Browsing by Author "Neira Molina, Vivian Alejandra"

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Análisis comparativo de los costos de la prevención y tratamiento asociados al cáncer de cuello uterino en Ecuador
(2024) Mendieta Muñoz, Luis Rodrigo; Figueroa Campoverde, David Sebastián; Neira Molina, Vivian Alejandra; Delgado López, Dayanara Alejandra; Ramos Rodríguez, Lisseth Carolina; Dávila Sacoto, Santiago Arturo; Andrade Galarza, Andrés Fernando; Vega Crespo, Bernardo José
Background: Cervical cancer is the second leading cause of death due to oncological pathologies in Ecuadorian women. Vaccination and early detection are effective in preventing this disease. The costs of cervical cancer treatment are high. Objective: To compare the cost per person for cervical cancer prevention versus the treatment of cervical lesions. Methodology: An analysis of therapeutic recommendations and associated costs for treatment and prevention was conducted based on the cost schedule for the national health system of Ecuador. Results: The investment in prevention varies according to the scheme used. When using the optimal vaccination and scree-ning with cytology, the investment is $395.62 USD. When using the optimal vaccination and human papillomavirus detection scheme, the cost is $761.42 USD. The cost of follow-up for low-grade lesions is $490.7 USD; for high-grade lesions and in situ cancer with outpatient management, it is $685.43 USD. In the case of in situ cancer/Stage IAI/or non-conizable cervixes, the cost reaches $3465.68 USD. For invasive stages I to 2; IB; IIA, it is $23,762.20 USD, and for stages IIB-III-IV, the minimum cost is $28,560.22 USD. Conclusions: The cost of managing advanced and invasive cervical lesions is 10 to 101 times more expensive than prevention per person. The cost for a person with a basic salary of $460 USD would create inequities in access to treatment and survival. The cost per person that the state must cover for the treatment of advanced cervical cancer is much higher than the investment in preven
Análisis de la violencia física y simbólica en la filmografía de Alejandro Jodorowsky mediante el ensayo audiovisual Cuerpo y carne
(Universidad de Cuenca, 2023-01-05) Maldonado Ordóñez, Samantha Alicia; Neira Molina, Vivian Alejandra
This study analyzes the representation of elements of physical and symbolic violence in Alejandro Jodorowsky's filmography. By using a surrealist, oneiric and performative cinematographic language, his filmography favors intrinsic symbolic content as well as violent physical actions made invisible in the collective imaginary. The audiovisual essay short film entitled Cuerpo y carne (Body and flesh) analyzes, observes and studies the images of three films from Jodorowsky's filmography: Fando y Lis (1968), El Topo (1970) and Santa Sangre (1989); in order to capture them in new audiovisual work that contemplates the patterns of both physical and symbolic violence. In other words, the audiovisual essay is used as a cinematographic tool of analysis and authorial expression.
Barriers and Advantages of Self-Sampling Tests, for HPV Diagnosis: A Qualitative Field Experience Before Implementation in a Rural Community in Ecuador
(2024) Delgado Lopez, Dayanara Alejandra; Neira Molina, Vivian Alejandra; Vega Crespo, Bernardo José; Guerra Astudillo, Gabriela Mireya
Barriers and facilitators to cervical cancer screening among under-screened women in Cuenca, Ecuador: the perspectives of women and health professionals
(2022) Neira Molina, Vivian Alejandra; Ortiz Segarra, José Ignacio; Vega Crespo, Bernardo José; Andrade Galarza, Andrés Fernando; Guerra Astudillo, Gabriela; Ortiz Mejía, José Stalin; Flores Salinas, María Antonieta; Mora Bravo, Lorena Viviana; Verhoeven, Veronique; Gama, Ana; Dias, Sonia; Verberckmoes, Bo; Vermandere, Heleen; Michelsen, Kristien; Degomme, Olivier
Background: Cervical cancer screening is a cost-effective method responsible for reducing cervical cancer-related mortality by 70% in countries that have achieved high coverage through nationwide screening strategies. However, there are disparities in access to screening. In Ecuador, although cervical cancer is the second most common cancer in women, only 58.4% of women of reproductive age have ever been screened for cervical cancer. Methodology: A qualitative study was performed to understand the current barriers to screening and to identify strategies that could increase uptake in Azuay province, Ecuador. Seven focus group discussions (FGDs) were conducted with under-screened women and health professionals (HPs). The FGDs were recorded and transcribed. Content analysis was done using the socio-ecological framework to categorize and analyse the data. Results: Overall, 28 women and 27 HPs participated in the study. The two groups perceived different barriers to cervical cancer screening. The HPs considered barriers to be mainly at the policy level (lack of a structured screening plan; lack of health promotion) and the individual level (lack of risk perception; personal beliefs). The women identified barriers mainly at organizational level, such as long waiting times, lack of access to health centres, and inadequate patient–physician communication. Both groups mentioned facilitators at policy level, such as national campaigns promoting cervical cancer screening, and at community and individual level, including health literacy and women’s empowerment. Conclusions: The women considered access to health services the main barrier to screening, while the HPs identified a lack of investment in screening programmes and cultural patterns at the community level as major obstacles. To take an integrated approach to cervical cancer prevention, the perspectives of both groups should be taken into account. Additionally, new strategies and technologies, such as self-administered human papillomavirus (HPV) testing and community participation, should be implemented to increase access to cervical cancer screening
Citología versus diagnóstico molecular de VPH para el tamizaje de cáncer de cuello uterino. Comparación de las propiedades diag- nósticas de cuatro pruebas en una comunidad rural de Cuenca Ecuador
(SECTEI, Espoch, 2023) Vega Crespo, Bernardo José; Neira Molina, Vivian Alejandra; Murillo Bacilio, Magdali del Rocio; Ochoa Avilés, María Cristina; Vega Crespo, Bernardo José
Cervical cancer (CC) is considered a threat to women’s lives, which is why the WHO launched the 90-70-90 strategy, seeking to eradicate CC by 2030. Part of the strategy involves screening with highly sensitive molecular biology tests for HPV diagnosis to replace cervical cytology. The objective of this research was to compare the sensitivity and specificity of molecular biology tests, including self-testing for HPV diagnosis with traditional cytology. Methodology: A study of diagnostic tests was conducted in a rural parish of Cuenca, Ecuador. A total of 120 women participated. Each participant self-collected a vaginal and a urine sample and then a health professional performed a standard cervical smear for HPV molecular diagnosis and cytology. The latter test was considered the gold standard. All three samples were processed with the same amplification and genomic hybridization protocol for HPV detection (Hybribio) following the manufacturer’s instructions. Cytology was processed following the standard technique. Results: The sensitivity of vaginal self-sampling for the diagnosis of HR HPV reached 100% (CI 75.7, 100.0), and specificity 94.4% (CI 88.4, 97.43). Urine self-sampling had a sensitivity of 91.6% (CI 64.61, 98.51), and a specificity of 96.435 (CI 91.18, 98.6). Cervical cytology achieved a sensitivity of 41.67% (CI 19.33, 68.5) and a specificity of 85.19% (CI 77.28, 90.67) Conclusions: This study demonstrates that vaginal self-sampling and urine self-sampling methods have similar sensitivity and specificity compared to the sample taken by the health professional for molecular diagnosis of HPV. The sensitivity of cytology (Papanicolaou) was lower in relation to molecular biology tests for primary screening of CC.
Conocimiento y prácticas de prevención de cáncer de cuello uterino en mujeres con lesiones histopatológicas. Cuenca, Ecuador 2021
(2021) Ortiz Mejía, José Stalin; Ortiz Segarra, José Ignacio; Guerra Astudillo, Gabriela Mireya; Pérez Paredes, Verónica Andrea; Vega Crespo, Bernardo José; Neira Molina, Vivian Alejandra; Mora Bravo, Lorena Viviana
Knowledge and practices are essential to promote health, prevent disease, maintain health, and cope with diseases in general and cervical cancer in particular. The objective of this study was to describe the sociodemographic characteristicsand prevention practices in women with histopathological lesions of the cervix, for which 174 female patients,between 30 and 89 years of age,were interviewed at the SOLCA and Vicente Corral hospitals in the city of Cuenca. The results show that the participants, mostlyliving in urban and marginal urban areas, married, with primary and secondary education, with economic difficulties and mestizo self-identification, more frequently presented histopathological lesions of the LIEAG, LIEBG and Cancer type. Although they have information about HPV, very few know that it is the main cause of CCU, that it is transmitted sexually, that there are vaccines and early detection tests. Among the facilitating factorsto carry out the Pap smearare:the follow-up visit, medical recommendation, own initiative and recommendation of a friend or relative; while personal factors, problems in the health service, economicand familydifficulties, constitute the main barriers.
Estandarización de la reacción en cadena de la polimerasa (PCR) específica para la amplificación del fragmento rs35532010 presente en el gen de la beta globina
(Universidad de Cuenca, 2023-11-07) Rodriguez Bravo, Axel Joffrey; Valle Soledispa, Miguel Alexander; Neira Molina, Vivian Alejandra
Thalassemias are hereditary diseases resulting from genetic defects that cause an alteration in the synthesis of globin chains. The β-thalassemia encompasses a group of mutations that cause defects in the β-globin chains. The 27/28 +C mutation, is characterized by the insertion of a cytosine nucleotide that causes a change in the reading frame of the gene resulting in β- thalassemia. Although few cases have been reported in countries where the prevalence of β- thalassemia is very high, information on this mutation in Latin America is scarce. However, unpublished data have identified this mutation as prevalent in the Ecuadorian population. The main objective of this titration work was to standardize a PCR protocol for the amplification of the rs35532010 polymorphism of the hemoglobin beta subunit (HBB) gene. Commercial DNA samples and specific primers were used to amplify the fragment of the gene where this mutation is located. Three different protocols were performed for standardization, being the first assay the one that allowed establishing the ideal conditions of 1μl of DNA diluted at 80ng/μl, at an alignment temperature of 64oC, for fragment identification by electrophoresis in 2% agarose gel. However, the use of polyacrylamide gel, of higher resolution and wide separation range, is recommended to improve the visualization of the bands. Standardization of this protocol will be of great utility for subsequent sequencing to determine allelic zygosity status in patients with β-thalassemia.
Estandarización de la reacción en cadena de la polimerasa (PCR) específica para la amplificación del segmento rs429358 del gen APOE4 en Alzheimer tardío
(Universidad de Cuenca, 2024-09-26) Cárdenas Fajardo, Juan Diego; Jiménez Jiménez, Jorge Luis; Neira Molina, Vivian Alejandra
Alzheimer's disease (AD) is a neurodegenerative disease that affects memory and the ability to generate new memories in people with AD. A relationship has been found between the different alleles encoding the APOE protein and late onset AD. The present work seeks to amplify and standardize the Polymerase Chain Reaction (PCR) specifically the rs429358 polymorphism located in exon 4 of the 19q13.32 locus (APOE4). Standardization of this PCR test is crucial for genetic and clinical studies. The ability to detect and analyze the rs429358 polymorphism efficiently opens new avenues for research and potentially for improving the quality of life of those at risk of developing AD. Methodology: Primers were designed with in silico test runs where amplification and specificity were demonstrated, after which they were sent to INVITROGEN for synthesis. In PCR standardization, we tried to optimize the conditions to ensure specific and reproducible amplification of APOE exon 4. This included adjusting the concentration of reagents and primers, hybridisation temperature, duration and number of cycles. Results: The primers synthesized and tested in silico were not specific for in situ amplification due to their self-complementarity.
Estandarización de una técnica de ELISA para la cuantificación de serotonina en muestras de orina
(Universidad de Cuenca, 2024-11-15) Enríquez Paladines, Guissela Carolina; Neira Molina, Vivian Alejandra
The present research project is part of a larger study entitled "Utility of Cognitive-Behavioral Play Therapy and Tryptophan Supplementation in the Reduction of Aggression in Children Aged 3 to 9 Years with a History of Child Abuse in Institutional Foster Care, Cuenca, 2023". In this context, it was required to carry out measurements of serotonin levels in urine before, during and after an intervention program combining cognitive-behavioral play therapy and a diet supplemented with tryptophan. This program was implemented in children aged 3 to 7 years who have been victims of child abuse. This study was based on the hypothesis that children who have suffered child abuse tend to manifest aggressive behaviors due to the reduction of serotonin levels in their organism. It is postulated that, through a diet enriched with tryptophan, together with play therapies, it is possible to regulate these levels and reduce aggressiveness in these children. To achieve one of the objectives of the main project, it was necessary to standardize the ELISA (Enzyme-Linked Immunosorbent Assay) technique for the accurate measurement of serotonin levels in urine samples. The central purpose of this research work is to achieve the standardization of an ELISA technique that allows the accurate measurement of serotonin levels in children. To achieve this objective, a calibration curve was constructed using dilutions of a serotonin standard. In addition, the replicability of the measurements was verified on multiple occasions to ensure that the method has been adequately standardized.
Evaluación de la calidad espermática en estudiantes de la Facultad de Ciencias Químicas durante el período enero - diciembre 2025
(Universidad de Cuenca, 2025-07-22) Criollo Mesías, Santiago Eduardo; Vivar Torres, Jordan Brandon; Neira Molina, Vivian Alejandra
Semen quality has shown a progressive decline worldwide over recent decades. A systematic review published in Human Reproduction Update reported an average annual decrease of 0.87 million/ml in sperm count between 1973 and 2018, particularly in North America, Europe, and Australia. In Cuenca, there is a lack of data regarding semen quality among the university population, which highlights the need to study this issue in local young men. This study aimed to assess the current status of sperm quality in university students and analyze its relationship with lifestyle variables. A cross-sectional descriptive study was conducted with 140 male students from the Faculty of Chemical Sciences at the University of Cuenca, who underwent semen analysis and completed a lifestyle survey, including diet and nutritional status. The mean sperm concentration was 84.59 million/ml, with normozoospermia observed in 27.14%, increased viscosity in 49.29%, and teratozoospermia in 30% of cases. Statistically significant associations were found between increased viscosity and overweight (p = 0.0229), as well as between teratozoospermia and poor dietary habits (p = 0.0284). These findings indicate that a considerable proportion of students present altered seminal parameters, potentially linked to modifiable lifestyle factors, underscoring the importance of promoting healthy habits from an early age as a preventive strategy in reproductive health.
Evaluación de la respuesta al tratamiento de asma en niños y adolescentes de 5 a 17 años en la ciudad de Cuenca-Ecuador, mediante el análisis del polimorfismo IL-10 rs3024496
(Universidad de Cuenca, 2022-10-17) Castillo Bravo, María Emilia; Tenorio Rodas, Sofía Carolina; Neira Molina, Vivian Alejandra
Asthma is a common chronic respiratory disease in childhood, this condition can impact on the patient's quality of life in many negative ways. It is estimated that the prevalence of asthma in the city of Cuenca is 17.8% and of this percentage 90.3% of patients do not respond to treatment. There may be genetic variables that interfere with therapeutic failure, including cytokine-related polymorphisms. IL-10 protein is an anti-inflammatory immunoregulatory cytokine, so variations in the sequence of the gene (polymorphism) encoding this protein could lead to a loss or reduction in the functionality of this cytokine leading to treatment failure in asthmatic patients. In this study, we evaluated the clinical significance of the IL-10 gene polymorphism (rs3024496) and its relationship with the response to asthma treatment in children and adolescents aged 5-17 years in Cuenca Ecuador. This study is part of the project "Factors associated with asthma attack recurrence (ATTACK) in children from three Ecuadorian cities during COVID-19" and therefore the samples to be analysed come from participants diagnosed with asthma recruited for the aforementioned study. The extraction of the genetic material was performed from blood samples using the Gentra® Puregene® Blood Kit (Qiagen) and subsequently the performance was checked with DNA quantification by a fluorescence method (Qubit 3). The genotyping assay for the IL-10 rs 3024496 polymorphism was performed using Taqman probes. Patients were classified into two groups (controlled and uncontrolled asthma) based on the clinical data obtained. Subsequently, T-test and Chi-square statistical analysis was performed for symmetrical variables, Wilcoxon test for asymmetrical variables and SNP association in order to establish relationships between observed genotype and treatment response. The results obtained showed a significant difference between the polymorphic genotype, applied for a recessive model, and the lack of response to treatment based on the number of visits for exacerbations in the last year. We conclude that the presence of the polymorphism in the IL-10 gene is related to the likelihood of patient non-response to treatment, however, further studies regarding this polymorphism are still needed.
Evaluation of urine and vaginal self-sampling versus clinician-based sampling for cervical cancer screening: a field comparison of the acceptability of three sampling tests in a rural community of Cuenca, Ecuador
(2022) Vega Crespo, Bernardo José; Neira Molina, Vivian Alejandra; Ortiz Segarra, José Ignacio; Gómez, Andrea; Vicuña, María José; Mejia Chicaiza, Jorge Victoriano
Self-sampling methods for HPV testing have been demonstrated to be highly sensitive and specific. The implementation of these methods in settings with a lack of infrastructure or medical attention has been shown to increase the coverage of cervical cancer screening and detect cervical abnormalities in the early stages. The aim of this study is to compare the acceptability of urine and vaginal self-sampling methods versus clinician sampling among rural women. A total of 120 women participated. Each participant self-collected urine and vaginal samples and underwent clinician sampling for Pap smear and HPV testing. After the sample collection, a questionnaire to qualify the device, technique, and individual acceptability was applied, and the additional overall preference of three sample tests was evaluated. Results: The characteristics of the participants were as follows: median age of 35 years; 40.8% were married; 46.7% had a primary level of education; median age of sexual onset of 17.6 years. Compared with clinician sampling, both vaginal self-sampling, OR 20.12 (7.67–52.8), and urine sampling, OR 16.63 (6.79–40.72), were more comfortable; granted more privacy: vaginal self-sampling, OR 8.07 (3.44–18.93), and urine sampling, OR 19.5 (5.83–65.21); were less painful: vaginal self-sampling, OR 0.07 (0.03–0.16), and urine sampling, OR 0.01 (0–0.06); were less difficult to apply: vaginal self-sampling, OR 0.16 (0.07–0.34), and urine sampling, OR 0.05 (0.01–0.17). The overall preference has shown an advantage for vaginal self-sampling, OR 4.97 (2.71–9.12). No statistically significant preference was demonstrated with urine self-sampling versus clinician sampling. Conclusions: Self-sampling methods have a high acceptance in rural communities. Doubts on the reliability of self-sampling often appear to be a limitation on its acceptability. However, the training and education of the community could increase the uptake of these methods.
Frecuencia de VPH positivo en semen de varones con problemas de fertilidad, revisión de literatura
(Universidad de Cuenca, 2024-09-30) Peralta González, Juliana Isabel; Neira Molina, Vivian Alejandra
Human papillomavirus (HPV) infection is considered the most common sexually transmitted infection (STI) worldwide. Studies show that the prevalence of HPV infection in semen is significantly higher in infertile men compared to the general population, suggesting that male infertility may be associated with increased susceptibility or exposure to HPV. The presence of HPV in semen is associated with a decrease in seminal parameters such as motility, morphology, and DNA fragmentation. Additionally, the infection can increase anti-sperm antibodies (ASA) and release pro-inflammatory cytokines, affecting both motility and DNA integrity. The infection originates from virions that can bind to the sperm head or tail, immobilizing them and affecting their motility. This binding can also transfer the viral genome to oocytes during fertilization, halting early embryonic division and increasing miscarriage rates. In the context of assisted reproductive technologies (ART), although implantation and pregnancy rates are not significantly affected, the presence of HPV in semen is associated with lower embryo quality and higher miscarriage rates in couples undergoing these treatments.
Identificación de la proteína p16 como biomarcador de cáncer cérvico-uterino en muestras de cepillado cervical obtenidas por citología convencional y por autotoma
(Universidad de Cuenca, 2023-03-09) Gonzalez Asanza, Johanna Esthela; Jaramillo Vicente, Kristhel Ariana; Neira Molina, Vivian Alejandra
Cervical cancer is the result of infection by the human papillomavirus (HPV) and is considered to be one of the leading causes of death in women worldwide. Traditional tests for HPV detection are very time consuming, so the determination of proteins present in the cervical epithelium at the stage of infection has now been implemented. The p16 and Ki-67 proteins are considered promising biomarkers of high specificity which, together with the autotome method, can guarantee a higher percentage of women with early diagnosis. In this study, 240 cervical samples were analyzed using the ELISA detection method, the samples were obtained from 120 female patients, whose age ranged from 18 to 70 years, two samples were collected per patient, obtained by the conventional method and by vaginal autotomy. The p16 protein calibration curves were standardized in two media, and the samples obtained by the two methods were analyzed. The threshold limit was established by the At most one change (AMOC) statistical test with Changepoint, by which it was possible to detect elevated levels of p16 protein. The behavior of the samples was analyzed using histogram plots and the U-Mann-Whitney statistic. Finally, it was identified that p16 protein is a possible early biomarker of cervical cancer and can be detected by ELISA. It was possible to identify the protein in both the samples obtained by cytology and those obtained by autotomy. The study was carried out during the months of July-December 2022 at the University of Cuenca.
Knowledge and perceptions about cervical cancer and HPV screening in women in rural areas of Ecuador: a qualitative research study
(2022) Vega Crespo, Bernardo José; Maldonado Rengel, Ruth; Espinosa González, María Elena; Neira Molina, Vivian Alejandra; Verhoeven, Veronique M.; Bautista Valarezo, Estefanía
Background: Cervical cancer continues to be a major health problem in developing countries. Educational programs, as well as Pap and HPV screening and vaccination, are important tools to reduce the morbidity and mortality rates associated with this disease. The objective of this study is to explore the diverse knowledge and perceptions about cervical cancer and the different diagnostic tests for HPV of populations living in the rural parish “El Valle”. Method: A qualitative study was conducted through eight focus groups, which included 46 participants from mixed ethnic groups. A phenomenological analysis was performed. Results: Four topics and seven sub-topics were identified. By analyzing all the narratives, it was possible to identify that the perception of cervical cancer was focused on its severity, secondary to its infectious process and screening periodicity. However, despite the diverse knowledge, indigenous people do not relate it to the human papilloma virus; in addition, there is also certain resistance to undergo the Pap smear test, for reasons such as inaccessibility and its sampling process. Conclusions: It is necessary to develop educational programs for the prevention of cervical cancer and to implement diagnostic alternatives to reach populations with precarious accessibility, as well as women who refuse to undergo the Pap smear test.
Morbi-mortalidad en el departamento de clínica del Hospital Vicente Corral Moscoso de la ciudad de Cuenca durante el período 2000-2002
(2005) Martínez Serrano, Andrés Eduardo; Neira Molina, Vivian Alejandra; Ordoñez Ugalde, Javier Eduardo; Cañar Lojano, Hugo Aníbal; García Alvear, Jorge Luis
For the tabulation of data, preparation of charts and graphs used the MS Excel program. The results obtained with the statistics of the country and Uruguay finding several similarities and differences in the incidence of diseases and their trends are compared. It was concluded that the 10 leading causes of mortality in the area of Pediatrics during 2000-2002 were: pneumonia; hemolytic disease of the fetus and newborn; intracranial trauma; other disorders originating in the perinatal period; diarrhea and gastroenteritis of presumed infectious origin; transient disorders carbohydrate metabolism specific to fetus and newborn; burns and corrosion; Other injuries of specified regions; Regions unspecified and multiple body regions; Other conditions originating in the perinatal period; infections of the skin and subcutaneous tissue. We recommend taking into account the need to strengthen actions to prevent morbidity and mortality from preventable diseases and coordinating the services of care at different levels of care
p16/Ki-67 dual staining as a predictive value for cervical cancer compared to other conventional triage tools: a descriptive literature review
(2024) Ochoa Avilés, María Cristina; Neira Molina, Vivian Alejandra; Vega Crespo, Bernardo José; Acosta Bedon, Ana Victoria; Delgado López, Dayanara Alejandra
Cervical cancer (CC) poses a significant global health concern, ranking as the fourth most frequently diagnosed cancer and the fourth leading cause of death among women worldwide. Ecuador bears a substantial burden of CC, with a considerable number of new cases and deaths reported annually. The primary cause of CC is the human papillomavirus (HPV), a sexually transmitted virus that is usually eliminated by cell immunity. However, around 5% of infections persist and can lead to invasive cancer. This literature review assessed the predictive value of p16 and Ki-67 dual staining (DS) as a standalone method or combined with conventional triage methods to improve CC screening programs. A total of 42 relevant articles were analyzed, evaluating the performance of DS in predicting cervical intraepithelial neoplasia (CIN) of varying severities. DS exhibited a median sensitivity and specificity of 87.7% and 76.7% for detecting CIN2+ and 89.7% and 79.6% for CIN3+. When combined with liquid-based (LB) cytology, DS demonstrated superior sensitivity and specificity compared to other screening strategies. This review suggests that p16 and Ki-67 DS alone or in combination with liquid base (LB) could enhance the accuracy and effectiveness of CC screening
Perfiles de metilación en la región promotora de IL10 en saliva de niños asmáticos
(Universidad de Cuenca, 2020-12-18) Ochoa Avilés, María Cristina; Neira Molina, Vivian Alejandra
Background: There is limited information available on epigenetic studies associated with asthma in Andean populations of Latin America. Objective: To identify and compare the percentage of DNA methylation in the promoter region of the gene encoding IL10 in search of differences associated with an asthma phenotype between asthmatic children and children free of the disease in the Cuenca population. Methods: A case-control study was carried out in asthmatic (cases) and non-asthmatic (controls) children between 5 and 11 years old in the city of Cuenca-Ecuador. Data on asthma, allergic diseases and risk factors were collected through questionnaires applied to the parents. Atopy was measured by skin prick tests on a panel of 14 aeroallergens. Methylation profile of the IL10 promoter region was performed by real-time PCR in a QuantStudio 12K using the OneStep qMethyl ™ kit. The differences in the percentage of methylation between cases and controls were analyzed using a multiple linear regression model, adjusting for those variables that were significant in the T tests or Fisher's test. Results: No significant differences were found in the percentage of methylation of the promoter region of the IL10 gene between cases and controls (𝛃 = 9.33, 95% CI -3.8-22.5, P = 0.16). However, when comparing cases and controls, a trend of a higher percentage of methylation of the promoter region of the gene was observed in the cases, which biologically could be associated with a decrease in its expression. Conclusions: No associations were found between the methylation profile of the IL10 promoter region and asthma in children. Future studies of methylation in other genes that could influence the course of asthma in children should be considered. IL10 could be considered as a future candidate for a study of polymorphisms in the population, as well as for the analysis of miRNAs, mutations, or polymorphisms in intronic regions of the gene.
Prevalence and risk factors for asthma, rhinitis, eczema, and atopy among preschool children in an andean city
(2020) Ochoa Avilés, María Cristina; Morillo Argudo, Diana Alexandra; Rodriguez, Alejandro; Cooper , Philip John; Andrade Tenesaca, Dolores Susana; Molina Cando, Maria Jose; Parra Ullauri, Mayra Alejandra; Parra Ullauri, Andrea; Mejía Coronel, Julio Danilo; Neira Molina, Vivian Alejandra; Rodas Espinoza, Claudia Rosana; Ochoa Avilés, Angélica María
Background: Limited data are available on prevalence and associated risk factors for atopy and allergic diseases from high-altitude urban settings in Latin America. Objective: To estimate the prevalence of atopy, asthma, rhinitis, and eczema, and associations with relevant risk factors in preschool children in the Andean city of Cuenca. Methods: A cross-sectional study was undertaken using a representative sample of 535 children aged 3-5 years attending 30 nursery schools in the city of Cuenca, Ecuador. Data on allergic diseases and risk factors were collected by parental questionnaire. Atopy was measured by skin prick test (SPT) reactivity to a panel of relevant aeroallergens. Associations between risk factors and the prevalence of atopy and allergic diseases were estimated using multivariable logistic regression. Results: Asthma symptoms were reported for 18% of children, rhinitis for 48%, and eczema for 28%, while SPT reactivity was present in 33%. Population fractions of asthma, rhinitis, and eczema attributable to SPT were 3.4%, 7.9%, and 2.9%, respectively. In multivariable models, an increased risk of asthma was observed among children with a maternal history of rhinitis (OR 1.85); rhinitis was significantly increased in children of high compared to low socioeconomic level (OR 2.09), among children with a maternal history of rhinitis (OR 2.29) or paternal history of eczema (OR 2.07), but reduced among children attending daycare (OR 0.64); eczema was associated with a paternal history of eczema (OR 3.73), and SPT was associated with having a dog inside the house (OR 1.67). Conclusions: A high prevalence of asthma, rhinitis, and eczema symptoms were observed among preschool children in a high-altitude Andean setting. Despite a high prevalence of atopy, only a small fraction of symptoms was associated with atopy. Parental history of allergic diseases was the most consistent risk factor for symptoms in preschool children.
Prevalence of chlamydia trachomatis, ureaplasma urealyticum, and neisseria gonorrhoeae in asymptomatic women from urban-peripheral and rural populations of Cuenca, Ecuador
(2022) Neira Naidiuk, Elizavet; Escandón Dután, Samuel Adrián; Viñansaca Atancuri, Lourdes Catalina; Abad, Sebastián; Neira Molina, Vivian Alejandra
Background: Sexually transmitted diseases (STDs) are a serious public health issue due to their high prevalence and a substantial percentage of women being asymptomatic. The present study aimed to determine the prevalence of three STD-causative pathogens in asymptomatic women from Southern Ecuador, with the ultimate purpose of updating the epidemiological data and obtaining a timely diagnosis, which can prevent further complications. Methods: This cross-sectional study included 102 asymptomatic women from Cuenca, Ecuador, who underwent a cervical cytology examination. They met all the inclusion criteria and signed the consent form. Nucleic acids were extracted from each sample, and PCR and flow-through hybridization were performed to detect the pathogens responsible for three STDs. Descriptive and inferential statistics were used to define and describe the study population, obtain the frequency data, and measure central tendencies to determine possible associations among the variables. Results: We found that 49.02% of the participants were infected with at least one of the three microorganisms, with 48.04% and 2.94% carrying Ureaplasma urealyticum (UU) and Chlamydia trachomatis (CT), respectively. Neisseria gonorrhoeae (NG) infection was not observed. Among the participants, 1.96% presented co-infections with CT and UU. Approximately half of the participants presented with asymptomatic infections caused by at least one microorganism. Conclusions: This study demonstrates the importance of conducting regular STD screening programs for high-risk asymptomatic women.