ABSTRACT Introduction: Rheumatic diseases are known for their systemic nature, affecting different organs and organ systems. Neuropsychiatric involvement is frequent and conditions additional disability. Anxious-depressive syndrome is one of the main expressions of affectation of the nervous system. Objective: To describe the clinical and epidemiological characteristics of the presentation of the anxious-depressive syndrome in patients with rheumatic diseases. Methods: A basic investigation was carried out, with a non-experimental, descriptive, cross-sectional and field design. The universe consisted of 557 patients diagnosed with rheumatic diseases treated at the Hospital Clinica Metropolitana in the city of Riobamba during the period January 2020 - December 2022. The sample was made up of a total of 229 patients. Results: Average age of 53.48 years, predominance of female patients (72.49 %) and with associated comorbidities (56.77 %). Hypothyroidism (39.23%), arterial hypertension (33.08 %) and diabetes mellitus (21.54 %) were the most represented comorbidities. Rheumatoid arthritis (67.68 %) was the rheumatic disease that was most frequently identified. 42.36 % of the patients presented manifestations of anxiety and 36.68 % clinical manifestations compatible with depression. Conclusions: High percentages of patients with rheumatic diseases and clinical manifestations compatible with anxiety and depression were identified; a higher percentage of presentation of these manifestations was identified in patients with systemic lupus erythematosus.

RESUMEN Introducción: Las enfermedades reumáticas son conocidas por su carácter sistémico, afectando distintos órganos y sistemas de órganos. La afectación neuropsiquiátrica es frecuente y condiciona discapacidad adicional. El síndrome ansioso depresivo constituye una de las principales expresiones de afectación del sistema nervioso. Objetivo: Describir las características clínicas y epidemiológicas de presentación del síndrome ansioso depresivo en pacientes con enfermedades reumáticas. Métodos: Se realizó una investigación básica, con diseño no experimental, descriptivo, transversal y de campo. El universo estuvo constituido por 557 pacientes con diagnóstico de enfermedades reumáticas atendidos en el Hospital Clínica Metropolita de la ciudad de Riobamba durante el periodo enero 2020 - diciembre 2022. La muestra quedó constituida por un total de 229 pacientes. Resultados: Promedio de edad de 53,48 años, predominio de pacientes femeninas (72,49 %) y con comorbilidades asociadas (56,77 %). El hipotiroidismo (39,23 %), la hipertensión arterial (33,08 %) y la diabetes mellitus (21,54 %) fueron las comorbilidades más representadas. La artritis reumatoide (67,68 %) fue la enfermedad reumática que con mayor frecuencia fue identificada. El 42,36 % de los pacientes presentó manifestaciones de ansiedad y el 36,68 % manifestaciones clínicas compatibles con depresión. Conclusiones: Se identificaron porcentajes elevados de pacientes con enfermedades reumáticas y manifestaciones clínicas compatibles con ansiedad y depresión; en los pacientes con lupus eritematoso sistémico fue donde se identificó un mayor porcentaje de presentación de estas manifestaciones.

ABSTRACT Introduction: Rheumatic diseases are known for their systemic nature, affecting different organs and organ systems. Neuropsychiatric involvement is frequent and conditions additional disability. Anxious-depressive syndrome is one of the main expressions of affectation of the nervous system. Objective: To describe the clinical and epidemiological characteristics of the presentation of the anxious-depressive syndrome in patients with rheumatic diseases. Methods: A basic investigation was carried out, with a non-experimental, descriptive, cross-sectional and field design. The universe consisted of 557 patients diagnosed with rheumatic diseases treated at the Hospital Clinica Metropolitana in the city of Riobamba during the period January 2020 - December 2022. The sample was made up of a total of 229 patients. Results: Average age of 53.48 years, predominance of female patients (72.49 %) and with associated comorbidities (56.77 %). Hypothyroidism (39.23%), arterial hypertension (33.08 %) and diabetes mellitus (21.54 %) were the most represented comorbidities. Rheumatoid arthritis (67.68 %) was the rheumatic disease that was most frequently identified. 42.36 % of the patients presented manifestations of anxiety and 36.68 % clinical manifestations compatible with depression. Conclusions: High percentages of patients with rheumatic diseases and clinical manifestations compatible with anxiety and depression were identified; a higher percentage of presentation of these manifestations was identified in patients with systemic lupus erythematosus.

RESUMEN Introducción: Las enfermedades reumáticas son conocidas por su carácter sistémico, afectando distintos órganos y sistemas de órganos. La afectación neuropsiquiátrica es frecuente y condiciona discapacidad adicional. El síndrome ansioso depresivo constituye una de las principales expresiones de afectación del sistema nervioso. Objetivo: Describir las características clínicas y epidemiológicas de presentación del síndrome ansioso depresivo en pacientes con enfermedades reumáticas. Métodos: Se realizó una investigación básica, con diseño no experimental, descriptivo, transversal y de campo. El universo estuvo constituido por 557 pacientes con diagnóstico de enfermedades reumáticas atendidos en el Hospital Clínica Metropolita de la ciudad de Riobamba durante el periodo enero 2020 - diciembre 2022. La muestra quedó constituida por un total de 229 pacientes. Resultados: Promedio de edad de 53,48 años, predominio de pacientes femeninas (72,49 %) y con comorbilidades asociadas (56,77 %). El hipotiroidismo (39,23 %), la hipertensión arterial (33,08 %) y la diabetes mellitus (21,54 %) fueron las comorbilidades más representadas. La artritis reumatoide (67,68 %) fue la enfermedad reumática que con mayor frecuencia fue identificada. El 42,36 % de los pacientes presentó manifestaciones de ansiedad y el 36,68 % manifestaciones clínicas compatibles con depresión. Conclusiones: Se identificaron porcentajes elevados de pacientes con enfermedades reumáticas y manifestaciones clínicas compatibles con ansiedad y depresión; en los pacientes con lupus eritematoso sistémico fue donde se identificó un mayor porcentaje de presentación de estas manifestaciones.

Hereditary transthyretin amyloidosis is a multisystemic autosomal dominant genetic disorder characterized by progressive distal sensory-motor polyneuropathy or restrictive cardiomyopathy, secondary to amyloid deposits. Its pathogenesis lies in the TTR gene mutation, and the Val50Met mutation is the most frequent. Patients have significant differences in the onset and severity of clinical presentation according to their country of origin. The diagnosis of this pathology is complex, even more in countries where it is not considered endemic. However, early suspicion and management are essential to improve survival and avoid unnecessary diagnostic and therapeutic strategies. We report a 69-year-old woman who presented a sensory-motor polyneuropathy, predominantly sensory, associated with distal neuropathic pain and bilateral vitritis. The history of her Italian father with polyneuropathy of unspecified etiology stood out. A vitreous biopsy identified amyloid substance deposits (congo red positive). These were also confirmed on a superficial peroneal nerve biopsy. During the etiological study of her polyneuropathy, an increased Kappa/Lambda index of 2.55 mg/L stood out. Therefore, light chain amyloidosis was suspected, and chemotherapy treatment was indicated without favorable response. After 10 years of progressive neurological and ophthalmological involvement, a genetic study confirmed the first case of late-onset hereditary transthyretin amyloidosis Val50Met with polyneuropathy in Chile.

Abstract: Our intention is to review the theme of love, the strength of this feeling and desire, its passion and the controversial reaches of its relationship with persuasive speech, in euripides’ tragedies. His works call our interest by presenting us with the questions of persuasive love speech where its particularity lies, among other aspects, in sustaining the deep plot of his words, his play and the complex mesh of sensitivity that it entails and symbolizes.

Resumen: Nuestra intención es revisar el tema del amor en las tragedias de Eurípides, la fuerza de este sentimiento y deseo, la pasión y los alcances polémicos de su relación con el discurso persuasivo. Sus obras llaman nuestro interés al presentarnos interrogantes del discurso amatorio persuasivo en donde su particularidad radica, entre otros aspectos, en sostener la trama profunda de sus palabras, su juego y la compleja malla de sensibilidad que conlleva y simboliza.

Abstract The ovulation mechanism is one of the fascinating physiological processes in reproductive biology in mammals. From the reproductive point of view, the species have been classified as spontaneous or induced ovulators. Although the release of GnRH followed by the preovulatory LH surge is shared between both types of ovulation, the stimulus to initiate GnRH release varies between both categories. In spontaneous ovulators, ovulation depends on the systemic concentration of ovarian steroids, however, in induced ovulators, different stimuli such as copulation, environmental, and social cues can facilitate or induce ovulation regardless of the increases in systemic estradiol concentration. In this review, we document evidence that a male-derived protein is the main factor responsible for inducing ovulation and also modulating the ovarian function in the domestic South American camelid, the llama. The neurotrophin beta-Nerve Growth Factor (β-NGF) is the principal factor present in the semen of llamas responsible for inducing ovulation in this species. After the intrauterine deposit of semen during mating, β-NGF is absorbed through the endometrium to reach the circulatory system, where it reaches the hypothalamus and stimulates GnRH release. The potential site of action of this neurotrophin at the brain has not been elucidated, however, hypotheses are raised that the factor may cross the blood-brain barrier and stimulate upstream neuronal networks that lead to the stimulation of GnRH-secreting neurons. It is possible that β-NGF could be sensed at the median eminence without crossing the blood-brain barrier. Finally, it has been observed that this factor is not only a powerful stimulator of ovulation but also has a luteotrophic effect, resulting in the development of a corpus luteum capable of secreting more progesterone when compared to other ovulation-stimulating analogues. mammals view ovulators categories steroids however copulation environmental review malederived male derived camelid llama betaNerve beta Nerve βNGF β NGF (β-NGF mating system elucidated bloodbrain blood GnRHsecreting neurons Finally effect ovulationstimulating stimulating analogues

Abstract: Our intention is to recognize how the reaches of Karl Jaspers’ thought regarding the tragic and tragic knowledge are present in Euripides tragedy The Bacchae, the greatest piece where the tragic conflict also becomes a conflict of realities, of existences, of provided by the enigmatic god Dionysus and of the enigmatic “triumph” over the tragic that is shown or tries to show.

Resumen: Nuestra intención es reconocer cómo los alcances del pensamiento de Karl Jaspers respecto a lo trágico y el saber trágico, están presentes en la tragedia de Eurípides Las Bacantes, pieza máxima donde el conflicto trágico deviene también en un conflicto de realidades, de existencias, proporcionadas por el enigmático dios Dionisos y por el peculiar “triunfo” sobre lo trágico que se muestra o intenta mostrar.

Abstract: This article was based on statistics that allow us to know the situation of femicide in the country, the causes and what results from this act, and the impact produced on Ecuadorian society and the laws that sanction it. The population made up of women is the most vulnerable percentage when men believe they have superiority and exert force on them, even killing them. This research was carried out in 196 citizens of the city of Riobamba in the province of Chimborazo, for which the questionnaire "Femicide and its social and psychological impact" was used as an instrument. it is negative since it generates insecurity and psychologically causes fear.

Resumen: El presente artículo se basó en estadísticas que permiten conocer la situación del femicidio en el país, las causas y lo que resulta de este acto, y el impacto producido en la sociedad ecuatoriana y las leyes que lo sancionan. La población conformada por mujeres es el porcentaje más vulnerable cuando el hombre cree tener superioridad y ejerce sobre ellas la fuerza llegándola a matar. Esta investigación se realizó en 196 ciudadanos de la ciudad de Riobamba en la provincia de Chimborazo, para la cual se utilizó como instrumento el cuestionario "El Femicidio y su impacto social y psicológico”. De los datos obtenidos se colige que la apreciación sobre este fenómeno es negativa, ya que genera inseguridad y psicológicamente causa miedo.

Abstract The objective of the research was to determine the presence of clinical signs of Burnout syndrome in leveling students of the medical career of the Polytechnic School of Chimborazo in the academic period March-July 2019 under a descriptive study with a qualitative approach with a sample of 86 medical degree leveling students, using the Maslach Burnout Inventory classification scale. As a result, it is presented that the Burnout syndrome is a pathology that students present.

Resumen El objetivo de la investigación fue determinar la presencia de signos clínicos del síndrome de Burnout en los estudiantes de nivelación de la carrera de medicina de la Escuela Superior Politécnica de Chimborazo en el periodo académico marzo-julio 2019 bajo un estudio descriptivo con enfoque cualitativo con una muestra de 86 estudiantes de nivelación de la carrera de medicina, utilizando la escala de clasificación Maslach Burnout Inventory. Como resultado se presenta que el síndrome de Burnout es una patología que presentan los estudiantes.

Cardiovascular diseases and cancer account for 27 and 25% of mortality in Chile, respectively. In the last decades, survival of people with cancer has improved due to preventive programs, early detection strategies, advances in technology and development of new antineoplastic therapies. Consequently, a progressive number of cancer-surviving patients have been generated, who may develop cardiovascular diseases, secondary to the same cancer therapy. Cardio-Oncology has emerged as the necessary link between both specialties to promote the prevention and early detection of cardiac complications, in patients undergoing oncological therapies. The aim is to curb cardiovascular complications. Also, to acquire knowledge about the mechanisms and effects of drugs that lead to heart damage aiming to develop efficient cardioprotective therapies. In this article we review and propose a didactic organization and classification of the main cardiovascular effects of cancer control therapy. We recognize that there is still a knowledge gap in basic sciences about the mechanisms that underlie these alterations.

In the context of the project “Education for social integration of population affected by the volcanic eruption of Chaitén,” an initiative of the Research Center on Vulnerability and Socio-Natural Disasters (CIVDES) the “Radio Workshops” line of action was developed, using Participatory Action Research (PAR) methodology between 2012 and 2013. The objective was to incorporate community communication through radio as an instrument of social reconstruction in Chaitén, with a special emphasis on the development of skills, networking and making youth visible in the local environment. 12 workshop sessions were implemented during the project, with 8 youths aged 14-18 from the Juan José Latorre School of Chaitén. This activity revealed various areas of interest including strengthening and community support, social spaces and the recognition of the natural heritage of a city still under reconstruction. Finally, the ethical and political dimensions of community action, the generation of conditions for a successful intervention, and the place of professional investigative and interventional dynamics are discussed.

En el marco del proyecto “Educación para la integración social de la población afectada por la erupción volcánica de Chaitén”, iniciativa emanada desde el Centro de Investigación en Vulnerabilidades y Desastres Socionaturales” (CIVDES), se desarrolló el eje de acción “Talleres de Radio”, bajo la metodología de Investigación-Acción-Participativa (IAP) entre los años 2012 y 2013. Éste tuvo como objetivo incorporar la comunicación comunitaria por medio de la radio como instrumento de reconstrucción social en Chaitén, con especial énfasis en el desarrollo de competencias, redes y visibilización de los jóvenes en el medio local. Se implementaron en total 12 sesiones de taller durante la duración del proyecto, con 8 jóvenes entre 14 a 18 años, de la Escuela Juan José Latorre de Chaitén. Esta actividad permitió relevar diversas áreas de interés como fortalecimiento y apoyo comunitario, espacios de socialización y reconocimiento patrimonial natural de una localidad aún en proceso de reconstrucción. Finalmente, se discuten las dimensiones éticas y políticas de la acción comunitaria, la generación de condiciones para hablar de una intervención exitosa, y el lugar del profesional en la dinámica investigativa e interventiva.

Oxidant/antioxidant imbalance has been reported in some infectious diseases, including community-acquired pneumonia (CAP). The aim was to assess the antioxidant status in adults with CAP and its relationship with clinical severity at admission. Fifty-nine patients with CAP were enrolled and categorized at admission by the FINE score, from July 2010 to October 2012. In the same period 61 controls were enrolled. Plasma samples were obtained at admission for determination of the ferric reducing ability of plasma (FRAP) and lipid peroxidation (8-isoprostane). Erythrocyte reduced (GSH)/oxidized (GSSG) glutathione, malondialdehyde (MDA) and antioxidant enzyme activity were assessed. Antioxidant status in adults with CAP represented by FRAP and the GSH/GSSG ratio were 16.8% (p=0.03) and 39.7% (p=0.04) lower than control values, respectively. In addition, FRAP values showed a positive correlation with GSH/GSSG ratio (r=0.852; p<0.02; n=59). The CAP group showed greater lipid peroxidation in both plasma and erythrocytes. The FINE score correlated negatively with FRAP (r= -0.718; p<0.05; n=59) and positively with MDA and F2 isoprostane levels (r=0.673; p<0.05; n=59; r=0.892; p<0.01; n=59, respectively). Antioxidant status alterations correlated with clinical severity. The FRAP assay and lipid peroxidation biomarkers may provide a useful parameter for estimating the severity and the clinical outcome of patients with CAP.

Cardiovascular diseases (CVD) are the leading cause of death in the world. Among them the ischemic type are of great importance, where the development of atherosclerotic plaques is the central pathophysiological process. The study of atherosclerosis is critical to understand how this disease process begins and factors influencing its development. Various laboratory methods, including immunohistochemistry, allow the recognition of cells and molecules involved in the atheromatous process that are interacting according to the progression of the lesion. A marker of endothelial dysfunction is the increased expression of intercellular adhesion molecule ICAM-1. In this paper, an immunohistochemistry method was standardized for the adhesion molecule ICAM-1, and its expression was studied in healthy human arteries with atheromatous plaque. In samples of human arteries with atherosclerotic disease, the expression of ICAM-1 was observed to be increased, but was hardly recognizable. This mainly because the tissue used as a control for standardization was a tonsil with an inflammatory process and hyperplasia, which significantly increases the expression of ICAM-1. The implementation of the immunohistochemistry method for ICAM-1 in human arteries will reveal endothelial dysfunction states that will enable a future design and implementation of methods of diagnosis in atherosclerotic processes in the early stages.

Las enfermedades cardiovasculares son la principal causa de muerte a nivel mundial. Entre ellas tienen gran relevancia las de tipo isquémicas, en donde el desarrollo de placas ateroscleróticas es el proceso fisiopatológico central. El estudio de la aterosclerosis es fundamental para comprender como se inicia este proceso patológico y los factores que influyen en su desarrollo. Distintas metodologías de laboratorio, entre otras la inmunohistoquímica, permiten reconocer las células y moléculas que participan en el proceso ateromatoso y que van interactuando según la progresión de la lesión. Un marcador de disfunción endotelial es la mayor expresión de la molécula de adhesión intercelular ICAM-1. En este trabajo se realizó la estandarización de inmunohistoquímica para la molécula de adhesión ICAM-1, y se estudió su expresión en arterias humanas sanas y con placa ateromatosa. En las muestras de arterias humanas con patología aterosclerótica, la expresión de ICAM-1 se observó aumentada, pero fue de difícil reconocimiento. Esto principalmente porque el tejido empleado como control en la estandarización fue una amígdala con hiperplasia y proceso inflamatorio que aumenta notablemente la expresión de ICAM-1. La implementación del método de inmunohistoquímica para ICAM-1 en arterias humanas permitirá conocer estados de disfunción endotelial y el desarrollo futuro del diseño e implementación de métodos de diagnóstico en aquellos procesos ateroclerótico en estado incipiente.

The endothelium helps to maintain the normal structure and homeostasis of the vasculature. However, chronic exposure to cardiovascular (CV) risk factors causes endothelial dysfunction, a phenomenon that is characterized by inflammation, reduced bioavailability of nitric oxide (NO) and a prothrombotic state. Epidemiological studies have shown that regular consumption of fruits and vegetables reduces CV risk, which has caused interest in knowing the bioactive compounds and the mechanisms involved. Among the components that protect the endothelium are antioxidants (vitamin C, vitamin E and poly phenols) and polyunsaturated fatty acids. Vitamin C and E promote vasodilatation protecting NO by blocking the reactive oxygen species (ROS). Poly phenols improve endothelial function primarily by increasing levels of NO, and inhibition of angiogenesis and platelet activation. Diets rich in poly-unsaturated fatty acids have shown beneficial effects by reducing the gene expression of cyclooxygenase-2 and the expression of cell adhesion molecules. This review mainly highlights the current understanding of endothelial dysfunction and the protective effect of endothelial cells by bioactive components of fruits and vegetables.

El endotelio normal ayuda a mantener la estructura y la hemostasia vascular. Sin embargo, la exposición crónica a factores de riesgo cardiovascular (CV) produce disfunción endotelial, fenómeno que se caracteriza por inflamación, disminución en la biodisponibilidad de óxido nítrico (NO) y un estado protrombótico. Estudios epidemiológicos han demostrado que el consumo regular de frutas y hortalizas disminuye el riesgo CV, lo que ha causado interés en conocer los compuestos bioactivos y los mecanismos involucrados. Entre los componentes que protegen el endotelio se encuentran las moléculas antioxidantes (vitamina C, vitamina E y polifenoles) y ácidos grasos poliinsaturados. Las vitaminas C y E favorecen la vasodilatación protegiendo el NO al bloquear las especies reactivas del oxigeno (ROS). Los polifenoles mejoran la función endotelial principalmente por el aumento de los niveles de NO, y la inhibición de la angiogénesis y de la activación plaquetaria. Dietas ricas en ácidos grasos poliinsaturados han mostrado efectos beneficiosos, mediante la reducción de la expresión géni-ca de la ciclooxigenasa-2 y de la expresión de moléculas de adhesión celular. Esta revisión principalmente señala los conocimientos actuales de la disfunción endotelial y el efecto protector de las células endoteliales por componentes bioactivos de frutas y hortalizas.

Rhabdomyolysis caused by cocaine abuse is multifactorial, involving tissue ischemia secondary to vasoconstriction and cellular damage caused by the drug. Renal failure may or may be not associated to rhabdomyolysis. We report a 41-year-old male admitted with a severe rhabdomyolysis after a cocaine overdose. In spite of a vigorous hydration and alkalization, he developed acute renal failure. Renal function recovered after several weeks of dialysis.