RSS 1.0Facultad de Ciencias de la Salud
Recent Submissions
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LATERALLY POSITIONED FLAP TO TREAT DEEP ISOLATED GINGIVAL RECESSION IN A ROTATED TOOTH. A CASE REPORT(Universidad Cientifica del Sur, 2026-01-01)Background: Complete root coverage (CRC) is the primary goal in the treatment of gingival recession defects. However, anatomical factors such as thin periodontal phenotype, limited keratinized tissue width, mucosal thickness, and tooth position can influence treatment prognosis. The laterally moved flap technique is recommended when keratinized tissue is absent apical to the recession defect, especially in malpositioned teeth. Methods: A 36-year-old woman presented with a Miller Class II (Cairo Recession Type 2) gingival recession defect on the buccal surface of a rotated tooth #24, characterized by absence of keratinized tissue and a thin gingival phenotype. A laterally moved coronally advanced flap combined with a connective tissue graft was performed to increase keratinized tissue and mucosal thickness prior to orthodontic treatment. Results: At 6 months post-surgery, the patient showed stable clinical conditions with 60% root coverage, significant gain of keratinized tissue (3 mm), and increased gingival thickness. Both donor and recipient sites demonstrated satisfactory healing without signs of inflammation. Conclusion: The combined use of a laterally moved coronally advanced flap with connective tissue graft is an effective mucogingival approach for managing deep gingival recession in rotated teeth with thin phenotypes. This technique enhances tissue thickness and keratinized tissue width, improving periodontal stability prior to orthodontic intervention.
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Diagnostic Performance of a Multiantigen Print ImmunoAssay (MAPIA) for Antibody Detection in Human Neurocysticercosis(Oxford University Press, 2026-01-01)Background Neurocysticercosis (NCC) is the most prevalent helminth infection affecting the human central nervous system. Although neuroimaging is required for definitive diagnosis, serology supports case confirmation and clarifies diagnostic doubts. Serology gold standard is antibody detection using the enzyme-linked immunoelectrotransfer blot assay, which uses 7 antigenic lentil-lectin purified parasite glycoproteins (LLGP-EITB). LLGP-EITB is poorly accessible to low-resource settings due to its technical complexity and costs, and it is inaccessible in many settings in which parasitic material to produce antigens is not readily available. We recently developed a 3-Antigen multiantigen print immunoassay (MAPIA) based on recombinant/synthetic antigens (rGP50, rT24H, and sTs14), corresponding to the 3 principal diagnostics antigenic families from LLGP-EITB, that is simpler and does not require parasite-derived materials. Methods MAPIA performance was evaluated using a well-defined set of serum samples from NCC patients confirmed by imaging, including 73 samples from subarachnoid NCC, 72 with >5 parenchymal cysts, 59 with 3-5 parenchymal cysts, 95 with 1-2 parenchymal cysts, and 77 healthy negative controls and compared it with the LLGP-EITB performance. Results Overall, our MAPIA presented a sensitivity of 97.7% and a specificity of 97.4%. Subgroup analyses by NCC type demonstrated a sensitivity of 100% for subarachnoid and parenchymal NCC with >5 cysts and a slight decrease for the groups with 3-5 cysts (96.6%) and 1-2 cysts (94.7%). Observed agreement with the LLGP-EITB assay was 98.33%. Conclusions Our 3-Antigen MAPIA obtained comparable results to LLGP-EITB and emerges as a simpler, reproducible, and easy-Access alternative tool for antibody diagnosis in NCC.
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Taenia solium neurocysticercosis: lts current epidemiological, diagnostic, therapeutic, and control landscapes(Public Library of Science, 2026-02-01)Neurocysticercosis is the most common helminthic parasitic disease affecting the human central nervous system and is pleomorphic in its presentation. It is frequently encountered in daily practice in most parts of the world, and also commonly seen in industrialized countries in immigrant populations. In the past decade, new treatment (combined anti-parasitic drugs, increased attention to reducing treatment-associated inflammation and damage, new surgical strategies), and diagnostic (more specific antigen and antibody detection concepts and tools, more sensitive magnetic resonance imaging sequences) approaches, new animal models, and data on control of transmission have emerged. Still, diagnostic challenges persist and treatment approaches for some types of disease may differ, affecting clinical practice. This review provides clinicians in endemic and non-endemic countries with a comprehensive and practical reference to understand the variabilities in clinical expression of the disease and the optimal diagnostic and treatment approaches.
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On the need for patient-centered approaches to Helicobacter pylori management in geriatric populations(Ediciones Doyma, S.L., 2026-03-01)El artículo examina críticamente la pertinencia de adoptar enfoques centrados en el paciente en el tratamiento de la infección por Helicobacter pylori en adultos mayores, subrayando la necesidad de integrar variables clínicas, comorbilidades y factores de calidad de vida en la toma de decisiones terapéuticas.
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Oncoplastic Approach to Juvenile Giant Fibroadenoma: A Case Series(Galenos Publishing House, 2026-04-01)Juvenile giant fibroadenoma (GFA) is defined as a benign tumor larger than 5 cm, 500 grams, and/or involving at least 80% of the breast. It typically occurs in young patients and causes breast deformity and asymmetry. Surgical treatment involves resection of the tumor (enucleation), rearrangement of the skin envelope, and repositioning of the nipple-areola complex. However, the expected re-expansion of the breast following tumor removal, often managed through periareolar approaches, can be unpredictable and prolonged in certain cases. For this reason, oncoplastic surgery techniques have been developed, which allow for immediate partial reconstruction and are now among the available therapeutic options. This report describes three cases in which an oncoplastic approach was used for the treatment of GFA.
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CLO26-131: Hematologic-IHC Prognostic Score for Therapeutic Prioritization in Breast Cancer: Multicenter Validation in Peru (2010-2020)(Journal of the National Comprehensive Cancer Network : JNCCN, 2026-03-31)Introduction: Early treatment selection in breast cancer is often delayed in Latin America due to limited access to advanced biomarkers. We propose an accessible score based on baseline complete blood count and standard immunohistochemistry (IHC) to stratify risk at first consultation. Objective: To internally develop and validate a hematologic–IHC prognostic score to estimate 5-year overall survival. Methods: Multicenter retrospective cohort across four public hospitals in Lima-Peru (2010–2020). A total of 883 patients with histologic confirmation, baseline blood counts and complete IHC (ER, PR, HER2, Ki-67) were included. The Hematologic–IHC Prognostic Score (SPHIQ) integrates six routinely available clinicopathologic and hematologic parameters, yielding a total score ranging from 0 to 12 points: PIV: <250 (0), 250–399 (1), ≥400 (2); PLR: <150 (0), 150–199 (1), ≥200 (2); Hemoglobin (g/dL): >12 (0), 11–12 (1), ≤11 (2); Stage: I–II (0), III (1), IV (2); Histologic grade: G1 (0), G2 (1), G3 (2); Molecular subtype: Luminal A (0), Luminal B (1), HER2+/HR- or TNBC (2). The cumulative SPHIQ score reflects tumor biological aggressiveness, where higher scores correlate with poorer prognosis. This integrated index enables early pre-consultation risk stratification by combining systemic inflammation, hematologic status, and molecular subtype into a single, reproducible prognostic tool. Risk groups: low 0–4, intermediate 5–8, high 9–12. Statistics: Kaplan–Meier, log-rank, multivariate Cox, bootstrap, AUC and C-index. Results: Risk distribution: low n=290 (32.8%), intermediate n=394 (44.6%), high n=199 (22.5%). 5-year OS: 83%, 61% and 34% (log-rank p<0.001). Independent predictors of lower OS: * PIV≥310 aHR 4.94 (95%CI 1.59–15.38; p=0.006) * PLR≥150 aHR 2.33 (95%CI 1.22–4.44; p<0.05) * Triple-negative and HER2+ HR-negative with worst prognosis Model performance: C-index 0.72, AUC 0.71. Calculation time: <5 minutes in clinic. Conclusion: SPHIQ enables immediate prognostic stratification using standard CBC and IHC, optimizing therapeutic prioritization and resource allocation in Latin American healthcare systems.
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Safety and clinical outcomes of mechanical thrombectomy for acute stroke in pregnant patients: A systematic review(BMJ Publishing Group, 2026-01-01)Mechanical thrombectomy (MT) is an established and guideline-endorsed treatment for acute ischemic stroke (AIS) due to large vessel occlusion. Intravenous thrombolysis (IVT) with alteplase remains the first-line therapy within the approved time window, often used alone or as a bridging strategy before MT. However, both interventions have been systematically understudied in pregnant patients, as this population has been excluded from most pivotal clinical trials. This systematic review critically evaluates the procedural feasibility, safety, and maternal-fetal outcomes of MT in pregnant patients experiencing AIS. A comprehensive literature search using PubMed, Embase, and Web of Science yielded 16 studies encompassing 26 cases. In 20 of these, the occlusions involved the M1 segment of the middle cerebral artery, with 58% receiving combined IVT and MT, and 42% undergoing MT alone. Successful reperfusion (TICI 2b-3) was attained in 84% of cases. The median times were 120 min from onset to hospital arrival, 92 min from arrival to puncture, and 330 min from onset to recanalization. Favorable maternal outcomes (mRS 0-1) were observed in 91% of cases at follow-up, and no direct MT-related fetal mortalities occurred. Radiological protection practices, though inconsistently reported, commonly included abdominal shielding and optimized fluoroscopic protocols. Despite limited high-level evidence, MT in pregnancy appears technically feasible and clinically beneficial, warranting prompt multidisciplinary coordination and robust imaging protocols. Future prospective research is essential to better define safety parameters and optimize guidelines for this vulnerable subgroup of patients.
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Tuberculosis presenting with necrotic retroperitoneal lymphadenopathy in an immunocompetent patient: A case report and literature review(Elsevier Ltd, 2026-01-01)Background: Extrapulmonary tuberculosis (EPTB) accounts for 15–20 % of TB, but necrotic retroperitoneal lymphadenopathy is exceptionally rare, particularly in immunocompetent hosts. Case presentation: A 32-year-old immunocompetent man from Peru presented with two weeks of severe abdominal pain and intermittent fever. CT revealed conglomerate necrotic retroperitoneal lymph nodes encasing the pancreatic head and major vessels. Image-guided biopsy showed necrotizing granulomas; acid-fast bacilli smear and GeneXpert MTB/RIF confirmed Mycobacterium tuberculosis. Chest CT demonstrated additional necrotic mediastinal nodes without parenchymal disease. Standard therapy (2HRZE/4HR) was initiated; due to partial radiologic response at six months, isoniazid–rifampicin was extended to complete ten months, achieving full clinical and imaging resolution. Literature review: A structured search identified seven additional immunocompetent adults with necrotic retroperitoneal lymphadenopathy. Abdominal pain predominated; CT consistently showed multiple necrotic nodes. Final diagnoses were tuberculosis (3/7), high-grade B-cell lymphoma (2/7), Kikuchi–Fujimoto disease (1/7), and metastatic esophageal carcinoma (1/7). All cases required tissue confirmation. Conclusions: Necrotic retroperitoneal lymphadenopathy is an uncommon manifestation of TB that can mimic malignancy. In patients from TB-endemic settings, TB should remain high in the differential when CT demonstrates necrotic retroperitoneal nodes. Early image-guided biopsy with mycobacterial testing is decisive. Drug-susceptible disease generally responds to standard six-month therapy, although extended treatment may be warranted for delayed radiologic response
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Application of artificial intelligence in cervical cytology: a systematic review of deep learning models, datasets, and reported metrics(Frontiers Media SA, 2026-01-01)Introduction: The use of artificial intelligence (AI) in cervical cytology has increased substantially due to the need for automated tools that support the early detection of precancerous lesions. Methods: This systematic review examined deep learning models applied to cervical cytology images, focusing on the architectures used, the datasets employed, and the performance metrics reported. Articles published between 2022 and 2025 were retrieved from Scopus using PRISMA methodology. After applying inclusion criteria and full-text screening, 77 studies were included for RQ1 (models), 75 for RQ2 (datasets), and 71 for RQ3 (metrics). Results: Hybrid models were the most prevalent (56%), followed by convolutional neural networks (CNNs) and a growing number of Vision Transformer (ViT)-based approaches. SIPaKMeD and Herlev were the most frequently used datasets, although the use of private datasets is increasing. Accuracy was the most commonly reported metric (mean 87.76%), followed by precision, recall, and F1-score. Several hybrid and ViT-based models exceeded 92% accuracy. Identified limitations included limited cross-validation, reduced clinical representativeness of datasets, and inconsistent diagnostic criteria. Discussion: This review synthesizes current trends in AI-based cervical cytology, highlights common methodological limitations, and proposes directions for future research to enhance clinical applicability and standardization.
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Improvement in Drug Prescription Skills Among Medical Students in Peru: A Quasi-Experimental Study Using In-Person and Remote Simulated Interviews(Routledge, 2026-01-01)Pharmacology learning plays a key role in medical education as the basis for prescribing and therapeutics, with direct implications for patients’ health. Studies have found deficiencies in medical students’ prescribing skills and a scarcity of pharmacology learning in the clinical context. The development of good prescribing skills requires innovative educational approaches. This quasi-experimental study aimed to determine the effects of simulated clinical interviews on the improvement of drug prescribing skills among medical students in Peru. In 2020, we led a research team from three local medical schools with competency-based curricula and an initial stage of simulation development. Using an expert-validated instrument constructed from the World Health Organization (WHO) Guide to Good Prescribing, we assessed students’ prescribing skills during three simulated interviews: baseline, pre-, and post-intervention. The educational intervention took place between Interviews 2 and 3, consisting of simulated interview (Interview 2), plus debriefing (after Interview 2), and pre-briefing (before Interview 3) simulation strategies focused on prescribing skills. We assessed its effects on students’ performance during Interview 3. Eligible participants were students from each institution who had taken pharmacology in the previous semester (pharmacokinetics, pharmacodynamics, and case studies). We sought their voluntary participation through social media, considering their availability of four hours over two days. Participants received the WHO Guide to Good Prescribing and information about the drugs to be used the following week in the simulated clinical interviews. We had to conduct the three interviews, to which participants were randomly assigned, in two groups—in-person in the first batch and remotely in the second batch—due to mandatory social distancing during the COVID-19 pandemic. Participants’ prescribing skills and knowledge significantly improved over the three interviews only when participants experienced all phases of the intervention: pre-briefing, debriefing, and feedback. Pharmacology learning may benefit from the implementation of remote and in-person simulated clinical interviews aimed at developing good prescribing skills. The logical sequence of the WHO Guide for Good Prescribing may facilitate skill assessment and acquisition.
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Comparison of Preferences between Children and their Parents based on the Characteristics of the Dental Operator and the Clinical Scenario(Association of Support to Oral Health Research (APESB), 2026-01-01)Objective: To compare the preferences of children and their parents regarding the characteristics of the dental operator and the clinical environment for dental care. Material and Methods: This cross-sectional study was conducted from August 2022 to July 2023. A questionnaire was developed in English and then translated into Spanish, before being subjected to a trial and a pilot study. After obtaining informed consent, 152 parents and their children, selected by convenience sampling, participated in the survey. Bivariate statistical analysis was performed using Fisher's exact and chi-square tests. Results: Statistically significant differences (p<0.05) were determined when comparing the preferences of children and parents for the variables gender, age, clothing, mask, floor, door, lighting, curtains, dental chair, play area, waiting area, and consulting room. Based on participants’ gender, it was determined that the highest percentage of boys (71.76%) and girls (86.57%) prefer to be seen by an operator of the same gender (p=0.001). Significant differences were identified among children regarding clothing preferences (p=0.001). Additionally, differences were observed in parents’ preferences for curtains and walls in the clinical scenario (p<0.05). Children showed varying preferences for the play area, waiting area, and office, whereas both parents and children had varying preferences for the reception area. Conclusion: Differences were observed when comparing the preferences of children and their parents concerning the dental operator and the clinical scenario.
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Effects of EMDR vs. waiting list for adults with post-traumatic stress disorder: A systematic review and meta-analysis of randomized controlled trials(Elsevier B.V., 2026-01-01)Posttraumatic Stress Disorder (PTSD) is a prevalent mental health condition that can significantly impair quality of life. Eye Movement Desensitization and Reprocessing (EMDR) has been proposed as a psychotherapeutic intervention for PTSD, yet its effects remain debated. We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines to evaluate EMDR versus waiting list in adults with PTSD. Included RCTs were assessed using the Cochrane Risk of Bias Tool. Random-effects meta-analyses were performed, and evidence certainty was graded using GRADE. Twelve RCTs (n = 690 randomized participants) met the inclusion criteria. EMDR may increase the likelihood of losing PTSD diagnosis at post-treatment (Risk Ratio [RR]: 2.13; 95 % CI: 1.08–4.23) and follow-up (RR: 3.56; 95 % CI: 0.82–15.48), although the evidence is very uncertain. EMDR may also reduce PTSD symptoms at post-treatment (standardized mean difference [SMD]: -1.19; 95 % CI: −1.70 to −0.68) and follow-up (SMD: -0.88; 95 % CI: −1.62 to −0.13), although evidence certainty remains low to very low. Similar trends were observed for depression, anxiety, social disability, and sleep disturbances, but long-term effects remain unclear. No study assessed relevant outcomes such as quality of life, treatment acceptability, or adverse effects. Risk of bias, particularly due to lack of shielding and allocation concealment, further limits confidence in these findings. Although EMDR may reduce PTSD symptoms and increase the likelihood of diagnostic remission compared to a waiting list, the certainty of the evidence is low to very low, and its long-term effects remain unknown.
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Urological management in a pediatric patient with mixed gonadal dysgenesis(Elsevier Inc., 2026-01-01)Disorders of sex development are conditions characterized by alterations in gonadal development that lead to discordance between chromosomal sex, gonadal sex, and phenotypic sex. We report the case of a 4 years old patient with ambiguous genitalia and 45,X/46,XY karyotype. A rudimentary uterus was visualized, and bilateral inguinal exploration was performed, during which the residual right spermatic cord was ligated and orchiectomy of the left testis located in the inguinal canal was carried out. This case highlights the relevance of clinical findings identified during physical examination and emphasizes the importance of multidisciplinary management due to the risk of gonadal malignancy.
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Bioaugmentation with native Bacillus strains enhance nitrate and nitrite removal and reshape microbiomes in low-salinity shrimp cultures: Elucidating genetic mechanisms(Public Library of Science, 2026-01-01)The intensification of shrimp farming contributes to the accumulation of toxic nitrogen compounds, which in turn affect productivity and complicates water quality management, especially under conditions of reduced salinity. This study evaluated the effects of 25% (CO, T2) and 50% (T1) water exchange, in combination with a bioaugmentation treatment using native Bacillus (T2), on nitrogen compound concentrations and bacterial community structure in Litopenaeus vannamei culture under reduced salinity conditions (4ppt). The results demonstrated that treatment with native Bacillus megaterium and Bacillus paralicheniformis (T2) leads to a significant reduction in nitrite and nitrate concentrations, reaching nearly 0mg/L from day 4. In contrast, T1 and CO treatments showed markedly higher concentration, reaching up to 5mg/mL and 160mg/L, respectively. The full-length 16S rRNA gene used for the metataxonomic analysis revealed changes in bacterial composition towards species with nitrifying and probiotic potential, with native Bacillus strains detected exclusively in T2. In addition, a reduction in bacterial diversity was detected, and significant differences were observed between the bacterial communities of T2 and those of T1 and CO (p=0.001, R2=0,328). The shotgun analysis further revealed a higher abundance of enzymes related to nitrification and dissimilatory nitrate reduction to ammonium in T2 treatment. The results highlighted the active involvement of Gram positive – Bacillus and Gram-negative bacteria such as Shewanella and Psychrobacter, and suggesting heterotrophic nitrification and aerobic denitrification. Overall, native B. megaterium and B. paralicheniformis provided an effective bioaugmentation strategy for the managing nitrate and nitrite in low-salinity shrimp farming, providing an eco-friendly alternative that may enhance productivity and reduce the industry´s water footprint.
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The role of the media in the coverage of childhood vaccination in children under two years of age in Peru, ENDES 2021–2024(Public Library of Science, 2026-01-01)In Peru, the national immunization schedule includes Bacillus Calmette–Guérin (BCG), Diphtheria–Tetanus–Pertussis (DTaP), Measles–Mumps–Rubella (MMR), and Poliomyelitis (Pol) vaccines. Despite their proven role in reducing infant morbidity and mortality, coverage remains uneven and is potentially influenced by access to communication media. We analyzed data from 37,791 mother–child pairs with children aged 18–24 months from the nationally representative Demographic and Family Health Survey (ENDES) 2021–2024. Using generalized linear models with a Poisson family and log link, we estimated adjusted prevalence ratios (PRa) for associations between complete vaccination and access to various media types (newspaper, radio, television, internet, computer, landline, mobile phone), accounting for the complex survey design through sampling weights, stratification, and clustering. Complete vaccination was reported for 94.1% of children for BCG, 85.5% for DTaP, 86.3% for Pol, and 52.9% for MMR. Mobile phone or smartphone ownership was consistently associated with higher completion across all vaccines, ranging from a 12% increase for BCG (PRa 1.12; 95% CI 1.03–1.21) to a 43% increase for MMR (PRa 1.43; 95% CI 1.15–1.77). Radio access was positively associated with DTaP (PRa 1.03; 95% CI 1.00–1.05) and Pol (PRa 1.04; 95% CI 1.01–1.06). Speaking a language other than Spanish or Quechua was linked to lower coverage, particularly for MMR (PRa 0.67; 95% CI 0.56–0.82) and DTaP (PRa 0.76; 95% CI 0.68–0.86). These findings suggest that expanding culturally and linguistically tailored communication strategies through both traditional and digital media, especially mobile phones and radio, could improve vaccination uptake, particularly for MMR, DTaP, and Pol.
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Doxycycline and carbonated Hydroxyapatite: A synergistic approach to target cancer cells − An in vitro evaluation of the drug loaded nanoparticles and their incorporation into PLA/PEG fibres(Elsevier B.V., 2026-01-05)Cancer remains as one of the most common causes of mortality worldwide. To develop future treatment strategies, antibiotics are being repurposed to target cancer cells. Among the antibacterials tested, it has been proposed that doxycycline (DOX) hinders the expansion and survival of tumoral cells. To guarantee its successful delivery, new nanoplatforms that can simultaneously potentiate the effect of DOX must be developed. Calcium phosphates fulfil these requirements due to their good biological activity, tuneable crystallinity, and their capacity to hamper the mitochondrial activity of cancer cells. Therefore, the aims of this study were to first determine the chemical changes produced by DOX on the tumoral HeLa cells via SR-FTIRM, followed by the synthesis, characterization and assessment of the antitumoral effect of DOX-loaded carbonated hydroxyapatite nanoparticles (DOX-CHAp NPs). TEM was used to visualize the morphological hallmarks of the cell death triggered by the nanosystems. Finally, the NPs were encapsulated into electrospun PLA/PEG fibres to facilitate the drug release in the tumour microenvironment. The results indicated that the calcium phosphate constituent ions prime the cancer cells to the DOX effect, leading to a mitochondrial dysfunction that, together with the antibiotic effect, alters the lipids, DNA, and proteins profiles. Altogether, the cell death threshold was reduced, and a higher cytotoxicity was reached with lower DOX concentrations. The NPs encapsulation into PLA/PEG fibres did not affect the bioactivity of the antibiotic but prevented the DOX-Ca2+ synergistic effect only observed after the NPs internalization and degradation. These results bring light to the role of the CHAp constituent Ca2+ to prime cancer cells for DOX cytotoxicity.
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Intraoperative evaluation of sentinel lymph nodes in patients with breast cancer treated with systemic neoadjuvant therapy: a systematic review and meta-analysis of diagnostic studies(BMJ Publishing Group, 2026-02-01)Background Frozen section (FS) and touch imprint (TI) are common intraoperative evaluation (IOE) techniques for sentinel lymph nodes (SLNs) in breast cancer surgery. Their accuracy in patients receiving neoadjuvant systemic therapy (NST) remains variable. Objective To summarise evidence on the diagnostic accuracy of FS and TI in the NST context. Methods A systematic search of PubMed, Embase, Scopus and Web of Science was conducted through April 2024 for studies evaluating FS and/or TI in SLNs of breast cancer patients treated with NST. Meta-analysis was performed using the logit function, and Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies-2 and Grading of Recommendation, Assessment, Development and Evaluation were employed to assess risk of bias and evidence certainty. Results 20 studies were included. At the lymph node level, TI demonstrated pooled sensitivity and specificity of 0.54 and 1.00, respectively, while FS achieved 0.85 and 0.99. At the patient level, TI showed sensitivity and specificity of 0.72 and 1.00, while FS reached 0.82 and 0.98. Combined, FS and TI presented pooled sensitivity and specificity of 0.59 and 1.00 at the patient level. Risk of bias was frequently unclear, and the certainty of evidence for both techniques ranged from low to very low. Conclusion FS exhibits higher sensitivity and specificity than TI at both lymph node and patient levels, but evidence certainty remains limited. Further prospective, blinded studies are needed to validate these findings and optimise IOE methods for NST-treated patients.
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Chronic Disease Association Between Mobility and Dexterity Disabilities in the Prison Population of Peru(Brieflands, 2026-04-01)Background: In the Peruvian penitentiary context, exposure to adverse conditions may contribute to the development of chronic diseases, whose association with physical disability, particularly in mobility and dexterity, has been scarcely explored. Objectives: The objective of this study is to estimate the association between chronic diseases and mobility and dexterity disabilities in the penitentiary population of Peru. Methods: A cross-sectional analytical study based on data from the 2016 National Census of the Penitentiary Population, which included 76,180 inmates in 66 penitentiary centers. Individuals over 18 years old who answered key questions about chronic diseases and disabilities were included. The final sample consisted of 75,963 inmates. A 405-item questionnaire was administered, from which only the information related to chronic diseases and disabilities was considered for analysis. Descriptive statistics, bivariate analyses, and Poisson regression models were applied to estimate adjusted associations, accounting for potential confounding variables and adhering to established ethical research principles. Results: The majority of participants were male (94%), and the predominant age group was 30 - 34 years (43.3%). About 9.7% reported mobility and dexterity disabilities, with 39.4% having mild disabilities. Regarding chronic diseases, 6.3% had lung diseases, 4.8% had hypertension, and 2.5% had diabetes. A significant association was found between chronic diseases and disability. Multimorbidity increased the risk of disability, with a prevalence ratio (PR) of 2.00 for one disease, 2.89 (2.62 - 3.20) for two diseases, and 3.91 (3.25 - 4.70) for three diseases. Conclusions: The presence of chronic diseases such as diabetes, hypertension, and respiratory disease, as well as their comorbidity, is significantly associated with a higher prevalence of mobility and dexterity disabilities among incarcerated individuals
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Recommendations of the GT-LATINFURG for the identification and initial management of patients with severe infection and sepsis in emergency departments(Sociedad Española de Medicina de Urgencias y Emergencias, 2026-02-01)TEXT: In November 2021, the Surviving Sepsis Campaign (SSC) published an update to its 2016 guidelines and recommendations. Subsequently, during the CIMU 2022 (33rd World Congress on Emergency Medicine, held in March 2022 in Guadalajara, Mexico), the 2021 SSC Guidelines were reviewed and analyzed from the perspective of emergency physicians (EPs). The experts involved in this task also reached consensus and published several key points of greatest interest and concern to EPs regarding the management of patients with severe infection or sepsis in hospital emergency departments (EDs). These points included several improvement proposals developed by GTLATINFURG (Latin American Working Group for Improving Infection Care in Emergency Departments) and formally presented in what became known as the "Guadalajara Declaration." That document outlined complementary or alternative considerations to the 2021 SSC Guidelines. The first proposal was to "develop guidelines aimed at detecting, preventing progression, and managing patients with severe infection and sepsis in EDs." Since then-and owing to numerous original research studies and review articles published by the GT-LATINFURG and INFURG-SEMES groups (Infection Study Group of the Spanish Society of Emergency Medicine)-we can now claim that there is scientific evidence generated in EDs themselves, or at least that existing evidence has been reviewed while considering the specific role of EPs. The main aim of this consensus document, as the initial presentation of the first proposal of the Guadalajara Declaration, is to analyze-based on routine clinical practice, experience, available evidence, and the perspective of ED physicians-several key issues and controversies in order to establish recommendations through expert consensus grounded in current scientific evidence.
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Identification of potential inhibitors of Mycobacterium tuberculosis PknA using integrative molecular modeling approaches(Elsevier Inc., 2026-03-01)Tuberculosis (TB) is one of the leading causes of mortality worldwide. Although it is considered a curable disease, the emergence of strains resistant to conventional treatments has rendered it a significant public health problem. Therefore, it is necessary to identify new therapeutic targets to combat this disease. The serine/threonine protein kinase A (PknA) has gained relevance due to its essential role in cell wall synthesis and the growth of Mycobacterium tuberculosis (Mtb). In the present study, an integrative molecular modeling approach was developed for the screening of libraries containing 1 581 625 compounds to identify potential PknA inhibitors. Pharmacophore-based virtual screening, followed by molecular docking, steered molecular dynamics, and binding free energy calculations have identified compound CHEMBL552033 as a promising hit compound. In addition, in silico ADME profiling, pharmacophore-based toxicity assessment, and kinase selectivity screening were performed to evaluate overall suitability as a promising hit. Molecular dynamics simulations of the PknA–CHEMBL552033 complex demonstrated the stability of the interaction, and the binding free energy values obtained by MM-GBSA (−49.54 ± 7.08 kcal/mol) and LIE-D method (−7.01 ± 1.26 kcal/mol) emphasize the potential of CHEMBL552033 as a potential inhibitor for the development of novel anti-TB therapies.
