Gabriele Davide Bigoni Ordóñez

Cancer therapies have substantially improved survival among girls and women with cancer, but chemotherapy and radiotherapy can impair ovarian endocrine function and fertility by damaging the finite follicular reserve and its supporting microenvironment. This mini-review compares the initiating lesions and cellular targets of chemotherapy and ionizing radiation and examines how they converge on DNA damage response (DDR), apoptosis, senescence, inflammation, and regulated cell death. Alkylating agents, platinum compounds, and anthracyclines differ in the DNA lesions, mitochondrial stress, and follicular compartments they affect, whereas radiation combines direct and indirect DNA damage with vascular, stromal, and fibrotic injury. We evaluate evidence linking cytosolic DNA sensing by cyclic GMP-AMP synthase–stimulator of interferon genes (cGAS–STING) to sterile inflammation and senescence and distinguish experimentally supported ferroptosis from nonspecific oxidative stress. Evidence for these emerging pathways ranges from direct gonadotoxicity models to ovarian aging, reproductive toxicology, and ovarian cancer models, and is therefore graded according to biological context. We also discuss reversibility, recovery of ovarian function, and antioxidant, anti-ferroptotic, anti-inflammatory, and ovarian niche-protective strategies. Since cancer control remains the first therapeutic priority, ovarian protectants require simultaneous demonstration of reproductive benefit and preserved antitumor efficacy.

Endometrial cancer is one of the gynecologic malignancies most strongly associated with obesity, yet the biological basis of this association extends beyond excess adiposity as a risk factor. Obesity reshapes the endometrial ecosystem through peripheral estrogen excess, progesterone imbalance, insulin resistance, adipokine dysregulation, chronic inflammation, and activation of anabolic signaling pathways. These mechanisms converge on metabolic programs that support proliferation, invasion, immune remodeling, and treatment resistance. Polyamine metabolism is emerging as a potentially relevant but still incompletely validated layer of this biology. Ornithine decarboxylase 1, the rate-limiting enzyme in polyamine biosynthesis, is overexpressed in aggressive endometrial cancers and has been associated with recurrence and poor survival. Recent evidence further suggests that metabolic syndrome-associated oleic acid may stabilize homeobox B9, protect ornithine decarboxylase 1 from degradation, increase polyamine accumulation, and promote tumor progression. This Mini Review critically examines the obesity–estrogen–polyamine axis as an integrative framework linking endocrine dysfunction, inflammatory remodeling, lipid signaling, and proliferative metabolic rewiring in endometrial cancer. It also discusses biomarker opportunities, therapeutic vulnerabilities, and the translational gaps that must be addressed before this axis can inform precision oncology.

Objetivo: caracterizar la presencia del gen blaCTX-M1, subgrupo 15, en cepas bacterianas del orden Enterobacterales aisladas en dos instituciones hospitalarias privadas de Cuenca, Ecuador, entre agosto de 2024 y enero de 2025. El estudio: se analizaron 85 cepas mediante la prueba de doble disco y PCR convencional para la detección molecular del gen de resistencia. Hallazgos: todas las cepas analizadas fueron confirmadas fenotípicamente como productoras de betalactamasas de espectro extendido (BLEE). El gen blaCTX-M1, subgrupo 15, se detectó en 39 de los 85 aislamientos analizados (45,88%). Escherichia coli fue la especie predominante (n=68; 80%), y la orina constituyó el tipo de muestra más frecuente (n=70; 82,35%). Conclusión: los hallazgos aportan información sobre la presencia local de este determinante genético y contribuyen al conocimiento de los mecanismos moleculares de resistencia en Enterobacterales productores de BLEE en Ecuador.

Triple-negative breast cancer represents one of the most aggressive and therapeutically challenging subtypes of breast malignancies, characterized by marked biological heterogeneity, rapid progression, and limited targeted treatment options. Conventional therapies are frequently constrained by drug resistance, systemic toxicity, and high rates of recurrence. In this context, natural products have gained increasing attention as multifunctional agents capable of modulating several hallmarks of triple-negative breast cancer. Bioactive compounds, including polyphenols, terpenoids, alkaloids, and marine-derived molecules, exhibit pleiotropic antitumor effects by interfering with key oncogenic pathways. Importantly, these compounds have demonstrated the ability to counteract major mechanisms of therapeutic resistance, modulate the tumor immune microenvironment, and enhance the efficacy of standard chemotherapy and immunotherapy. Advances in drug delivery strategies, such as nanoparticle-based systems and tumor-targeted formulations, together with patient-specific molecular profiling, further expand the potential of these agents within personalized treatment approaches. This narrative review critically examines the role of natural compounds in targeting the hallmarks of triple-negative breast cancer and their potential synergistic use to improve therapeutic efficacy while reducing treatment-related toxicity. Overall, the integration of natural product-based strategies into precision oncology frameworks may offer more effective, less toxic, and individualized therapeutic options for this aggressive breast cancer subtype.

Grassroots recyclers play a fundamental role in solid waste management in Ecuador; however, they often work under precarious conditions that may compromise their health. This study aimed to identify factors associated with nutritional status, operationalized as the presence or absence of nutritional alterations, among grassroots recyclers through supervised machine learning approaches. Data from 303 recyclers from three Ecuadorian cities (Cuenca, Macas, and La Libertad) were analyzed, incorporating sociodemographic, occupational, and health-related variables. Nutritional alterations were defined based on anthropometric and biochemical indicators, specifically, excess body weight and/or elevated total lipid levels. The results showed that 71% presented nutritional alterations, evidencing an important public health problem in this vulnerable population. Significant associations were observed with sex, age, canton of residence, ability to ride a bicycle, bicycle use for work, and attendance at medical check-ups. Among the evaluated models, CatBoost trained with SMOTE achieved the highest ROC-AUC value and the most balanced performance between classes, although sensitivity for individuals without nutritional alterations remained limited. Feature importance analysis highlighted sociodemographic, occupational, economic, and healthcare access factors, underscoring the multidimensional nature of nutritional risk and supporting the use of machine learning as a support tool for public health planning and targeted interventions.

Breast cancer is the most frequent gynecological malignancy and the main cause of cancer death in the female population worldwide. One of the most significant challenges in its clinical management is the molecular heterogeneity of malignant breast tumors, which is reflected in the current molecular classification of these entities. In each of these tumor molecular subtypes, distinct genetic alterations are involved, and several intracellular signaling pathways contribute to defining their biological identity and clinical response. This literature review summarized the main classic and emerging biomarkers in breast cancer, along with the therapies associated with them. There are several classic biomarkers associated with this disease, such as estrogen and progesterone receptors, the HER2 receptor, and the Ki-67 cell proliferation marker. Given the limitations of these biomarkers, new biomarkers have been identified, including the TP53 tumor suppressor gene, the EGFR, different types of RNAs, plus epigenetic and immunological biomarkers. The integration of classic and emerging biomarkers along with new therapeutic targets in the clinical practice has promoted a thorough understanding of the high molecular complexity of breast cancer and the development of precision medicine strategies which increase the chances of therapeutic success.

Endometriosis is a chronic disease affecting approximately 10% (190 million) of women and girls of reproductive age worldwide. It is associated with a variety of often debilitating symptoms, including severe pelvic pain, pain during intercourse, bowel movements and/or urination, bloating, nausea, fatigue, risk of infertility, as well as depression and anxiety in some cases. This review summarized the pathogenesis of endometriosis and the criteria for clinical diagnosis, proposed a panel of potential biomarkers for predictive molecular diagnosis, as well as choice of treatments for pain and infertility management.

This study aims to gather information on the characteristics and functions of the CD66c moleculethrough a literature review, as well as its prognostic role when expressed in acute lymphoblasticleukemia (ALL). ALL is a disease originating from the malignant proliferation of hematopoietic cells. It is the most common cancer in the pediatric population, with a survival rate exceeding 70% globally in developed countries. In adult patients, the disease most frequently occurs between the ages of 20 and 40, with an unfavorable prognosis in this population. Several studies have demonstrated the presence of the glycoprotein CD66c in ALL, describing it as a potential marker related to genetic alterations such as BCR-ABL1, hyperdiploidy, and TEL-AML1 fusiongene negativity. CD66c is a member of the carcinoembryonic antigen (CEA) family, expressedin the granulocytic lineage, and is involved in functions such as cell adhesion, regulation of gene expression, migration, and signal transduction.

Human papillomaviruses (HPVs) and, specifically, high-risk HPVs (HR-HPVs) are identified as necessary factors in the development of cancer of the lower genital tract, with CaCU standing out as the most prevalent tumor. This review summarizes ten mechanisms activated by HR-HPVs during cervical carcinogenesis, which are broadly associated with at least seven of the fourteen distinctive physiological capacities of cancer in the newly established model by Hanahan in 2022. These mechanisms involve infection by human papillomavirus, cellular tropism, genetic predisposition to uterine cervical cancer (CaCU), viral load, viral physical state, regulation of epigenetic mechanisms, loss of function of the E2 protein, deregulated expression of E6/E7 oncogenes, regulation of host cell protein function, and acquisition of the mesenchymal phenotype.

Introduction: antibiotic resistance in pathogenic bacteria such as Escherichia coli and Klebsiella spp. producing beta-lactamases has emerged as a global public health problem. Their presence has been associated with both hospital-acquired and community-acquired infections, leading to increased morbidity and mortality in patients. Objective: to determine the frequency of betalactamase-producing E. coli and Klebsiella spp. in cultures processed in a clinical laboratory. Methods: a descriptive documentary design study was conducted. The sample consisted of a total of 1465 positive culture results for Escherichia coli or Klebsiella spp. in the year 2022. Data collection involved accessing the laboratory's anonymized database in an Excel sheet for subsequent analysis. The data were tabulated in SPSS version 25. Results: the analysis of ESBL-producing bacteria showed a positivity of 22.3% in E. coli and 46.1% in Klebsiella spp. E. coli showed a higher frequency of negatives (77.7%) compared to Klebsiella spp. The presence of E. coli was more common in urine samples (90.6%) and in other samples such as sputum and skin wounds (21.3%). Eight antibiotics were evaluated, with high sensitivity noted for amikacin (AK) (99.6% and 98.0%) and high resistance for ampicillin (AM) (91.5% and 100%) in both species. Ciprofloxacin (CIP) and Trimethoprim/Sulfamethoxazole (STX) showed a relatively higher frequency of resistance. Conclusion: the results show a high frequency of ESBL-producing bacteria in E. coli and Klebsiella spp., with a higher prevalence in Klebsiella spp. Furthermore, the resistance to AM, CIP, and STX highlights the importance of proper management of antimicrobial resistance. Introducción: la resistencia antibiótica en bacterias patógenas como Escherichia coli y Klebsiella spp. productoras de betalactamasas, han surgido como un problema global de salud pública. Su presencia, se asocia con infecciones intrahospitalarias y comunitarias, aumentando la morbilidad y la mortalidad de los pacientes. Objetivo: determinar la frecuencia de E.coli y Klebsiella spp productoras de betalactamasas en cultivos procesados en un laboratorio clínico.Métodos: se realizó un estudio descriptivo de diseño documental. La muestra estuvo constituida por un total de 1465 resultados de cultivos positivos para Escherichia coli o Klebsiella spp. en el periodo 2022. Para la recolección de la información, se tuvo acceso a la base de datos anonimizada del laboratorio en una hoja de Excel para su posterior análisis. Los datos fueron tabulados en SPSS versión 25. Resultados: el análisis de bacterias productoras de BLEE mostró una positividad del 22,3% en E. coli y 46,1% en Klebsiella spp. E. coli presentó mayor frecuencia de negativos (77,7%) en comparación con Klebsiella spp. La presencia de E. coli fue más común en muestras de orina (90,6%) y en otras muestras como esputo y heridas cutáneas (21,3%). Se evaluaron 8 antibióticos, y se destacó la alta sensibilidad para amikacina (AK) (99,6% y 98,0%) y elevada resistencia ampicilina (AM) (91,5% y 100%) en ambas especies. Ciprofloxacino (CIP) y Trimetropin/Sulfametoxazol (STX) mostraron relativa frecuencia mayor de resistencia. Conclusión: los resultados muestran una alta frecuencia de bacterias productoras de BLEE en E. coli y Klebsiella spp., con una mayor prevalencia en Klebsiella spp. Además, la resistencia a AM, CIP y STX destaca la importancia de una gestión adecuada de la resistencia antimicrobiana.