This study focused on estimating the prevalence of extended-spectrum β-lactamases (ESBLs), plasmid-mediated AmpC β-lactamases, carbapenemases and MCR-1-producing Escherichia coli in canine faeces from a public park in Quito, Ecuador. Phenotypic and genotypic characterisation of E. coli isolated from 50 canine faecal samples recovered from a city park in Quito was performed. In addition, a multiple choice survey was conducted among 50 dog owners. Of the 50 faecal samples, 20 (40.0%) presented E. coli resistant to ceftriaxone. Moreover, 23 E. coli isolates were recovered for further analysis. All of the isolates showed as multidrug-resistant (MDR) phenotype (resistant to three or more antibiotic families). Resistance to carbapenems, tigecycline and amikacin was not observed. No major clonal relatedness was observed among the resistant isolates. The ESBL genes blaCTX-M-15, blaCTX-M-55 and blaCTX-M-65 were the most common. Two isolates harboured the blaCMY-2 gene and one isolate harboured both mcr-1 and blaCTX-M-65. Statistical analysis showed that older people were more conscious of collecting and disposing of dog faeces than subjects aged <35 years (P < 0.05). The finding of MDR E. coli in dog faeces in a city park in Ecuador illustrates the importance of analysing canine faeces in public settings (e.g. parks, playgrounds) as part of surveillance programmes for MDR E. coli. In addition, this research might be a sentinel sampling method to gain a better understanding of community sources of antibiotic-resistant Enterobacteriaceae at human-animal-environment interfaces.

Background: The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and mean platelet volume-to-platelet ratio (MPR) are combined hematology tests that predict COVID-19 severity, although with different cut-off values. Because sex significantly impacts immune responses and the course of COVID-19, the ratios could be biased by sex.Purpose: This study aims to evaluate sex-dependent differences in the contribution of NLR, PLR, MLR, and MPR to COVID-19 severity and mortality upon hospital admission using a sample of pneumonia patients with SARS-CoV-2 infection.Methods: This single-center observational cross-sectional study included 3,280 confirmed COVID-19 cases (CDC 2019-Novel Coronavirus real-time RT-PCR Diagnostic) from Quito (Ecuador). The receiver operating characteristic (ROC) curve analysis was conducted to identify optimal cut-offs of the above parameters when discriminating severe COVID-19 pneumonia and mortality risks after segregation by sex. Severe COVID-19 pneumonia was defined as having PaO₂ < 60 mmHg and SpO₂ < 94%, whereas non-severe COVID-19 pneumonia was defined as having PaO₂ ≥ 60 mmHg and SpO₂ ≥ 94%.Results: The mortality rate of COVID-19 among men was double that in women. Severe COVID-19 pneumonia and non-surviving patients had a higher level of NLR, MLR, PLR, and MPR. The medians of NLR, MLR, and MPR in men were significantly higher, but PLR was not different between men and women. In men, these ratios had lower cut-offs than in women (NLR: 2.42 vs. 3.31, MLR: 0.24 vs. 0.35, and PLR: 83.9 vs. 151.9). The sensitivity of NLR, MLR, and PLR to predict pneumonia severity was better in men (69–77%), whereas their specificity was enhanced in women compared to men (70–76% vs. 23–48%).Conclusion: These ratios may represent widely available biomarkers in COVID-19 since they were significant predictors for disease severity and mortality although with different performances in men and women.

The present study aimed to assess the validity of a Spanish version of the Geriatric Depression-15 Scale (GDS-15) in Ecuadorian adults. Cross-sectional study to validate GDS-15 in its short version (GDS-15). Internal consistency and factor structure were assessed through Kuder Richardson 20 and Confirmatory Factor Analysis. A total of 211 subjects 65 years of age and older participated in the validation process. Internal consistency was adequate, the Kuder Richardson 20 coefficient for the total scale was 0.73. Three factor structure was found for the scale. This study highlights the importance of having a validated scale for screening depression in the elderly. This study provides an evidence for the use of GDS-15 in Ecuadorian elderly population to screen for depression.

Congress of Pharmacogenetics and Personalized Medicine. Ethnicity, clinical implementation and regulatory environment (MESTIFAR 2016 Quito) Quito, Ecuador, 19–21 May 2016. The Ibero-American Network of Pharmacogenetics and Pharmacogenomics (RIBEF) was created in 2006 with the main aim of promoting personalized medicine and collaborative pharmacogenetics research in Spanish- and Portuguese-speaking countries in America and the Iberian Peninsula. The final goal of this initiative was the inclusion of Latin American populations that may benefit from the implementation of personalized medicine in drug therapy. Several initiatives have been promoted including the MESTIFAR project, which aimed to analyze the ethnicity, genotype and/or metabolic phenotype in Ibero-American populations. To date, 6060 healthy volunteers have been analyzed; among them, 2571 were admixed, 1824 were Caucasians, 1395 were Native Americans, 174 were Jews and 96 were Afro-descendants. Due to the large genetic variability within Latin Am...

Bayesian methods had established a foothold in developing therapies in oncology trials. Methods: We identified clinical trials posted on the ClinicalTrials.gov database focused on Oncology trials with a Bayesian approach in their design. Differences in study characteristics such as design, study phase, randomization, masking, purpose of study, main outcomes, gender, age and funding involvement according to Bayesian approach were assessed using Chi-squared or Fisher's exact tests. Results: We identified 225 studies with Bayesian components in their design addressing oncological diseases. The most common designs were Bayesian Toxicity Monitoring (26.4%), Model-based designs (36%) Model-assisted designs (8%). Statistical methods such as Bayesian logistic regression model (59.4%), Bayesian piecewise exponential survival regression (10.9%) and the Continual reassessment method (9.4%) were the most used. Conclusions: Bayesian trials are more common in the early phases of drug development specifically in phase II trials (43.6%). Cancer institutes or Hospitals funded most of the studies retrieved. This type of design has increased over time and represent an innovative means of increasing trial efficiency.