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INTRODUCTION: Electronic cigarettes (e-cigarettes) have emerged as a new paradigm in nicotine delivery systems. Although they are marketed as safer alternatives to tobacco, public perceptions of their safety and utility vary widely. This study aims to understand the percentage of use, factors associated, perceptions, and attitudes about e-cigarettes among Ecuadorian adults. METHODS: A cross-sectional survey was conducted among the Ecuadorian population aged 18-65 years through a convenience sample, using a structured online questionnaire designed to collect responses from voluntary participants over three months, from February to April 2023. The questionnaire assessed the respondents' attitudes and perceptions towards e-cigarettes. Data were analyzed using descriptive statistics, chi-squared tests, and adjusted logistic regression analyses to identify factors associated with e-cigarette use. RESULTS: Out of a total of 3047 Ecuadorian adults, the percentage of e-cigarette ever use was 27.9% (n=850), with 19.4% being current users and 8.5% former users. A negative stance towards e-cigarettes was predominant, with 66.3% considering e-cigarette use a public health problem in Ecuador. A significant association was observed between e-cigarette use and perceived harmfulness (p<0.001). Among non-users, there was a predominant stance in favor of control measures and disapproval of e-cigarette use among minors (p<0.001). The factors associated with the use of electronic cigarettes included being health personnel (AOR=1.51; 95% CI: 1.26-1.80). Older age (aged >24 years) and a history of tobacco use were associated with lower e-cigarette use (current users, OR=0.31; 95% CI: 0.25-0.38; previous users, OR=0.23; 95% CI: 0.18-0.28). CONCLUSIONS: The findings highlight a significant percentage of e-cigarette use among Ecuadorian adults, especially among younger groups. There is a need for comprehensive public health education about e-cigarettes in Ecuador. There is strong support from the public for control measures, suggesting the potential acceptability of regulations concerning e-cigarettes.

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We aimed to evaluate the facilitation effects of an aluminum (Al) hyperaccumulator species bearing cluster roots, Gevuina avellana, on the seedling growth and performance of an Al-intolerant and phosphorus (P)-deficient-sensitive plant, Vaccinium corymbosum. For this, seedlings of G. avellana and V. corymbosum were grown alone or together as follows: i) two G. avellana seedlings, ii) one G. avellana + one V. corymbosum and iii) two V. corymbosum, in soil supplemented with Al (as Al2(SO4)3) and in the control (without Al supplementation). We determined relative growth rate (RGR), photosynthetic rate, chlorophyll concentration, lipid peroxidation and Al and nutrient concentration [Nitrogen (N), P, potassium (K), calcium (Ca), magnesium (Mg), sodium (Na), manganese (Mn), iron (Fe), copper (Cu), zinc (Zn), and sulfur (S)] in leaves and roots of both species. The results showed that, in general, G. avellana did not assist V. corymbosum to enhance its RGR nor reduce its Al uptake. However, G. avellana assisted V. corymbosum in enhanced N acquisition and, consequently, to increase its chlorophyll concentration and photosynthetic rate. Besides, V. corymbosum had lower lipid peroxidation in leaves when grown in the soil with high Al supplementation in association with G. avellana. Our results suggest a facilitating effect of G. avellana to V. corymbosum when grown in soils with high Al concentration, by enhancing chlorophyll concentrations and photosynthetic rate, and decreasing the oxidative damage to lipids.

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Long COVID is a term used to describe the long-terms effects of COVID-19 infection that continue for weeks or months after the patient has recovered from COVID-19. Long COVID is defined by the persistence of symptoms beyond 12 weeks from the onset of the disease. Corticosteroids are part of the treatment in this period with good results in controlling the disease; however, it is a predisposing factor for the development of avascular necrosis. We present a clinic case of a young man of 39 years old with diagnosis of avascular necrosis in his left hip, before the administration of corticosteroids for the treatment of COVID-19. There is a lack of consensus about the dosage and duration of steroids required to develop avascular necrosis. Some authors have reported that cumulative dose of 2,000 mg prednisone (or its equivalent) was required for avascular necrosis development. For patients with advanced avascular necrosis stages total hip arthroplasty is an attractive option with excellent outcomes in terms of pain relief and survivorship.

El COVID de larga duración es un término que describe la enfermedad en pacientes que se recuperaron de una infección por COVID-19 y reportan síntomas por más de 12 semanas. Los corticosteroides forman parte del tratamiento en este período con buenos resultados en el control de la enfermedad; sin embargo, el uso de este grupo de medicamentos se ha descrito como un factor de riesgo para el desarrollo de necrosis avascular. Se describe el caso clínico de un paciente masculino de 39 años con diagnóstico de necrosis avascular de la cadera izquierda posterior a la administración de corticosteroides para el tratamiento de COVID-19. La dosis de esteroides capaz de provocar necrosis avascular no está clara o bien descrita; sin embargo, existen reportes en la literatura donde se habla de dosis de 2,000 mg de prednisona (o equivalentes) para su desarrollo. El tratamiento de la necrosis avascular tiene como objetivo el alivio del dolor, retardar la progresión del cuadro, prevenir el colapso en etapas tempranas y restaurar la función articular. La artroplastía o recambio total de cadera parece ser una excelente opción de tratamiento quirúrgico para aquellos pacientes en etapas avanzadas.

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INTRODUCTION: Gastroesophageal reflux disease (GERD) is very prevalent in the general population, with a broad spectrum of clinical manifestations, requiring accurate diagnosis and treatment. AIM: The aim of this expert review is to establish good clinical practice recommendations for the diagnosis and personalized treatment of GERD. METHODS: The good clinical practice recommendations were produced by a group of experts in GERD, members of the Asociación Mexicana de Gastroenterología (AMG), after carrying out an extensive review of the published literature and discussing each recommendation at a face-to-face meeting. This document does not aim to be a clinical practice guideline with the methodology such a document requires. RESULTS: Fifteen experts on GERD formulated 27 good clinical practice recommendations for recognizing the symptoms and complications of GERD, the rational use of diagnostic tests and medical treatment, the identification and management of refractory GERD, the overlap with functional disorders, endoscopic and surgical treatment, and GERD in the pregnant woman, older adult, and the obese patient. CONCLUSIONS: An accurate diagnosis of GERD is currently possible, enabling the prescription of a personalized treatment in patients with this condition. The goal of the good clinical practice recommendations by the group of experts from the AMG presented in this document is to aid both the general practitioner and specialist in the process of accurate diagnosis and treatment, in the patient with GERD.

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The acaricidal effect of 14 strains of Metarhizium anisopliae sensu lato isolated from soil of livestock farms in the Mexican tropics was evaluated against larvae and engorged females, and during the laying and hatching of eggs of Rhipicephalus microplus (Ixodida: Ixodidae). For each fungal strain, the larvae mortality percentage was evaluated through a larval immersion test, while the reproductive efficiency indices in engorged females were measured using adult immersion tests at a dose of 1 × 108 conidia/ml. All strains of M. anisopliae (s.l.) proved to be highly effective against R. microplus larvae (66-100%) and engorged females (100%). The strains also showed a good effect in inhibiting egg laying (16.45-56.38%) and a moderate effect in decreasing egg hatching (5.24-32.68%). Two strains demonstrated to be effective against all development phases of R. microplus in an integrated manner.

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INTRODUCTION: Handgrip strength is a robust indicator of the biological health of elderly. OBJECTIVE: The purpose of this study is twofold: 1) estimate the normative values of absolute and relative handgrip strength, specific to adults over 60 years of age in Colombia, using quantile regression models: 2) compare the normative values of absolute and relative handgrip strength in Colombian older adults with those from different countries. METHODS: A cross-sectional analysis of a sample of 5377 older adults. Handgrip strength was evaluated with a TKK 5101 digital dynamometer (Takei Scientific Instruments Co., Ltd., Tokyo, Japan). Relative handgrip strength was estimated by dividing by weight in kilograms. The absolute and relative handgrip strength normative values were estimated through quantile regression models for the percentiles P5, P10, P25, P50, P75, P90 and P95, they were developed independently for each sex; all analyzes were adjusted for the expansion factor. RESULTS: Absolute handgrip strength values were considerably higher in men (P50 60-64 years = 32.0 kg, P50 >85 years = 18.0 kg) compared to women (P50 60-65 years = 19.0 kg; P50 >85 years = 12.0 kg), in all age groups. Additionally, as age increases in both sexes, there is a decrease in the values of absolute and relative manual grip strength. CONCLUSIONS: The estimated normative values in the Colombian population were generally lower than those reported in other studies around the world. These results could be related with methodologies used variability to evaluate handgrip strength and the estimation methods, which could influence the discrepancies between the different reports.

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INTRODUCTION: Chronic idiopathic constipation (CIC) negatively impacts quality of life and increases healthcare costs. Lubiprostone stimulates the secretion of intestinal fluid, in turn facilitating the passage of stools and alleviating associated symptoms. Lubiprostone has been available in Mexico since 2018, but its clinical efficacy has not been studied in a Mexican population. AIM: To evaluate the efficacy of lubiprostone, assessed by changes in spontaneous bowel movement (SBM) frequency after one week of treatment with 24 µg oral lubiprostone (b.i.d.), as well as its safety, over four weeks of treatment. STUDY: Randomized, double-blind, placebo-controlled study on 211 adults with CIC in Mexico. RESULTS: The increase in SBM frequency, after one week of treatment, was significantly higher in the lubiprostone group than in the placebo group (mean: 4.9 [SD: 4.45] vs. 3.0 [3.14], p = 0.020). Secondary efficacy endpoints revealed a significantly higher proportion of SBM frequency/week in the lubiprostone group at weeks 2, 3, and 4. There was a better response within 24 h after the first dose with lubiprostone vs. placebo (60.0% vs. 41.5%; OR: 2.08, CI95%: [1.19, 3.62], p = 0.009) and the lubiprostone group also had significant improvement, with respect to straining, stool consistency, abdominal bloating, and Satisfaction Index. The main adverse events were gastrointestinal disorders in 13 (12.4%) lubiprostone-treated subjects and 4 (3.8%) control subjects. CONCLUSIONS: Our data confirm the efficacy and safety of lubiprostone for the treatment of CIC in a Mexican population. Lubiprostone treatment induces relief from the most bothersome symptoms associated with constipation.

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INTRODUCTION: osteoarthritis is one of the most prevalent chronic diseases in the world and is defined as the gradual loss of cartilage in the joints, mainly that of the knee. It is considered a cause of disability in older adults and is characterized by pain, stiffness and loss of mobility. MATERIAL AND METHODS: observational study to evaluate the effect of the combination of non-hydrolyzed type II native collagen (CII-NH), omega-3 (Om-3) and astaxanthin (AX), in a population of 182 patients with knee osteoarthritis grade I/II. Measurements of thigh circumference, arcs of movement and pain were obtained through international scales such as the visual analogue pain scale (VAS), the Lequesne index and the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scale. Medical check-ups were performed every 30 days for three months. The Statgraphics software (Statgraphics Technologies, Virginia) was used, the evaluation of the variables and the statistical significance were determined by t Student test and the results are shown as a mean. RESULTS: it was shown that daily consumption increases mobility, decreases knee pain and inflammation in patients within three months. Additionally, there was a reduction in the consumption of nonsteroidal anti-inflammatory drugs (NSAIDs) by the study subjects. CONCLUSION: the fixed combination of non-hydrolyzed type II collagen, omega-3 and astaxanthin, generates, in the short term, a decrease in inflammation and stiffness in patients with osteoarthritis.

INTRODUCCIÓN: la osteoartritis es una de las enfermedades crónicas con mayor prevalencia en el mundo y se define como la pérdida gradual de cartílago en las articulaciones, principalmente la de rodilla. Es considerada como una causa de discapacidad en adultos mayores y se caracteriza por dolor, rigidez y pérdida de la movilidad. MATERIAL Y MÉTODOS: estudio observacional para evaluar el efecto de la combinación de Sólo debe decir, colágeno nativo tipo II, omega-3 (Om-3) y astaxantina (AX), en una población de 182 pacientes con artrosis de rodilla grado I/II. Se obtuvieron las mediciones de circunferencia del muslo, arcos de movimiento y dolor a través de las escalas internacionales como la escala visual analógica de dolor (EVA), el índice de Lequesne y escala Western Ontario McMaster Universities Osteoarthritis Index (WOMAC). Las revisiones médicas se realizaron cada 30 días durante tres meses. Se utilizó el software Statgraphics (Statgraphics Technologies, Virginia), la evaluación de las variables y la significancia estadística fueron determinadas por la prueba t de Student y los resultados se muestran como media. RESULTADOS: se demostró que el consumo diario incrementa la movilidad, disminuye el dolor y la inflamación de rodilla en los pacientes en un lapso de tres meses. Adicionalmente se registró una reducción en el consumo de antiinflamatorios no esteroideos (AINE) por parte de los sujetos de estudio. CONCLUSIÓN: la combinación fija colágeno nativo tipo II, omega-3 y astaxantina, genera, en el corto plazo, disminución de la inflamación y la rigidez en pacientes con osteoartritis.

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INTRODUCTION: to evaluate the long term radiographic and functional results achieved in adult patients with osteoporotic, atrophic, non-unions of the diaphyseal humerus, treated surgically by open reduction and internal fixation with plates and bone graft. MATERIAL AND METHODS: we retrospectively evaluated 22 patients. Patient's age averaged 72 years. Time from initial trauma to definitive surgery averaged 18 months. Eleven patients were smokers, and four had active infection. Pre-operative Constant score and DASH score averaged 23.13 and 81.04, respectively. Pre-operative pain scale averaged 7.45 points. RESULTS: follow-up averaged 69 months. Union was achieved in all cases after an average of 4.68 months. DASH score at last follow-up averaged 20.27 points and Constant score 79.31 points. Analog pain scale averaged 0.77 points. Stabilization was performed using locking blade plates in 12 non-unions, locking compression plates in six cases, and double plating in four non-unions. Patients with active infection were treated in two stages using Masquelet's technique. Bone graft was associated in all cases (cancellous iliac crest autograft in 17, allograft in three, and combined structural allograft and cancellous autograft in two). Two grams of vancomycin powder were associated to the bone graft in all cases. CONCLUSION: the use of open reduction and internal fixation with plates associated to bone graft with local antibiotics, aloud achieving bony union and good predictable long-term objective and subjective functional results in all cases, without major complications or the need of further surgical intervention.

INTRODUCCIÓN: evaluar los resultados radiográficos y funcionales obtenidos a largo plazo en pacientes adultos que presentaron no-consolidaciones atróficas diafisarias de húmero asociadas a osteoporosis; tratadas quirúrgicamente mediante reducción abierta y fijación interna con placas e injerto óseo. MATERIAL Y MÉTODOS: evaluamos retrospectivamente 22 pacientes, con edad promedio de 72 años, el tiempo desde el trauma inicial hasta la cirugía definitiva promedió, 18 meses. Once pacientes eran fumadores y cuatro presentaban infección activa. El score de Constant y el DASH preoperatorios promediaron 23.13 y 81.04, respectivamente. El valor de la escala analógica del dolor preoperatorio promedió 7.45 puntos. RESULTADOS: el seguimiento promedió 69 meses. Se obtuvo la consolidación en todos los casos, luego de un promedio de 4.68 meses. Al último seguimiento, los valores del DASH promediaron 20.27 puntos y el score de Constant promedió 79.31 puntos. La escala analógica del dolor promedió 0.77 puntos. La estabilización se realizó utilizando clavos placa bloqueados en 12 no-consolidaciones, placas bloqueadas de compresión en seis y doble placa en cuatro. Los pacientes con infección activa fueron tratados en dos etapas utilizando la técnica descripta por Masquelet. Se asoció injerto óseo en todas las reconstrucciones (autoinjerto esponjoso de cresta ilíaca en 17, aloinjerto en tres y se combinó aloinjerto estructural con autoinjerto esponjoso en dos). Dos gramos de vancomicina en polvo fueron asociados localmente al injerto óseo. CONCLUSIÓN: la combinación de reducción abierta y fijación interna con placas e injerto óseo permitió obtener la consolidación y resultados funcionales objetivos y subjetivos buenos y predecibles a largo plazo en todos los casos, sin complicaciones mayores ni la necesidad de intervenciones quirúrgicas sucesivas.

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