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Vega Crespo, Bernardo José

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1971-07-30

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0000-0002-2545-4733

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55551482600

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Universidad de Cuenca, Cuenca, Ecuador
Universidad de Cuenca, Facultad de Ciencias Médicas, Cuenca, Ecuador

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Ecuador

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Facultad de Ciencias Médicas
La Facultad de Ciencias Médicas de la Universidad de Cuenca fue creada en el año 1867, convirtiéndose en una de las facultades más antiguas. La Facultad de Ciencias Médicas es un lugar donde la pasión por la salud y el compromiso con el bienestar se fusionan para formar profesionales altamente capacitados en diversas disciplinas del área de la salud. Nos enorgullece ofrecer un amplio programa académico de calidad que abarca varias áreas importantes para el bienestar de nuestra comunidad. Ofrecemos un entorno de aprendizaje enriquecedor y vanguardista, con docentes altamente capacitados y recursos actualizados. Valoramos la vinculación con lo colectivo y la investigación científica, con compromiso social al igual que ética. Nuestros graduados son reconocidos por su excelencia y están preparados para afrontar los desafíos de un mundo en constante evolución.

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Vega Crespo

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Bernardo José

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2014 - 201912020 - 20246
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Now showing 1 - 7 of 7
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    Publication
    Factorial validation of the Attitudes toward Women Scale for Adolescents (AWSA) in assessing sexual behaviour patterns in Bolivian and Ecuadorian adolescents
    (2014) Jaruseviciene, Lina; Auquilla Díaz, Nancy Eulalia; Vega Crespo, Bernardo José; Lazarus, Jeffrey Victor
    Abstract Background: Adolescents' health is greatly influenced by social determinants, including gender norms. Although research has shown that there is an association between gender attitudes and adolescents' sexual behaviour, few studies have assessed this relationship carefully. The Attitudes toward Women Scale for Adolescents (AWSA) is widely used to assess gender attitudes among adolescents; however, to our knowledge it has not been applied in Latin America. Objective: To apply AWSA in Latin America for the first time, to perform a factorial validation of this scale and to assess the relationship of gender attitudes and sexual behaviour in Bolivian and Ecuadorian adolescents. Design: This cross-sectional study was carried out in 2011 among 14-18 year olds in 20 high schools in Cochabamba (Bolivia) and six in Cuenca (Ecuador) as a part of a larger project. Schools were purposively selected. A Spanish version of the 12-item AWSA was employed for this study. The assessed aspects of adolescent sexual behaviour were: reported sexual intercourse, reported positive experience during last sexual intercourse and reported current use of contraception. The psychometric properties of AWSA were investigated, and both explanatory and confirmatory factorial analyses were performed. Results: The number of questionnaires included in the analysis was 3,518 in Bolivia and 2,401 in Ecuador. A factorial analysis of AWSA resulted in three factors: power dimension (PD), equality dimension (ED) and behavioural dimension (BD). ED showed the highest correlates with adolescent sexual behaviour. Higher scores of this dimension were associated with a more positive experience of sexual relationships, a higher current use of modern contraception and greater sexual activity among girls. Conclusions: This study revealed a three-factorial structure of AWSA and demonstrated that by employing factors, the sensitivity of AWSA increases as compared to using the scale as a whole to assess sexual behaviour. This could have important implications for future research on gender and the sexual experiences of adolescents. Keywords: Latin America; adolescents; contraceptive use; gender attitudes; sexual behaviour.
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    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
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    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.
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    Rol del auto muestreo para el diagnóstico del virus del papiloma humano
    (Universidad Técnica de Ambato, 2022) Viñansaca Atancuri, Lourdes Catalina; Verhoeven, Veronique; Parrón Carreño, Tesifón; Morales Díaz, María Angélica; Dávila Sacoto, Santiago Arturo; Ortiz Segarra, José Ignacio; Mejía Chicaiza, Jorge Victoriano; López Sigüenza, Diana; Espinoza González, María Elena; Neira Molina, Vivian Alejandra; Vega Crespo, Bernardo José; Mora Bravo, Lorena Viviana; Vega Crespo, Bernardo José
    Introducción: Durante el año 2020, se reportaron 604127 nuevos casos de cáncer de cuello uterino (CC) y 341831 muertes por ésta causa a nivel mundial. En el mismo año, se identificaron 1534 nuevos casos y 813 muertes por CC en Ecuador. El programa nacional de prevención del CC, centra sus esfuerzos principalmente en la citología vaginal y la vacunación para adolescentes en el sistema de atención primaría, sin embargo, solamente el 58,4% de las mujeres en edad reproductiva se ha realizado una prueba de tamizaje a lo largo de su vida en el país. Se han identificado diferentes barreras para el acceso al tamizaje del CC, entre ellas: tiempos de espera prolongados, dolor, vergüenza, desconocimiento y falta de percepción de riesgo entre las más importantes. Las técnicas de auto muestreo, han incrementado las coberturas y han alcanzando a mujeres que tradicionalmente no accedían a las pruebas de detección precoz. Objetivos: Identificar la aceptabilidad de las pruebas de auto muestreo en mujeres de zona rural. Comparar la sensibilidad, especificidad de las pruebas de orina y auto toma con la toma tradicional con espéculo, para el diagnostico de el VPH. Método: La presenta investigación forma parte del proyecto “Haciendo accesible la detección del cáncer de cuello uterino a través del auto muestreo: un paso hacia la igualdad en salud mediante el empoderamiento de las mujeres en un contexto intercultural, financiado por el VLIR UOS” (CAMIE). En su fase cualitativa realizo un estudio, fenomenológico, mediante grupos focales de discusión (GFD) con mujeres de zona rural de la parroquial El Valle del cantón Cuenca. Los grupos focales fueron grabados y trascritos, su análisis se realizó utilizando en programa Nvivo. En su fase cuantitativa, se realizó una invitación a participar en el estudio, a las mujeres que acudían al servicio de salud, mismas que luego de firmar el consentimiento informado, procedieron a la recolección de orina, muestreo por auto toma y toma tradicional con espéculo. Las muestras fueron procesadas en el departamento de biología molecular de la Universidad de Cuenca. Principales resultados: Cualitativos: Un total de 47 mujeres participaron en 7 GFD. La participantes consideran la técnica de toma de Papanicolaou es dolorosa, invasiva y vergonzosa; en tanto que los métodos de auto toma, tienen ventajas como la privacidad, ahorran tiempo de espera, son más cómodos y menos dolorosos. Cuantitativos: Se procesaron las muestras de orina, auto toma y toma normal para el diagnóstico de VPH de 120 participantes. La toma con espéculo, fue usada como prueba de oro. La sensibilidad y especificidad fue de 89% y 95% para la prueba de orina; 94% y 92% para la prueba de auto toma. Conclusiones: Las pruebas de auto muestreo, constituyen una estrategia válida y aceptada para el tamizaje primario del VPH a nivel comunitario. La aplicación de estas técnicas sumadas a estrategias educativas permitirá romper barreras en el acceso a la detección oportuna del CC
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    The Hallmarks of Cervical Cancer: Molecular Mechanisms Induced by Human Papillomavirus
    (2024) Ortiz Segarra, José Ignacio; Vega Crespo, Bernardo José; Bigoni Ordóñez, Gabriele Davide
    Human papillomaviruses (HPVs) and, specifically, high-risk HPVs (HR-HPVs) are identified as necessary factors in the development of cancer of the lower genital tract, with CaCU standing out as the most prevalent tumor. This review summarizes ten mechanisms activated by HR-HPVs during cervical carcinogenesis, which are broadly associated with at least seven of the fourteen distinctive physiological capacities of cancer in the newly established model by Hanahan in 2022. These mechanisms involve infection by human papillomavirus, cellular tropism, genetic predisposition to uterine cervical cancer (CaCU), viral load, viral physical state, regulation of epigenetic mechanisms, loss of function of the E2 protein, deregulated expression of E6/E7 oncogenes, regulation of host cell protein function, and acquisition of the mesenchymal phenotype.
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    Universal cervical cancer control through a right to health lens: refocusing national policy and programmes on underserved women
    (2020) Perehudoff, Katrina; Vermandere, Heleen; Williams, Alex; Bautista Arredondo, Sergio; De Paepe, Elien; Dias, Sonia; Gama, Ana; Keygnaert, Ines; Longatto Filho, Adhemar; Ortiz Segarra, José Ignacio; Padalko, Elizaveta; Reis, Rui Manuel; Vanderheijden, Nathalie; Vega Crespo, Bernardo José; Verberckmoes, Bo; Degomme, Olivier
    Background: Cervical cancer claims 311,000 lives annually, and 90% of these deaths occur in low- and middle-income countries. Cervical cancer is a highly preventable and treatable disease, if detected through screening at an early stage. Governments have a responsibility to screen women for precancerous cervical lesions. Yet, national screening programmes overlook many poor women and those marginalised in society. Under-screened women (called hard-to-reach) experience a higher incidence of cervical cancer and elevated mortality rates compared to regularly-screened women. Such inequalities deprive hard-to-reach women of the full enjoyment of their right to sexual and reproductive health, as laid out in Article 12 of the International Covenant on Economic, Social and Cultural Rights and General Comment No. 22. Discussion: This article argues first for tailored and innovative national cervical cancer screening programmes (NCSP) grounded in human rights law, to close the disparity between women who are afforded screening and those who are not. Second, acknowledging socioeconomic disparities requires governments to adopt and refine universal cancer control through NCSPs aligned with human rights duties, including to reach all eligible women. Commonly reported- and chronically under-addressed- screening disparities relate to the availability of sufficient health facilities and human resources (example from Kenya), the physical accessibility of health services for rural and remote populations (example from Brazil), and the accessibility of information sensitive to cultural, ethnic, and linguistic barriers (example from Ecuador). Third, governments can adopt new technologies to overcome individual and structural barriers to cervical cancer screening. National cervical cancer screening programmes should tailor screening methods to under-screened women, bearing in mind that eliminating systemic discrimination may require committing greater resources to traditionally neglected groups. Conclusion: Governments have human rights obligations to refocus screening policies and programmes on women who are disproportionately affected by discrimination that impairs their full enjoyment of the right to sexual and reproductive health. National cervical cancer screening programmes that keep the right to health principles (above) central will be able to expand screening among low-income, isolated and other marginalised populations, but also women in general, who, for a variety of reasons, do not visit healthcare providers for regular screenings.
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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