54 patients (50.9%), antihypertensive agents were required (Group 2). There was more significant mortality in the group that received antihypertensives: 11 patients in group 1 (21.2%) versus 25 patients in group 2 (46.3%) (P = 0.005). Survival was more significant in group 1, with an HR of 2.2163 (1.125–4.158) (P = 0.0243). Conclusion In hemodiafiltration and hemodialysis programs, blood pressure control with active ultrafiltration measures and without using antihypertensives is essential for survival in patients with CKD.
The potential risk areas for emerging or reemerging diseases are determined by the presence, abundance, and distribution of mosquitoes. Here new records and geographical distribution extension of mosquito species in phytotelmata are updated for Argentina. We report for the first time Toxorhynchites bambusicola in Aechmea distichantha in Salta and Tucumán provinces, in the northwest region of Argentina. We also report Anophelesargyritarsis in A. distichantha in Salta province. Culexcoronator, Cx. fernandezi, and Cx.hepperi are reported for the first time from Vriesea friburgensis, a new phytotelma from the northwest region of Tucumán province, Argentina. These findings confirm the need for continued research on mosquito-plant relationships to better understand this complex ecological network and the epidemiological importance of phytotelmata-breeding mosquito species.
Background Dental services are often overlooked within healthcare systems, despite their critical role in overall health. Socioeconomic barriers and disparities in insurance coverage frequently limit access to oral care, particularly among vulnerable populations like older adults. Objective To examine the impact of different health insurance types on the frequency of dental consultations among Ecuadorian senior citizens, aiming to highlight gaps in access to care. Methods Using the 2009 National Survey of Health, Well-being, and Aging (SABE), which aims to determine the health and living conditions of older individuals, this study analyzed the health insurance status and dental service visits of 4,565 older adults in Ecuador. Binary logistic regression was employed to explore the association between insurance type and dental-care utilization. Results In the sample, 76.50% of older adults had not visited a dentist in the past year. Insurance breakdown revealed 17.04% with general IESS, 9.59% with rural IESS, 2.23% with private insurance, 1.86% with ISSFA/ISSPOL, 1.86% with municipal insurance, and 69.66% were uninsured. Individuals with private insurance or ISSFA/ISSPOL insurance were 32% and 91% more likely, respectively, to seek oral care compared to those without these respective insurances. Conversely, uninsured individuals were 43% less likely to seek dental care than those with any type of insurance. Conclusion Health insurance significantly influences the frequency of dental consultations among Ecuadorian seniors, highlighting the need for policy interventions to ensure equitable access to oral care.
Background: Microsporidia, particularly E. bieneusi and E. intestinalis, are emerging opportunistic pathogens that pose significant health risks to immunocompromised individuals, especially people living with HIV (PLHIV). Despite the global recognition of microsporidia’s impact, there has been limited research on their prevalence and associated risk factors in Ecuador. This study aimed to investigate the prevalence and identify risk factors associated with microsporidia infections among PLHIV with diarrhea in Ecuador. Methods: A cross-sectional study was conducted at the José Daniel Rodríguez Infectious Hospital in Guayaquil, Ecuador, between April 2021 and May 2022. A total of 85 PLHIV with diarrhea were included in the analysis. Fecal samples were tested for microsporidia using fast-hot Gram chromotrope staining, immunofluorescence microscopy, and transmission electron microscopy. Logistic regression was performed to assess the association between demographic, clinical, and behavioral factors and microsporidia infection. Results: The prevalence of microsporidia infections among the study population was 18.8%. Logistic regression analysis identified significant associations with age ≥ 60 years (OR = 19.169, p = 0.036), female sex (OR = 10.491, p = 0.028), and non-adherence to antiretroviral therapy (OR = 8.466, p = 0.077). Marginally significant associations were observed for substance use (OR = 0.262, p = 0.094) and high/very high HIV viral load (≥10,000 copies/mL, OR = 0.457, p = 0.094). CD4 count and marital status showed descriptive trends but were not statistically significant. Conclusions: This study highlights the burden of microsporidia infections among PLHIV in Ecuador and underscores the need for targeted public health interventions. Strategies should prioritize older individuals, females, and those with poor ART adherence to reduce infection risk. Future research is needed to explore additional risk factors and refine precision medicine approaches for this population.
El objetivo de este artículo es analizar el impacto de la ética profesional en los Gobiernos Autónomos Descentralizados (GAD) Municipales y su influencia en la toma de decisiones estratégicas, con un enfoque específico en el cantón Salitre, provincia del Guayas, Ecuador, durante el 2024. Para ello, se empleó una metodología cualitativa descriptiva, que consistió en la realización de entrevistas a funcionarios municipales clave, con el fin de identificar cómo la implementación de un código de ética contribuye a fortalecer la confianza de la ciudadanía, promoviendo valores como la transparencia, la responsabilidad social, la equidad, la probidad y la imparcialidad en la gestión de los recursos públicos. Además, se exploró cómo estos principios éticos influyen directamente en la formulación de decisiones estratégicas que buscan garantizar un uso eficiente y equitativo de los recursos, lo cual se refleja en el progreso y las obras comunitarias. A través del análisis cualitativo de las respuestas obtenidas, se midió el impacto de estas decisiones, que se espera evaluar mediante indicadores y resultados concretos que evidencien los beneficios para la comunidad. Los hallazgos sugieren que la ética profesional desempeña un papel clave en asegurar que las decisiones estratégicas estén alineadas con los intereses de la sociedad, mejorando la gestión pública y promoviendo el desarrollo sostenible a nivel local. Esto refuerza la importancia de la ética como pilar fundamental para lograr un gobierno más transparente y justo en el contexto de los GAD municipales.
El presente artículo analiza el cambio curricular implementado en la carrera de Sociología de la Universidad de Guayaquil, con el propósito de incorporar competencias que fortalezcan el perfil profesional de los egresados y que respondan a las demandas de un entorno académico y social en constante evolución. El diseño curricular se entiende como un proceso social que debe basarse en una evaluación integral del programa educativo, considerando el contexto, las metas académicas, los perfiles de ingreso y egreso, y los resultados de aprendizaje. En este marco, se abordan los puntos críticos de la educación superior, tales como el nuevo modelo educativo, la evaluación de aprendizajes, los constructos epistemológicos y las políticas del Plan Nacional del Buen Vivir (PNBV). A través de una metodología cualitativa, se analizan los reajustes curriculares realizados, los cuales fueron socializados y validados mediante reuniones con exalumnos, funcionarios y un grupo multidisciplinario de directivos, docentes y representantes de organizaciones sociales. La validación del rediseño curricular se realizó utilizando indicadores descriptivos y lógicos, asegurando la pertinencia y efectividad del proceso. Los cambios propuestos buscan fortalecer la formación académica, promover una mirada crítica y reflexiva, y alinear el perfil de egresado con las exigencias del entorno y los objetivos de desarrollo integral de la sociedad
El presente artículo proviene de un estudio realizado en el 2019, donde se analiza el comportamiento de las élites empresariales guayaquileñas operan para ejercer presión en el Ejecutivo y conseguir diseños institucionales favorables a sus intereses. Dicho estudio se enfoca en los procesos de captura del Estado, considerando cómo las dinámicas político-económicas condicionaron la configuración de un Estado orientado al servicio de intereses particulares, especialmente en niveles locales. La investigación se efectuó empleando una metodología cualitativa y un proceso de triangulación de fuentes e información. Dicho enfoque permitió observar de manera para desentrañar y examinar las estrategias empleadas por las élites empresariales guayaquileñas en su rol como grupos de presión directa e indirecta, influyendo en las decisiones del poder Ejecutivo para obtener prebendas y espacios de poder
Resumen Introducción El uso de la placa tercio de tubo como placa gancho para el tratamiento de fracturas de tobillo ha sido considerado una alternativa eficaz para la osteosíntesis en situaciones que involucran fragmentos óseos pequeños, fracturas multifragmentarias, o en pacientes con huesos de baja calidad. Esta técnica fue documentada por primera vez en 1948. La placa tercio de tubo se ha empleado exitosamente en fracturas de diversas localizaciones anatómicas. Hoy en día, esta placa está disponible en titanio y acero inoxidable con un grosor de 1,0 milímetros, siendo apropiada para zonas con escasa cobertura de tejido blando. Después de dos décadas de uso, este artículo presenta la placa tercio de tubo tipo placa gancho como una alternativa viable y efectiva para el tratamiento de fracturas de tobillo. Material Y Métodos Se realizó un estudio descriptivo retrospectivo que incluyó a 83 pacientes a lo largo de 20 años. De estos, el 57,84% eran hombres y la edad varió entre 22 a 85 años. El 9,6% de las fracturas eran expuestas, distribuyéndose en 50% Grado II, 38% Grado IIIA, y 12% Grado IIIB. Todos los pacientes recibieron reducción abierta y osteosíntesis dentro de las primeras 24 horas. Resultados La consolidación de las fracturas se observó en el 81,93% de los casos a las 12 semanas, en el 4,8% entre las 13 years 16 semanas, y en el 9,6% después de 16 semanas. Un 3,6% de los casos presentó retardo en la consolidación, con un proceso de consolidación entre 20 years 24 semanas. Las complicaciones se reportaron en un 3,61% de los casos. Además, un paciente desarrolló artrosis de tobillo, y solo el 2,49% requirió la extracción de implantes. Conclusión Los resultados obtenidos demuestran que la placa tercio de tubo tipo placa gancho es una opción efectiva y recomendable en la cirugía de fracturas de tobillo, con buenos resultados funcionales, altas tasas de consolidación y bajas tasas de complicaciones.
Background Ancylostoma caninum is a soil-borne, soil-transmitted helminth with infective larvae and produces cutaneous larva migrans in humans. The objective of this study was to confirm the presence of A. caninum in domestic dogs from the urban-marginal and rural sectors of the Ecuadorian coast through morphometry, culture, and molecular techniques. Material/Methods A total of 498 domestic dogs were analyzed via 5 coproparasitic screening methods: direct, modified flotation, sedimentation with centrifugation using saline solution (identification of eggs), and modified Baermann and Harada-Mori methods (identification of larvae). For confirmation, culture (agar in plates, Müller-Hinton agar plates, MacConkey agar plates, and artisanal media with sand and/or ravine soil, both sterile, and all prepared in Petri dishes), polymerase chain reaction (PCR), and DNA sequencing analyses were subsequently conducted via morphometric methods. Results A total of 250 domestic dogs were diagnosed with A. caninum (50.20%) via coproparasitic methods. The parasite was subsequently confirmed via morphometry, cultured in 5 culture media, and detected by PCR, and phylogenetic characterization was performed. Conclusions The coproparasitic methods used for screening increased the sensitivity of the results. Morphometry is an easily accessible and low-cost confirmatory method. The culture method was used to test the good adaptability of and infection by the parasite. The presence of A. caninum was detected for the first time via PCR, and its phylogenetic profile was analyzed using the molecular marker cox1.
The Gulf of Guayaquil (GG) is the most important tropical estuarine system of the eastern coast of South America, receiving an average water flow of about 1 650 m³ s⁻¹ from a river basin of approximately 33 700 km². The city of Guayaquil surrounds the inner coastal lagoon of the Estero Salado (ES) that empties into the GG. This coastal lagoon is of high social, food production, and environmental importance for the city and the GG. However, there is limited high quality data on metal pollution in this zone, no recent information on Hg, and the extent to which sediment metal pollution extends into the GG is presently unknown. As, Cd, Pb, and Hg were analysed in surface sediments from the urban zone and gave average concentrations of 32.3, 2.08, 41.9, and 0.12 mg kg⁻¹ (dry weight), respectively. Additionally, data were obtained for the first time for the El Morro Channel, south of the ES in the GG, which is expected to be a relatively pristine zone; average As, Cd, Pb and Hg concentrations were 6.6, 0.22, 7.9 and 0.02 mg kg⁻¹ (dry weight), well below concentrations seen in the urban ES zone. Estimates of the geo-accumulation index for metal pollution, using the El Morro data as background values, were 1.7 (As), 2.7 (Cd), 1.8 (Pb) and 2.0 (Hg), making the ES class II and a moderately polluted estuary for As, Hg and Pb, but class III and “moderately to heavily polluted” for Cd. If the lowest concentrations of the EM samples are taken the ES is class III for As, IV for Hg and Pb, and V for Cd; id est, the ES would classify as a heavily to extremely polluted estuary regarding these metals. These data show the metal concentrations increase significantly as the main conurbation of Guayaquil is approached from offshore, indicating a strong anthropogenic source of metals from the city, with anticipated negative environmental impacts.
Humanization in the ICU has become a central topic over the last decade. New research focuses on technologies such as virtual reality and music therapy, as well as on practices like family presence during and after ICU stays, open-door policies, and monitoring of both family members and healthcare personnel. Psychiatric disorders, including depression, post-traumatic stress, anxiety, and delirium, are prevalent in ICU survivors and contribute to post-ICU syndrome. This research aimed to determine the role of humanization in critical care, with a secondary objective of evaluating the impact of open-door policies on critically ill patients. Analyses, results tables, and conclusions are presented. Humanization encompasses improvements and new associated concepts such as end-of-life care, personalized ICU-VIP care, and virtual reality in the ICU. Flexibility is crucial to address all factors that affect long-term neuropsychiatric outcomes. Humanizing the intensive care unit improves communication and information flow, ultimately reducing delirium and neuropsychiatric symptoms. Keywords: Humanism; Humanities; Intensive Care; Neonatal Intensive Care; Telecare; Tele-Intensive Care.
Simulation is a learning technique or tool that allows medical professionals to have dynamic training for diagnosing and treating clinical-surgical pathologies. It can also be employed on the patient as a distraction to reduce pain and anxiety using virtual reality. The objective of this research was to determine the usefulness of medical simulation and its current advances, for which a bibliographic search was carried out of 58 medical articles obtained from databases such as PubMed, ScienceDirect, Mendeley, Latindex, published in the last 5 years that included observational studies, randomized studies, systematic reviews and meta-analyses referring to the research topic. It is concluded that the advances of simulation in medicine and the vast majority of medical specialties recommend implementing this technique for teaching, diagnosis, and treatment. In addition, it can also be used through virtual reality, artificial intelligence, and mixed reality to reduce stress in patients, being an advance in development; however, it was found that there are areas where the help of expert evaluators is indispensable, in topics such as resuscitation and physical rehabilitation where simulation did not surpass conventional treatment. Keywords: Patient simulation; Training Simulation; Faculties of Medicine; Coroner; Medical Specialties.
Objectives Globally, hepatocellular Carcinoma (HCC) ranks seventh in women's cancer and fifth in men's cancer. Early identification can minimize mortality and morbidity. MicroRNAs and Toll-like receptors have been suggested as potential new biomarkers for HCC; Therefore, we explored Toll-like receptor 4 (TLR-4) and miRNA 15b-5p as new non-invasive HCC biomarkers and early detection approaches. Methodology In this case-control study, four primary groups were formed from 400 patients who participated in this study: 100 hepatitis C (HCV) patients without cirrhosis or HCC, 100 HCV with cirrhosis patients, 100 HCC and HCV patients, and 100 healthy controls. The HCC diagnosis was confirmed according to the American Association for the Study of Liver Disease (AASLD) Practice Guidelines. Triphasic computed tomography was used to assess the HCC tumor size. Real-time PCR was used to analyze miRNA 15b-5p and Toll-like receptor 4 (TLR-4) expression profiles. Results Significant diagnostic performance was achieved by miRNA 15b-5p in differentiating the HCC group from the control group, with 90 % sensitivity and 88 % specificity (AUC] 0.935, p < 0.001), while TLR-4 had moderate diagnostic performance with 85 % sensitivity and 86 % specificity (AUC:0.885, p < 0.001). Conclusions The ability of miR-15b-5p to recognize HCC was positive and it outperformed Toll-like receptor4. MiR-15b-5p has the potential to be a more precise and predictive biological marker for HCC than Toll-like receptor4. Future studies exploring different miRNAs and HCC cases from various etiologies are required to better understand the role of miRNAs in this disease and allow for more effective strategies.
In 2020, Ecuador was among the most affected places in the world in the context of the COVID-19 emergency. Serious problems of structural inequality and governance resulted in corpses lying in the streets of Guayaquil—Ecuador’s largest city—while local communities resisted in different ways. We interviewed 18 participants who engaged in actions of solidarity during this context, critically analyzed their discourses, and generated relevant themes. There was a structural scheme of (pandemic) brutality that determined embodied experiences of horror, conditioned by a governance of abandonment and its related problems. To confront such horror, solidary community resistance focused on food, physical and mental health, management of corpses, community-led communication, online education, and political participation. We interpret that this was a process of social determination of collective health and discuss important theoretical, methodological, and ethical–political implications.
Background : This study examines the prevalence and incidence of dementia in Ecuador, with a focus on understanding demographic and social factors associated with increased risk. Data were obtained from the Institute of Neurosciences of Guayaquil, covering patient records from 2010 to 2022. The purpose was to identify prevalence trends and key risk factors to inform targeted prevention and early intervention efforts in high-risk groups. Methods: This observational, correlational study analysed patient data to estimate dementia prevalence and incidence. Statistical analyses included descriptive statistics to calculate overall and age-specific prevalence rates, while incidence was calculated per 1,000 person-years. Correlations and chi-square analyses were used to evaluate associations between dementia and potential risk factors, including age, gender, education level, and marital status. Results: The overall prevalence of dementia was 3.1%, with higher rates among women (1.8%) compared to men (1.3%). Dementia incidence was calculated at 2.4 per 1,000 person-years. Prevalence increased significantly with age, from 1.2% in individuals aged 65–69 to 54.8% in those aged 95 and older. Advanced age, female gender, lower education levels, and lack of a marital partner were associated with higher dementia prevalence. Conclusions: These findings highlight a rising dementia prevalence in Ecuador, particularly among women and older individuals, with social and educational factors contributing to increased risk. The results underscore the need for tailored dementia prevention and early intervention strategies, especially as prevalence rates continue to rise across Latin America.
Fieldwork, examination of herbarium specimens and photographic images, supported by molecular sequencing have resulted in the re-interpretation of a number of species of Ipomoea L. found in Ecuador and the recognition of four new species. Ipomoea ophiodes Standl. & Steyerm. is shown to be a distinct species from I. regnellii Meisn. and their contrasting distribution is mapped. An unusual variation in I. setosa Ker Gawl. is discussed and illustrated. It is shown that, whereas I. velardei O’Donell is present in the south of Ecuador, records of I. jujuyensis O’Donell are probably all errors for I. quitensis J.R.I.Wood & Cerón, which is described as a new species endemic to Ecuador. Three other endemic species all known from single locations, I. ceronii J.R.I.Wood & P.Muñoz, I. condorensis J.R.I.Wood & Scotland and I. papyrifera J.R.I.Wood & Scotland are described as new. The full distribution of I. aequatoriensis T.Wells & P.Muñoz is mapped as a result of recent fieldwork and I. amazonica (D.F.Austin & Staples) J.R.I.Wood & Scotland is recorded from Ecuador for the first time. Taxonomic notes, information on habitat and distribution, maps, line drawings and photographs illustrate the species discussed. A key to all 57 species of Ipomoea recorded from Ecuador is provided to facilitate identification.
In this work, we present a novel approach to lexical complexity prediction (LCP) that combines diverse linguistic features with encodings from deep neural networks. We explore the integration of 23 handcrafted linguistic features with embeddings from two well-known language models: BERT and XLM-RoBERTa. Our method concatenates these features before inputting them into various machine learning algorithms, including SVM, Random Forest, and fine-tuned transformer models. We evaluate our approach using two datasets: CompLex for English (a high-resource language) and CLexIS2 for Spanish (a relatively low-resource language in ), allowing us to study performance issues from a cross-lingual perspective. Our experiments involve different combinations of linguistic features with encodings from pretrained deep learning models, testing both token-based and sequence-related encodings. The results demonstrate the effectiveness of our hybrid approach. For the English CompLex corpus, our best model achieved a mean absolute error (MAE) of 0.0683, representing a 29.2% improvement over using linguistic features alone (MAE 0.0965). On the Spanish CLexIS2 corpus, we achieved an MAE of 0.1323, a 19.4. These findings show that handcrafted linguistic features play a fundamental role in achieving higher performance, particularly when combined with deep learning approaches. Our work suggests that hybrid approaches should be considered over full end-to-end solutions for LCP tasks, especially in multilingual contexts.
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Glenda Velasquez
  • Investigación. Facultad de Ciencias Médicas. Carrera de Medicina
Beatriz Pernia
  • Faculty of Natural Science
Maria C Villacres
  • Faculty of Chemical Sciences
Lorenzo Cevallos
  • FACULTAD DE CIENCIAS MATEMÁTICAS Y FÍSICAS
Telmo Fernandez
  • Tropical Medicine
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Guayaquil, Ecuador