Surgery is a very effective way to gain the trust of the community, due to immediate results. Trust opens doors to other programmes (e.g. family medicine). Surgery can be incorporated with all other aspects of health care, which can in turn be incorporated with all other aspects of human development, education, food production and nutrition, housing, work and productivity, communication, and recreation.

No abstract

Mobile surgery provided by Cinterandes effectively overcomes many barriers patients encounter when seeking surgical care in rural Ecuador: decreased patient wait times, limited number of referrals to multiple locations, and decreased cost. Partnering with local clinics within the communities and bringing care much closer to patients' homes may provide a better patient friendly health care delivery system for rural Ecuador.

No abstract

Preeclampsia (PE) is associated with placental insufficiencies and is characterized by an increase in placental apoptosis. Several mechanisms had been suggested but not much information is available on the role of the inhibitor of apoptosis family (IAP) of proteins. The X‐linked inhibitor of apoptosis protein (XIAP) is one of the most potent members of the IAP family of proteins. Its activation is controlled by the X‐linked of apoptosis associated factor 1 (XAF1). Our objective was to determine the level of XAF1 and its correlation with active XIAP protein in PE placenta compared to controls. Control and PE placental samples were collected shortly after delivery. Tissues were frozen in liquid Nitrogen for western blot studies. We observed: 1) No significant differences in XIAP protein expression; 2) a significant decrease in active (phospho) XIAP protein (30%; p<0.05) in the placentas of PE women; and 4) a significant increase (38%; p<0.008) for XAF1 during preeclampsia. We conclude that the decrease in XAIP activation during PE could potentially account for the increased apoptosis observed in this tissue at term. Also, that a mechanism for this decreased XIAP activation involves increasing placental XAF1 during preeclampsia. This result gives insights into pathways associated with the increased placental apoptosis and could be useful in the understanding of potential mechanisms that lead to placental insufficiency associated with this disease.