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PURPOSE: The purpose of this study is to assess the frequency of use of information and communication technologies and patterns of preference among Ecuadorian patients with diabetes. METHODS: We conducted an anonymous cross-sectional survey on type 2 diabetes mellitus. A chi-square test for association and adjusted regression analyses were performed. RESULTS: 248 patients were enrolled, with a mean sample age of 57.7 years. SMS was the most used ICT (66.0%). The Internet was used by 45.2% of patients to obtain information about diabetes. SMS and email were rated as the most useful ICTs for receiving information (64.5% and 28.1%, resp.) and asking physicians about diabetes (63.8% and 26.1%, resp.). Patients were also interested in receiving disease information (82.4%) and asking physicians about diabetes (84.7%) through WhatsApp. Adjusted logistic regressions revealed that individuals aged 55 years or younger, those with superior degree level, and those with long diabetes history preferred email for receiving information and asking physicians about diabetes compared to those above 55 years, those with low education level, and those with short diabetes history, respectively. CONCLUSION: Understanding preferences of ICTs among patients with diabetes could facilitate application development targeted towards specific requirements from patients.

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The aim of the present study was to assess the frequency of uses and preferences of information and communication technologies (ICTs) among Latin American chronic obstructive pulmonary disease (COPD) patients. We conducted an anonymous cross-sectional survey study on Latin American COPD patients. The adapted version of the Michigan questionnaire was employed in eligible outpatients in different cities of Latin America. We categorized age and educational levels into three groups. The time passed since COPD diagnosis was categorized as ≤5 years and >5 years. χ2 and crude and adjusted logistic regressions were performed. A total of 256 patients were enrolled with a mean age of 68.7 years old. The most recurrently used ICTs were short message service (SMS; 47.1%) and WhatsApp (30.7%) for receiving COPD information. Moreover, SMS (85.8%) and Facebook (36.1%) were rated as useful for asking physicians information about COPD. Regression analysis showed that the best predictor for patients using ICTs, for any purpose, was higher education (undergraduate or graduate school). Understanding the preferences of ICTs among COPD patients could help improve patient's outcomes through developing applications in response to specific requirements of each patient.

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BACKGROUND: Information on the burden of atrial fibrillation (AF) in rural areas of developing countries is limited. Here, we aimed to assess AF prevalence in community-dwelling older adults living in rural Ecuador. METHODS: Atahualpa residents aged ≥60 years (mean age 70.5 ± 8.1 years) underwent 24-h Holter monitoring. Participants belong to the Amerindian ethnic group. The mean height in the study population was 147.9 ± 8.9 cm. Oily fish was a major source of food (mean intake: 8 ± 4 servings/week). RESULTS: Seven of 298 participants (2.3%) had AF. Persons with AF were older than those without (p = 0.051), but there were no differences in cardiovascular risk factors across groups. None of the seven AF cases had been detected in routine 12-lead ECGs taken at enrollment. CONCLUSIONS: Prevalence of AF in older Amerindians living in rural Ecuador is low. Both, racially-determined short stature and frequent dietary oily fish intake might explain the low prevalence of AF in this rural setting.

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BACKGROUND: Inadequate communication between asthmatic patients and their physicians may interfere directly with asthma control. In the last years, the use of information and communication technologies (ICTs) it has increased in Latin-America. This technology seems to be a good tool to improve communication and management of the asthmatic patient. OBJECTIVE: We evaluated the frequency and preference patterns of communication and information technologies in Ecuadorian patients with bronchial asthma. METHODS: We conducted a pilot cross-sectional study to identify the frequency and preferences of ICT in patients with asthma. The Spanish version of the Michigan questionnaire was used. Age and educational level were categorized into 3 groups. We used logistic regression between these groups regarding the frequency of use, interest in seeking and receiving information related to their asthma for the age and educational level of the patients. RESULTS: A total of 222 patients participated in our study. The mean age was 45.6 years (SD 17.4), the most common sex was female with 89.25 %. Almost all patients had a cell phone (87.5 %) and internet access (62.7 %). The three ICTs most likely to be used to search for or receive information about their illness were WhatsApp, Facebook and email (p <0.05). CONCLUSION: Information and communication technologies improve the care of asthmatic patients. In our pilot study email and text messages are the most preferred ICT among patients however WhatsApp and Facebook may be appropriate for certain ages especially young asthmatic. Knowledge of preferences can help the development of ICT in a personalized way and improve the outcomes in patients with asthma.

Antecedentes: La comunicación inadecuada entre los pacientes y sus médicos puede interferir directamente con el control del asma. En los últimos años, el uso de tecnologías de la información y comunicación se ha incrementado en Latinoamérica y parece ser un recurso útil para mejorar la comunicación, adherencia y control del paciente con asma. Objetivo: evaluar la frecuencia y patrones de preferencia de las tecnologías de comunicación e información en pacientes ecuatorianos con asma bronquial. Métodos: estudio transversal en el que se utilizó la versión en español del cuestionario Michigan. La edad y el nivel educacional fueron categorizados en tres grupos. Se utilizó regresión logística entre los grupos respecto a la frecuencia de uso e interés en buscar y recibir información relacionada con el asma, según la edad y nivel educativo. Resultados: en nuestro estudio participaron 222 pacientes. La edad media fue de 45.6 ± 17.4 años y el sexo más común fue el femenino, con 89.25 %. Casi todos los pacientes tenían teléfono celular (87.5 %) y acceso a internet (62.7 %). Las tres tecnologías de la información y comunicación con mayor probabilidad de ser usadas con fines de buscar o recibir información acerca de la enfermedad fueron WhatsApp, Facebook y correo electrónico (p < 0.05). Conclusión: el correo electrónico y los mensajes de texto fueron preferidos por los pacientes, sin embargo, WhatsApp y Facebook pueden ser apropiados para ciertos grupos, especialmente para los jóvenes. La selección de TIC adecuadas para la comunicación médico-paciente podría mejorar la adherencia y el control de los pacientes con asma.

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BACKGROUND: Diagnosis of cerebral small vessel disease (SVD) is a challenge in remote areas where MRI is not available. Hypertensive retinopathy (HTRP) has shown to correlate with SVD in different ethnic groups, but there is no information from indigenous Latin American people. We assessed the usefulness of retinal photographs to detect cases with SVD among Amerindians living in rural Ecuador. METHODS: Atahualpa residents aged ≥60years with arterial hypertension or prehypertension were identified during a door-to-door survey. A confocal line scanning laser ophthalmoscope was used to identify and grade HTRP (according to the Keith-Wagener-Barker classification). MRIs were read with attention to the presence of white matter hyperintensities (WMH) of presumed vascular origin and lacunar infarcts. Using logistic regression models, we evaluated whether HTRP was independently associated with neuroimaging signatures of SVD. RESULTS: Of 323 eligible candidates, 241 (75%) were enrolled. MRI readings revealed moderate-to-severe WMH in 49 (20%) cases and lacunar infarcts in 29 (12%). HTRP Grade 1 was noticed in 90 (37%) individuals and Grade 2-3 in 42 (17%). After adjusting for demographics and cardiovascular risk factors, multivariate analyses showed a significant association between Grades 2-3 HTRP and moderate-to-severe WMH (OR: 3.87, 95% C.I.: 1.64-9.13) but not with lacunar infarcts (OR: 2.22, 95% C.I.: 0.83-5.92). CONCLUSION: Amerindians with HTRP Grades 2-3 are almost four times more likely to have SVD-related subcortical damage than those with no- or only Grade 1-HTRP. Retinal photographs might allow recognition of people who need further investigation and therapy.

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Photochemical degradation of methylparathion (O,O,-dimethyl O-4 nitrophenylphosphorothioate) in the presence of fulvic acid (FA) between pH 2 and 7 was studied by differential pulse polarography (DPP). Fulvic acid and its photoproducts were not electro-active under the experimental conditions used in this study, and only the pesticide exhibited polarographic signals. Photolysis of methylparathion in acid media was sensitized by fulvic acid since the pesticide did not degrade in the absence of this compound. Methylparathion degradation was observed at each of the studied pHs. The reaction was first-order with rate constant values ranging from 3.3 x 10(-3) to 8.8 x 10(-3)min(-1).

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Photochemical degradation of methylparathion (O,O,-dimethyl O-4 nitrophenylphosphorothioate) in the presence of humic acid between pH 2 and 7 was monitored by differential pulse polarography. Humic acid was not electro-active under the experimental conditions used in this study. Only the pesticide and its main degradation product at pH 2 exhibited polarographic signals. Photolysis of methylparathion in acid media was sensitized by humic acid since the pesticide did not degrade in the absence of this compound. Methylparathion degradation in the presence of humic acid was observed at each of the studied pHs. The reaction was first-order with rate constant values ranging from 2 x 10(-3) to 6.3 x 10(-3) min(-1).

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Kinetic studies of endosulfan photochemical degradation in controlled aqueous systems were carried out by ultraviolet light irradiation at lambda = 254 nm. The photolysis of (alpha + beta: 2 + 1) endosulfan, alpha-endosulfan and beta-endosulfan were first-order kinetics. The observed rate constants obtained from linear least-squares analysis of the data were 1 x 10(-4) s(-1); 1 x 10(-4) s(-1); and 2 x 10(-5) s(-1), respectively, and the calculated quantum yields (phi) were 1, 1 and 1.6, respectively. Preliminary differential pulse polarographic (DPP) analysis allowed to observe the possible endosulfan photochemical degradation pathway. This degradation route involves the formation of the endosulfan diol, its transformation to endosulfan ether and finally the ether's complete degradation by observing the potential shifts.

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A study was undertaken to determine the transformation kinetic of methylparathion (O, O, -dimethyl O-4 nitrophenylphosphorotioate) in the presence of Fe(III) between pH 2 and 7. The Fe(III) was not electroactive under the conditions used in this study, and polarographic signals were exhibited by methylparathion and main degradation product only. Data suggest that hydrolysis of methylparathion in an acid medium is catalyzed by Fe(III) and the pesticide did not degrade in this medium without this cation. Methylparathion degradation was observed at all the pHs studied and was independent of the predominant chemical form of Fe(III) in the aqueous medium. The reaction was first-order with pH-dependent rate constant (k) values ranging from 3.3 x 10(- 3) h(- 1) to 7.0 x 10(- 3) h(- 1). The k values increased as pH decreased, suggesting that Fe(III) acted as an electrophile in the reaction mechanism.

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