Numerical Analysis of the ACL, with Sprains of Different Degrees after Trauma.

Nowadays, cruciate ligament injuries have increased in incidence, since practicing a sport or physical activity has become a trend in current societies. Although this lifestyle generates multiple benefits, as a consequence, injury has also increased. Due to its nature and complexity, the ligaments of the knee are those that are most frequently affected, mainly the ACL (anterior cruciate ligament). This tissue reacts to overexertion or movements out of range, either caused by the exercise itself or caused by trauma caused by the practice of physical activity, causing various degrees of sprain. Whatever the etiology of these injuries, they will require a therapy indicated for each degree of injury. This therapy initially entails immobilization of the affected area and later; physical therapy will be required to a lesser or greater degree. Commonly, in the physiotherapy of these injuries, rehabilitation exercises are prescribed, where the physiotherapist asks a patient to use equipment with an estimated weight. However, the effectiveness of a generalized therapy in this way does not always give the expected results. This is related to the fact that these therapies are standardized and do not consider some factors such as the remaining muscle fibres that are not directly affected by the sprain, which does not mean that they should not be considered. Therefore, in the present work, a biomodel of a human knee has been developed and used to evaluate numerically how the ACL acts under an external load, when there are different degrees of injuries, caused by trauma. Four case studies were considered: Case 1 (control case) where the ACL is healthy, Case 2 where the ACL presents a 1st-degree sprain, Case 3 where the ACL presents a 2nd-degree sprain, and finally Case 4 where the ACL presents a 3rd-sprain grade. After performing the analyses, in the control case, it was found that it presents a balance between tensile and compressive stresses. While in the 4th case, the most critical tensile stress decreases while compression stresses increase. This shows that the ligament, having considerable damage, no longer works as it should and can eventually damage the collateral structures. It was found that, when there was a sprain, where the continuity of the ligament is compromised, a second torsional moment occurs in the ACL which causes the tissue fibres not to act according to their normal physiology or in a healthy state. The results obtained from the present study provide the possibility of predicting where the following injuries will occur by considering the von Mises failure criterion. Likewise, they will allow to improve the therapeutic procedures considering not only the injured structure but also the system as a whole.

Comparative Numerical Analysis between Two Types of Orthodontic Wire for the Lingual Technique, Using the Finite Element Method.

In the lingual orthodontic technique, there are two paradigms regarding the type of wire used. Regardless of the material or gauge, some orthodontists choose to use the straight wire and resin and bond it to the surface of the tooth; they call it compensations. Other orthodontists prefer to bend the wire, giving it a mushroom shape. There is no specific indication for the use of each type of wire, so orthodontists use them according to their criteria. The present study establishes the bases so that it is possible to find the indications for each type of wire. A clinical trial of a lingual orthodontic patient was used. To carry out the comparative study, a straight arch was placed in his right arch and a mushroom arch in the left arch. Using 3D imaging, a high-biofidelity biomodel of the patient's mandible was generated, with which the FEM analysis was performed, which allowed comparing the reactions of the mandibular bone and appliances with the different arches. It was found that, on the side with the straight arch, there were greater deformations, and in the mushroom arch, there were greater stresses. With this, it is possible to find which clinical cases in each type of wire are indicated.

High Biofidelity 3D Biomodel Reconstruction from Soft and Hard Tissues (Knee), FEM, and 3D Printing: A Three-Dimensional Methodological Proposal.

The modelling of biological structures has allowed great advances in Engineering, Biology, and Medicine. In turn, these advances are seen from the design of footwear and sports accessories, to the design of prostheses, accessories and rehabilitation treatments. The reproduction of the various tissues has gone through an important evolution thanks to the development of computer systems and programs. However, knowledge of the medical-biological and engineering areas continues to be required, and it involves a considerable investment of time and resources. The resulting biomodels still require great precision. The present work shows a methodology that allows to optimize computational resources and reduce elaboration time of biomodels. Through this methodology, it is possible to generate a biomodel of high biofidelity of a human knee. This biomodel is constituted by hard tissues (cortical and trabecular bones) and soft tissues (ligaments and meniscus) resulting in the modelling of the lower third of the femur, the tibial plateaus, the anterior cruciate ligament, posterior cruciate ligament, external lateral ligament, interior lateral ligaments, and the meniscus. With this model and methodology, it is possible to perform numerical analyses that will provide results very similar to those of real life. As, the methodology allows to assign the mechanical properties to each tissue and the anatomical structure.

High-Biofidelity Biomodel Generated from Three-Dimensional Imaging (Cone-Beam Computed Tomography): A Methodological Proposal.

Experimental research on living beings faces several obstacles, which are more than ethical and moral issues. One of the proposed solutions to these situations is the computational modelling of anatomical structures. The present study shows a methodology for obtaining high-biofidelity biomodels, where a novel imagenological technique is used, which applies several CAM/CAD computer programs that allow a better precision for obtaining a biomodel, with highly accurate morphological specifications of the molar and tissues that shape the biomodel. The biomodel developed is the first lower molar subjected to a basic chewing simulation through the application of the finite element method, resulting in a viable model, able to be subjected to various simulations to analyse molar biomechanical characteristics, as well as pathological conditions to evaluate restorative materials and develop treatment plans. When research is focused in medical and dental investigation aspects, numerical analyses could allow the implementation of several tools commonly used by mechanical engineers to provide new answers to old problems in these areas. With this methodology, it is possible to perform high-fidelity models no matter the size of the anatomical structure, nor the complexity of its structure and internal tissues. So, it can be used in any area of medicine.

Metformin use is associated with a lower risk of osteoporosis in adult women independent of type 2 diabetes mellitus and obesity. REDLINC IX study.

Metformin may decrease cell senescence, including bone; hence we aimed at evaluating the association between metformin use and osteoporosis. This was a cross-sectional study carried out in 1259 Latin American adult women aged 40 or more who were not on anti-osteoporotic drugs, were on metformin and had a bone densitometry performed. Of the whole sample, 40.3% reported being on metformin (at least 1 year), 30.2% had type 2 diabetes mellitus and 22.6% had osteoporosis. Median (interquartile range) body mass index (BMI) for the whole cohort was 27.7 (4.6) kg/m2 and 30.2% had type 2 diabetes mellitus. Current use of hormone therapy, calcium, and vitamin D corresponded respectively to 10.7%, 47.7%, and 43.1% of all surveyed women. A logistic regression model was used to analyze the association of osteoporosis with various covariates incorporated into the model such as age (OR: 1.07, 95% CI: 1.05-1.09), BMI (OR: 0.92, 95% CI: 0.89-0.96) and metformin use (OR: 0.44, 95% CI: 0.32-0.59). Metformin use, regardless of the presence of type 2 diabetes or obesity, was associated with a lower risk of osteoporosis in adult women. We propose that one explanation for this observation could be the effect of the drug over cellular senescence.

Numerical Analysis of a Dental Zirconium Restoration and the Stresses That Occur in Dental Tissues.

When it is about restorative dental materials, aesthetics is traditionally preferred. This has led to the selection of materials very visually similar to the enamel, but unfortunately, their mechanical properties are not similar. This often translates into disadvantages than advantages. In the present work, a comparison is made of the stresses that occur during dental occlusion (dental bit) in a healthy dental organ and those that are generated in a dental organ with a dental zirconium restoration. Numerical simulation was carried out by means of the Finite Element Method, in computational biomodels, from Cone-Beam Tomography, to obtain the stresses generated during dental occlusion. It was found that the normal and von Mises stresses generated are substantially greater in the molar with restoration compared to those produced in the healthy molar. In addition, the normal function of the enamel and dentin to disperse these stresses to prevent them from reaching the pulp is altered. Therefore, it is necessary to analyze the indiscriminate use of this restoration material and consider other aspects, in addition to aesthetics and biocompatibility for the choice of restorative materials such as biomechanical compatibility.

Nuevos retos en la protección de la vida y salud de las mujeres / New challenges in protecting women's life and health

Background: One of the UN Sustainable Development Goals is to reduce maternal mortality. Objective: To determine knowledge, attitudes and practices of health professionals regarding abortion. Design: Cross-sectional type of survey. Methods: During 2017, the Ecuadorian Federation of Gynecology and Obstetrics Society FESGO applied a survey to 132 health professionals to determine their knowledge, attitudes and practices regarding abortion. Results: We identified more nonpunishable abortion causes than those the law recognizes. The most frequent of these were rape (21%) and congenital malformations (13%). 83% of respondents agreed that law should allow ending a pregnancy if the woman's life were at risk and 46% if her health was at risk. 61% of them agreed if the fetus had a congenital malformation. In addition, 46% agreed if it was the product of rape of a disabled woman, 40% if it was the product of rape, and 28%, if it was product of an incest. In case of a disabled woman pregnant because of rape, 57% would give information on options for pregnancy interruption, and 26% would give information on the legal frame that allows pregnancy interruption. However, 23% would lie by saying that the country's legal frame does not allow pregnancy interruption. Conclusions: The survey reflects a wider perception on non-punishable abortion causatives than what the law recognizes. Nevertheless, 23% would indicate that the country's legal frame does not allow pregnancy interruption, contradicting the legal regulation that protects the woman's right to abortion access to protect her health and life. Barriers against the women's right to decide on her health persist.

Introducción. Uno de los Objetivos de Desarrollo Sostenible es reducir la mortalidad materna. Objetivo. Valorar los conocimientos, actitudes y prácticas de profesionales de la salud en relación con el aborto. Diseño. Estudio transversal tipo encuesta. Métodos. En el año 2017, FESGO aplicó una encuesta a 132 profesionales de la salud, para valorar sus conocimientos, actitudes y prácticas en relación con el aborto. Resultados. La encuesta reflejó una percepción más amplia de causales de aborto no punible que las que la ley reconoce, destacando la violación en 21% y las malformaciones congénitas en 13%. El 83% estaría de acuerdo que la ley permita la interrupción de un embarazo frente al riesgo para la vida de la mujer, 46% frente al riesgo de salud; 61% por malformaciones congénitas fetales, 46% en caso de violación a una mujer con discapacidad y 40% en la violación en general; 28%, en casos de incesto. En caso de una mujer con discapacidad embarazada por violación, el 57% señaló que le daría información sobre las opciones de interrupción. El 26% le daría información sobre el marco legal que le permite la interrupción del embarazo. Pero, el 23% le indicaría que el marco legal del país no permite la interrupción. Conclusiones. La encuesta refleja una percepción más amplia de causales de aborto no punible que las que la ley reconoce. Un 23% indicaría que el marco legal del país no permite la interrupción del embarazo, contradiciendo la norma legal que protege el derecho de esa mujer a acceder a un aborto para proteger su salud y su vida. Persisten barreras para garantizar el derecho de las mujeres a decidir sobre su salud.

Practical regio- and stereoselective azidation and amination of terminal alkenes.

There is significant interest in developing more rapid and efficient production of nitrogen-containing allylic compounds, as widely used in various syntheses. This work reports a variety of allylic azides and allylic amines synthesized by an efficient, new one-pot protocol that employs readily available terminal alkenes as starting materials. This method is highly regio- and stereoselective, affording the linear (E)-isomer, under metal-free conditions. This process tolerates several functional groups including halogen-containing molecules; it is general for azides and amine nucleophiles; and, adducts were obtained in good yields.

Análisis de conocimiento, actitudes y prácticas sobre aborto incompleto en una muestra de proveedores de salud en obstetricia de Ecuador / Analysis of knowledge, attitudes and practices about incomplete abortion in a sample of obstetrics health providers in Ecuador

Objetivos: analizar el nivel de conocimientos, actitudes y prácticas que tiene una muestra voluntaria de proveedores de salud en obstetricia asistentes al XXI Congreso Nacional de Ginecología y Obstetricia del Ecuador sobre muerte materna, leyes nacionales y tratamientos relacionados al aborto incompleto. Material y Métodos: Se realizó una intervención investigativa transversal...

Objectives: To examine the level of knowledge, attitudes and practices which has voluntary sample of health care providers at obstetrician tending the 21st National Congress of Gynecology and Obstetrics of Ecuador on maternal death, national laws and treatment related to incomplete abortion. Material and Methods: a descriptive and analytical cross - sectional investigative intervention through suvery...

Conocimientos, actitudes y prácticas sobre aborto en una muestra de médicos gineco-obstetras de Ecuador / Knowledge, attitudes and practices regarding abortion in a sample of obstetrician-gynecologists from Ecuador

Objetivos: Determinar el nivel de conocimientos, actitudes y prácticas en una muestra intencionada de médicos gineco-obstetras líderes provinciales de la Federación de Sociedades de Ginecología y Obstetricia del Ecuador (FESGO) sobre el aborto inducido. Diseño: Estudio transversal, correlacional, de corte prospectivo y analítico. Institución: Federación de Sociedades de Ginecología y Obstetricia del Ecuador (FESGO). Participantes: Médicos gineco-obstetras líderes provinciales de FESGO. Metodología: En una muestra intencionada de 33 médicos gineco-obstetras se aplicó una encuesta estructurada validada y basada en experiencias de la región, acerca de datos generales y sociodemográficos del encuestado, conocimientos teóricos sobre la epidemiología del aborto y la muerte materna, actitudes con relación del manejo del aborto inseguro, y la práctica de prescripción de misoprostol y tratamiento quirúrgico por aspiración. Principales medidas de resultados: Nivel de conocimientos, actitudes y prácticas. Resultados: La población encuestada tenía promedio de edad de 49 años, 16 años de práctica, con relación estable, hijos y religión declarada. Consideraron de alta prioridad la muerte materna por aborto, pues atendían pacientes públicas y privadas con intención de aborto inducido frecuente y uso de misoprostol previo. Consideraron la ampliación de motivos para aborto con la proyección de reducción de mortalidad, aunque los casos aumentaran. En su mayoría consideraron suficientes sus conocimientos de derechos reproductivos, se sentían solventes respecto a la consejería en misoprostol, aunque la satisfacción alta respecto a consejería de aborto inducido fue apenas en 51%. Conclusiones: Los líderes provinciales de esta muestra intencionada conocían la temática del aborto y su atención integral. Los conocimientos fueron altos, aunque las actitudes y prácticas resultaron diversas, con respuestas que sugieren mayor sensibilización y capacitación. Nuevos estudios necesitan ser realizados en una población más amplia de gineco-obstetras federados, así como intervenciones educativas y de sensibilización para mejorar la calidad de atención del aborto.

Objectives: To determine knowledge, attitudes and practices regarding abortion in an intentioned sample of obstetrician/gynecologists who are provincial leaders of the Federación de Sociedades de Ginecología y Obstetricia del Ecuador (FESGO). Design: Prospective, correlational, cross-sectional, and analytical survey. Setting: Federación de Sociedades de Ginecología y Obstetricia del Ecuador (FESGO). Participants: FESGO obstetrician/gynecologists provincial leaders. Methods: A structured and validated survey was applied to an intentional sample of 33 obstetrician/gynecologists. The survey was based on experiences in the region, general and demographic information of the respondent, theoretical knowledge about the epidemiology of abortion and maternal death, attitudes about the management of unsafe abortion, and practice on misoprostol prescription and surgical aspiration. Main outcome measures: Knowledge, attitude and practices. Results: The survey respondents were 49 years old average, had 16 years of medical practice, and stable family relations, with declared children and religion. They considered maternal death due to abortion of high priority be-cause they attended public and private patients with frequent history of induced abortion and use of misoprostol. They also considered the expansion of reasons for abortion in the light of a potential reduction in mortality, even if the number of cases increased. Most considered sufficient their knowledge on reproductive rights and felt proficient with respect to counseling on misoprostol, although high satisfaction on induced abortion counseling was just 51%. Conclusions: Provincial leaders of this sample knew about abortion and its comprehensive care. Knowledge was high, but attitude and practices were diverse and require more awareness and training. Further studies are needed in a b broader federated population of obstetrician/ gynecologists. Educational and sensitizing interventions are needed to improve the quality of abortion care.

Application of the 10-item Cervantes Scale among mid-aged Ecuadorian women for the assessment of menopausal symptoms.

BACKGROUND: The majority of instruments used to evaluate menopausal symptoms are long and complex. In this sense, more simple tests are being designed to rapidly obtain a snapshot of the global clinical picture. OBJECTIVE: To assess menopausal symptoms in mid-aged women using the short 10 item version of the original menopause Cervantes Scale (CS-10). METHOD: This was a cross sectional study in which a total of 451 Ecuadorian women (40-59 years) were surveyed with the CS-10 and a general socio-demographic questionnaire containing personal and partner data. RESULTS: Median age of the whole sample was 48 years. A 41.2% were postmenopausal, 44.3% abdominally obese (waist circumference >88cm), 6% diabetic, 16.9% hypertense, 11.5% smoked, 6.9% currently used hormone therapy, 9.5% phytoestrogens and 6.7% psychotropic drugs. For the entire sample, median [interquartile range] CS-10 global scores were 10.0 [9.5], and for pre-, peri- and postmenopausal women: 5.0 [7.0], 11.0 [9.0] and 13.5 [8.0], respectively. The CS-10 displayed good internal consistency (Cronbach's alpha 0.87). According to the CS-10, the three most prevalent menopausal symptoms were: muscle and joint pains (88.5%), hot flushes (77.6%) and skin dryness (71.4%). Multiple linear regression analysis found that postmenopausal status, parity, unhealthy perceived status, psychotropic drug use, partner erectile dysfunction, lower coital frequency and living at high altitude were related to higher CS-10 global scores. CONCLUSION: In this mid-aged Ecuadorian female sample severity of menopausal symptoms, as determined by the CS-10, were related to environmental and female/partner personal and socio-demographical aspects.

Resilience and related factors during female Ecuadorian mid-life.

BACKGROUND: Studies reporting on resilience (capacity to overcome life adversity) and the menopausal transition are scarce. OBJECTIVE: To assess resilience and related factors in mid-aged Ecuadorian women. METHOD: This was a cross sectional study in which 904 women aged 40-59 completed the 14-item Wagnild and Young Resilience Scale (WYRS) and a general socio-demographic questionnaire containing personal and partner data. Lower total WYRS scores indicate less resilience. Internal consistency of the tool was also assessed. RESULTS: Median age of all surveyed women was 49 years. A 51.1% were postmenopausal, 43.8% lived high altitude, 43.5% were abdominally obese, 12.6% used hormone therapy and 80.8% had a partner. Internal consistency was high for the WYRS tool (Cronbach's alpha: 0.94). Multiple linear regression analysis determined that lower total WYRS scores (less resilience) correlated with high altitude residency, more severe hot flushes, sedentarism, higher abdominal circumferences and having a partner with erectile dysfunction. Contrary to this, higher WYRS scores correlated with higher parity and sexual activity. CONCLUSION: As assessed with the WYRS tool, lower resilience of this mid-aged Ecuadorian female sample was related to various female and partner lifestyle and health issues, not necessarily related per se to the ageing process. More research using the tool is warranted.

Assessment of sexual function of mid-aged Ecuadorian women with the 6-item Female Sexual Function Index.

BACKGROUND: Assessing sexuality is a difficult task, hence used tools should be straight forward and easy to use. OBJECTIVE: To assess sexual function in mid-aged Ecuadorian women. METHOD: In this cross sectional study, 904 otherwise healthy women 40-59 years completed the short 6-item Female Sexual Function Index (FSFI-6) and a general socio-demographic questionnaire containing personal/partner data. Internal consistency of the tool was also assessed. RESULTS: Median age of the whole sample was 49 years, 51.1% were postmenopausal, 43.8% lived at high altitude, 12.6% used hormone therapy (HT), 58.5% presented hot flushes, 43.5% were abdominally obese and 80.8% had a partner. Overall, 72.4% of surveyed women reported sexual activity (n=655/904) with 65% of these presenting total FSFI-6 scores equal or below 20 the calculated median (lower sexual function). A 10.2% of those having a partner were sexually inactive. Internal consistency of tool was high (Cronbach's alpha=0.91). Total FSFI-6 scores positively correlated with coital frequency and female and partner educational level and inversely with female age, waist circumference, hot flush intensity and partner age (bivariate analysis). Multiple linear regression analysis determined that lower scores (lower sexual function) were related to high altitude, history of sexual abuse, sedentarism, hot flush intensity, partner age and sexual dysfunction whereas partner educational level, coital frequency and female parity were significantly related to higher scores (better sexual function). CONCLUSION: As assessed with a consistent, short, and easy to use tool lower sexual function of this mid-aged series was related to several female and partner factors. More research with this tool is warranted.

Perceived control over menopausal hot flushes in mid-aged women.

BACKGROUND: Hot flushes (HFs) and night sweats are frequent complaints among both peri- and postmenopausal women. Perceived control of this complaint may vary from one population to another. OBJECTIVE: To assess perceived control over menopausal HFs and determinant factors among mid-aged Ecuadorian women. METHODS: In this cross-sectional study healthy women aged 40-59 years, seeking healthcare centres of eight main cities of Ecuador with more than 100,000 inhabitants, were assessed with the Menopause Rating Scale (MRS) and those presenting HFs were requested to fill out the Perceived Control Index (PCI) and a questionnaire containing socio-demographic data (female and partner). RESULTS: A total of 1154 women participated in this study of which 56% presented HFs (n = 646). According to the MRS, 29.1% and 9.1% of these HFs were graded as severe and very severe, respectively. Mean age of women presenting HFs was 49.5 +/- 5.2 years, with 51.9% having 12 years or less of education, 61.5% being postmenopausal and 47.2% living in high altitude. At the moment of the survey 13.9% were on hormone therapy, 12.8% on phytoestrogens and 7.1% on psychotropic drugs. There was a significant decreasing trend for PCI scores (total and difficulty in control items) from one menopausal stage to the next, with no differences observed for time since menopause onset. Despite this, logistic regression analysis determined that HF severity, as determined with the MRS, was the only single predictive factor related to lower HF perceived control (total PCI score <38) (OR: 1.83 CI 95% [1.15-2.90], p < 0.01). CONCLUSION: As determined with the PCI, HF severity was related to a lower perceived control among mid-aged women.

Beliefs regarding menopausal hot flushes among climacteric women as assessed with the Hot Flush Beliefs Scale.

BACKGROUND: Hot flushes (HFs) and night sweats are frequent complaints among both peri- and postmenopausal women. Beliefs regarding these complaints may vary from one population to another. OBJECTIVE: To assess HF beliefs and factors related to negative beliefs in a climacteric Hispanic population using the Hot Flush Beliefs Scale (HFBS). METHODS: A total of 1154 healthy women (40-59 years) were assessed with the Menopause Rating Scale (MRS), those presenting HFs were requested to fill out the HFBS and a questionnaire containing socio-demographic data (female and partner). RESULTS: A total of 646 presented HFs (56%) graded according to the first item of the MRS as mild (28.6%), moderate (33.2%), severe (29.1%) and very severe (9.1%). Mean age of these women was 49.5+/-5.2 years, with 51.9% having 12 or less years of education, 61.5% being postmenopausal and 47.2% living in high altitude. At the moment of the survey 13.9% were on HT, 12.8% on phytoestrogens and 7.1% on psychotropic drugs. Women strongly disagreed in more negatively oriented items of those contained in subscale one (beliefs about self in social context). Contrary to this, women strongly agreed in more negative oriented items contained in subscale two which assesses beliefs about coping with HFs. Women presenting with severe-very severe HFs displayed higher HFBS total and subscale scores indicating a more negative belief regarding HFs. Logistic regression analysis determined that HF severity was related to higher HFBS scores for the total and subscales one and two. Current smoking, higher parity, lower female education, female psychiatric consultation, time since menopause and partner unhealthiness and alcohol consumption were also related to higher HFBS scorings. Postmenopausal status and church attendance were related to lower scores. CONCLUSION: In this mid-aged Ecuadorian female series negative beliefs regarding HFs were related to the severity of HFs and individual female or partner characteristics. Data provided from clinical research using this tool, alone or in combination with other tests, is warranted.

Risk factors related to the presence and severity of hot flushes in mid-aged Ecuadorian women.

BACKGROUND: Several studies drawn from the Ecuadorian population have previously reported that more than half of mid-aged women present hot flushes, which can impair their quality of life. However up-to-date risk factors for their presence and severity have not been assessed. OBJECTIVE: To assess hot flush frequency and intensity and related risk factors among middle-aged Ecuadorian women. METHODS: In this cross-sectional study, 1154 healthy women aged 40-59 years, visiting healthcare centers of eight main cities of Ecuador with more than 100,000 inhabitants, were assessed with the first item of the Menopause Rating Scale (MRS) and a questionnaire containing female and partner socio-demographic data. RESULTS: Mean age of the entire sample was 48.8+/-5.6 years (median 48), a 48.7% had 12 or less years of schooling, 52.8% were postmenopausal, 43.6% lived at high altitude, 56.8% were married and 10% were on hormonal therapy (HT). Hot flushes accounted for 56% (n=646) of the whole sample, of which 29.1% and 9.1% were respectively graded as severe and very severe. Logistic regression determined that female sedentarism (OR: 2.42, CI 95% [1.63-3.59]), accessing a free healthcare system (OR: 1.96, CI 95% [1.30-2.96]), living at high altitude (OR: 1.82, CI 95% [1.14-2.90]) and having a partner abusing alcohol (OR: 1.92, CI 95% [1.09-3.35]) were significant risk factors related to the presence of hot flushes. The regression model also determined that among women with hot flushes (n=646), sedentarism (OR: 1.73, CI 95% [1.14-2.62]) and having a partner with erectile dysfunction (OR: 2.57, CI 95% [1.44-4.59]) were significant risk factors related to severe/very severe hot flushes whereas married status (OR: 0.53, CI 95% [0.32-0.86]), living at high altitude (OR: 0.46, CI 95% [0.26-0.78]) and partner healthiness (OR: 0.59, CI 95% [0.36-0.95]) were not. CONCLUSION: To the best of our knowledge this is the first and largest study assessing hot flushes in a mid-aged Ecuadorian population. We found that the presence and severity were not significantly related to age and hormonal status yet to other individual female/male characteristics and the demography of the studied population.