Survival analysis of patients with heart failure in the Ecuadorian Andean population

Introduction In western countries, it is estimated that one to two people per 100 adults have heart failure. In Latin America, and particularly in Ecuador, few studies have assessed survival in this disease. For this reason, this study aimed to determine survival and prognostic factors based on clinical and socio-demographic characteristics. Methods We did a single-center study of survival analysis in 228 patients with heart failure between 2015 and 2019. Survival analysis was done by the actuarial method and a multivariate Cox regression analysis. Results Overall survival at the first year was 86% and at five years was 46%. Heart failure etiology (hazard ratio, 1.162: 95% confidence interval, 1.001 to 1.349; P = 0.049), ethnicity (1.415; 10.1 to 199; P = 0.043), age (1.035; 1.011 to 1.06; P = 0.04) and altered values of basal creatinine (1.21; 1.002 to 1.461; P = 0.048) were associated with worse prognosis. Conclusions Global survival time was similar to other international studies. Etiology, ethnicity, creatinine values, and age were factors associated with a worse vital prognosis.

Gingival zenith evaluation in an Andean population from Ecuador

Objectives: The aim of this study was to evaluate the characteristics of the gingival zenith of the maxillary incisors, canines and premolars in an Andean population from Ecuador. Materials and methods: A total of 51 subjects (30 men and 21 women; mean age = 21 years) with healthy gingival tissue were recruited. Digital study models were obtained from maxillary casts and the features of the gingival zeniths including its position, gingival lines and level in the lateral incisors were analyzed. Results: The gingival zenith was distally displaced in all the maxillary central and lateral incisors and in 70.59%; 62.74% and 91.17% of the canines, first and second premolars, respectively. For the maxillary anterior teeth, the greater mean of displacement was verified in central incisors (0.89mm ±0.27 SD), followed by the lateral incisors (0.58mm ±0.22 SD) and the canines (0.48mm ±0.21 SD). The displacement levels in the central incisors were significantly higher in females compared to male participants (p=0.037). In addition, the ascending gingival line was the most common in the anterior dentition (right: 52.9%; left: 51%), whereas the descending one was the most prevalent in the premolar area (right: 58.8%; left: 70.6%). Lastly, the gingival zeniths of lateral incisors were more frequently located coronal to the gingival line (86.27%), to a mean distance of 0.82mm (0.1 – 3.1mm; ±0.46 SD) and without significant differences among the genders (p=0.520). Conclusion: The data obtained from the present study could be taken into consideration during dental esthetic treatments, especially for Andean patients.

Protective role of estrogen against excessive erythrocytosis in Monge’s disease

Monge’s disease (chronic mountain sickness (CMS)) is a maladaptive condition caused by chronic (years) exposure to high-altitude hypoxia. One of the defining features of CMS is excessive erythrocytosis with extremely high hematocrit levels. In the Andean population, CMS prevalence is vastly different between males and females, being rare in females. Furthermore, there is a sharp increase in CMS incidence in females after menopause. In this study, we assessed the role of sex hormones (testosterone, progesterone, and estrogen) in CMS and non-CMS cells using a well-characterized in vitro erythroid platform. While we found that there was a mild (nonsignificant) increase in RBC production with testosterone, we observed that estrogen, in physiologic concentrations, reduced sharply CD235a+ cells (glycophorin A; a marker of RBC), from 56% in the untreated CMS cells to 10% in the treated CMS cells, in a stage-specific and dose-responsive manner. At the molecular level, we determined that estrogen has a direct effect on GATA1, remarkably decreasing the messenger RNA (mRNA) and protein levels of GATA1 (p < 0.01) and its target genes (Alas2, BclxL, and Epor, p < 0.001). These changes result in a significant increase in apoptosis of erythroid cells. We also demonstrate that estrogen regulates erythropoiesis in CMS patients through estrogen beta signaling and that its inhibition can diminish the effects of estrogen by significantly increasing HIF1, VEGF, and GATA1 mRNA levels. Taken altogether, our results indicate that estrogen has a major impact on the regulation of erythropoiesis, particularly under chronic hypoxic conditions, and has the potential to treat blood diseases, such as high altitude severe erythrocytosis.

Luis Jerónimo de Oré y la poesía de su Símbolo católico indiano (1598)

El Concilio de Trento propuso la implementación de nuevos modos de atraer a los neófitos a la fe católica. Siguiendo estas directivas, los concilios eclesiásticos de Lima en el virreinato del Perú, auspiciaron la catequización en lenguas nativas por medio de la publicación de gramáticas y catecismos. Por estar dirigido a los andinos y por sus numerosos himnos en lengua quechua, entre estas publicaciones sobresale Símbolo católico indiano (1598) de Luis Jerónimo de Oré. Este ensayo destaca la importancia de Símbolo, analiza la temática de los himnos, su relación con antiguas prácticas católicas y cómo los cánticos adquieren un carácter singular en el contexto peruano. Abstract The Council of Trent promoted new ways to attract the neophytes to the Catholic faith. Following these directives, the Lima Church Councils in the Viceroyalty of Peru sponsored the publication of catechisms and grammars in native languages to help missionize the Andean population. Addressed to the indigenous groups and including numerous hymns in Quechua, Símbolo Católico Indiano (1598) by Luis Jerónimo de Oré, is representative of these efforts. This essay underscores the importance of Símbolo; it analyzes the themes of the hymns, their link to ancient Catholic practices, and how they acquire their singularity within the Peruvian context.

Is unemployment less important than expected for suicide attempted in developing regions? Occupational profile of suicide attempts in Jujuy, north westernmost Argentina

Background: Mental health practices consider unemployment as a suicide main risk factor, based on models built for populations of developed countries. Aim: This study assesses the association between the occupational risk factor and suicidal behaviors, by considering sex, age and temporal distribution, in a Latin American Andean population from north westernmost Argentina. Methods: Data include 481 suicide attempt cases assisted by emergency service psychologists at a head hospital in the Jujuy Province, northern Argentina, during two biennials. General categories and specific types of occupational situation, sex, age and temporal distribution were analyzed. Results: 83.58% of cases corresponded to the with occupation category, but without occupation characterized male cases ( p-value = .01). The type no referred occupation (19.15%) mainly contributed to this association ( p-value = .02). Unemployed only represented 1.6%. These features revealed independent from the biennial period of assistance ( p-value = .96 (general), p-value = .86 (specific)). Associations by age ranges did not seem to be specific of suicidal attempts. Conclusion: The present contribution provides an occupational characterization of suicide attempts in an Andean population from north westernmost Argentina. Unemployment is not associated with suicidal behavior in this population, suggesting that dissimilar patterns underlie suicidal behavior of populations from developed and developing regions.