[Lymnaea cousini , intermediate host of Fasciola hepatica in the Colombian high tropical Andes, and its new haplotypes confirmed with the mitochondrial marker cytochrome oxidase I]. / Lymnaea cousini , huésped de Fasciola hepatica en el trópico alto andino de Colombia, y sus nuevos haplotipos, confirmados con el marcador mitocondrial del gen de la citocromo oxidasa I.

INTRODUCTION: Fasciolosis is the disease transmitted by vectors with the highest latitudinal, longitudinal, and altitudinal distribution due to the colonizing capacity of the parasite Fasciola hepatica and its intermediate hosts, Lymnaeidae mollusks. These snails are under research due to their epidemiological importance, but their taxonomic identification is difficult given their interspecific phenotypical similarity. For this reason, there is uncertainty regarding Lymnaea cousini -a host of F. hepatica in Colombia- due to the morphological similarity it has with Lymnaea meridensis , recently described for Venezuela. OBJECTIVE: To confirm with the COI marker (ADNmt) the taxonomic status of individuals morphologically identified as L. cousini from Nariño, Norte de Santander, and Santander (Colombia), deposited in the Vector Mollusks Collection VHET No. 37 of Universidad de Antioquia. MATERIALS AND METHODS: The amplification of the mitochondrial COI required total DNA extraction of each individual´s foot using the DNeasy Blood and Tissue Kit (Qiagen®). Products amplified were sent for sequencing to Macrogen Inc., Korea. Twenty seven sequences generated in this research were compared to sequences published in the GenBank, including sequences of the type locality of L. cousini . RESULTS: Two new haplotypes of L. cousini were obtained for Colombia. Specimens from Nariño correspond to haplotype A, referenced for Ecuador, and specimens from Santander and Norte de Santander belong to a new haplotype we called haplotype D. CONCLUSION: By using the mitochondrial COI marker, we confirmed that the species under study did correspond to L. cousini . The number of known haplotypes of the species for Colombia has been duplicated and its geographical distribution has been extended to the southwest and northeast of the Colombian high Andean region.

A new synonym for Pristimantis luscombei (Duellman and Mendelson 1995) and the description of a new species of Pristimantis from the upper Amazon basin (Amphibia: Craugastoridae).

We consider Pristimantis achuar as junior synonym of P. luscombei, based on morphological and genetic evidence. Paratype specimens of P. luscombei are part of a new species, which lead to taxonomic confusion regarding the identity of P. luscombei. We describe and name this new species as Pristimantis miktos sp. nov. from Juyuintza, Pastaza province, eastern lowlands of Ecuador. Morphological diagnostic characters used to distinguish the new species from other brownish Amazonian Pristimantis are: (1) skin of dorsum shagreen with scattered tubercles or pustules; (2) tympanum prominent; (3) a thick X-shaped scapular dermal ridge in males; and (4) an orange iris in life. Pristimantis miktos is an inhabitant of the lowlands forests of the Pastaza and Napo drainages in eastern Ecuador and northern Loreto in Peru, reaching elevations of up to 350 m; P. luscombei is widely distributed in the upper Amazon Basin of Ecuador, northern Peru and extreme western Brazil, up to 1000 m. Phylogenetic analyses reveals that P. luscombei and the new species are not closest relatives, as also deduced from morphological evidence.

Two new species of Oxytrechus Jeannel, 1927 from Ecuador (Coleoptera, Carabidae).

Two new species of Oxytrechus Jeannel 1927 are described from the páramos of the Ecuadorian Andes in Pichincha province (Ecuador: Northern Sierra): O. osellai n. sp. from Cangahua at 3375 m a.s.l. and O. belloi n. sp. from Paso de la Virgen at 3515 m a.s.l.

A new colorful species of Pristimantis (Anura: Craugastoridae) from the eastern flank of the Cordillera Central in Colombia .

We describe a new species of Pristimantis from the humid forests on the eastern flank of the northern Cordillera Central in Colombia (6º 23' 19.3554" N, 75º 1' 24.0594" W; ca. 1150 m.a.s.l.). Pristimantis jaguensis sp. nov. is characterized by an extraordinary variation in color and is readily distinguished from congeneric species by lacking nuptial pads, discoidal fold and conical calcar tubercles; flanks and belly white to cream without blotches as well as iris yellow ocher to copper with thick brown reticulation and cream sclera. Molecular phylogenetic analyses recovered the new species in a clade with species mostly distributed in Ecuador. Our finding suggests that new taxa can still be discovered in the Middle Magdalena River valley of Colombia despite the extensive sampling this region has received during the last decades. 

Redescription of the sun-spider Mummucina titschacki Roewer, 1934 (Solifugae, Mummuciidae) with notes on the taxonomy of the genus.

Mummucina Roewer, 1934 is the second largest genus in the South American sun-spider family Mummuciidae. The limits of this and other genera are largely unexplored, and the traditional classification system is controversial. In the present contribution, the type species Mummucina titschacki Roewer, 1934 is redescribed, aided by scanning electron micrographs and the examination of a series of 72 specimens (including males) from the type locality in Ecuador. Some taxonomic remarks are made.

Revision of the Neotropical genus Marbenia Malloch (Diptera: Periscelididae).

The Neotropical genus Marbenia Malloch is revised and now includes 3 species: Marbenia cinerea, sp. nov., Marbenia pallida, sp. nov. and Marbenia peculiaris Malloch, 1931. The genus is herein recorded from the amazonian region of South America (Bolivia, Brazil and Ecuador), and characters of male and female terminalia are illustrated for the first time.

[Equity-based considerations for transforming the Ecuadorian health system]. / Consideraciones para la transformación del sistema de salud del Ecuador desde una perspectiva de equidad.

OBJECTIVE: The present study was aimed at analysing socioeconomic inequity regarding the use of health services in Ecuador, inequity regarding the geographic distribution of healthcare-related human resources and reflecting on the challenges concerning equity which the Ecuadorian health system is currently facing. METHODS: The Ecuadorian Demographic, Maternal and Infant Health Survey (2004) was used as the main data source, as its sample was representative of the Ecuadorian population. Multilevel multivariate analysis (MLWiN 2.02 statistical software) and spatial data analysis regarding health resources (GeoDa 1.0.1) were used for estimating the effects of using health services. RESULTS: It was found that social, economic and geographic inequity limited access to health services in Ecuador. People living in low economic resource households or indigenous housing and people living in rural areas (many of them having all three characteristics at the same time) had less possibility of using health services. In spite of a marked concentration of health-service providers in urban areas, it was found that the presence of healthcare personnel (excluding doctors) in rural public entities increased the possibility of using preventative and curative services. CONCLUSIONS: Efforts at transforming the Ecuadorian health system must be aimed at reducing social, cultural and financial barriers and inequality regarding the distribution de healthcare-related human resources, particularly in rural areas. Community and family orientation of the services and increasing spaces for citizen participation are necessary for reducing such inequity.

First record of Diaphorina citri (Hemiptera: Psyllidae) in Ecuador infesting urban citrus and orange jasmine trees.

Adults and nymphs of the Asian citrus psyllid, Diaphorina citri Kuwayama (Hemiptera: Psyllidae), were collected in the Guayaquil, Samborondón, and Durán cantons in coastal Ecuador. Psyllids were found in high numbers in citrus (Citrus spp., Sapindales: Rutaceae) and orange jasmine (Murraya exotica [L.] Jack, Sapindales: Rutaceae) trees within the Guayaquil-Samborondon-Duran conurbation; however, none was found during scoutings in the main citrus producing areas in coastal Ecuador. To the best of our knowledge, this is the first report of D. citri in Ecuador and the Pacific coastal plain of South America.

Lucio Leprosy with Lucio's phenomenon, digital gangrene and anticardiolipin antibodies.

Lucio's phenomenon (LPh) is considered a necrotizing panvasculitis and a variant of leprosy Type 2 reaction, clinically characterised by necrotic-haemorrhagic lesions on the extremities and trunk. LPh is observed in diffuse lepromatous leprosy (DLL or Lucio-Latapí leprosy). This is a distinct form of lepromatous leprosy (LL) reported mainly in Mexico. Anti-phospholipid antibody syndrome (APS) has been rarely described in LPh. We report a case of Lucio-Latapí leprosy with LPh observed in a patient from the province of El Oro in Ecuador, who presented clinical manifestations of long standing DLL (non-nodular infiltration of the skin, collapse of the nasal pyramid, madarosis, atrophy of the earlobes), of LPh (necrotic-haemorrhagic macules with irregular shapes) and of APS (necrosis of the right big and second toe). Histopathology showed perineural and periadnexal foamy macrophages with numerous bacilli (diagnostic of LL) in the subcutis, a mild lobular panniculitis with a large subcutaneous vessel infiltrated by macrophages in the wall (typical of LPh) and vessels of the superficial and mid dermis occluded by thrombi but without signs of vasculitis (typical of occlusive vasculopathy as in APS). Our observations suggest that some cases of LPh may be associated with APS. Anti-cardiolipin antibodies (aCL) and lupus anticoagulant (LA) should be tested in patients with LPh because this may have therapeutic implications.

Psychological distress in patients with restless legs syndrome (Willis-Ekbom disease): a population-based door-to-door survey in rural Ecuador.

BACKGROUND: Reported prevalence of restless legs syndrome (RLS), also known as Willis-Ekbom disease (WED), varies from country to country, and methodologic inconsistencies limit comparison of data. Impact of RLS on quality of life and health has been studied primarily in industrialized countries, particularly Europe and the United States. Many studies have relied exclusively on self-report of symptoms or have assessed only medical populations. Recently, interest has emerged on the impact of WED in rural, underserved populations globally. METHODS: In a population-based survey conducted in rural Ecuador, we assessed the relationship of psychological distress to WED, evaluated with the Depression Anxiety Stress Scales-21. WED was diagnosed through a 2-phase method in which all residents were screened with the International Restless Legs Syndrome Study Group (IRLSSG) questionnaire and all suspected cases were subsequently confirmed through expert medical examination. WED severity was assessed with the IRLSSG rating scale. RESULTS: Of 665 persons (mean [SD] age, 59.5 [12.6] years; women, 386 [58%]), 76 had depression, 93 had anxiety, and 60 reported stress. Forty persons (6%) had WED, with 15 (38%) having severe disease. In a regression model adjusted for age and sex, the prevalence of depression, anxiety, and stress was about 3 times greater among persons with WED than the general population. CONCLUSIONS: Although cross-sectional data cannot establish causation, this study shows the large behavioral health burden associated with WED in an untreated, rural population.

Geospatial patterns in traditional knowledge serve in assessing intellectual property rights and benefit-sharing in northwest South America.

ETHNOPHARMACOLOGICAL RELEVANCE: Without an understanding of the geography of traditional knowledge, implementing the Nagoya Protocol and national or regional strategies for benefit-sharing with local and indigenous communities will be difficult. We evaluate how much traditional knowledge about medicinal palm (Arecaceae) uses is unique and how much is shared across (i) four countries (Colombia, Ecuador, Peru, Bolivia), (ii) two cultural groups (Amerindian and non-Amerindian), (iii) 52 Amerindian tribes, (iv) six non-Amerindian groups, (v) 41 communities, and (vi) individuals in the 41 communities. MATERIALS AND METHODS: We first sampled traditional knowledge about palms from 255 references and then carried out 2201 field interviews using a standard protocol. Using the combined data set, we quantified the number of "singletons" that were unique to one of the analyzed scales. For the 41 communities, we evaluated how many uses were cited by <10% and by ≥50% of informants. We performed a Kruskal-Wallis test to evaluate whether the number of unshared uses (cited by <10%) differed significantly in relation to the informants׳ gender and degree of expertise, and performed a two-way ANOVA to test for differences in the number of unshared and shared uses accounted for by the five birth cohorts. RESULTS: We found that most knowledge was not shared among countries, cultural groups, tribes, communities, or even individuals within them. Still, a minor knowledge component was widely shared, even across countries. General informants cited a significantly higher number of unshared uses than experts, whereas no significant differences were found in the number of unshared uses cited by men and women or by different age groups. CONCLUSION: Our region-wide analysis highlights the geospatial complexity in traditional knowledge patterns, underscoring the need for improved geographic insight into the ownership of traditional knowledge in areas where biocultural diversity is high. This high geographic complexity needs consideration when designing property right protocols, and calls for countrywide compilation efforts as much localized knowledge remains unrecorded.

Road development and the geography of hunting by an Amazonian indigenous group: consequences for wildlife conservation.

Protected areas are essential for conservation of wildlife populations. However, in the tropics there are two important factors that may interact to threaten this objective: 1) road development associated with large-scale resource extraction near or within protected areas; and 2) historical occupancy by traditional or indigenous groups that depend on wildlife for their survival. To manage wildlife populations in the tropics, it is critical to understand the effects of roads on the spatial extent of hunting and how wildlife is used. A geographical analysis can help us answer questions such as: How do roads affect spatial extent of hunting? How does market vicinity relate to local consumption and trade of bushmeat? How does vicinity to markets influence choice of game? A geographical analysis also can help evaluate the consequences of increased accessibility in landscapes that function as source-sink systems. We applied spatial analyses to evaluate the effects of increased landscape and market accessibility by road development on spatial extent of harvested areas and wildlife use by indigenous hunters. Our study was conducted in Yasuní Biosphere Reserve, Ecuador, which is impacted by road development for oil extraction, and inhabited by the Waorani indigenous group. Hunting activities were self-reported for 12-14 months and each kill was georeferenced. Presence of roads was associated with a two-fold increase of the extraction area. Rates of bushmeat extraction and trade were higher closer to markets than further away. Hunters located closer to markets concentrated their effort on large-bodied species. Our results clearly demonstrate that placing roads within protected areas can seriously reduce their capacity to sustain wildlife populations and potentially threaten livelihoods of indigenous groups who depend on these resources for their survival. Our results critically inform current policy debates regarding resource extraction and road building near or within protected areas.

A school-based intervention improves physical fitness in Ecuadorian adolescents: a cluster-randomized controlled trial.

BACKGROUND: Effective lifestyle interventions are needed to prevent noncommunicable diseases in low- and middle-income countries. We analyzed the effects of a school-based health promotion intervention on physical fitness after 28 months and explored if the effect varied with important school characteristics. We also assessed effects on screen time, physical activity and BMI. METHODS AND RESULTS: We performed a cluster-randomized pair matched trial in schools in urban Ecuador. The intervention included an individual and environmental component tailored to the local context and resources. Primary outcomes were physical fitness (EUROFIT battery), screen time (questionnaires) and physical activity (accelerometers). Change in BMI was a secondary outcome. A total of 1440 grade 8 and 9 adolescents (intervention: n = 700, 48.6%) and 20 schools (intervention: n = 10, 50%) participated. Data of 1083 adolescents (intervention: n = 550, 50.8%) from 20 schools were analyzed. CONCLUSIONS: A school-based intervention with an individual and environment component can improve physical fitness and can minimize the decline in physical activity levels from childhood into adolescence in urban Ecuador. TRIAL REGISTRATION: Clinicaltrials.gov identifier NCT01004367.

Estudio cualitativo del aprendizaje de ciencias básicas en medicina. La neurociencia como modelo de "aprender a aprender", un estudio en la Facultad de Ciencias Médicas de la Universidad de Cuenca ­ Ecuador / Qualitative study of learning of basic sciences in medicine. The neuroscience as a model of "learning to learn", a study in the Faculty of Medical Sciences of the University of Cuenca ­ Ecuador

Introducción. La necesidad de un cambio en el modelo de formación profesional en la universidad ecuatoriana requiere con urgencia modificaciones en las conductas de los actores del proceso; profesores que sean tutores ­ mentores y, estudiantes que sean aprendices.Metodología. Es un estudio descriptivo observacional que analiza los instrumentos utilizados en un curso de formación en ciencia básica, particularmente neurofisiología, en los primeros ciclos de la carrera de medicina y su correlato con los estilos que desarrollan los estudiantes en su aprendiza-je contra los resultados finales.Resultados. La muestra incluye 42 estu-diantes durante un ciclo de 6 meses en el aprendizaje de neurofisiología; 24% de ellos cumple con un nivel mínimo de conocimiento de prerrequisitos (neuroanatomía); las herramientas de aprendizaje muestran una dicotomía importante entre un apren-dizaje colaborativo ­ problematizador durante las actividades diarias y herramientas de examen escrito repetitivo en la primera mitad del curso y problematizador hacia el final. El 19% de los estudiantes reprueba y no demuestra lograr generar herramientas de autoaprendizaje; del 81% que aprueban, solamente un tercio consigue desarrollar herramientas y hábitos de au-toaprendizaje. Conclusión. Es fundamental la formación y perfeccionamiento de los profesores de medicina en docencia; no es suficiente saber mucho sino saber mostrar y tutorizar el aprendizaje. Un nuevo sistema de educación universitario debe basarse en el compromiso de todos los actores, mejores herramientas de aprendizaje y sobre todo coordinar las herramientas de evaluación con los objetivos de la carrera.

Introduction. A change in the model of professional training in the Ecuadorian Uni-versity needs urgent modifications that are related to the behaviour of the actors im-merse at the process; teachers being tutors - counselors and students being apprenti-ces. Methodology. It is a descriptive observatio-nal study analyzing the instruments used in a training course in basic science, particu-larly neurophysiology in the first stages of the medical career and his correlation with the styles developed by the students in his learning process against the final results.Results. The sample includes 42 students during a cycle of 6 months in the neuro-physiology course; 24% fulfill a minimal le-vel of knowledge about prerequisites (neu-ro-anatomy); the learning tools show an important dichotomy between a collabo-rative, problem based learning during the daily activities and tools of examination based on repetitive learning at the first half of the course and problem based exami-nation towards the end. The 19 % of the students fails and does not demonstrates to manage and generate tools of self-lear-ning; of the 81 % that success the course, only a third develop tools and habits of self-learning.Conclusion. The specialization in teaching is a basic tool for education in medici-ne schools; it is not enough to ́know very much ́ but to ́be able to show and tuto-red the learning process ́. A new educa-tion university system must be based on the commitment of all the actors, better tools of learning and especially harmonize the evaluation tools with the career goals.

Los servicios de emergencias médicas en el Ecuador: una tarea pendiente / Medical emergency services in Ecuador: a outstanding task

Pre-hospital care is a relatively new discipli-ne within the field of medicine. However, it is becoming one of the most complex and important areas for the management of acute pathology. Pre-hospital services do not currently fit a unique model because they must meet countries' specific needs. The inadequate replication of a specific model could lead to failure of these services, causing ineffi-cient and inaccurate management of ti-me-dependent pathologies.In Ecuador, the development of pre-hos-pital emergency medical care has been uneven. Attempts to organize services have not been successful. A national pro-gram for emergency care is currently being implemented that aims to achieve coordi-nation among institutions. However, there are still problems related to organizational structure, which we discuss in this paper.

La atención prehospitalaria es una disciplina relativamente nueva en el campo de la medicina. Sin embargo, se está convirtiendo en una de las áreas más complejas e importantes para el manejo de la patología aguda.Los servicios prehospitalarios no encajan actualmente como un modelo único, pues deben cumplir con las necesidades específicas de cada país. La réplica inadecuada de un modelo específico podría llevar al fracaso de estos servicios, haciendo que la gestión sea ineficiente e inexacta en pa-tologías dependientes del tiempo.En Ecuador, el desarrollo de atención médica prehospitalaria de emergencia ha sido desigual. Los intentos de organizar los servicios no han tenido éxito. Un programa nacional para la atención de emergencia está siendo implementado actualmente, teniendo como objetivo, lograr la coordinación entre las instituciones. Sin embargo, todavía hay problemas relacionados con la estructura de la organización, lo que se discute en este trabajo.

Lessons learned in evaluating the Familias Fuertes program in three countries in Latin America / Lecciones aprendidas al evaluar el programa Familias Fuertes en tres países de América Latina

This report describes 1) the evaluation of the Familias Fuertes primary prevention program in three countries (Bolivia, Colombia, and Ecuador) and 2) the effect of program participation on parenting practices. Familias Fuertes was implemented in Bolivia (10 groups, 96 parents), Colombia (12 groups, 173 parents), and Ecuador (five groups, 42 parents) to prevent the initiation and reduce the prevalence of health-compromising behaviors among adolescents by strengthening family relationships and enhancing parenting skills. The program consists of seven group sessions (for 6-12 families) designed for parents/caregivers and their 10-14-year-old child. Parents/caregivers answered a survey before the first session and at the completion of the program. The survey measured two important mediating constructs: "positive parenting" and "parental hostility." The Pan American Health Organization provided training for facilitators. After the program, parents/caregivers from all three countries reported significantly higher mean scores for "positive parenting" and significantly lower mean scores for "parental hostility" than at the pre-test. "Positive parenting" practices paired with low "parental hostility" are fundamental to strengthening the relationship between parents/caregivers and the children and reducing adolescents' health-compromising behaviors. More research is needed to examine the long-term impact of the program on adolescent behaviors.

Este informe describe 1) la evaluación del programa de prevención primaria Familias Fuertes en tres países (Bolivia, Colombia y Ecuador) y 2) el efecto de la participación en el programa sobre las prácticas de crianza. El programa Familias Fuertes se llevó a cabo en Bolivia (10 grupos, 96 padres), Colombia (12 grupos, 173 padres) y Ecuador (5 grupos, 42 padres) para prevenir el inicio y reducir la prevalencia de comportamientos que constituyen un riesgo para la salud de los adolescentes, mediante el fortalecimiento de las relaciones familiares y la mejora de las habilidades de crianza. El programa consta de siete sesiones de grupo (para 6 a 12 familias) dirigidas a padres o cuidadores y sus hijos de 10 a 14 años de edad. Los padres o cuidadores respondieron a una encuesta antes de la primera sesión y al término del programa. La encuesta midió dos conceptos importantes: la "crianza positiva" y la "hostilidad parental". La Organización Panamericana de la Salud capacitó a los facilitadores. Después del programa, los padres o cuidadores de los tres países presentaron puntuaciones ­ medias significativamente mayores en "crianza positiva" y significativamente menores en "hostilidad parental" que en la encuesta previa. La prácticas de "crianza positiva" asociadas con una baja "hostilidad parental" son fundamentales para fortalecer la relación entre los padres o cuidadores y los niños, y reducen los comportamientos que constituyen un riesgo para la salud de los adolescentes. Es necesaria una investigación más amplia para analizar la repercusión a largo plazo del programa sobre los comportamientos de los adolescentes.

Psicólogos europeos en los países andinos (Bolivia, Ecuador y Perú) durante la primera mitad del siglo XX / European Psychologists in Andean Countries (Bolivia, Ecuador, and Peru) in the First Half of the 20th Century

Un reducido número de psicólogos y pedagogos europeos trabajó en Bolivia, Ecuador y Perú, los así llamados países andinos, en la primera mitad del siglo XX. En Bolivia, Georges Rouma, un educador belga, fue el responsable de la reforma educativa emprendida por el Gobierno boliviano, organizando una expedición antropológica en los Andes. En Ecuador, Oliver Brachfeld, un psicólogo húngaro de orientación adleriana, se desempeñó por un corto tiempo en la Universidad de Quito, en tanto que en el Perú, Walter Blumenfeld, un psicólogo alemán, obligado a dejar su país en los años del nacionalsocialismo, trabajó en la Universidad de San Marcos desde 1935 y fue un pionero de la orientación objetiva en la psicología en ese país.

A small number of European psychologists and educators worked in the so called Andean countries, Bolivia, Ecuador and Peru, in the first half of 20th. century. In Bolivia Georges Rouma, a Belgian teacher, was responsible for the education reform in the 1910s, and organized an anthropological expedition in the highlands. Oliver Brachfeld, an Hungarian adlerian psychologist, was in Colombia (1965-1966) and Ecuador (1966-1967), where he dead in 1967, teaching at the University of Quito. In Peru the German psychologist Walter Blumenfeld, forced to leave Germany in the years of Hitlerian regime, worked since 1935 at the San Marcos University and was a pioneer of the objective orientation of psychology in this country.

The Leganés cognitive test correlates poorly with MRI evidence of global cortical atrophy in an underserved community: A population-based and nested case-control study in rural Ecuador (The Atahualpa Project) / O teste cognitivo Leganés tem baixa correlação com atrofia cortical global avaliada por RM em uma comunidade socialmente desprovida. Um estudo de base populacional e caso-controle no Equador Rural (Projeto Atahualpa)

We aimed to evaluate whether the Leganés cognitive test (LCT) correlates with global cortical atrophy (GCA) and can be used as a surrogate for structural brain damage. Methods: Atahualpa residents aged greater 60 years identified during a door-to-door survey underwent MRI for grading GCA. Using multivariate generalized linear models, we evaluated whether continuous LCT scores correlated with GCA, after adjusting for demographics, education, cardiovascular health (CVH) status, depression and edentulism. In a nested case-control study, GCA severity was assessed in subjects with LCT scores below the cutoff level for dementia (? 22 points) and in matched controls without dementia. Results: Out of 311 eligible subjects, 241(78%) were enrolled. Mean age was 69.2±7.5 years, 59% were women, 83% had primary school education, 73% had poor CVHstatus, 12% had symptoms of depression and 43% had edentulism. Average LCT score was 26.7±3, and 23 (9.5%) subjects scored ? 22 points. GCA was mild in 108, moderate in 95, and severe in 26 individuals. On the multivariate model, mean LCT score was not associated with GCA severity (?=0.06, SE=0.34, p=0.853). Severe GCA was noted in 6 / 23 case-patients and in 8/23 controls (OR: 0.67, 95% CI: 0.14-2.81, p=0.752, McNemar?s test). Conclusion: The LCT does not correlate with severity ofGCA after adjusting for potential confounding variables, and should not be used as a reliable estimate of structural brain damage.

O teste cognitivo Leganés (TCL) é um instrumento para o rastreio rápido de demência em idosos com baixo nível educacional. Objetivo: Tivemos como objetivo avaliar se o TCL associa-se com medidas de atrofia cortical global (ACG) e pode ser usado como um substituto para a lesão cerebral estrutural. Métodos: Residentes de Atahualpa com idade maior ou igual 60 anos identificados durante um levantamento porta-a-porta foram submetidos a ressonância magnética para avaliar a intensidade da ACG. Usando modelos lineares generalizados multivariados, avaliamos se escores TCL contínuos correlacionavam com a intensidade da ACG após ajustes para a dados demográficos, educação, saúde cardiovascular (CVH), depressão e edentulismo. Em um estudo caso-controle aninhado, avaliamos a gravidade da ACG em pessoas com escores no TCL abaixo do nível de corte para demência (? 22 pontos) e em pessoas pareados sem demência. Resultados: Dentre as 311 pessoas elegíveis, 241 (78%) foram selecionadas. A média de idade foi de 69,2±7,5 anos, 59% eram mulheres,83% tinham o ensino primário, 73% tinham mau estado CVH, 12% apresentaram sintomas de depressão e 43% tinham edentulismo. Pontuações médias no TCL foram 26,7±3 e 23 (9,5%) pessoas tinham 22 pontos. ACG foi leve em 108, moderada em 95 e grave em 26 pessoas. No modelo multivariado, a média de pontuação no TCL não foi associada com a gravidade da ACG (B=0,06, SE=0,34, p=0,853). ACG grave foi observada em 6 de 23 pacientes e em 8 de 23 controles (OR:0,67; IC 95%: 0,14-2,81, p=0,752, teste de McNemar). Conclusão: O TCL não se associa com a gravidade da ACG após o ajuste para possíveis fatores de confusão e não deve ser usado como uma estimativa confiável de dano cerebral estrutural.

Imaginario sobre la homosexualidad en estudiantes de politécnicos ecuatorianos / Imaginary on homosexuality ecuatorian polytechnic students

Objetivo: analizar el imaginario sobre la homosexualidad en estudiantes de politécnicos. Métodos: investigación tipo cuantitava-cualitativa en estudiantes de la Escuela Superior Politécnica de Chimborazo en Ecuador. Se aplicó un cuestionario validado por expertos en una muestra probabilística estratificada monoetápica. Se investigó sobre la orientación sexual y si la asumen, los conocimientos sobre los derechos sexuales relacionados con la orientación sexual y si consideran que la homosexualidad debería aceptarse. Se organizaron grupos focales y en ellos se indagó el imaginario de los estudiantes frente a si los homosexuales nacen o se hacen. Se realizó procesamiento estadístico de textos y análisis de correspondencia de los argumentos y discursos. Resultados: los estudiantes en su mayoría son heterosexuales, algunos no asumen su orientación sexual, presentaron actitudes desfavorables ante la homosexualidad; la mayoría indicó que la homosexualidad no debería aceptarse, porcentajes importantes desconocían los derechos sexuales de la diversidad sexual. Se identificaron creencias y mitos que indicaron que la homosexualidad surge de situaciones negativas como problemas, desordenes en el ámbito biológico, hormonal, psicológico y del ambiente familiar y social. Ninguno expuso un discurso sobre la homosexualidad como una conducta normal o estilo de vida. Un grupo indicó que se debe respetar y aceptar a los homosexuales. Conclusiones: el imaginario vivenciado al interior de la población estudiantil se configura en discriminación a los homosexuales, por tanto, emerge la importancia de implementar propuestas de intervención para incidir de manera positiva y aclarar conocimientos, desmitificar conceptos y reforzar actitudes que se traduzcan en la disminución de esta discriminación y la consecuente valoración positiva de la diversidad sexual(AU)

Objective: to analyze the imagery on homosexuality in polytechnical education students. Methods: quantitative-qualitative research with two implementation techniques: an expert-validated questionnaire applied to a selection of single-stage stratified probabilistic sample in which the sexual orientation, whether it is accepted, the knowledge about sexual rights related to sexual orientation and the acceptance of homosexuality or not were under study. As a qualitative technique, focus groups were created; they were then asked whether homosexuality is an in-born or acquired condition to find out the imagery of the polytechnic education students. Statistical processing of texts and analysis of matching of arguments with speeches were performed. Results: the students were mostly heterosexuals, few do not assume their sexual orientation; they showed unfavorable attitudes towards homosexuality, most of them stated that homosexuality should not be accepted, and a significant number of them ignored the rights of sexual diversity. Exist beliefs and myths based on imaginary thoughts indicating that homosexuality arises from negative situations such as problems, disorders or alterations in the biological, hormonal, psychological, family and social environments. None of them speak about homosexuality as a normal behavior or lifestyle, just one group was in favor of respect to and acceptance of homosexuals. Conclusions: the imagery observed in this student population is set on the discrimination of homosexuals, so it is important to implement interventional proposals that have positive impact and clarify knowledge, demystify concepts and encourage attitudes towards reduction of discrimination and the consequent positive assessment of sexual diversity(AU)