“Revista de Ciencias Médicas Torreón” is a semiannual scientific journal, published as a non-commercial open-access publication in the areas of Clinical Sciences, Basic Sciences, and Research in Medical Education. Its objective is to promote and disseminate high-quality scientific knowledge from works produced by various health and educational institutions in our country. The articles published by Revista de Ciencias Médicas Torreón have been submitted to similarity detection systems and have undergone double-blind peer review. Ciencias Médicas Torreón is registered in academic information systems such as LATINDEX, under registration number 28144, which increases the visibility, accessibility, and dissemination of the published works. In order to promote international visibility, all published articles include bilingual metadata in Spanish and English, including title, abstract, and keywords.
GLP-1 and GLP-1/GIP Incretin Agonists and Related Therapies in Metabolic Obesity: A Narrative Review of Pivotal Trials, Pathophysiological Foundations, and Practical Management of Complications
The rapid adoption of glucagon-like peptide-1 receptor agonists, GLP-1/glucose-dependent insulinotropic polypeptide coagonists and related incretin-based therapies has reshaped the management of obesity, type 2 diabetes and cardiometabolic complications. Nevertheless, widespread use outside appropriate medical settings has raised concerns about prescribing by untrained personnel, non-regulated magnitud absoluta del efecto, eventos adversos y products, inadequate titration and insufficient gastrointestinal, renal, nutritional and glycemic follow-up. This narrative review summarizes the pivotal trials and major real-world evidence supporting current prescriptions of liraglutide, dulaglutide, semaglutide, tirzepatide and emerging therapies. A standardized clinical framework is used across studies: population, intervention, comparator, primary endpoint, absolute effect size, safety and applicability. The review also expands the mechanistic rationale by which weight loss and potentially weight- independent pharmacologic actions may influence cardiovascular disease, heart failure with preserved ejection fraction, chronic kidney disease, obstructive sleep apnea, osteoarthritis, polycystic ovary syndrome and metabolic dysfunction-associated steatotic liver disease. Practical recommendations are provided for hypoglycemia prevention, dehydration, acute kidney injury, lean mass preservation and gastrointestinal adverse event management, including insulin/sulfonylurea adjustment, hydration, protein prescription and resistance training.
Methamphetamine-Induced cardiomyopathy in young adult man: A case report.
Methamphetamine-associated cardiomyopathy (MACM) causes structural and functional myocardial abnormalities that can progress to advanced heart failure and even necessitate heart transplantation. We present the case of a 23- year-old man with an eight-year history of methamphetamine use and abuse who presented to the emergency department with severe dyspnea on minimal exertion and lower- extremity edema. He denied any personal or family history of cardiovascular disease. Urine toxicology screening was positive for methamphetamines. Physical examination revealed advanced heart failure, classified as New York Heart Association (NYHA) functional class IV. He was hospitalized for three days and treated with diuretics— primarily loop diuretics—showing clinical improvement. Rising methamphetamine use and its initiation at younger ages have contributed to the emergence of MACM in young patients. This underscores the importance of maintaining a high index of clinical suspicion in patients with a history of use, regardless of age. Early cardiological assessment allows for the detection of subclinical ventricular dysfunction and intervention prior to irreversible myocardial damage. We present and discuss the case of a young adult with dyspnea at rest secondary to severe dilated cardiomyopathy associated with chronic methamphetamine use.
High-energy electrical burn of the hand treated with skin grafting: case report.
An electrical burn is a severe tissue injury that occurs when an electric current flows through the body, turning it into a conductor and generating internal heat. This case report describes a 52-year-old male patient admitted to the emergency department with an electrical burn and an Allman type III left clavicle fracture. A multidisciplinary approach and early rehabilitation are essential to optimize functional outcomes, reduce complications, and preserve hand function, which is a key factor in the patient's quality of life.
Severe dengue with fulminant myocarditis and acute coronary syndrome in a young woman:case report.
Dengue is an endemic viral disease that is usually self-limited but may progress to severe organ dysfunction. Cardiovascular involvement is uncommon and can present as myocarditis, arrhythmias, or a clinical picture mimicking acute coronary syndrome. We report a 34-year-old woman with hypertension and class II obesity with confirmed dengue who developed intense abdominal pain, metabolic acidosis, elevated troponin I and CK-MB, and ST-segment elevation in leads V2–V4. Point-of-care echocardiography showed apical hypokinesia and systemic venous congestion, raising the differential diagnosis of fulminant myocarditis versus acute myocardial infarction. Given the high bleeding risk inherent to severe dengue, initial antiplatelet therapy was withheld. Despite early transfer to a tertiary center, the patient deteriorated rapidly, developing cardiogenic shock and cardiac arrest with fatal outcome. This case highlights the diagnostic and therapeutic challenges of dengue-related myocardial injury and underscores the need for early recognition and individualized management.
Abscessed retroperitoneal hematoma as a late complication of adrenalectomy: a case report.
Retroperitoneal hematoma is an uncommon complication following adrenalectomy; however, its progression to abscess represents a potentially life-threatening condition associated with high morbidity and mortality when diagnosis and treatment are delayed. Clinical presentation is often nonspecific, including fever without an identifiable source, abdominal or flank pain, and systemic inflammatory response, which may delay early recognition. Predisposing factors include recent surgical procedures, persistent undrained collections, and immunocompromised states, particularly in oncologic patients. Diagnosis relies on clinical suspicion supported by imaging studies, with computed tomography being the modality of choice to identify retroperitoneal collections and signs of infection. Treatment depends on the patient’s clinical condition and characteristics of the collection, requiring broad-spectrum antibiotic therapy and, in most cases, percutaneous or surgical drainage. We present the case of a 76-year-old male with a history of right nephrectomy for metastatic clear cell renal carcinoma and adrenalectomy, who developed left retroperitoneal collections suggestive of abscess, requiring specialized hospital management.
Acral lentiginous melanoma of the finger. Case report.
Acral lentiginous melanoma (ALM) is a subtype of cutaneous melanoma that primarily affects the palms, soles, and subungual regions. We present the case of a 60-year-old male with a history of smoking (with a non-significant pack-year index), active alcohol use since youth, and type 2 diabetes mellitus (diagnosed 6 years prior and treated with glimepiride, metformin, and insulin glargine); his remaining medical history was unremarkable. He presented with a pigmented nail disorder that had been evolving for approximately 10 months, prompting him to seek a dermatology consultation. Upon specialist evaluation, a suspected diagnosis of a malignant pigmented nail lesion was established, and a biopsy protocol was initiated. In this patient, the relatively early identification of the lesion allowed for diagnosis at a localized stage, with favorable histopathological characteristics and the prospect of conservative management of the digit.
Aesthetic treatment of molar-incisor hypomineralization lesions in a pediatric patient.
Molar-incisor hypomineralization (MIH) is a qualitative enamel defect affecting the first permanent molars and, frequently, the incisors as well. It manifests as opaque white, cream, or yellowish-brown areas associated with sensitivity, post-eruptive fractures, and an increased risk of caries. Its origin is linked to a defect in enamel maturation during the first three years of life, although the exact causes remain under investigation. The etiology of MIH is multifactorial, involving systemic factors—such as febrile illnesses, respiratory infections, prolonged antibiotic use, and perinatal complications—that can interfere with ameloblast function during tooth development. Global prevalence ranges from El aislamiento absoluto se efectuó con dique de goma, clamp individual y sellado periférico con sellador líquido, libre de garantizando un campo operatorio seco y contaminación. Se efectuó profilaxis inicial con piedra pómez y cepillo de goma sin flúor. Tratamiento en dientes anteriores. Se empleó un protocolo combinado de microabrasión e infiltración resinosa (ICON®). 1 5% to 40.2%, depending on the country and diagnostic criteria; in Mexico, the most robust studies place the prevalence between 13.9% and 15.8%, although one specific study suggests a figure as high as 30.9%, and the condition is recognized as a growing public health issue. 1 .- Microabrasión: Aplicación de base ácida (Antivet, HCl 21% estabilizado, pH 3) durante 1–5 minutos, seguida de enjuague. Aplicación de base alcalina (hidróxido de calcio, pH >12) por < Clinically, managing MIH poses a challenge for pediatric dentists due to hypersensitivity, reduced adhesion of restorative materials, and the dental anxiety it provokes in pediatric patients. 2 minutos como neutralizante y sellador superficial. 2 . Infiltración resinosa: Grabado con Icon-Etch (HCl 15%) por 120 segundos × 3 aplicaciones, lavado y secado. This case report describes an 11-year-old male patient who presented for a pediatric dental consultation because orthodontic brackets could not be placed due to the poor condition of his teeth. Clinical and radiographic evaluation confirmed the presence of varying degrees of molar-incisor hypomineralization (MIH), accompanied by sensitivity in the maxillary incisors. Deshidratación con Icon-Dry (etanol 99%) durante 30 segundos × 2. Aplicación de Icon-Infiltrant durante 3 minutos, fotocurado 4 0 segundos, reaplicado por 1 minuto y nuevamente fotocurado 40 segundos. Acabado y pulido final con puntas de goma y pasta fina. The clinical approach followed a comprehensive protocol. Restorative treatment on affected molars involved the fabrication of nanohybrid composite resin "table-top" restorations; this process entailed removing affected enamel with a fine-grit diamond bur, conditioning with 37% orthophosphoric acid for 30 seconds, applying a universal adhesive, and light-curing for 20 seconds. For the incisors, an infiltration protocol using ICON® resin was employed; this included etching with 15% hydrochloric acid for 2 minutes, rinsing, drying with absolute ethanol, and applying the infiltrant resin followed by 40 seconds of light-curing. <span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; line-height: 107%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; mso-bidi-theme-font: minor-bidi; color: black; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">Additionally, Antivet®<span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; line-height: 107%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; mso-bidi-theme-font: minor-bidi; color: black; letter-spacing: 2.35pt; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;"> <span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; line-height: 107%; font-family: 'Times New Roman',serif; mso-fareast-font-family: 'Times New Roman'; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin; mso-bidi-theme-font: minor-bidi; color: black; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">was applied to the maxillary and mandibular incisors to reduce postoperative sensitivity. The results showed marked aesthetic improvement, a significant reduction in sensitivity, and a clear boost in the patient's self-esteem, leaving him in optimal condition to begin orthodontic treatment.
The burn patient as a time-dependent entity: an evidence-based practical guide.
The management of burn patients is time-critical; initial care directly influences the progression of tissue damage, protein coagulation, circulatory disturbances, and necrosis. Key initial interventions include primary assessment using the ABCDE approach, early analgesia, fluid resuscitation, evaluation of injury characteristics and extent, and criteria for timely referral to specialized centers. Thermal burns are the most prevalent (86%), followed by electrical (4%) and chemical (3%) burns, with high global annual morbidity and mortality (11 million affected; 180,000 deaths). It is proposed, practical algorithm is proposed to standardize initial management, optimize decision-making, and improve clinical outcomes for burn patients during the initial care phase.
Workload and the quality of nursing care in critically ill patients: a systematic review
Introduction: The Intensive Care Unit (ICU) is a highly complex environment that requires continuous and specialized care, exposing nursing staff to a high workload. This overload may affect both the physical and mental health of professionals, as well as the quality and safety of care provided to critically ill patients.Objective: To evaluate whether workload overload among nursing staff affects the quality of care for critically ill patients in intensive care units.Methodology: A systematic literature review was conducted following PRISMA guidelines. The search was carried out between March and May 2022 in the PubMed, Google Scholar, SCIELO, LILACS, and ScienceDirect databases. Studies published between 2010 and 2022 in Spanish, English, and Portuguese, related to nursing workload in adult ICUs, were included. After applying inclusion and exclusion criteria, 16 articles were selected for the final analysis. Methodological quality was assessed according to the hierarchy of evidence proposed by Stetler et al.Results: The analyzed studies show a significant association between nursing workload overload and deterioration in the quality of care. A high workload was associated with increased healthcare-associated infections, eficiencia y calidad de las mismas, dado que por cada paciente que sea asignado por una enfermera aumente el riesgo de mortalidad (Isabel et al., 2021; Mol et al., 2017). Por esta razón, el ámbito psicosocial influye de manera positiva como negativa hacia la salud, el bienestar y rendimiento del enfermero(a), en los cuales se presentan como exigencias psicológicas; ajuste entre las tareas y los tiempos laborales, familiares y sociales; control sobre el trabajo; apoyo social e instrumental de compañeros y superiores; calidad de liderazgo; compensaciones del trabajo; y seguridad en el empleo. En cuanto a las demandas mentales son una de las principales fuentes de carga mental, teniendo efectos perjudiciales para la salud de los trabajadores y para el logro de los objetivos de la organización (Ceballos- Vásquez et al., 2015). ventilator-associated pneumonia, pressure injuries, medication errors, and higher mortality. Instruments such as the Nursing Activities Score (NAS) and the Therapeutic Intervention Scoring System (TISS) were the most frequently used to measure workload, demonstrating that higher scores are associated with poorer clinical outcomes and reduced patient safety.Conclusions: The available evidence confirms that excessive nursing workload negatively impacts the quality of care for critically ill patients. Insufficient staffing levels and inadequate personnel distribution in the ICU are key factors contributing to adverse events and increased mortality. Adequate human resource planning and continuous workload monitoring are essential to ensure safe, effective, and high-quality care in the intensive care setting.
Complicated perirenal abscess: Diagnostic and therapeutic approach: case report.
Perirenal abscess is an uncommon but potentially life- threatening infection of the perirenal space, associated with high morbidity and mortality when diagnosis and treatment are delayed. Its clinical presentation is often nonspecific, making early recognition difficult and favoring progression to sepsis and organ failure. Predisposing factors include diabetes mellitus, urinary tract obstruction, nephrolithiasis, and recurrent urinary tract infections. Diagnosis relies on clinical suspicion supported by imaging studies, with computed tomography being the diagnostic modality of choice. Treatment depends on abscess size, patient clinical status, and response to antibiotic therapy, and may require percutaneous or surgical drainage. We present the case of a male patient with a complicated left perirenal abscess requiring hospital management, along with a narrative review of the literature focusing on its pathophysiology, diagnosis, and therapeutic options.
Disfunción inmunometabólica en el VIH: bases epistemológicas
The relationship between metabolic syndrome and proinflammatory cytokines in people living with HIV has not been conclusively established. It is suggested that chronic inflammation, derived from viremia and metabolic alterations, could explain this association. This article proposes an epistemological reflection aimed at strengthening scientific understanding and the application of bioethics in future epidemiological research. Materials and methods: A qualitative study was conducted with a hermeneutic and epistemological approach. A documentary and critical analysis of scientific articles, systematic reviews, and regulatory documents related to HIV, cytokines, and metabolic syndrome was performed. Results: The analysis allowed us to identify patterns and ethical and epistemological implications in the reviewed literature. The ideas of David Hume on experience-based knowledge and Bradford Hill on the criteria of causality in epidemiology are taken up as references for the construction of scientific knowledge. In conclusion, the integration of philosophical and bioethical thought into medical research allows us to reinterpret knowledge from a humanistic perspective, recovering lessons from the past to guide science toward a more reflective, ethical, and socially responsible practice
Nutritional support in critical patients in the Intensive Care Unit.
Nutritional support (NS) refers to the provision of nutrients enterally or parenterally with the purpose of maintaining an adequate nutritional status in critically ill patients in whom normal nutrition is not possible. The patient who is admitted to the Intensive Care Unit (ICU) presents an alteration in a vital organ and various metabolic disorders that lead to requiring more energy and protein, deterioration of the immune system, body composition and gastrointestinal function. Nutritional support is administered to patients by nursing staff. A systematic review was carried out with the methodology of Holly Salmond and Saimbert, the eligibility criteria were applied, which were with the PIO question (Problem, Intervention and Results). With a bibliographic search analysis period it was during the year 2022. The PRISMA methodology was applied. This study identifies that the nutritional support of patients in critical condition is very important for the favorable evolution of their health status, starting early as an added treatment. To date, there is no general caloric contribution for patients in critical condition. serious since very important parameters such as the pathology and the general state of health of the patient have to be evaluated; However, the route of administration is one of the variables since both require specific nursing care in administration.
Identificación de compuestos fenólicos en albahaca (Ocimum basilicum L.) para elaboración de repelente para Aedes aegypti.
This study aimed to identify phenolic compounds in Ocimum basilicum L. (basil) leaves to develop a natural repellent against Aedes aegypti, the vector of dengue, zika, and chikungunya. Essential oil was extracted through hydrodistillation using a Clevenger apparatus and compared with commercial oils. A liquid repellent was then formulated from the extracted oil, and the active compounds were identified using thin-layer chromatography (TLC), confirming eugenol as the main phenolic component. The experimental design included stability analyses at 0, 3, and 6 months, with the retention factor (Rf) used as the reference parameter. Results revealed a gradual decrease in Rf over time, indicating eugenol degradation and reduced product stability. It was concluded that basil essential oil possesses repellent potential; however, formulation adjustments in pH and storage conditions are necessary to maintain its effectiveness. This research provides experimental evidence supporting the development of sustainable, plant-based repellents as natural alternatives to synthetic products.
Nivel de Conocimiento de la NOM-087-ECOL-SSA1-2002 en Universitarios de Nuevo Ingreso y Egreso del Área de la Salud
Biologically Infectious Hazardous Waste (BIHW) generated from healthcare activities represents a risk due to pathogenic microorganisms. The Mexican Official Standard (NOM)-087 establishes procedures for the management of BIHW. Incoming university students are those beginning their careers at higher education institutions, while graduating students are those who complete the necessary professional training program and administrative requirements. OBJECTIVE. To conduct a comparative analysis of the level of knowledge of NOM- 087 among incoming and outgoing university students in the health field. METHODOLOGY. With prior informed consent, a measurement instrument designed in 2015 by Oscar Zúñiga-Lemus was administered to 126 health students during the year 2024. A quantitative, cross-sectional, and descriptive study was conducted and analyzed using SPSS version 21 software. RESULTS. The results showed that 12.7% of incoming students and 25.4% of graduating students had low to average knowledge of RBW management. CONCLUSION. Additional training and specialized courses on RBW management are being implemented as an integral part of health sciences education.
Determinación de la potencia antimicrobiana por el método Turbidimétrico. Antimicrobial potency assessment using the turbidimetric method.
The pharmaceutical industry is an essential sector within life science, facilitating the development of new drugs and technologies aimed at human and animal health. The quality of pharmaceutical products must be guaranteed through systematic evaluation processes that ensure both their efficacy and safety; in this context, the assessment of microbiological methods becomes an essential component within the quality control laboratory. The objective of this research was to determine the antimicrobial potency of an injectable pharmaceutical product with oxytetracycline as the active ingredient using the Turbidimetric method, as well as to design and validate the methodology. The methodology used refers to the general analysis method 0100, microbiological assay of antibiotics from the Mexican Pharmacopoeia. In this study, the antimicrobial potency obtained for the veterinary injectable pharmaceutical product with Oxytetracycline was 109.91%, which is acceptable. This result confirms that the drug inhibits the growth of the test microorganism, Staphylococcus aureus (ATCC 29373). By implementing this validated method, the reliability of the results is guaranteed.
Safety Evaluation of Branched-Chain Amino Acids in Centropomus Viridis Brain Cells: In Vitro Assay.
Branched-chain amino acids (BCAAs), composed of L- leucine, L-isoleucine, and L-valine, are essential amino acids in the nutrition of various animal species, including marine fish. Traditionally considered precursors of protein synthesis, BCAAs also act as key signaling molecules and metabolic modulators. Although its physiological role has been widely studied, information on its toxicity and safety, especially in fish cell systems, remains limited. The species Centropomus viridis, due to its high dietary requirements of amino acids, represents a relevant model to explore the effects of BCAAs on brain cells in an in vitro environment. Immortal cultures of Centropomus viridis brain cells were established from juvenile specimens, following standardized protocols of enzymatic disintegration and seeding in 96-well plates. The cells were kept in L-15 medium supplemented with 10% fetal bovine serum and antibiotics, incubated at 25 °C without CO2. The treatments consisted of exposure to BCAAs solutions (L-leucine, L-isoleucine, and L-valine) at concentrations of 50, 100, 250, 500, 1000, 2500, 5000 and 1 0000 μg/mL, instantly prepared from sterile stocks. Negative controls (cells without BCAAs) and positive controls were included. Cell viability was assessed using the MTT assay, adding 10μL of MTT solution (5 mg/mL) per well and measuring absorbance at 570 nm after 4 hours of incubation. Additionally, trypan blue exclusion was performed by incubating the cells with the dye for 5 minutes and counting viable and non-viable cells under light microscopy. The evaluation criteria included percentage of viability with respect to the negative control and observation of cell morphology. BCAA treatments even at concentrations of 1000, 2500, 5000 and 10000 μg/mL did not produce significant alterations in cell viability, with percentages greater than 95% compared to the negative control. No morphological changes or increase in trypan blue exclusion ABSTRACT were observed. At the maximum concentration evaluated (5000 and 10000 μg/mL), no decrease in viability was detected (up to 95% of live cells), without reaching criteria of significant cytotoxicity or evident morphological damage. The positive control showed a reduction in viability of less than 60%, validating the sensitivity of the experimental system. Therefore, the cellular safety limit for BCAAs in this line is above 5000 and 10000 μg/mL, with no appreciable adverse effects above this threshold. The results obtained coincide with the few previous reports in mammals, where BCAAs present low toxicity even at high concentrations. The absence of relevant cytotoxic effects in brain cells of Centropomus viridis suggests a wide tolerance to these amino acids, in accordance with the physiological needs of marine species with high protein requirements. However, the literature indicates a lack of controlled studies in humans and other species, which makes it difficult to extrapolate these data to broader clinical and dietary contexts. This study demonstrated that branched-chain amino acids are harmless and safe for brain cells of Centropomus viridis under in vitro conditions, even at elevated concentrations of up to 10000 μg/mL. The methodology used, based on MTT assays and exclusion of trypan blue, provides robust criteria for the toxicological evaluation of nutritional supplements in marine fishes. These findings contribute to knowledge about food safety in aquaculture and highlight the need to expand research to other cell systems and species, as well as to generate comprehensive metabolic and toxicological data to establish accurate recommendations on the use of BCAAs in animal and human feed.
Septal Bounce as an Echocardiographic Finding: Report of Two Clinical Cases.
Septal bounce is an abnormal interventricular septal motion pattern seen on echocardiography, characterized by an abrupt protodiastolic oscillation. Classically associated with constrictive pericarditis, it can also be observed in other clinical contexts such as ventricular dyssynchrony, severe pulmonary hypertension, previous cardiac surgeries, and restrictive cardiomyopathies. This article presents two clinical cases where the echocardiographic finding of septal bounce was key in guiding the differential diagnosis and clinical decision-making. A comprehensive literature review is also provided, exploring the pathophysiology, diagnostic value, and clinical utility of this sign.
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Diffuse spinal cord astrocytoma in a pediatric patient with progressive quadriplegia of six years' duration: case report.
An unusual presentation of a diffuse astrocytoma in a pediatric patient is described. Astrocytomas are a group of primary intracranial neoplasms of the central nervous system. These tumors are characterized by a slow growth pattern, heterogeneous clinical manifestations, and multiple factors influencing their prognosis. The case of a 13-year-old female patient is discussed, with a six-year history of progressive quadriplegia and neurological symptoms. An MRI performed upon admission identified an intramedullary mass with both cystic and solid components, along with fusiform vasogenic edema at the cervical level (C2 to C8), which widened the spinal canal to a diameter of 3 centimeters. A surgical approach was undertaken to remove a 5 x 3 cm tumor. Histopathological analysis identified the tumor as a grade II diffuse astrocytoma, according to the 2021 World Health Organization classification.
Atypical vascular lesion in the abdominal wall: Differential diagnosis between benign and malignant, Case report.
Among atypical vascular lesions, we can identify hemangiomas and angiosarcomas. The former are described as benign neoplasms more common in childhood and predominantly present in the abdominal wall. Angiosarcomas, on the other hand, are malignant neoplasms with greater aggressiveness, presenting progressively growing lesions, ulceration, and spontaneous bleeding. They are most commonly located on the scalp and face, with a high rate of recurrence and metastasis. We present the clinical case of a 60-year-old male patient with a 10-year history of ulcerative lesion on his left flank, which had been developing slowly and was bleeding spontaneously. A biopsy was taken, and a surgical procedure was performed with wide resection and local flap rotation. The biopsy result revealed a hemangioma, so the variable presentation of hemangiomas and their simulation for malignant lesions can be discussed.
Relationship between benzodiazepine use and the development of Alzheimer's disease: A meta-analysis.
Alzheimer’s disease (AD) is the most common form of dementia in older adults and represents a major global public health issue. Various studies have suggested a possible association between chronic use of benzodiazepines (BDZ) and the risk of developing AD. This meta-analysis aimed to examine the relationship between BDZ use and the development of AD through a systematic review of human studies conducted over the past 15 years. Six case-control and cohort studies were included, comprising a total of 659,756 patients. Five out of six studies showed a positive association between BDZ use and the risk of AD (OR=1.30; 95% CI: 1.09–1.54; p<0.00001). The findings suggest that prolonged use of BDZ may be a risk factor for developing AD, possibly due to its effects on synaptic plasticity and memory. However, there are methodological limitations and confounding factors such as uncontrolled comorbidities. This study contributes to the growing body of evidence on the long-term effects of BDZ use in older adults and highlights the need for cautious prescription as well as further large-scale longitudinal research.
Use of the clinical debriefing technique in medical simulation for decision making in medical students at a private university in Northern Mexico.
Arsenic (As) is a metalloid widely recognized for its toxicity, particularly when present in drinking water, where it poses a significant public health threat. In regions such as the Comarca Lagunera, Mexico, arsenic contamination has reached alarming levels due to geological, climatic, and anthropogenic factors. This article reviews the chemical properties of arsenic, its environmental mobility, sources of exposure, and toxicity mechanisms. The negative effects of arsenic on human health are highlighted. Additionally, the challenges faced by vulnerable groups, who are at greater risk due to higher exposure and susceptibility, are addressed. Finally, perspectives on mitigation strategies are presented, along with the need for further research on long-term effects and innovative technological solutions.
Relationship Between High Dietary Protein Intake and Kidney Damage: A Systematic Review
A high dietary protein intake has been identified as a risk factor for the progression of established chronic kidney disease. However, over the years, research has focused on determining whether this same high protein intake in individuals without pre-existing renal disease could lead to progressive kidney damage and, consequently, be a triggering factor for kidney disease over time. To address this question, this meta-analysis evaluates a series of 14 selected studies from a total of 97, based on eligibility criteria related to hyperproteinemia and renal damage. Through data analysis, our study concludes that there is no evidence supporting or refuting the role of dietary protein intake on renal function in the absence of chronic kidney disease.
Risk factors associated with preeclampsia in patients at General Hospital Zone No. 16 in Torreón Coahuila, Mexico.
Preeclampsia is defined as sustained blood pressure levels above 140/90 associated with proteinuria in pregnant women with a gestational age greater than 20 weeks, it is a pathology with a worldwide prevalence of 10% of pregnancies. In Mexico, the incidence is 47.3 per 1,000 births.Objective: To determine the risk factors associated with preeclampsia in patients at General Hospital Zone No. 16 in Torreón, Coahuila. Materials and Methods: A cross-sectional, observational, retrospective, and analytical study was conducted. Sociodemographic characteristics, gynecological-obstetric data, and medical history were analyzed. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using SPSS version 25.Results: A total of 139 cases were analyzed. The predominant age group was 20 to 29 years (56.2%). Of the total, 91.4% were overweight or obese, and 36.7% were primigravidas. A history of preeclampsia was present in 18.7% of cases. During the current pregnancy, 87.1% were diagnosed clinically and 12.9% biochemically. Intensive care unit (ICU) admission was required in 5.8% of cases.Discussion: Identified risk factors included obesity, multiple pregnancy, chronic kidney disease, early gestational age, and a history of preeclampsia. Early-onset preeclampsia was associated with a higher rate of ICU admission.
Prevalence of malocclusions in children aged 3 to 5 years who were breastfed, bottle- fed or mixed
Breastfeeding is the best source of nutrients for the newborn. Breastfeeding promotes correct craniofacial development since it promotes the exercise of the muscles of mastication, which favors the correction of mandibular pseudoretrognathism that babies present at birth. Objectives: To know the prevalence of malocclusion in children aged between 3 and 5 years who were fed with exclusive breastfeeding, artificial or mixed feeding. Materials and methods: This research was exploratory and descriptive. A total of 70 children of both sexes were examined. Surveys were applied to the mothers to collect data on the type and duration of breastfeeding received. The clinical examination data collection sheet was filled out to observe if they presented any type of malocclusion. Results: 51.4% of the children received exclusive breastfeeding, while 37.1% (n=36) were fed with mixed breastfeeding (n=26) and 11.4% (8) with a bottle. 51.3% (n=36) presented some malocclusion, the most common being deep bite 10% (n=7) and anterior cross bite 8.6%. (n=6). 17.1% (n=12) presented lower midline deviation. Conclusions: It is concluded that, the more time of exclusive breastfeeding, the lower the presence of malocclusions.
Assessment of BMI and waist-to-height ratio in the infant population at a UMF on the northern border of Mexico
Objective. Determine BMI and waist-to-height ratio (WHtR) in the pediatric population at a UMF on the northern border of Mexico. Methods: An observational, prospective study was conducted on pediatric beneficiaries of UMF No. 60 of the IMSS. Anthropometric measurements were taken, and BMI and WHtR were calculated for the subsequent detection of the percentage of children with overweight and obesity. Results: The mean BMI and WHtR in this population were 17.91±2.42 and 0.48±0.057, respectively. No significant differences were found in age and gender for these indicators (p>0.05). Additionally, the prevalence of overweight was 45.8%, while 26.4% of the children were obese. Conclusion: The values obtained for BMI and WHtR in this pediatric population on the northern border of Mexico align with those reported in the literature and do not vary by gender or age. However, it is alarming to note that the prevalence of overweight and obesity is more than double the national level reported.
Complications, management and prevention of variceal hemorrhage
Bleeding from esophageal varices (EV) is an acute clinical problem with manifestations of haematemesis, with or without melaena or hematochezia, which is accompanied by hemodynamic instability. It is the main complication of portal hypertension due to cirrhosis. It represents 10-30% of all cases of upper gastrointestinal bleeding. Esophageal varices occur in 30% of patients with cirrhosis and are responsible for 80-90% of bleeding. They are the result of portal hypertension, which is described as portal vein pressure exceeding 10 mmHg; when it exceeds 12 mmHg, it is associated with a high risk of bleeding. Its endoscopic severity is correlated with the hepatic venous pressure gradient (HVPG) and consequently with the risk of variceal hemorrhage.
Typical AV reentry paroxysmal supraventricular tachycardia (AVNRT): new diagnostic methods; a case analysis
Paroxysmal supraventricular tachycardia is a type of arrhythmia with clinical manifestations such as sudden-onset and sudden-termination tachycardia upon positional changes. This condition presents with symptoms such as vertigo, syncope, diaphoresis, precordial pain, and an increase in heart rate exceeding 150 BPM, in this case reaching up to 269 BPM. The primary cause of this arrhythmia is a pathway that reenters the AV node, which typically disrupts the electrical flow, producing an abnormal cycle. This condition is diagnosed through a 12-lead electrocardiogram performed during the arrhythmic episode. Non-pharmacological treatment options include Valsalva maneuvers, which naturally attempt to lower the heart rate. If unsuccessful, the use of adenosine is indicated as the first-line pharmacological treatment. In some chronic cases, indefinite pharmacological treatment or interruption of the affected electrical circuit through cardiac ablation may be warranted
Acute Liver Injury Associated with DILI Due to Itraconazole: Case Report
This is the case of a 24-year-old woman with a history of vaginal candidiasis, treated with itraconazole 3 times a day for one month. She presented with abdominal pain, acholia, choluria, profuse gingival bleeding, and jaundice. Drug-induced liver injury (DILI) is defined as a common and severe adverse drug reaction, characterized by liver damage caused by a medication or herbal product, leading to abnormal liver function tests or hepatic dysfunction, after excluding other potential causes. Medications, herbs, and dietary supplements can induce several types of liver damage depending on the severity of the injury. Most of these reactions are either asymptomatic or cause mild symptoms that resolve after discontinuation of the offending drug. DILI is typically detected through elevated liver enzymes, with or without signs of liver disease. It can lead to acute liver failure or chronic liver disease. This case emphasizes the importance of early recognition of potential cases of liver injury associated with prolonged drug.
Giant basal cell carcinoma of the scalp in an elderly adults. Case Report.
Objective: To describe the clinical characteristics of a pigmented basal cell carcinoma in a geriatric patient, which is considered an atypical presentation in the scalp. Clinical case: 83-year-old patient attends to consultation due to the presence of two neoformations in the scalp wich presented an increase in their extension in the past two years, accompanied by hair loss and itching. As a diagnostic and therapeutic protocol, a comprehensive clinical assessment is initially carried out supervised by physical examination directed with polarized cross-light dermatoscopy of both lesions, which in the dermatological analysis meet the criteria of malignancy and high suspicion of basal cell carcinoma, which is why it was decided to perform an incisional biopsy on both of the neoformations. The start of non-surgical therapy is proposed based on monthly cryotherapy sessions and outpatient local chemotherapy. Upon interpretation of the histopathological report of both biopsies, the diagnosis is confirmed and the lineage of the skin neoplasia is defined with the subclassification of pigmented basal cell carcinoma correlating with the diagnostic impression previously described. Currently the patient is in her second cycle of cryotherapy, with an adequate response to the treatment. Conclusion: The giant basal cell carcinoma is considered a less frequent variation on skin neoplasms, becoming a challenge for therapeutics due to its characteristics and dimensions. Currently, multiple pharmacological therapies, cryotherapy, dermabrasions and specialized surgeries are used in its treatment, with the aim of giving the patient a wide variety and therapeutic options depending on the particular case.
Combination of Cannabidiol and Current Medicinal Drugs
This work aimed to review the literature on the combination de Cannabidiol and current medicinal drugs. A search in PubMed and Google Scholar was performed. We use the following keywords combination: CBD plus, analgesic, anticonvulsants, antibiotics, antipsychotics, antidepressants, antineoplastics, antiemetics, and anesthetics. Original articles with in vitro, in vivo assays, and clinical trials were selected. Current literature reports mainly in vitro and in vivo studies where CBD is evaluated in combination with other medicinal drugs for epilepsy, pain, depression, infections, and psychosis with promising results. There are few studies on the combination of CBD plus medicinal drugs, however, they suggest that CBD seems to act synergically with the studied drugs, and more confirmatory studies are needed. CBD is a potent CYP3A4 and CYP2C19 Inhibitor; therefore, potential interactions should be considered.