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Filamentous fungal infections are an important cause of systemic infections in immunocompromised patients. Fusarium genus members potentially cause disseminated infections, especially in patients with catheters, due to the ability to adhere to these devices. We describe a case of fatal fungemia due to Fusarium oxysporum in a patient with COVID-19 in Ecuador. The genus identification was carried out with conventional techniques and species identification by molecular and phylogenetic techniques through sequencing of the ITS region.

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INTRODUCTION: The safety of electroconvulsive therapy has improved greatly over the last decades, making the potentially adverse effects on memory and other neurocognitive functions the main clinical aspect of concern in the present. In Colombia, the general population and healthcare professionals (even some psychiatrists) seem to have mostly negative opinions towards electroconvulsive therapy treatment, but maybe this could be reconsidered if more information is provided; therefore, the aim of the present study was to evaluate the changes in memory and the severity of the symptoms in a group of patients with severe depression before and after electroconvulsive therapy. METHODS: Twenty-three patients ranging in age from 23 to 70 years from the electroconvulsive therapy service at the San Juan de Dios Clinic (Manizales, Colombia) were recruited in order to assess the effect of electroconvulsive therapy on memory in patients with severe depression. Depressive symptoms and memory were assessed with the Hamilton Depression Scale (HAMD) and Rey Auditory Verbal Learning Test (RAVLT), respectively. The assessment was administered to participants before the initial treatment of electroconvulsive therapy series (0-1 day) and 2 days after their last treatment. RESULTS: Electroconvulsive therapy resulted in significant improvement in the rating of depression. There were no significant differences in the five learning trials, delayed recall, learning and forgetting scores from pre-treatment to post-treatment. Significant pre-treatment/post-treatment differences were found in the delayed recognition trial. CONCLUSIONS: Pre- and post- electroconvulsive therapy cognitive assessment is a feasible and useful procedure. In general, memory performance does not worsen after electroconvulsive therapy in patients with depression. Only delayed recognition is affected a few days following electroconvulsive therapy, particularly in patients with low educational level and bitemporal (BT) electrode placement.

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Introducción: La seguridad de la terapia electroconvulsiva ha mejorado mucho en las últimas décadas, lo que hace que los efectos potencialmente adversos en la memoria y otras funciones neurocognitivas sean el principal aspecto clínico de preocupación en el presente. En Colombia, la población general y los profesionales de la salud (incluso algunos psiquiatras) parecen tener opiniones mayoritariamente negativas sobre el tratamiento electroconvulsivo, pero quizá esto podría reconsiderarse si se brinda más información; por lo tanto, el objetivo del presente estudio es evaluar los cambios en la memoria y la gravedad de los síntomas en un grupo de pacientes con depresión grave antes y después de la terapia electroconvulsiva. Métodos: Se incluyó a 23 pacientes con edades comprendidas entre los 23 y los 70 anos del Servicio de Terapia Electroconvulsiva de la Clínica San Juan de Dios (Manizales, Colombia) para evaluar el efecto de esta terapia en la memoria de pacientes con depresión grave. Los síntomas depresivos y la memoria se evaluaron con la escala de depresión de Hamilton (HAMD) y la prueba de aprendizaje auditivo verbal de Rey (RAVLT) respectivamente. Se evaluó a los participantes antes de la sesión inicial de la serie de terapia electroconvulsiva (0-1 día) y 2 días después de su último tratamiento. Resultados: La terapia electroconvulsiva resultó en una mejora significativa en la puntuación de depresión. No hubo diferencias significativas en las puntuaciones de las 5 pruebas de aprendizaje, recuerdo retardado, aprendizaje y olvido desde antes del tratamiento hasta después de este. Se encontraron diferencias significativas antes y después del tratamiento en la prueba de reconocimiento retardado. Conclusiones: Los problemas de memoria pueden evaluarse y caracterizarse de manera práctica tras la terapia electroconvulsiva. La evaluación cognitiva antes y después de la terapia electroconvulsiva es un procedimiento viable y útil. En general, el rendimiento de la memoria no empeora después de la terapia electroconvulsiva en pacientes con depresión. Solo el reconocimiento retardado se ve afectado unos días después, particularmente en pacientes con bajo nivel educativo y colocación de electrodos bitemporales (BT).

Introduction: The safety of electroconvulsive therapy has improved greatly over the last decades, making the potentially adverse effects on memory and other neurocognitive functions the main clinical aspect of concern in the present. In Colombia, the general population and healthcare professionals (even some psychiatrists) seem to have mostly negative opinions towards electroconvulsive therapy treatment, but maybe this could be reconsidered if more information is provided; therefore, the aim of the present study was to evaluate the changes in memory and the severity of the symptoms in a group of patients with severe depression before and after electroconvulsive therapy. Methods: Twenty-three patients ranging in age from 23 to 70 years from the electroconvulsive therapy service at the San Juan de Dios Clinic (Manizales, Colombia) were recruited in order to assess the effect of electroconvulsive therapy on memory in patients with severe depression. Depressive symptoms and memory were assessed with the Hamilton Depression Scale (HAMD) and Rey Auditory Verbal Learning Test (RAVLT), respectively. The assessment was administered to participants before the initial treatment of electroconvulsive therapy series (0-1 day) and 2 days after their last treatment. Results: Electroconvulsive therapy resulted in significant improvement in the rating of depression. There were no significant differences in the five learning trials, delayed recall, learning and forgetting scores from pre-treatment to post-treatment. Significant pre-treatment/post-treatment differences were found in the delayed recognition trial. Conclusions: Pre- and post- electroconvulsive therapy cognitive assessment is a feasible and useful procedure. In general, memory performance does not worsen after electroconvulsive therapy in patients with depression. Only delayed recognition is affected a few days following electroconvulsive therapy, particularly in patients with low educational level and bitemporal (BT) electrode placement.

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The Vesicular Stomatitis Virus (VSV) is an arbovirus causing vesicular stomatitis (VS) in livestock. There are two serotypes recognized: New Jersey (VSNJV) and Indiana (VSIV). The virus can be transmitted directly by contact or by vectors. In 2018, Ecuador experienced an outbreak of Vesicular Stomatitis (VS) in cattle, caused by VSNJV and VSVIV, with 399 cases reported distributed over 18 provinces. We determined the phylogenetic relationships among 67 strains. For the construction of phylogenetic trees, the viral phosphoprotein gene was sequenced, and trees were constructed based on the Maximum Likelihood method using 2004 outbreak strains from Ecuador (GenBank) and the 2018 sequences (this article). We built a haplotype network for VSNJV to trace the origin of the 2004 and 2018 epizootics through topology and mutation connections. These analyses suggest two different origins, one related to the 2004 outbreak and the other from a transmission source in 2018. Our analysis also suggests different transmission patterns; several small and independent outbreaks, most probably transmitted by vectors in the Amazon, and another outbreak caused by the movement of livestock in the Andean and Coastal regions. We recommend further research into vectors and vertebrate reservoirs in Ecuador to clarify the mechanisms of the reemergence of the virus.

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Arthropod-borne viruses (arboviruses) are a diverse group of ribonucleic acid (RNA) viruses, with the exception of African swine fever virus, that are transmitted by hematophagous arthropods to a vertebrate host. They are the important cause of many diseases due to their ability to spread in different environments and their diversity of vectors. Currently, there is no information on the geographical distribution of the diseases because the routes of transmission and the mammals (wild or domestic) that act as potential hosts are poorly documented or unknown. We conducted a systematic review from 1967 to 2021 to identify the diversity of arboviruses, the areas, and taxonomic groups that have been monitored, the prevalence of positive records, and the associated risk factors. We identified forty-three arboviruses in nine mammalian orders distributed in eleven countries. In Brazil, the order primates harbor the highest number of arbovirus records. The three most recorded arboviruses were Venezuelan equine encephalitis, Saint Louis encephalitis and West Nile virus. Serum is the most used sample to obtain arbovirus records. Deforestation is identified as the main risk factor for arbovirus transmission between different species and environments (an odds ratio of 1.46 with a 95% confidence interval: 1.34-1.59). The results show an increase in the sampling effort over the years in the neotropical region. Despite the importance of arboviruses for public health, little is known about the interaction of arboviruses, their hosts, and vectors, as some countries and mammalian orders have not yet been monitored. Long-term and constant monitoring allows focusing research on the analysis of the interrelationships and characteristics of each component animal, human, and their environment to understand the dynamics of the diseases and guide epidemiological surveillance and vector control programs. The biodiversity of the Neotropics should be considered to support epidemiological monitoring strategies.

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The plasma membrane and autoinhibited Ca2+-ATPases contribute to the Ca2+ homeostasis in a wide variety of organisms. The enzymatic activity of these pumps is stimulated by calmodulin, which interacts with the target protein through the calmodulin-binding domain (CaMBD). Most information about this region is related to all calmodulin modulated proteins, which indicates general chemical properties and there is no established relation between Ca2+ pump sequences and taxonomic classification. Thus, the aim of this study was to perform an in silico analysis of the CaMBD from several Ca2+-ATPases, in order to determine their diversity and to detect specific patterns and amino acid selection in different species. Patterns related to potential and confirmed CaMBD were detected using sequences retrieved from the literature. The occurrence of these patterns was determined across 120 sequences from 17 taxonomical classes, which were analyzed by a phylogenetic tree to establish phylogenetic groups. Predicted physicochemical characteristics including hydropathy and net charge were calculated for each group of sequences. 22 Ca2+-ATPases sequences from animals, unicellular eukaryotes, and plants were retrieved from bioinformatic databases. These sequences allow us to establish the Patterns 1(GQILWVRGLTRLQTQ), 3(KNPSLEALQRW), and 4(SRWRRLQAEHVKK), which are present at the beginning of putative CaMBD of metazoan, parasites, and land plants. A pattern 2 (IRVVNAFR) was consistently found at the end of most analyzed sequences. The amino acid preference in the CaMBDs changed depending on the phylogenetic groups, with predominance of several aliphatic and charged residues, to confer amphiphilic properties. The results here displayed show a conserved mechanism to contribute to the Ca2+ homeostasis across evolution and may help to detect putative CaMBDs.

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Non-tuberculous mycobacteria that cannot be identified at the species level represent a challenge for clinical laboratories, as proper species assignment is key to implementing successful treatments or epidemiological studies. We re-identified forty-eight isolates of Ziehl-Neelsen (ZN)-staining-positive "acid-fast bacilli" (AFB), which were isolated in a clinical laboratory and previously identified as Mycobacterium species but were unidentifiable at the species level with the hsp65 PCR restriction fragment length polymorphism analysis (PRA). As most isolates also could not be identified confidently via 16S, hsp65, or rpoB DNA sequencing and a nBLAST search analysis, we employed a phylogenetic method for their identification using the sequences of the 16S rDNA, which resulted in the identification of most AFB and a Mycobacterium species diversity not found before in our laboratory. Most were rare species with only a few clinical reports. Moreover, although selected with the ZN staining as AFB, not all isolates belonged to the genus Mycobacterium, and we report for the first time in Latin America the isolation of Nocardia puris, Tsukamurella pulmosis, and Gordonia sputi from sputum samples of symptomatic patients. We conclude that ZN staining does not differentiate between the genus Mycobacterium and other genera of AFB. Moreover, there is a need for a simple and more accurate tree-based identification method for mycobacterial species. For this purpose, and in development in our lab, is a web-based identification system using a phylogenetic analysis (including all AFB genera) based on 16S rDNA sequences (and in the future multigene datasets) and the closest relatives.

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The COVID-19 pandemic has led to a global disruption of several services, including routine immunizations. This effect has been described in several countries, but there are few detailed studies in Latin America and no reports in Ecuador. Therefore, this work aims to quantify the reduction in routine immunizations for infants during the 2020 COVID-19 pandemic in Ecuador. 2018, 2019, and 2020 data were obtained from the Ministry of Health, Ecuador. The number of doses and the extent of immunization coverage was descriptively compared for four vaccines: rotavirus (ROTA), poliovirus (PV), pneumococcal (PCV), and pentavalent (PENTA) vaccines. There was no significant difference in doses applied during the 2018 and 2019 years. However, a significant (p < 0.05) drop of 137,000 delivered doses was observed in 2020 compared to the pre-pandemic years. Reductions in the percentage of coverage were more pronounced for the PENTA vaccine (17.7%), followed by PV (16.4%), ROTA (12%), and PCV vaccines (10.7%). Spatial analysis shows a severe impact on vaccination coverage on provinces from the Coast and Highland regions of the country. The pandemic has significantly impacted the immunization programs for infants across Ecuador. This retrospective analysis shows an urgent need to protect vulnerable zones and populations during public health emergencies.

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Aedes (Stegomyia) albopictus is a mosquito native to Southeast Asia. Currently, it has a wide distribution in America, where natural infection with arboviruses of medical and veterinary importance has been reported. In spite of their importance in the transmission of endemic arbovirus, the basic information of parameters affecting their vectorial capacity is poorly investigated. The aim of the work was to update the distribution range of Ae. albopictus in the Americas, review the blood-feeding patterns, and compare the minimum infection rate (MIR) of the Dengue virus (DENV) between studies of vertical and horizontal transmission. The current distribution of Ae. albopictus encompasses 21 countries in the Americas. An extensive review has been conducted for the blood-feeding patterns of Ae. albopictus. The results suggest that the mosquito is capable of feeding on 16 species of mammals and five species of avian. Humans, dogs, and rats are the most common hosts. Eight arboviruses with the potential to infect humans and animals have been isolated in Ae. albopictus. In the United States of America (USA), Eastern equine encephalitis virus, Keystone virus, La Crosse Virus, West Nile virus, and Cache Valley virus were isolated in the Asian mosquito. In Brazil, Mexico, Colombia, and Costa Rica, DENV (all serotypes) has been frequently identified in field-caught Ae. albopictus. Overall, the estimated MIR in Ae. albopictus infected with DENV is similar between horizontal (10.95) and vertical transmission (8.28). However, in vertical transmission, there is a difference in the MIR values if the DENV is identified from larvae or adults (males and females emerged from a collection of eggs or larvae). MIR estimated from larvae is 14.04 and MIR estimated in adults is 4.04. In conclusion, it has to be highlighted that Ae. albopictus is an invasive mosquito with wide phenotypic plasticity to adapt to broad and new areas, it is highly efficient to transmit the DENV horizontally and vertically, it can participate in the inter-endemic transmission of the dengue disease, and it can spread zoonotic arboviruses across forest and urban settings.

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Background: Malaria is a disease caused by hemoparasites of the Plasmodium genus. Non-human primates (NHP) are hosts of Plasmodium sp. around the world. Several studies have demonstrated that Plasmodium sp. emerged from Africa. However, little information is currently available about Plasmodium falciparum in the neotropical NHP and even less in Ecuador. Indeed, the objective of our study was to identify by molecular phylogenetic analyses the Plasmodium species associated with NHP from the Western Amazon region of Ecuador, and to design a molecular taxonomy protocol to use in the NHP disease ecology. Methods: We extracted DNA from faecal samples (n = 26) from nine species of captive (n = 19) and free-ranging (n = 7) NHP, collected from 2011 to 2019 in the Western Amazon region of Ecuador. Results: Using a pan-Plasmodium PCR, we obtained one positive sample from an adult female Leontocebus lagonotus. A maximum likelihood phylogenetic analysis showed that this sequence unequivocally clustered with Plasmodium falciparum. Conclusions: The identification of Plasmodium sp. in NHP of the Ecuadorian Amazon would be essential to identify their role as potential zoonotic reservoirs, and it is also important to identify their origin in wildlife and their transmission in captive NHP.

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Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread throughout Latin America, a region swept by multiple previous and ongoing epidemics. There are significant concerns that the arrival of COVID-19 is currently overlapping with other viruses, particularly dengue, in various endo-epidemic regions across South America. In this report, we analyzed trends for both viral infections in Colombia during the first 20 epidemiological weeks (EWs) of 2020. From 1st January to 16th May 2020 (EWs, 1-20), a total of 52 679 cases of dengue and 14 943 cases of COVID-19 have been confirmed in Colombia. As both conditions may potentially lead to fatal outcomes, especially in patients with chronic co-morbidities, overlapping infections, and co-occurrence may increase the number of patients requiring intensive care and mechanical ventilation. In regions, such as Valle del Cauca, intensified preparation for such scenarios should be pondered, and further studies should be performed to address this critical issue in a timely matter.

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As the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic continues to expand, healthcare resources globally have been spread thin. Now, the disease is rapidly spreading across South America, with deadly consequences in areas with already weakened public health systems. The Amazon region is particularly susceptible to the widespread devastation from Coronavirus disease 2019 (COVID-19) because of its immunologically fragile native Amerindian inhabitants and epidemiologic vulnerabilities. Herein, we discuss the current situation and potential impact of COVID-19 in the Amazon region and how further spread of the epidemic wave could prove devastating for many Amerindian people living in the Amazon rainforest.

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Introducción: La hipertensión arterial es el principal factor de riesgo de enfermedad cardiovascular, cerebrovascular y renal. Causa mortalidad y discapacidad en individuos en edades productivas. Sin embargo, un gran porcentaje de los pacientes hipertensos desconocen que padecen la enfermedad. Objetivo: Estimar la frecuencia de hipertensión arterial en personas adultas del barrio México, Pastaza, Ecuador. Métodos: Se realizó un estudio descriptivo transversal en 413 adultos del Barrio México de la provincia de Pastaza de abril a junio del 2018 mediante un cuestionario en el que se determinaron factores de riesgo de hipertensión arterial. Además, se midió peso, talla y tensión arterial. Se emplearon los criterios de JNC7 para la definición de hipertensión arterial. Resultados: La frecuencia de hipertensión arterial fue del 8,96 por ciento, con predominio en el sexo femenino. El promedio de edad de hipertensos fue de 64,5 ± 13,2 años, mientras que en pacientes no hipertensos fue de 38,4 ± 14,7 años. Conclusiones: La frecuencia de hipertensión arterial en la población de estudio fue del 8,96 por ciento, con predominio en el sexo femenino. Entre las características clínicas y demográficas de la población se identificó que la edad, el nivel educacional, la evaluación del estado nutricional (sobrepeso, obesidad) y la presencia de comorbilidad influyen en la aparición de hipertensión arterial, como lo mencionan otros estudios(AU)

Introduction: Arterial Hypertension is the main risk factor for cardiovascular, cerebrovascular and renal disease. It produces mortality and disability in individuals of productive ages, however, a large percentage of hypertensive patients are unaware that they are carriers of the disease. Objective: To estimate the frequency of arterial hypertension in adults from the Mexico neighborhood, April to June 2018. Methods: A cross-sectional descriptive study was carried out in 413 adults of the Barrio Mexico of the province of Pastaza. The technique for collecting the information was a survey, where risk factors for arterial hypertension were determined and weight, height and blood pressure were measured; the criteria for the definition of Arterial Hypertension were those established in JNC7. Results: 413 adults from Barrio Mexico were included. The prevalence of Arterial Hypertension was 8, 96 percent with predominance in the female sex. The average age of hypertensive patients was 64.5 ± 13.2 years while in non-hypertensive patients it was 38.4 ± 14.7 years. Conclusions: The frequency of arterial hypertension in the study population was 8.96 percent , with predominance in females. Within the clinical and demographic characteristics of the population, it was identified that age, educational level, evaluation of nutritional status (overweight, obesity) and the presence of comorbidity influence the appearance of Arterial Hypertension, as mentioned in other studies(AU)

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This research represents the first attempt to assess the spatial and temporal distribution based on micro-meso scales on two species with different host preference habits (anthropophilic vs zoophilic), in the major Leishmaniasis endemic area in Ecuador, tourist locations, and Biosphere reserve. Phlebotomine species, Lutzomyia trapidoi (Fairchild) and Lutzomyia reburra (Fairchild and Hertig), were analyzed by trap/habitat/month/locality/altitude, through the Poisson generalized regression model. Our data reveal a bimodal pattern for both species related with low precipitations and preference for forest habitat. Altitude, proximity to the forest, and the river were the variables that determine the hypervolume of the spatial distribution of relative abundance, where the overlap of these two species increases the risk of translocation and circulation of the etiological agent of leishmaniasis in sylvatic environments to rural-tourist-biosphere reserve areas and vice versa. The ecological characteristics of these two phlebotomines could explain the permanence of the major active and endemic focus of cutaneous leishmaniasis in the North-Western Ecuador a key aspect in tourism health-security in alternative tourism.

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Introducción: las enfermedades reumáticas son consideradas como una de las principales causas de discapacidad y de disminución de la percepción de calidad de vida relacionada con la salud. El daño articular y sistémico que producen conduce a un deterioro progresivo y crónico del cuerpo humano, de ahí que se hace necesario contar con herramientas diagnosticas que faciliten la sospecha clínica y el diagnóstico definitivo de la enfermedad. Objetivo: describir las bondades de la determinación de los anticuerpos circulantes en el diagnóstico de las enfermedades reumáticas. Métodos: se realizó una búsqueda en distintos sitios web para identificar artículos relacionados con la temática de estudio y que puedan publicados en los últimos cinco años. Resultados: se encontraron un total de 129 artículos, los cuales fueron revisados para conocer cuál es el papel que desempeñan los marcadores inmunológicos el diagnóstico de las enfermedades reumáticas. Las revistas que mayor número de artículos aportaron fueron la Revista Cubana de Reumatología (28,76 por ciento), la Revista Colombiana de Reumatología y la revista Reumatología Clínica (22,37 por ciento)). La búsqueda se realizó en sitios como Scopus, Latindex, Redalyc, ICE Web of Ciencie y Lilacs. Conclusiones: los marcadores inmunológicos representan una ayuda considerable para los profesionales de la salud en su afán de realizar el diagnóstico oportuno y precoz de las enfermedades reumáticas. Conjuntamente con las manifestaciones clínicas y los demás hallazgos de laboratorio, constituyen los pilares del diagnóstico de estas afecciones(AU)

Introduction : rheumatic diseases are considered one of the main causes of disability and decrease in the perception of quality of life related to health. The joint and systemic damage they cause leads to a progressive and chronic deterioration of the human body, which is why it is necessary to have diagnostic tools that facilitate clinical suspicion and the definitive diagnosis of the disease. Objective: describe the benefits of the determination of circulating antibodies in the diagnosis of rheumatic diseases. Methodology: a search was carried out in different websites to identify articles related to the topic of study and that could be published in the last five years. Results: a total of 129 articles were found, which were reviewed to determine the role of immunological markers in the diagnosis of rheumatic diseases. The journals that contributed the most articles were the Cuban Journal of Rheumatology (28.76 percent), the Colombian Journal of Rheumatology and the Clinical Rheumatology journal (22.37 percent). The search was carried out in sites such as Scopus, Latindex, Redalyc, ICE Web of Science and Lilacs. Conclusions: the immunological markers represent a considerable help for the health professionals in their desire to make the opportune and early diagnosis of the rheumatic diseases. Together with clinical manifestations and other laboratory findings, they are the cornerstones of the diagnosis of these conditions(AU)

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Introducción: Estudios previos indican que la gravedad de las alteraciones de las funciones cognitivas de los diagnosticados de trastorno bipolar tipo I (TBI) están directamente relacionadas con el deterioro del funcionamiento general y la calidad de vida. Un funcionamiento cognitivo alterado se asocia con peor pronóstico del TBI, pero se conoce poco de la relación entre las funciones cognitivas y las características clínicas del TBI. Objetivo: Establecer posibles asociaciones entre el funcionamiento cognitivo y las características clínicas y sociodemográficas de los pacientes con TBI. Métodos: Se evaluó el funcionamiento cognitivo a través de la aplicación de una batería neuropsicológica a un grupo de pacientes con diagnóstico de TBI que se encontraran en ausencia de episodios afectivos durante al menos 6 meses, atendidos ambulatoriamente en la Clínica San Juan de Dios de Manizales. El análisis estadístico implicó la metodología de clasificación en clusters para dividirlos pacientes con mejor y peor funcionamiento cognitivo, y después se correlacionó con las variables clínicas y sociodemográficas. Resultados: Se encontró asociación estadísticamente significativa entre el número de años de estudio y la edad de inicio del trastorno con alteraciones en el nivel de funcionamiento cognitivo (p = 0,002 y p = 0,017 respectivamente). No se encontraron asociaciones significativas con otras variables. Conclusiones: El inicio temprano de la afección y un menor número de años de estudio serían factores de riesgo asociados con un peor funcionamiento cognitivo de los pacientes con TBI.

Introduction: Previous studies suggest that the severity of alterations in cognitive functions in people with a diagnosis of bipolar I disorder (BP-I) are directly related to the deterioration in overall functioning and life quality. Altered cognitive function is associated with a worse prognosis of BP-I, however little is known about the relationship between cognitive functions and the clinical features of BP-I. Objective: To establish possible associations between cognitive function and the clinical and socio-demographic characteristics of patients with BP-I. Methods: Cognitive function was evaluated by applying a neuropsychological battery to a group of patients with a BP-I diagnosis, who did not have affective episodes for at least 6 months, and who were outpatients treated at the San Juan de Dios Clinic in Manizales. The statistical analysis involved using clustering methodology in order to divide those patients with the best and worst cognitive function and it was later correlated with the clinical and socio-demographic variables. Results: A statistically significant corrrelation was found between the number of years of education and the age the disorder started with alterations in the level of cognitive function (P=.002 and P=.017 respectively). No significant correlations were found with other variables. Conclusions: An early onset of the pathology and fewer years of education seems to be risk factors associated with poorer cognitive function in patients with BP-I.

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INTRODUCTION: Previous studies suggest that the severity of alterations in cognitive functions in people with a diagnosis of bipolar I disorder (BP-I) are directly related to the deterioration in overall functioning and life quality. Altered cognitive function is associated with a worse prognosis of BP-I, however little is known about the relationship between cognitive functions and the clinical features of BP-I. OBJECTIVE: To establish possible associations between cognitive function and the clinical and socio-demographic characteristics of patients with BP-I. METHODS: Cognitive function was evaluated by applying a neuropsychological battery to a group of patients with a BP-I diagnosis, who did not have affective episodes for at least 6 months, and who were outpatients treated at the San Juan de Dios Clinic in Manizales. The statistical analysis involved using clustering methocology in order to divide those patients with the best and worst cognitive function and it was later correlated with the clinical and socio-demographic variables. RESULTS: A statistically significant corrrelation was found between the number of years of education and the age the disorder started with alterations in the level of cognitive function (P=.002 and P=.017 respectively). No significant correlations were found with other variables. CONCLUSIONS: An early onset of the pathology and fewer years of education seems to be risk factors associated with poorer cognitive function in patients with BP-I.

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