Mechanical thrombectomy (MT) is the standard of care for acute ischemic stroke due to large vessel occlusion. In Ecuador, no previous national data on MT outcomes have been reported, and, to our knowledge, there are no published series performed at high altitude. This was a retrospective, observational, descriptive study based on consecutive patients treated within a multicenter mechanical thrombectomy program in Quito, Ecuador, located at an altitude of ≈2,800 meters above sea level. Thirty-two patients treated between October 2023 and November 2024 were included. Baseline characteristics, procedural details, and 90-day functional outcomes were analyzed. The median age was 64 years [IQR 54–72], and the mean baseline NIHSS score was 18, decreasing to 7 at discharge. The median ASPECTS was 7. Intravenous thrombolysis was administered in 59.4
Overweight and obesity are major global health challenges. Minimally invasive and reversible therapies such as the Allurion® gastric balloon (AGB) have emerged as alternatives for selected patients. To evaluate the efficacy and safety of the AGB in a real-world Ecuadorian cohort. A retrospective cohort study including consecutive patients aged ≥ 13 years with BMI ≥ 25 kg/m² who underwent AGB placement between September 2021 and September 2024. The primary endpoint was total weight loss percentage (TWL
Abstract Tourette Syndrome and other tic disorders (TD) are common, highly heritable neurodevelopmental conditions with complex genetic architectures. We conducted a genome-wide association study of 13,247 TD cases and 536,217 European ancestry controls and identified six independent genome-wide significant loci, including a pleiotropic signal at 3p21 shared with attention-deficit/hyperactivity disorder, among other traits. Gene prioritization highlighted 20 genes, including PCDH9, HCN1, NCKIPSD, WDR6, DALRD3 , and CELSR3 . Integrative analyses provide genetic support for the role of cortico-striato-thalamo-cortical circuits in TD pathophysiology and further localize TD genetic risk to specific cell types, including dopamine D1- and D2-receptor-positive medium spiny neurons, cortical pyramidal neurons, and oligodendrocyte-lineage cells. We further demonstrate extensive genetic correlations with neurodevelopmental and psychiatric traits, but not with neurological disorders. These findings advance our understanding of the genetic basis of TD, pinpointing specific genes and cell types that drive pathophysiology and providing a foundation for future mechanistic studies.
To report the early visual outcomes of eyes with a variety of retinal conditions that were treated with intravitreal faricimab during routine clinical practice in Latin America. Retrospective multicenter case series of 757 eyes of 732 patients who underwent at least one intravitreal injection of faricimab and had a least 4 weeks of follow-up. Our cohort consisted of 392 eyes with neovascular age-related macular degeneration (NV-AMD) (naive = 105; prior tx = 287); 225 with DME (naive = 74; prior tx = 151); 50 with central retinal vein occlusion (CRVO) (naive = 29; prior tx = 21); 20 with previously treated branch retinal vein occlusion (BRVO) and 69 (naive = 25; prior tx = 44) with other conditions. After a mean follow-up of 26.6 weeks and 4 injections, eyes with treatment naive NV-AMD eyes gained 9.1 letters (p < 0.0001) with a last mean treatment interval of 9.5 weeks. Previously-treated NV-AMD eyes gained 6.6 to 9.5 letters (p = 0.00146 and p < 0.0001) after a mean follow-up of 29 to 42 weeks and 3.8 to 4.3 injections with a last mean treatment interval of 9.2 to 12.1 weeks. In treatment naive diabetic macular edema (DME) eyes, after a mean follow-up of 24.8 weeks and 4.2 injections, there was a gain of 12 letters (p < 0.0001) with a last mean treatment interval of 9.2 weeks. In previously-treated DME eyes after a mean follow-up of 27.2 to 44.2 weeks and 3.8 to 3.9 to injections, there was a gain of 6.1 to 11.7 letters (p < 0.0001) with a last mean treatment interval of 9.6 to 15.2 weeks. Treatment-naive CRVO eyes gained 22.6 letters (p = 0.00369) after a mean follow-up of 26.2 weeks and 3.7 injections. Previously treated CRVO eyes gained 9.8 letters (0.5233) after a mean follow-up of 21.8 weeks and 3.4 injections. Previously-treated BRVO eyes gained 5.4 letters (p = 0.00862) after a mean follow-up of 28.1 weeks and 3.5 injections and a last treatment interval of 11.1 weeks. A total of 38 eyes discontinued treatment with faricimab and switched back to aflibercept. There were 3 cases of anterior uveitis that were treated with topical steroids. None of the eyes developed infectious endophthalmitis or occlusive retinal vasculitis. The early Latin American experience with faricimab is promising. On average treated eyes had functional and anatomic gains from baseline.
Breast cancer (BC) is a biologically heterogeneous disease in which tumor progression and therapeutic response vary substantially across patients and molecular subtypes. Alongside genetic, endocrine, and immunological determinants, microbial ecosystems have been proposed as components of the host environment that interact with tumor biology. Microorganisms detected in breast tissue, the gastrointestinal tract, and the oral cavity coexist with epithelial and immune compartments and participate in metabolic and inflammatory processes relevant to mammary physiology. Differences in microbial composition have been reported between non-malignant and malignant breast tissue, while intestinal microbial metabolism generates bioactive compounds capable of interacting with immune regulation and systemic endocrine signaling. Microbial enzymatic activity involved in estrogen deconjugation further connects intestinal ecology with hormone-responsive disease. Microbiome-related variation has also been examined in relation to systemic therapies, where differences in microbial composition have been observed alongside variability in therapeutic outcomes. This review examines current knowledge on host-microbiome interactions across breast, gut, and oral environments and discusses how microbial ecology intersects with inflammatory signaling, metabolic regulation, and endocrine pathways relevant to breast cancer progression and treatment response. Methodological challenges and future research directions for microbiome-informed oncology are also considered.
