Isidro Ayora Research Articles

Urban property tax and public finances in the municipality of Isidro Ayora - Ecuador

Urban property tax and public finances in the municipality of Isidro Ayora - Ecuador

Influencia de la política pública y la episiotomía selectiva en el parto normal en Ecuador

Introducción: La episiotomía se consideró un procedimiento obstétrico aplicado de manera rutinaria para facilitar el período expulsivo. En la actualidad, varios estudios, normativas y protocolos indican que su uso debe restringirse y se cuestionan sus beneficios. Objetivo: Conocer la influencia de las normativas emitidas sobre el uso selectivo de la episiotomía en los establecimientos del Ministerio de Salud Pública al comparar el año 2007 con el 2017.Métodos: Se efectuó un estudio epidemiológico analítico de fuente secundaria (historias clínicas de parto normal) y de fuente primaria (encuestas a profesionales). Se realizó en las unidades de salud del MSP-EC: Centro de Salud Centro Histórico, Hospital Enrique Garcés, y Hospital Gineco-obstétrico Isidro Ayora, centros de atención médica en los que se revisó el formulario 0.51 de las historias clínicas y se registró un instrumento prediseñado para el estudio. Con la información compilada se organizó la base de datos para establecer diferencias significativas, se utilizó la prueba de Chi cuadrado entre los datos afirmativos de acción de episiotomía en los dos años comparados. Resultados: La aplicación de la episiotomía presentó un cambio notable al comparar el año 2007 con un 29,2 % y 8,7 % en el 2017. Cabe destacar, que las mujeres primíparas fueron el grupo al que se realizó el mayor número de episiotomías. Conclusión: El aspecto que más influyó en la reducción del número de episiotomías fue la capacitación impartida a los profesionales graduados después de 2008, incluida en la normativa del MSP-EC para la aplicación selectiva de la episiotomía.

Differences between preterm infants receiving a dose for lung maturation and those receiving an additional rescue dose of corticosteroids

it is unknown if there is a difference between preterm infants with a history of receiving pulmonary corticosteroid maturation or using an additional rescue dose of corticosteroid. This paper aims to determine the difference between infants with pulmonary maturation and infants who received a rescue dose of corticosteroid. We performed an epidemiological, observational, and cross-sectional study. We analyzed time of stay, the requirement of mechanical ventilation, the use of surfactant, and neurological complications in newborns hospitalized in Neonatology of the Isidro Ayora Gyneco-Obstetric Hospital, 2019. We analyzed 204 preterm infants of 28-37 weeks who received a total lung maturation dose versus an added rescue dose. We analyzed the information with the statistical program SPSS v 22.0. With rescue dose the stay time was 28.4±21.6 days (p <0.05), days of invasive mechanical ventilation 3±5.7 days (p <0.05); Surfactant use 33.3% (p>0.05). We found neurological complications in 6.9% of patients (p> 0.05). In group 2 with not rescue dose use, the stay time was 21.5±16.6 days (p<0.05), days of invasive mechanical ventilation 1.8 ± 4.1 days (p <0.05). Surfactant use was 24.5% (p>0.05), and neurological complications 2% (p> 0.05). Preterm males weighing <1000 g from 30 to 32 weeks, who used rescue doses of corticosteroids, showed an increase in intraventricular hemorrhage (13.7%), seizures (6.9%), and leukomalacia (13.7%), associated with the fact that in the group with rescue dose they are younger and had lower weight.

Vaginal Microbiota Evaluation and Lactobacilli Quantification by qPCR in Pregnant and Non-pregnant Women: A Pilot Study.

Pregnancy outcomes and women's health are directly affected by vaginal microbiota. This microbiota consists of a dynamic ecosystem of various microbes in different ratios, which in healthy conditions protect the vaginal epithelium from infections. However, cases of vaginal infection are regularly diagnosed in women of reproductive age, contributing to more severe outcomes. Therefore, our main goal was to determine the prevalence of bacterial vaginosis (BV), aerobic vaginitis (AV), and vulvovaginal candidiasis (VVC) among Ecuadorian pregnant and non-pregnant women. A cross-sectional study was conducted among 217 women between 13 and 40 years old seeking primary healthcare in Carlos Andrade Marin Hospital (HCAM), Gynecological-Obstetric Hospital Isidro Ayora (HGOIA) and Center for Teaching Health Cipriana Dueñas during October 2018 to February 2019. The classical characterization of the vaginal microbiota was performed through microscopy by the Nugent criteria to evaluate the presence of BV, healthy and intermediate microbiota, by the criteria of Donders to determine the presence of AV and by the Marot-Leblond criteria to diagnose VVC. DNA extraction from vaginal samples and Polymerase Chain Reaction (PCR) analysis was performed to characterize the presence of Gardnerella spp., Mobiluncus mulieris, Escherichia coli, Enterococcus spp., and Lactobacillus spp. Finally, quantification of the lactobacilli was performed by quantitative real-time PCR (qPCR) for samples from women with normal vaginal microbiota and women with AV. Our results showed 52% of women with healthy microbiota, 7% with intermediate microbiota, and 41% with vaginal dysbiosis, comprising 27% with AV, 8% with BV and 4% with VVC and 2% with co-infections or co-dysbiosis. Additionally, a higher amount of lactobacilli were found in pregnant women when compared to non-pregnant women, while AV cases were characterized by a significant drop of Lactobacillus spp., more precisely, between 1E3 and 1E5 colony forming units (CFU)/ml. Finally, women with normal vaginal microbiota showed an average load of lactobacilli between 1E6 and 1E7 CFU/ml. This pilot study showed no statistically significant differences between pregnant and non-pregnant women, pointing to the possibility to use lactobacilli quantification for the prevention of future vaginal infections.

Neurodevelopmental Delay in Premature Ecuadorian Children Born Weighing Less than 1500 g: a Follow-up Study

To determine neurodevelopmental disorders at 3 years of age in two cohorts of premature infants with at least two comorbidities and weigh less than 1500 g, applying the neurodevelopmental scales EDI and Brunet-Lezine. Epidemiological study, observational study, and cross-sectional study were performed at Neonatology Service of the Gynecological Obstetric Hospital Isidro Ayora, Quito, between 2015 and 2016. It analyzed 204 neonates, distributed in two cohorts, 102 premature newborns under 1500 g with two comorbidities and 102 under 1500 g with more than two comorbidities at birth. Mestizo mothers, between 25 and 39 years of age, with two or more comorbidities, including hypertension, preeclampsia, and HELLP syndrome, show children with greater neurodevelopmental delay. Children under 1500 g, born between 33 and 36 weeks of gestation and with moderate asphyxia or respiratory depression, whose mother had two more comorbidities are related with a greater delay in neurodevelopment, at 36 months of age when they were evaluated. The patent ductus arteriosus, connate infection, and hydrocephalus are the pathologies on admission which relates with preterm with neurodevelopment delay and with weight. Severe asphyxia, weight between 700 and 900 g, and presence of connate infection early sepsis and septic shock combined cause neurodevelopmental delay. Delay in neurodevelopment is present in the 11.8% of patients (24/204), at 3 years of age. Mestizo mothers between 25 and 39 years of age with two or more comorbidities, including hypertension, preeclampsia, and HELLP syndrome, with children born between 33 and 36 weeks of gestation, and born with severe asphyxia, show children with greater neurodevelopmental delay.

Pregnancy in adolescence and adverse neonatal outcomes in Ecuadorian mestizo newborns

To establish the association between pregnancy in early and middle adolescence and adverse neonatal outcomes in Ecuadorian mestizo newborns. Study design: epidemiological, observational/descriptive, and cross-sectional. Gynecological and Obstetric Hospital Isidro Ayora at Quito, Ecuador, from July to October of 2018. this study included 303 newborns and their mothers, 101 children of adolescent mothers between 14 and 16 years old, 101 adolescents between the ages of 17 and 19, and 101 infants born to adult mothers between 20 and 34 years of age. There is no statistically significant association between maternal age, gestation time, neonatal morbidity and APGAR at 5min. Neonatal morbidity is higher in adolescent mothers residing in rural areas and in these who had fewer than five prenatal check-ups. In the case of mothers with a pathological history, regardless of the area in which they resided, the highest percentages were recorded in the case of mothers of 24-30 years with five or more prenatal appointments, and in adolescent mothers from 14 to 19 years of age with fewer than five prenatal appointments. Indeed, the greater the number of prenatal evaluations the higher the percentage of pathological findings. There is a close relationship between the age of the mother and the number of prenatal check-ups performed during pregnancy. Teenage mothers have a higher percentage of neonatal morbidity in deliveries with gestational age equal to or greater than 37 weeks of gestation and AGPAR 8 and 9at 5min. In addition, there were a higher percentage of cases of respiratory failure and sepsis in newborns, especially when fewer than five prenatal examinations were performed. The highest percentage of identified prenatal pathological antecedents occurred in the group of mothers from 20 to 34 years old who attended more than five prenatal controls. Young pregnant women go less frequently to prenatal appointments, particularly in rural areas, and their newborns have a higher percentage of respiratory failure and sepsis.

Is pulse oximetry helpful for the early detection of critical congenital heart disease at high altitude?

To assess the pulse oximetry as a method for screening critical congenital heart disease (CHD) in newborns. This is an observational, transversal, descriptive simple study. The pre-ductal and postductal saturation were taken in term newborns that fulfilled the criteria of inclusion and exclusion in the Hospital Gineco-Obstetrico Isidro Ayora (HGOIA) in Quito. These measurements were performed between the 24 and 48 h after birth. Those newborns that saturated less than 90% on initial pulse oxìmetry underwent 3 successive measurements at 1-h intervals. Those who saturate less than 90% after 3 measurements or have a difference higher than 3% in preductal saturation and postductal saturation (positive screening) underwent transthoracic echocardiography evaluate for CHD. Pulse oximetry from 963 newborns was evaluated. In Quito, at an altitude of 2820 meters above sea level (9252 feet), the mean preductal saturation was 92.76% (SD±3) and the postductal saturation, 93.76% (SD±4.7). Pulse oximetry in 53 patients (5.5%) was classified as a positive screening. No critical congenital heart diseases were found. Atrial septal defect (ASD) was the most common finding in a 46.94% (n=23), followed by the association of patent ductus arteriosus (PDA) and ASD with a 12.24% (n=6). In this cohort of patients who underwent screening pulse oximetry, no critical congenital heart diseases (CHD) were observed. However, identifying those with oxygen saturation less than 90% after 3 successive measurements or a pre- and postductal oxygen difference of>3% resulted in successful identification of ASD and PDA. It is necessary to implement new cutoff points in saturation values to identify critical cardiac anomalies in cities placed at a high altitude. The use of pulse oximetry should be recommended in all the newborns.

Mobile Technology as a Virtual Assistant at the Museum of the Isidro Ayora Fiscal School

The Isidro Ayora School located in the Latacunga Canton, between Quijano / Ordóñez and Tarqui streets, has a museum that is open to the citizens without any age difference, projecting during the tour in a traditional, monotonous and unconventional way all their art, By this factor the influx of public is very sporadic, which does not allow the development and recognition of the Museum. For the development of the research was applied the hypothetical-deductive method and the analytical, on the other hand was applied the methodology of application development for Smartphones Mobile-D; Through the collection of information that involves eld research, it was veri ed that the Museum does not have technological alternatives that allow the dissemination of the historical-cultural heritage, thus demonstrating that the creation of the virtual guide through mobile technology is the technological solution to improve The user’s experience in visiting and disseminating museums; So is the search for the use of new technologies helping to turn a forgotten environment into an interactive and friendly environment. With the implementation of Mobile Technology in the Museum of the Isidro Ayora School, visitors will be able to interact with the art articles displayed and visualize their information on any Android device through a multimedia library by simply scanning the QR code that each contains and In consequence it will allow the innovation, difusion and recognition of the Museum.

Suma de la historia de los conocimientos médicos en el Ecuador

Social Medicine has had its notorious achievements among us, since 1928 when, during the administration of Doctor Isidro Ayora, the Pension Fund for all public employees in the country was founded. The Medical Services were organized in 1937 for employees and the Health Insurance began in 1944, the year in which the Social Security Medical Department was also organized in the Insurance Fund for all workers in the country.

Conocimientos, actitudes y prácticas de embarazadas en control prenatal relacionadas con salud oral y embarazo, de mujeres que acuden a consulta externa del Hospital Gíneco Obstétrico Isidro Ayora

Esta investigación explora conocimientos, actitudes y prácticas (CAPs) de embarazadas que acuden al Hospital Isidro Ayora (HGOIA), para entender su relación con su salud bucal. Este estudio transversal analítico inferencial, realizado en agosto-septiembre de 2015 en Consulta externa Odontológica del HGOIA, aplicó una encuesta que investigó: Datos sociodemográficos; Conocimientos sobre embarazo y salud oral; Actitudes sobre atención odontológica durante el embarazo; y Acciones prácticas de salud oral en embarazo. Los resultados indican que las embarazadas conocen qué es la caries y cómo prevenirla; estarían dispuestas a realizarse una profilaxis. Sin embargo, acudirían al dentista por derivación del ginecólogo, sólo cuando hay dolor y siempre que no haya riesgo (madre o bebé); la mayor proporción de mujeres presentaron un promedio de 4.2 caries, y todas tenían enfermedad periodontal. En conclusión, los CAPs de salud oral en embarazadas, están influenciados por factores sociodemográficos, favoreciendo o no los controles odontológicos en el embarazo.

Central Bank of Ecuador, 1927: among Dictatorship, Revolution and Crisis

On July 9 th , 1925, a coup d’etat overthrew the Ecuadorian government of the president Gonzalo S. Cordova. The Military Junta chose the new president, Dr. Isidro Ayora, who founded the Central Bank of Ecuador in 1927. The majority of historians emphasize the patriotic spirit of the military forces in order to eliminate the influence of private banks. Nonetheless, there is a less popular view of the Julian Revolution, which understands the coup d’etat, and the foundation of the Central Bank of Ecuador, as the result of struggles between bankers due to controversies around currency emissions. The arguments behind the Julian Revolution were based on some economic facts. Even though real GDP did not decrease in any year from 1913 to 1927, there was a generalized perception of a critical economy due to the constant fluctuation in prices, the increasing of fiscal deficit, and the reduction of revenues from the trade balance. The economic crisis was a common factor in the urban areas, which represented less than half percent of the total population.

Prevalence and determinants of exclusive breastfeeding among adolescent mothers from Quito, Ecuador: a cross-sectional study.

BackgroundExclusive breastfeeding (EBF) is the optimal way to feed children during their first six months of life, having important benefits for them and their mothers. However, the proportion of Ecuadorian mothers who continue to exclusively breastfeed their infants during the recommended six-month period has been reported to remain below the World Health Organization’s goal set of 90 %. Little is known regarding factors influencing adolescent mothers to decide whether to practice EBF or not. Furthermore, there is no data about the EBF rates among adolescent mothers in Quito, Ecuador.MethodsThis cross-sectional study took place from April to November 2013 in the largest maternity ward in Quito, Ecuador (Hospital Gineco Obstétrico Isidro Ayora). Adolescent mothers parenting an infant between 6 and 24 months of age (n = 375) were interviewed using a structured questionnaire about EBF knowledge, beliefs and practices. Bivariate and multivariate analyses were used to identify the independent predictors of EBF.ResultsIn our sample, 62.9 % of adolescent mothers raising infants between 6 to 24 months of age chose EBF. Knowledge about the maternal benefits of breastfeeding and awareness of appropriate time frame for EBF were statistically associated with increasing the likelihood of choosing EBF. Adolescent mothers who were acquainted with the recommended duration of EBF were more likely to practice EBF (adjusted odds ratio (AOR) = 1.73; 95 % confidence interval (CI) 1.003, 2.98) as well as those who knew that breastfeeding is a protective factor against breast cancer (AOR = 5.40; 95 % CI 1.19, 24.56).ConclusionsAlthough adolescent mothers may be more prone to discontinuing EBF before their infants reach six months of age, the prevalence of EBF among adolescent mothers interviewed was higher than the rate reported for Ecuadorian mothers in other age groups. Our data underscores the importance of emphasizing the correct practice of BF and its benefits in breastfeeding education programs provided to Ecuadorian mothers, in order to promote the extension of breastfeeding duration to the recommended levels.

Assessment of Genetic Contributions to Risk of Preeclampsia in Ecuadorian Women

Aim: To identify the immunogenetic factors that trigger the beginning of preeclampsia and eclampsia. Methods: A retrospective, case-control study of 142 pregnant women in Obstetrics and Gynecological Hospital Isidro Ayora in Quito, who are grouped into two different groups, diseased and healthy. The study analyzed ethnicity, age, gynecological history, contraception, immunizations, blood type and Rh factor, and family history of preeclampsia-eclampsia of each of the pregnant women; and gestational age, sex, weight, and blood type and Rh factor of the progeny. Results: Age, ethnicity, history of pregnancy, abortions, contraception, and blood type and Rh factor were similar for both groups (p > 0.05). Gestational age and weight of the progeny was lower in cases compared with controls (p < 0.05). There was no statistical difference when comparing the blood type and Rh factor of the two groups (p > 0.05). Male gender was predominant in both groups for cases 69.01 and 87.32% for controls (p < 0.05). Conclusions: There was a higher predisposition for inherited cases (26%) versus controls (9.85%), p < 0.05, for the occurrence of preeclampsia. The frequency of the recessive gene for Mendelian inheritance model mother-fetus homozygous (aa/aa), in agreement with the Hardy-Weinberg Law, was 0.41 for the sample.

NO in Early Pregnancy and Development of Preeclampsia

To the Editor: We read with interest the article published by Khan et al.1 Between April 2001 and November 2002 we conducted a prospective study approved by the Bioethics Committee.2,3 There were included 68 healthy pregnant women, primigravidae, younger than 25 years, and attending the Hospital Gineco Obstetrico Isidro Ayora in Quito, Ecuador. All women were included at 16 weeks of gestation and were evaluated every 4 weeks until week 36, after then every 2 weeks up to delivery. Onset of preeclampsia was defined as a blood pressure >140/90 mm Hg on at least 2 occasions more than 6 hours apart …

Abnormal release of nitric oxide from nitrosoprotein in preeclampsia

Preeclampsia (PE) is a common (~7% of all pregnancies) disorder of human pregnancy in which the normal hemodynamic response to pregnancy is compromised. S-nitroso derivatives of protein and non-protein thiols acts like NO. However transition metals and reductants are often required for this function [1]. This study investigates the release of nitric oxide (NO) from plasma S-nitrosoprotein in normal pregnant (NP n = 60) preeclamptic (PE n = 30) and non-pregnant women (NON-P n = 30) attending to Hospital Gineco-Obstetrico Isidro Ayora in Quito Ecuador. (excerpt)

C-reactive protein during normal pregnancy and preeclampsia

International Journal of Gynecology & ObstetricsVolume 89, Issue 3 p. 299-300 Brief communications C-reactive protein during normal pregnancy and preeclampsia Enrique Teran, Corresponding Author Enrique Teran [email protected] Experimental Pharmacology and Cellular Metabolism Unit, Biomedical Center, Central University of Ecuador, EcuadorCorresponding author. Biomedical Center, Central University of Ecuador, P.O. Box 17-03-4716 Quito, Ecuador. Tel.: +593 9 4402800; fax: +593 2 3228454.Search for more papers by this authorCarlos Escudero, Carlos Escudero Experimental Pharmacology and Cellular Metabolism Unit, Biomedical Center, Central University of Ecuador, EcuadorSearch for more papers by this authorAndres Calle, Andres Calle Hospital Gineco Obstetrico Isidro Ayora, Quito, EcuadorSearch for more papers by this author Enrique Teran, Corresponding Author Enrique Teran [email protected] Experimental Pharmacology and Cellular Metabolism Unit, Biomedical Center, Central University of Ecuador, EcuadorCorresponding author. Biomedical Center, Central University of Ecuador, P.O. Box 17-03-4716 Quito, Ecuador. Tel.: +593 9 4402800; fax: +593 2 3228454.Search for more papers by this authorCarlos Escudero, Carlos Escudero Experimental Pharmacology and Cellular Metabolism Unit, Biomedical Center, Central University of Ecuador, EcuadorSearch for more papers by this authorAndres Calle, Andres Calle Hospital Gineco Obstetrico Isidro Ayora, Quito, EcuadorSearch for more papers by this author First published: 13 March 2005 https://doi.org/10.1016/j.ijgo.2005.02.002Citations: 29Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume89, Issue3June 2005Pages 299-300 RelatedInformation

Calcium supplementation and the risk of preeclampsia in ecuadorian pregnant teenagers

To determine whether increased calcium intake (2 g/day) in pregnancy is effective in reducing the risk of preeclampsia in pregnant teenagers. The present study was a prospective, randomized, double-blind, controlled clinical trial. Two hundred sixty teenaged pregnant girls attending the Hospital Gíneco-Obstétrico Isidro Ayora in Quito, Ecuador, were included. Selection criteria were age less than 17.5 years, nulliparity, first prenatal visit before 20 weeks' gestation, and residency in Quito (2800-m altitude). We used a table of random numbers to assign 125 girls to receive 2000 mg of elemental calcium daily, beginning at 20 weeks of gestation and continuing until delivery; 135 women in the control group received a placebo. Blood pressure (BP) was measured twice every 4 weeks until delivery and at 48 hours after delivery. The diagnosis of preeclampsia was defined as BP greater than 140/90 mmHg on at least two occasions more than 6 hours apart and proteinuria greater than 30 mg/dL (over one cross by dipstick on two occasions 4-24 hours apart). The average daily calcium intake in this population was approximately 51% of the Recommended Dietary Allowance. Calcium supplementation was associated with a significantly decreased risk of preeclampsia (risk reduction 12.35%; P < .001), with 3.2% (n = 4) developing preeclampsia in the treatment group versus 15.5% (n = 21) in the placebo group. Moreover, calcium supplementation led to a reduction in systolic BP of 9.1 mmHg and in diastolic BP of 6.0 mmHg. These results suggest that calcium supplementation during pregnancy in populations with low calcium intake is a safe, effective, and inexpensive preventive measure that significantly reduces the risk of preeclampsia.

Kangaroo mother method: randomised controlled trial of an alternative method of care for stabilised low-birthweight infants

Summary Because resources for care of low-birthweight (LBW) infants in developing countries are scarce, the Kangaroo mother method (KMM) was developed. The infant is kept upright in skin-to-skin contact with the mother's breast. Previous studies reported several benefits with the KMM but interpretation of their findings is limited by small size and design weaknesses. We have done a longitudinal, randomised, controlled trial at the Isidro Ayora Maternity Hospital in Quito, Ecuador. Infants with LBW (<2000 g) who satisfied out-of-risk criteria of tolerance of food and weight stabilisation were randomly assigned to KMM and control (standard incubator care) groups (n=128 and 147, respectively). During 6 months of follow-up the KMM group had a significantly lower rate than the control group of serious illness (lower-respiratory-tract disorders, apnoea, aspiration, pneumonia, septicaemia, general infections; 7 [5%] vs 27 [18%], p<0·002), although differences between the groups in less severe morbidity were not significant. There was no significant difference in growth or in the proportion of women breastfeeding, perhaps because the proportion breastfeeding was high in both groups owing to strong promotion. Mortality was the same in both groups; most deaths occurred during the stabilisation period before randomisation. KMM mothers made more unscheduled clinic visits than control mothers but their infants had fewer re-admissions and so the cost of care was lower with the KMM. Since the eligibility criteria excluded nearly 50% of LBW infants from the study, the KMM is not universally applicable to these infants. The benefits might be greater in populations where breastfeeding is not so common.