Enfermedad pulmonar obstructiva crónica y salud respiratoria / Chronic obstructive pulmonary disease and respiratory health

La enfermedad pulmonar obstructiva crónica (EPOC) es una enfermedad que cursa con manifestaciones multisistémicas y agudizaciones, y que conlleva una importante carga de morbilidad, mortalidad y costes sanitarios. Distintas medidas terapéuticas y de prevención juegan un papel importante en mejorar el pronóstico y la salud respiratoria de estos pacientes. Realizar actividad física de forma generalizada, llevar a cabo unos hábitos dietéticos y nutricionales adecuados, abandonar el consumo de tabaco y alcanzar un estado de inmunización óptimo son varias de las acciones de salud recomendadas. Estas también enlentecerán el proceso de envejecimiento. Además, se recomienda realizar políticas de salud pública para reducir la contaminación del aire y el cambio climático. Por último, debemos prestar especial atención a las características del sueño de estos pacientes y llevar a cabo un abordaje terapéutico que incluya una mejor calidad del sueño. (AU)

Chronic obstructive pulmonary disease (COPD) is a disease with multisystemic manifestations and exacerbations that lead to a significant burden of morbidity, mortality, and health care costs. Various therapeutic and preventive measures play an important role in improving the prognosis and respiratory health of the patients. General physical activity, proper dietary and nutritional habits, smoking cessation, and achieving an optimal immunization status are some of the recommended health actions. They also slow down the aging process. In addition, public health policies are recommended to reduce air pollution and climate change. Finally, we should pay special attention to the sleep characteristics of these patients and carry out a therapeutic approach that includes better sleep quality. (AU)

Diabetes Mellitus and Pregnancy: An Insight into the Effects on the Epigenome.

Worldwide, diabetes mellitus represents a growing health problem. If it occurs during pregnancy, it can increase the risk of various abnormalities in early and advanced life stages of exposed individuals due to fetal programming occurring in utero. Studies have determined that maternal conditions interfere with the genotypes and phenotypes of offspring. Researchers are now uncovering the mechanisms by which epigenetic alterations caused by diabetes affect the expression of genes and, therefore, the development of various diseases. Among the numerous possible epigenetic changes in this regard, the most studied to date are DNA methylation and hydroxymethylation, as well as histone acetylation and methylation. This review article addresses critical findings in epigenetic studies involving diabetes mellitus, including variations reported in the expression of specific genes and their transgenerational effects.

Muscle quality an evolving concept.

Muscle quality concept can be analyzed from a morphological and functional perspectives that include relation between these properties. Morphological muscle quality considers muscle composition, architectural and structural properties. Functional muscle quality has been defined as a ratio between muscle strength or power per unit of muscle mass or area. Biological and adaptative changes to ageing must be considered when interpretation of muscle quality assessment is done in a clinical or research context. One of the conditions that requires an adequate homologation in terminology is sarcopenia, to establish definition and cut-off points.

Scheimpflug Corneal Tomography Anterior Chamber Depth in Descemet Stripping Endothelial Keratoplasty Recipients.

PURPOSE: Our study investigates whether preoperative anterior chamber depth (ACD) measured by Scheimpflug tomography could serve as a potential predictor of graft failure in eyes undergoing Descemet stripping endothelial keratoplasty (DSEK). METHODS: A retrospective review was conducted on patients who underwent primary or repeat DSEK between January 2020 and August 2021 at Bascom Palmer Eye Institute. Charts from 378 primary and 192 repeat DSEK patients were reviewed and ultimately 47 primary and 21 repeat DSEK patients met criteria for inclusion. Data collection included demographics, preoperative ACD, best-corrected visual acuity, and length of follow-up. RESULTS: Demographics were similar between groups, and there was no significant difference in the average best-corrected visual acuity between the single and repeat DSEK groups preoperatively. Baseline preoperative ACD was greatest in the single DSEK group (3.51 ± 0.90 mm) when compared to baseline preoperative ACD in the repeat DSEK group (3.01 ± 0.67 mm, P = 0.003). The preoperative mean ACD was smallest in the repeat DSEK group before the second DSEK (2.94 ± 0.48 mm, P = 0.001). Preoperative baseline ACD was the only variable to affect graft survival time significantly (P = 0.012). The incidence of glaucoma diagnosis was similar in both groups (42.5% vs. 42.8%, P = 0.471). The diagnosis of glaucoma and presence of incisional glaucoma surgery did not affect the graft survival time (P = 0.129, P = 0.559) or need for repeat DSEK. CONCLUSIONS: Smaller baseline preoperative Scheimpflug ACD measurement may be a possible predictor of the need for repeat DSEK. Our study found that Scheimpflug ACD decreases with subsequent DSEK failure.

Zeolite Nanoparticles Loaded with 2-Methoxystradiol as a Novel Drug Delivery System for the Prostate Cancer Therapy.

The estrogen metabolite 2-methoxyestradiol (2ME) is a promissory anticancer drug mainly because of its pro-apoptotic properties in cancer cells. However, the therapeutic use of 2ME has been hampered due to its low solubility and bioavailability. Thus, it is necessary to find new ways of administration for 2ME. Zeolites are inorganic aluminosilicates with a porous structure and are considered good adsorbents and sieves in the pharmaceutical field. Here, mordenite-type zeolite nanoparticles were loaded with 2ME to assess its efficiency as a delivery system for prostate cancer treatment. The 2ME-loaded zeolite nanoparticles showed an irregular morphology with a mean hydrodynamic diameter of 250.9 ± 11.4 nm, polydispersity index of 0.36 ± 0.04, and a net negative surface charge of -34 ± 1.73 meV. Spectroscopy with UV-vis and Attenuated Total Reflectance Infrared Fourier-Transform was used to elucidate the interaction between the 2ME molecules and the zeolite framework showing the formation of a 2ME-zeolite conjugate in the nanocomposite. The studies of adsorption and liberation determined that zeolite nanoparticles incorporated 40% of 2ME while the liberation of 2ME reached 90% at pH 7.4 after 7 days. The 2ME-loaded zeolite nanoparticles also decreased the viability and increased the mRNA of the 2ME-target gene F-spondin, encoded by SPON1, in the human prostate cancer cell line LNCaP. Finally, the 2ME-loaded nanoparticles also decreased the viability of primary cultures from mouse prostate cancer. These results show the development of 2ME-loaded zeolite nanoparticles with physicochemical and biological properties compatible with anticancer activity on the human prostate and highlight that zeolite nanoparticles can be a good carrier system for 2ME.

Untangling the Effects of Plant Genotype and Soil Conditions on the Assembly of Bacterial and Fungal Communities in the Rhizosphere of the Wild Andean Blueberry (Vaccinium floribundum Kunth).

Microbial communities in the rhizosphere influence nutrient acquisition and stress tolerance. How abiotic and biotic factors impact the plant microbiome in the wild has not been thoroughly addressed. We studied how plant genotype and soil affect the rhizosphere microbiome of Vaccinium floribundum, an endemic species of the Andean region that has not been domesticated or cultivated. Using high-throughput sequencing of the 16S rRNA and ITS region, we characterized 39 rhizosphere samples of V. floribundum from four plant genetic clusters in two soil regions from the Ecuadorian Highlands. Our results showed that Proteobacteria and Acidobacteria were the most abundant bacterial phyla and that fungal communities were not dominated by any specific taxa. Soil region was the main predictor for bacterial alpha diversity, phosphorous and lead being the most interesting edaphic factors explaining this diversity. The interaction of plant genotype and altitude was the most significant factor associated with fungal diversity. This study highlights how different factors govern the assembly of the rhizosphere microbiome of a wild plant. Bacterial communities depend more on the soil and its mineral content, while plant genetics influence the fungal community makeup. Our work illustrates plant-microbe associations and the drivers of their variation in a unique unexplored ecosystem from the Ecuadorian Andes.

Colloidal Synthesis, Characterization, and Photoconductivity of Quasi-Layered CuCrS2 Nanosheets.

The current need to accelerate the adoption of photovoltaic (PV) systems has increased the need to explore new nanomaterials that can harvest and convert solar energy into electricity. Transition metal dichalcogenides (TMDCs) are good candidates because of their tunable physical and chemical properties. CuCrS2 has shown good electrical and thermoelectrical properties; however, its optical and photoconductivity properties remain unexplored. In this study, we synthesized CuCrS2 nanosheets with average dimensions of 43.6 ± 6.7 nm in length and 25.6 ± 4.1 nm in width using a heat-up synthesis approach and fabricated films by the spray-coating method to probe their photoresponse. This method yielded CuCrS2 nanosheets with an optical bandgap of ~1.21 eV. The fabricated film had an average thickness of ~570 nm, exhibiting a net current conversion efficiency of ~11.3%. These results demonstrate the potential use of CuCrS2 as an absorber layer in solar cells.

Fragility fractures: proposal of the best practice through the fracture coordination units: the experience of Mexico.

Fragility fractures represent a health problem in Mexico and in the world. This paper reviews and puts forward the implementation of Fracture Liaison Services (FLS) as a feasible and cost-effective alternative in health institutions in our country through the identification, treatment, and follow-up of this type of fractures.

Text-message-based behavioral weight loss for endometrial cancer survivors with obesity: A randomized controlled trial.

OBJECTIVE: To evaluate the ability of a personalized text-message-based intervention to increase weight loss among endometrial cancer survivors with obesity. METHODS: In this randomized, controlled trial, endometrial cancer survivors with obesity (BMI ≥30 kg/m2) were randomized to a personalized SMS text-message-based weight loss intervention or enhanced usual care. Primary outcome was weight loss at 6 months; secondary outcomes were weight loss at 12 months and changes in psychosocial measures. We also compared clinical characteristics and weight change between trial participants and non-participants. RESULTS: Between May 18 and December 31, 2017, 80 endometrial cancer survivors with obesity consented to participate in the randomized trial. There were no differences in clinical characteristics between the two arms. Weight changes were similar in the two arms (P = 0.08). At 6 months, no differences in quality of life, physical activity, or body image were noted. Of 358 eligible patients, 80 became trial participants and 278, non-participants. Trial participants were younger (59.3 vs. 63.4 years, P < 0.001), more likely non-white (P = 0.02), on fewer medications (4 vs. 7, P < 0.001), and had a higher median BMI (38.7 vs. 37.6 kg/m2, P = 0.01) than non-participants. Weight change was similar between participants and non-participants (P = 0.85). At 6 months, similar percentages of participants and non-participants (47.7% vs. 44.4%) had gained weight, and similar percentages (9.2% vs. 11.2%) had lost at least 5% of their body weight. CONCLUSIONS: This text-message-based intervention did not increase weight loss among endometrial cancer survivors with obesity, nor did participation in the trial. Other weight management interventions should be promoted to increase weight loss. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT03169023.

The yawning gap between osteoporosis diagnosis and treatment after a fragility fracture in Mexico.

This study shows a diagnostic and therapeutic gap for osteoporosis in patients with fragility fractures of the hip, distal radius, and vertebrae. Patients with fragility fractures treated in Mexico fail to receive an osteoporosis diagnosis, referral, and follow-up treatment. The therapeutic gap is higher than reported in other countries. INTRODUCTION: Osteoporosis is a highly prevalent and disabling disease. While there is typically a gap between osteoporosis diagnosis and treatment after a fragility fracture, this gap has not been measured in Mexico. The study aimed to describe and quantify the gap between osteoporosis diagnosis and treatment after an incident fragility fracture. MATERIALS AND METHODS: A descriptive and 3-year retrospective chart review study was conducted on patients over the age of 50 with a diagnosis of an incident acute low-energy fracture of either the hip, distal radius, or vertebrae. RESULTS: We included 838 patients with a mean age of 76.3 ± 12.2 years. The sample was mostly women (665 participants, 79.4%); 589 (70.3%) had a hip fracture, 173 (20.6%) had a distal radius fracture, and 76 (9.1%) had a vertebral fracture. Only 28 (3.3%) had a previous diagnosis and were taking a pharmacological treatment for osteoporosis; 11 (1.3%) received their diagnosis while hospitalized. Immediately after the fracture, and 1 and 3 years later, 144 (17.1%), 71 (8.4%), and 96 (11.4%) respectively received a pharmacological treatment, 195 (23.2%), 65 (7.7%), and 45 (5.3%) supplementation, and 16 (1.9%), 16 (1.9%), and 21 (2.5%) a non-pharmacologic treatment. No significant differences in treatment prescriptions were found after a second or third fracture. CONCLUSION: The study quantifies the too high frequency of failure to diagnose and treat osteoporosis in patients with fragility fractures. Measures should be established to reduce the yawning gap between osteoporosis diagnosis and treatment after a fragility fracture.

Obese endometrial cancer survivors' perceptions of weight loss strategies and characteristics that may influence participation in behavioral interventions.

We aimed to evaluate obese endometrial cancer (EC) survivors' perceptions of weight loss barriers and previously attempted weight loss methods and to identify characteristics that predicted willingness to enroll in a behavioral intervention trial. We administered a 27-question baseline survey at an academic institution to EC survivors with body mass index ≥ 30 kg/m2. Survivors were asked about their lifestyles, previous weight loss attempts, perceived barriers, and were offered enrollment into an intervention trial. Data was analyzed using Fisher's Exact, Kruskal-Wallis, and univariate and multivariate regressions. 155 of 358 (43%) eligible obese EC survivors were surveyed. Nearly all (n = 148, 96%) had considered losing weight, and 77% (n = 120) had tried two or more strategies. Few had undergone bariatric surgery (n = 5, 3%), psychologic counseling (n = 2, 1%), or met with physical therapists (n = 9, 6%). Lower income was associated with difficulty in accessing interventions. Survivors commented that negative self-perceptions and difficulties with follow-through were barriers to weight loss, and fear of complications and self-perceived lack of qualification were deterrents to bariatric surgery. 80 (52%) of those surveyed enrolled in the trial. In a multivariate model, adjusting for race and stage, survivors without recurrence were 4.3 times more likely to enroll than those with recurrence. Most obese EC survivors have tried multiple strategies to lose weight, but remain interested in weight loss interventions, especially women who have never experienced recurrence. Providers should encourage weight loss interventions early, at the time of initial diagnosis, and promote underutilized strategies such as psychological counseling, physical therapy, and bariatric surgery.

Addressing Unmet Basic Needs to Improve Colposcopy Adherence Among Women With Abnormal Cervical Cancer Screening.

OBJECTIVES: The aims of the study were to identify unmet basic needs (BNs) among women referred to colposcopy, to assess patient acceptability/satisfaction with assistance from a navigator to address unmet BNs, and to estimate adherence to colposcopy. METHODS: Women were recruited between September 2017 and January 2019 from 2 academic colposcopy centers, one serving a rural and one an urban area. Basic needs were assessed by phone before colposcopy appointments and considered unmet if unlikely to resolve in 1 month. Colposcopy adherence prestudy and poststudy implementation was abstracted over 4-6 months from administrative records. After a lead-in phase of 25 patients at each site, a BN navigator was offered to new participants with 1 or more unmet BNs. Primary outcome was adherence to initial appointment. RESULTS: Among 100 women, 59% had 1 or more unmet BNs, with similar prevalence between urban and rural sites. Adherence to initial colposcopy was 83% overall, 72% at the rural clinic, and 94% at the urban clinic (p = .006). These adherence rates were improved from 4 months before study launch (30/59 [51%] rural clinic and 68/137 [50%] urban clinic). Although acceptability of BN navigation was greater than 96% and women felt that it helped them get to their colposcopy visit, having a navigator was not associated with adherence. Women reporting no unmet BNs had the lowest adherence compared with women with 1 or more unmet BNs, regardless of navigator assistance (p = .03). CONCLUSIONS: Disadvantaged women who need colposcopy have unmet BNs and value navigator assistance for initial appointments. However, when appointment scheduling includes telephone reminders and inquiring about BNs, a navigator may not add value.

Adaptation of clinical practice guidelines for osteoporosis in a Mexican context. Experience using methodologies ADAPTE, GRADE-ADOLOPMENT, and RAND/UCLA.

High quality guidelines are required to enhance clinical practice, but its development is time consuming and a complex process. Adaptation might shorten development time and prevent double effort adjusting recommendations for a local context. BACKGROUND AND OBJECTIVE: The aim of this article is to present our experience in a process in which we combined two methodologies for the adaptation of high quality osteoporosis CPGs for a primary health care context, with the inclusion of a formal consensus. METHODS: We began an adaptation process with ADAPTE, and required to migrate to GRADE-ADOLOPMENT methodology, based on GIN-McMaster Guideline Development Checklist. To identify high quality clinical practice guidelines, we performed a systematic review as per the PRISMA-statement methodology (PROSPERO: CRD42019138548, August 19th, 2019); methodological quality was assessed using the Appraisal of Guidelines for Research & Evaluation version II system. We developed a RAND/UCLA consensus to support the inclusion of good practice statements and feasibility of selected recommendations. RESULTS: Thirteen clinical questions were integrated, and fracture risk was selected as the main outcome for intervention recommendations analysis. Six high quality guidelines were selected. We prepared final recommendations from selected guides in an evidence synthesis framework. After the consensus, we integrated 50 recommendations. CONCLUSION: By starting the adaptation process with ADAPTE, we experienced a time consuming process, which we could overcome when migrating to GRADE-Adolopment in combination with a consensus panel.

Outcomes of an intermediate respiratory care unit in the COVID-19 pandemic.

BACKGROUND: 15% of COVID-19 patients develop severe pneumonia. Non-invasive mechanical ventilation and high-flow nasal cannula can reduce the rate of endotracheal intubation in adult respiratory distress syndrome, although failure rate is high. OBJECTIVE: To describe the rate of endotracheal intubation, the effectiveness of treatment, complications and mortality in patients with severe respiratory failure due to COVID-19. METHODS: Prospective cohort study in a first-level hospital in Madrid. Patients with a positive polymerase chain reaction for SARS-CoV-2 and admitted to the Intermediate Respiratory Care Unit with tachypnea, use of accessory musculature or SpO2 <92% despite FiO2> 0.5 were included. Intubation rate, medical complications, and 28-day mortality were recorded. Statistical analysis through association studies, logistic and Cox regression models and survival analysis was performed. RESULTS: Seventy patients were included. 37.1% required endotracheal intubation, 58.6% suffered medical complications and 24.3% died. Prone positioning was independently associated with lower need for endotracheal intubation (OR 0.05; 95% CI 0.005 to 0.54, p = 0.001). The adjusted HR for death at 28 days in the group of patients requiring endotracheal intubation was 5.4 (95% CI 1.51 to 19.5; p = 0.009). CONCLUSIONS: The rate of endotracheal intubation in patients with severe respiratory failure from COVID-19 was 37.1%. Complications and mortality were lower in patients in whom endotracheal intubation could be avoided. Prone positioning could reduce the need for endotracheal intubation.

Catalytic assessment of solid materials for the pyrolytic conversion of low-density polyethylene into fuels.

Pyrolysis techniques provide an interesting way of recycling plastic wastes (PW) by transforming them into liquid fuels with high calorific values. Catalysts are employed in PW pyrolysis in order to favor cracking reactions; in that regard, cheap and abundant natural resources are being investigated as potential catalyst precursors. This article explores the pyrolysis of low-density polyethylene (LDPE) in a semibatch reactor under a reduced pressure of 300 torr and temperatures in the range of 370 °C-430 °C. Three different solid materials, an activated carbon (AC1), a commercial Fluid cracking catalyst (FCC) and an aluminum- pillared clay (Al-PILC), were tested as catalysts for the pyrolysis process. Thermogravimetric analyzes were previously performed to select the most catalytically active materials. AC1 displayed very low catalytic activity while FCC and Al-PILC displayed high activity and conversion to liquid products. Hydrocarbons ranging from C5 to C28 were identified in the liquid products as well as significant changes in their composition when FCC and Al-PILC catalyst were used. Differences in the catalytic activity of the 3 solid materials are ascribed mainly to differences in their acid properties.

Low rates of cascade genetic testing among families with hereditary gynecologic cancer: An opportunity to improve cancer prevention.

OBJECTIVE: Cascade genetic testing (CGT) of hereditary breast and ovarian cancer (HBOC) or Lynch Syndrome (LS) patients' relatives offers opportunities to prevent cancer, but CGT rates are not well described. We aimed to measure reported disclosure of genetic testing results and CGT rates in these families and evaluate patients' views of educational media. METHODS: Patients with HBOC or LS identified from germline genetic testing at an academic institution between 2011 and 2016 were surveyed regarding disclosure, testing among relatives, and perceptions of educational materials. Medical records and pedigrees provided numbers of total and first-degree relatives. RESULTS: Of 103 mutation carriers consented, 64 (63%) completed the survey an average of 38 months after receiving genetic testing results. Participants' mean age was 53 years, and thirty-one (48%) had a cancer diagnosis. The majority (86%) felt extremely or very comfortable sharing health information. Participants disclosed results to 87% of first-degree relatives, but reported that only 40% of first-degree relatives underwent testing. First-degree female relatives had significantly higher CGT rates than first-degree male relatives (59% versus 21%, P < 0.001). Participants with HBOC reported higher CGT rates than those with LS (49% versus 33%, P = 0.02). Participants did not identify any one educational medium as more helpful than the others for disclosing results. CONCLUSION: Disclosure rates are high among HBOC and LS mutation carriers, but reported CGT rates are low. Gender- and mutation-specific barriers prevent patients' family members from undergoing CGT. Future studies should implement materials to address these barriers and improve CGT rates.

Nonpharmacological interventions for osteoporosis treatment: Systematic review of clinical practice guidelines.

OBJECTIVES: The aim of this study was to perform a systematic review of clinical practice guidelines to identify nonpharmacologic recommendations for osteoporosis treatment. METHODS: A systematic review of literature following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-statement methodology for clinical practice guidelines was conducted; PROSPERO CRD42019138548. Assessment of selected clinical practice guidelines with the AGREE (Appraisal of Guidelines for Research & Evaluation)-II methodological quality instrument was performed, and those graded over 60 points were selected for recommendations extraction and evidence analysis. RESULTS: Only 6 clinical practice guidelines fulfilled criteria, 69 nonpharmacological recommendations were extracted: 13 from American Association of Clinical Endocrinologists and American College of Endocrinology guideline, 16 from Malaysian Osteoporosis Society guideline, 15 from the Ministry of Health in Mexico guideline, 14 from Royal Australian College of General Practitioners guideline, 7 from Sociedad Española de Investigación Ósea y del Metabolismo Mineral guideline, and 7 from National Osteoporosis Guideline Group guideline. Percentage by theme showed that the highest number of recommendations were 12 (17.1%) for vitamin D, 11 (15.7%) for a combination of calcium and vitamin D, and 11 (15.7%) for exercise. CONCLUSIONS: These recommendations address integrating interventions to modify lifestyle, mainly calcium and vitamin D intake, and exercise. Other recommendations include maintaining adequate protein intake, identification and treatment of risk factors for falls, and limiting the consumption of coffee, alcohol and tobacco. Considerations on prescription must be taken.

Prevalencia de anticuerpos anti-eritrocitarios en donantes voluntarios de sangre Ecuatorianos / Prevalence of anti-erythrocyte antibodies in Ecuadorian voluntary blood donors / Prevalência de anticorpos anti-eritrocitários em doadores de sangue voluntários equatorianos

El rastreo de anticuerpos anti-eritrocitarios es una de las pruebas pretransfusionales más importantes en medicina transfusional por su aporte en la prevención de reacciones adversas luego de la administración de hemocomponentes. Sin embargo, no todos los bancos de sangre ecuatorianos han incluido esta prueba en sus protocolos de trabajo. Para demostrar su importancia se realizó el presente estudio cuyo propósito fue alertar al sistema nacional de salud sobre la existencia de aloinmunización en la población de donantes de sangre. Se estableció una prevalencia de anticuerpos anti-eritrocitarios del 0,27% y se identificó una mayor frecuencia en el género femenino. Los anticuerpos identificados estuvieron relacionados con los sistemas eritrocitarios Rh (RH), Kell (KEL), Duffy (FY) y Kidd (JK). Una de las limitaciones para la inclusión de esta prueba en los bancos de sangre y servicios de medicina transfusional es el elevado costo de los reactivos y la falta de paneles de células eritrocitarias de composición homocigota y heterocigota para la identificación de anticuerpos anti-eritrocitarios nativos, situación que constituye una oportunidad para que el Ministerio de Salud Pública del Ecuador promueva mejores estrategias para la importación de reactivos, reducción de costos y disponibilidad de paneles de células.

The screening of anti-erythrocyte antibodies is one of the most important pretransfusion tests in transfusion medicine because of its contribution to the prevention of adverse reactions after the administration of blood components, however not all blood banks in Ecuador have included this test in their work protocols. This study has the purpose to alert the national health system about the existence of alloimmunization in the blood donour population. A prevalence of anti-erythrocyte antibodies of 0.27% was established, with a higher frequency being found in the female gender. The identified antibodies are related to the erythrocyte systems Rh (RH), Kell (KEL), Duffy (FY) and Kidd (JK). One of the limitations for the inclusion of this test in blood banks and transfusion medicine services is the excessive cost of serological and gel methodology reagents, and the lack of homozygous and heterozygous erythrocyte cell panels for the identification of native anti-erythrocyte antibodies. That situation constitutes an opportunity for the Ministry of Public Health of Ecuador to promote better strategies for the imports of reagents, cost reduction and availability in the country.

O rastreamento de anticorpos anti-eritrocitários é um dos testes pré-transfusão mais importantes na medicina transfusional pela sua contribuição na prevenção de reações adversas após a administração de componentes sanguíneos. No entanto, nem todos os bancos de sangue do Equador tem incluído esse teste em seus protocolos de trabalho. Para demonstrar a sua importância, foi realizado o presente estudo que teve como objetivo alertar o sistema nacional de saúde sobre a existência de aloimunização na população de doadores de sangue. Foi estabelecida uma prevalência de anticorpos anti-eritrocitários de 0,27%, identificando maior frequência no sexo feminino. Os anticorpos identificados estiveram relacionados com os sistemas eritrocitários Rh (RH), Kell (KEL), Duffy (FY) e Kidd (JK). Uma das limitações para a inclusão destes testes em bancos de sangue e serviços de medicina da transfusão é o alto custo dos reagentes, além da falta de painéis de células eritrocitárias de composição homozigótica e heterozigótica para a identificação de anticorpos anti-eritrocitários nativos, situação que constitui uma oportunidade para que o Ministério da Saúde Pública do Equador promova melhores estratégias para a importação de reagentes, redução de custos e disponibilidade de painéis de células.