Resumen Introducción La investigación ha demostrado que el perfil del turista con capacidades especiales busca destinos turísticos con servicios e infraestructura accesible e inclusiva; sin embargo, muchas áreas como la de estudio no cuentan con todos estos requerimientos. Objetivo Conocer las necesidades y deseos de una persona con capacidades especiales, para ayudar a fortalecer y a planificar de forma adecuada los destinos turísticos. Método La naturaleza de la investigación es cualitativa y cuantitativa, lo cual nos permitió cuantificar y analizar los resultados obtenidos a través de una encuesta. Resultados Los resultados de la investigación fueron que las personas con capacidades especiales estarían dispuestos a desarrollar turismo en áreas naturales como el Parque Nacional Yacuri, siempre y cuando tengan tanto las condiciones idóneas de accesibilidad como los requerimientos necesarios para desarrollar el turismo: baños accesibles, servicios de alojamiento, servicios de alimentación, transporte y actividades lúdicas y recreativas. Conclusión La investigación del perfil del turista con capacidades especiales resulta estratégica para que en política pública se construyan acciones y se consideren proyectos de implementación de servicios e infraestructura en áreas naturales; de esta manera, así reducir las brechas de desigualdad.

Abstract Introduction Research has shown that the profile of tourists with special abilities seeks tourist destinations with accessible and inclusive services and infrastructure; however, many areas such as the one under study do not meet all these requirements. Objective Knowing the needs and desires of a person with special abilities, to help strengthen and adequately plan tourist destinations Method The nature of the research is qualitative and quantitative, which allowed us to quantify and analyze the results obtained through a survey. Result The results of the research were that people with special needs would be willing to develop tourism in natural areas such as Yacuri National Park, as long as they have both the ideal conditions of accessibility and the necessary requirements to develop tourism: accessible bathrooms, lodging services, food services, transportation, and recreational and leisure activities. Conclusion Research on the profile of tourists with special abilities is strategic for public policy to build actions and consider projects for the implementation of services and infrastructure in natural areas, thus reducing inequality gaps.

ABSTRACT This research analyzes the degree of accessibility for people with disabilities in hotels categorized as three, four and five stars in the city of Loja-Ecuador, in terms of facilities and physical infrastructure. The methodology consisted of an exploratory case study with the use of different quantitative and qualitative tools. Extensive documentary research was carried out, basically on the NTE-INEN standards on accessibility to the physical environment, and a data collection instrument, a checklist, was developed to evaluate the degree of accessibility of the hotels. The results obtained indicate that the higher the star rating of the hotel establishments, the greater the probability of compliance with the NTE-INEN standards and the more improvement actions carried out in infrastructure, especially for people with physical limitations.

RESUMEN La presente investigación analiza el grado de accesibilidad para personas con discapacidad de los hoteles categorizados como tres, cuatro y cinco estrellas de la Ciudad de Loja-Ecuador, en cuanto a las instalaciones e infraestructura física. La metodología consistió en un estudio de caso de carácter exploratorio con la utilización de distintas herramientas tanto cuantitativas como cualitativas. Se realizó una amplia investigación documental, básicamente sobre las normas NTE-INEN sobre accesibilidad al medio físico, y se elaboró un instrumento de recolección de datos, una lista de verificación, para evaluar el grado de accesibilidad de los hoteles. Los resultados obtenidos indican que a mayor categorización de estrellas de los establecimientos hoteleros, mayor es la probabilidad del cumplimiento con las normas NTE-INEN y más son las acciones de mejoramiento realizadas en infraestructura, especialmente para personas que tienen limitaciones físicas.

ABSTRACT The pictorial works that are so numerous in the territory of the city of Loja and are linked to the events of the historical past, to artistic aesthetics, and the emotions that can be presented to the viewer when he observes, but leaving a void in the interpretation. The objective of the research is to make a diagnosis and interpretation of the most relevant Christian religious symbology of the colonial era. In the absence of the tools for its interpretation and information of the religious symbology of the pictorial art of the city of Loja, an inventory of the pictorial works of the churches and religious museums is made and then analyzed and described through the use of documents related to the religious symbology Exploratory, descriptive and analytical research was applied to the development of the same, and through the application of information collection techniques, 245 artistic works were distributed, distributed in the different containers between museums and churches of the city that dates back to the time of the colony; Likewise, making an analytical comparison it was determined that they are the product of the revival of the imaginary of the medieval church.

RESUMEN Las obras pictóricas que son tan numerosas en el territorio de la ciudad de Loja y están ligadas a los eventos del pasado histórico, a las estéticas artísticas, y las emociones que puede presentar al espectador cuando observa, pero dejando un vacío en la interpretación. El objetivo de la investigación es hacer un diagnóstico e interpretación de la simbología religiosa cristiana más relevante de la época de la colonia. Al no haber las herramientas para su interpretación e información de la simbología religiosa del arte pictórico de la ciudad de Loja se realiza un inventario de las obras pictóricas de las iglesias y museos religiosos para luego ser analizadas y descritas mediante la utilización de documentos relacionados a la simbología religiosa. Para el desarrollo de la misma se aplicó la investigación exploratoria, descriptiva y analítica, y mediante la aplicación de técnicas de recolección de información se logró inventariar 245 obras artísticas que están distribuidas en los diferentes contenedores entre museos e iglesias de la ciudad que se remonta a la época de la colonia; así mismo haciendo una comparación analítica se determinó que son producto de la reactivación de la imaginaria de la iglesia medieval.

ABSTRACT The article identifies the factors that influence the students of the Educational Unit February 12 in the city of Zamora, the use of psychoactive substances. The data were obtained methodologically through surveys applied to 80 students, 80 parents and 12 teachers, subsequently the analysis of the results was carried out, which are framed in the characteristics of a quantitative and qualitative study, which indicates that both Family problems such as the influence of friends are risk factors in substance use in the students that make up the sample. The findings found in the investigation allowed to identify that the students of the Educational Unit February 12 if they consume psychoactive substances, after collecting and analyzing the information of the surveys applied to students, it was determined that there are several causes of the consumption of psychoactive substances such as influence of friends, bad intra-family relationships, accessibility to drugs and often out of curiosity, resulting in the absence of a comprehensive development of students, because adolescents are vulnerable to addictions.

RESUMEN En el artículo se identifican los factores que influyen en los estudiantes de la Unidad Educativa 12 de febrero en la ciudad de Zamora, el uso de sustancias psicoactivas. Los datos fueron obtenidos metodológicamente a través de encuestas aplicadas a 80 estudiantes, 80 padres de familia y 12 docentes, posteriormente se realizó el análisis de los resultados, mismos que se enmarcan en las características de un estudio cuantitativo y cualitativo, la cual indica que tanto los problemas familiares como la influencia de amigos son factores de riesgo en el consumo de sustancias en los estudiantes que conforman la muestra. Los hallazgos encontrados en la investigación permitieron identificar que los estudiantes de la Unidad Educativa 12 de febrero si consumen sustancias psicoactivas, luego de recopilar y analizar la información de las encuestas aplicadas a estudiantes se determinó que existen varias causas del consumo de sustancias psicoactivas como la influencia de amigos, malas relaciones intrafamiliares, accesibilidad a drogas y muchas veces por curiosidad, teniendo como consecuencia que no exista un desarrollo integral de los estudiantes, pues los adolescentes son vulnerables a las adicciones.

ABSTRACT The study aims to make an analysis of the bibliometric information of accessible and inclusive tourism in Ecuador, versus accessible tourism in other countries and cities: by means of a bibliometric review of scientific articles from different journals, those related to the subject have been classified of research to support this group that will gradually grow in the future and will be an objective audience with great potential, and for this, the identification of Ecuador's problem of accessibility was important to recognize and to solve them. It was identified that in Ecuador there is little information on the subject, so it is necessary that through case studies we can help this group and have a better vision of standards and minimum characteristics for people affected gradually in the accessibility in tourist destinations.

RESUMEN El estudio tiene por objetivo hacer un análisis de la información bibliométrica del turismo accesible e inclusivo en el Ecuador, frente al turismo accesible en otros países y ciudades: mediante una revisión bibliometrica de artículos científicos de diferentes revistas se ha clasificado los que tienen relación al tema de investigación para apoyar a este colectivo que gradualmente en el futuro ira creciendo y será un público objetivo con gran potencial, y para ello la identificación de la problemática del Ecuador sobre la accesibilidad fue importante reconocer para dar solución; mediante un árbol de problemas, se identificó que en el Ecuador hay poca información acerca del tema, por eso es necesario que a traves de estudios de caso se pueda apoyar a este colectivo y tener una mejor visión de normas y características mínimas para ir desarrollando paulatinamente la accesibilidad en los destinos turisticos.

ABSTRACT The objective of the following article is to analyze the professional development of people with disabilities in tourist companies in the city of Loja. From the study carried out, it was possible to know that the labor insertion in touristic companies of people with disabilities is 7% in relation to the 305 companies surveyed, likewise the respondents mentioned in the companies that work or business, the corresponding 82% 251 touristic companies do not have access for people with disabilities and 18% corresponding to 54 companies if they have this service that goes from ramps, elevator, bathrooms and signage. Touristic companies in the field of labor insertion should implement more accessibility in their companies such as labor insertion since it implies a new structural change in public and private companies.

RESUMEN El objetivo del siguiente artículo es analizar el desarrollo profesional de personas con discapacidad en empresas turísticas de la ciudad de Loja. A partir del estudio realizado se pudo conocer que la Inserción laboral en empresas turísticas de personas con discapacidad, es del 7% en relación a las 305 empresas encuestadas, así mismo los encuestados mencionaron en las empresas que trabajan o negocio, el 82% que corresponde a 251 empresas turísticas no tienen acceso para personas con discapacidad y el 18% que corresponde a 54 empresas si cuentan con este servicio que va desde rampas, ascensor, baños y señalética. Las empresas turísticas en materia de inserción laboral deberían implementar más accesibilidad en sus empresas como el de inserción laboral ya que supone un nuevo cambio estructural en las empresas públicas como privadas.

ABSTRACT The use of high-dose chemotherapy with autologous support of hematopoietic progenitor cells is an effective strategy to treat various hematologic neoplasms, such as non-Hodgkin lymphomas and multiple myeloma. Mobilized peripheral blood progenitor cells are the main source of support for autologous transplants, and collection of an adequate number of hematopoietic progenitor cells is a critical step in the autologous transplant procedure. Traditional strategies, based on the use of growth factors with or without chemotherapy, have limitations even when remobilizations are performed. Granulocyte colony-stimulating factor is the most widely used agent for progenitor cell mobilization. The association of plerixafor, a C-X-C Chemokine receptor type 4 (CXCR4) inhibitor, to granulocyte colony stimulating factor generates rapid mobilization of hematopoietic progenitor cells. A literature review was performed of randomized studies comparing different mobilization schemes in the treatment of multiple myeloma and lymphomas to analyze their limitations and effectiveness in hematopoietic progenitor cell mobilization for autologous transplant. This analysis showed that the addition of plerixafor to granulocyte colony stimulating factor is well tolerated and results in a greater proportion of patients with non-Hodgkin lymphomas or multiple myeloma reaching optimal CD34+ cell collections with a smaller number of apheresis compared the use of granulocyte colony stimulating factor alone.

Transplante de medula óssea de doador irmão HLA-idêntico pode curar 70%-90% dos portadores de anemia aplásica severa (AAs). Pacientes mais idosos, muito transfundidos, longamente tratados com imunossupressão (IS) e com infecções ao tempo do transplante têm pior evolução. Nós transplantamos 18 pacientes com AAs e pelo menos um dos fatores associados a pior prognóstico (idade >35 anos, >50 transfusões antes do transplante, falta de resposta à imunossupressão prévia e infecção bacteriana ou fúngica ao transplante) de 2001 a 2005, com ciclofosfamida (Cy - 5 pacientes) ou bussulfan mais Cy (13 pacientes). Dezesseis pacientes apresentaram pega do enxerto, dois morreram sem pega, três tiveram rejeição aos dias +67, +524 e +638 (dois morreram e um foi resgatado com IS). Mucosite grau III/IV ocorreu em 39% e não observamos DECH aguda ou crônica. A probabilidade de sobrevida pelo método de Kaplan-Meier foi de 75% aos 2,14 anos, e uma tendência a melhor sobrevida foi encontrada entre os portadores de apenas um fator de risco ao transplante (P: .06). Estes resultados são comparáveis a recentes relatos de literatura envolvendo condicionamentos baseados em fludarabina para tratar pacientes com alto risco. Devido à pequena amostra analisada, estudos clínicos prospectivos com maior número de pacientes são necessários, visando comprovar o real benefício dos condicionamentos baseados em fludarabina, definir o melhor agente a ser a ela associado e assim obter o melhor condicionamento para portadores de AAs com fatores de mau prognóstico para o transplante.

Hematopoietic progenitor cell transplantation from HLA-identical sibling donors cures 70-90% of Severe Aplastic Anemia (sAA) patients. Older age, heavy exposure to transfusions, immunosuppression treatment (IST) with a long interval from diagnosis to transplant and infection at procedure are associated with poor outcomes. We transplanted 18 patients with sAA and at least one risk factor (RF) for poor prognosis (age >35 years, >50 transfusions prior to transplant, unresponsiveness to previous IST and bacterial or fungal infection at transplant) from 2001 to 2005, using cyclophosphamide (CY - 5 patients) or busulfan plus CY (13 patients). Sixteen patients engrafted, two died with no engraftment, three patients had evidence of graft failure at days +67, +524 and +638 (two died and one was rescued with IST). Grade III/IV mucositis occurred in 39% but neither aGVHD nor cGVHD were observed. The Kaplan-Meier probability of survival was 75% at 2.14 years, with a trend favoring survival by number of RF (1 versus =2 RF) (P = 0.06). These results are comparable to recent data reported with fludarabine-based conditioning in patients with poor prognosis sAA. Due to the small sample size, prospective clinical trials with larger cohorts of patients are needed to confirm the real benefits of fludarabine-based conditioning, and also to define the best agent(s) to be associated with Fludarabine as preparative regimen for sAA patients with poor prognosis.

O mesilato de imatinibe é atualmente o tratamento de escolha para pacientes com Leucemia mielóide Crônica (LMC) recém-diagnosticados. Desde os primeiros estudos clínicos em 1998 até o estudo IRIS, que comparou o uso em primeira linha de imatinibe com interferon + ara-C, esta droga vem se consolidando em segurança e eficácia. Ainda há, entretanto questionamentos sobre a melhor dose inicial, a identificação dos pacientes que mais se beneficiariam e a melhor abordagem frente a respostas sub-ótimas e resistência. Os principais estudos clínicos publicados com mesilato de imatinibe são revisados no presente artigo, e discutidos sob a perspectiva da realidade brasileira.

Imatinib mesylate is currently the gold-standard therapy for patients with newly diagnosed Chronic Myelogenous Leukemia. From the clinical trials in 1998 to the IRIS study, which compared first line imatinib treatment with interferon and low dose ara-C, this drug has been consolidated in regards to its safety and efficacy. There are still some questions to answer. Which would be the best initial dose? Are there any patients who benefit more than others? What is the best approach to suboptimal response and resistance? The most important published clinical studies are reviewed in the current article and discussed from a Brazilian perspective.

INTRODUÇÃO: A Leucemia Mielóide Crônica (LMC) é uma doença clonal caracterizada pela presença da translocação entre os cromossomos 9 e 22 (cromossomo Philadelphia). O gene resultante BCR-ABL possui atividade de tirosino-quinase, que estimula o crescimento celular. O mesilato de imatinibe é um inibidor potente e específico de todas as quinases relacionadas ao ABL. PACIENTES E MÉTODOS: Noventa e oito pacientes com LMC foram tratados com mesilato de imatinibe de outubro de 2000 a janeiro de 2003: 28 em fase crônica (FC) resistente ou intolerante ao interferon alfa; 55 em fase acelerada (FA) e 55 em crise blástica (CB). Dose: 400 mg para CP e 600 mg para FA ou CB. OBJETIVOS: Avaliação da eficácia, segurança e sobrevida após tratamento da LMC com mesilato de imatinibe. RESULTADOS: Seguimento mediano: 545 dias (variação: 7-862). Resposta hematológica completa ocorreu em 86% dos pacientes em FC, 47% na FA e 13% na CB. Sessenta e um por cento, 24% e 0% dos pacientes em FC, FA e CB, atingiram resposta citogenética completa, respectivamente. Não foram detectados transcritos BCR-ABL por "nested RT-PCR" em 9% dos pacientes. Toxicidade hematológica grau 3-4: 21% na FC, 74% na FA e em 87% na CB. Toxicidade não hematológica grau 3-4: 11% na FC, 51% na FA e 53% na CB. A sobrevida global em dois anos foi de 64% para todos os pacientes, 96% na FC e 36% na FA. Todos os pacientes em CB faleceram numa mediana de 60 dias. CONCLUSÕES: O mesilato de imatinibe induziu respostas citogenéticas completas em pacientes brasileiros com LMC em fase crônica e acelerada. Os eventos adversos nos nossos pacientes foram semelhantes aos relatados em literatura, exceto pela menor incidência de sintomas gastro-intestinais e câimbras.

Chronic Myeloid Leukemia (CML) is a clonal disease characterized by balanced translocation between chromosomes 9 and 22 (Philadelphia chromosome). The resulting BCR-ABL gene has tyrosine kinase activity which stimulates cellular growth. Imatinib mesylate is a potent and specific inhibitor of all ABL related kinases. Ninety-eight CML patients were treated with imatinib mesylate from October 2000 to January 2003. Disease stage was: late chronic phase resistant or intolerant to alpha-interferon (CP): 28; accelerated phase (AP): 55; blastic phase (BP): 15 patients. Dose: 400 mg for CP and 600 mg for AP or CB. The objectives were to evaluation the efficacy, safety and survival with imatinib mesylate therapy in all phases of CML. The median follow up time was 545 days (range: 7-862), complete hematologic response was 86% in CP, 47% in AP and 13% in BP. Complete cytogenetic response was 61%, 24% and 0% respectively. BCR-ABL was not detected by nested RT-PCR in 9% of patients. Grade 3-4 hematologic toxicity was seen in 21% of CP, 74% of AP and 87% of BP patients. Grade 3-4 non-hematologic toxicity was observed in 11% of CP, 51% of AP and 53% of BP patients. Two-year overall survival was 64% for all patients, 96% for CP and 36% for AP patients. All BP patients died within a median of 60 days. Imatinib mesylate induced cytogenetic responses in Brazilian patients with previously treated CML in chronic and accelerated phase. Adverse events are similar to those reported in the literature, except for lower rates of gastrointestinal symptoms and muscle cramps in our study group.