International Science Journal "TheSci". Issue 2, Volume 1, No. 02, July-December 2025,, is a biannual electronic publication edited by Quality Consulting Instituto de Educación Capacitación y Certificación de México. Street el Rosario 82, Settlement San Antonio del Carmen, Dolores Hgo., Gto. Mexico, ZIP Code 37803. Phone: +1 418 106 3722. Email: thesciworld@gmail.com Responsible Editors: PhD. Alfredo Gutiérrez García; PhD. Dirk Hans Krakaur Floranes. Exclusive Use Rights Reserved No. 04-2025-100312450800-102, E-ISSN: 3122-3591, P-ISSN: 3122-3753, both granted by the Instituto Nacional del Derecho de Autor (National Institute of Copyright). Person responsible for the latest update of this issue: PhD. Alfredo Gutiérrez García, Street el Rosario 82, Settlement San Antonio del Carmen, Dolores Hgo., Gto. Mexico, ZIP Code 37803. Last modification date: December 28, 2025. Email: thesciworld@gmail.com The opinions expressed by the authors do not necessarily reflect the views of the publication's editors. Reproduction, either total or partial, of the contents and images in this publication is strictly prohibited without prior authorization from the editors. This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY-NC-SA 4.0).
Quality Consulting Instituto de Educación Capacitación y Certificación de México
CRISPR-Based Genome Editing in Contemporary Clinical Medicine: Therapeutic Translation, Global Challenges and the Future of Precision Medicine
CRISPR-based genome editing has transformed the therapeutic possibilities of genomic medicine by enabling programmable modification of disease-associated genes and regulatory pathways. This review analyzed the evolution, current clinical applications, emerging therapeutic strategies, safety limitations, ethical challenges, and future perspectives of CRISPR-based technologies within an international framework that incorporates Latin America. An integrative literature review was conducted using scientific evidence published between 2012 and July 2026, with emphasis on peer-reviewed studies indexed in major biomedical databases and relevant international and regulatory documents. The evidence showed a rapid progression from foundational CRISPR-Cas9 research toward base editing, prime editing, ex vivo cellular modification, and direct in vivo genome editing. Clinical translation was most advanced in hematology, particularly in sickle cell disease and transfusion-dependent β-thalassemia, where genome-edited autologous hematopoietic stem and progenitor cells have demonstrated clinically meaningful therapeutic outcomes. Applications in oncology and hereditary transthyretin amyloidosis further demonstrated the feasibility of engineered immune cells and systemic in vivo genome editing. However, broader clinical implementation remains limited by delivery and tissue targeting, off-target and unintended on-target modifications, immunogenicity, manufacturing complexity, long-term safety, regulatory requirements, and accessibility. The international analysis identified heterogeneous capacity for clinical implementation, emphasizing the need to strengthen genomic infrastructure, population representation, professional training, regulatory preparedness, and research participation in Latin America. CRISPR has therefore progressed from an experimental genome-engineering technology to a clinically relevant therapeutic platform, although its future impact will depend on the ability to combine molecular precision and durable therapeutic benefit with rigorous safety assessment, responsible governance, and equitable access across diverse populations and healthcare systems.
CRISPR-Cas9, genome editing, gene therapy, precision medicine, base editing, prime editing, clinical medicine, genetic diseases, bioethics, genomic safety, Latin America, personalized medicine
Copyright (c) 2026 International Science Journal
Photon-Counting Computed Tomography in the Era of Precision Medicine: Technological Advances, Artificial Intelligence Integration, and Multidisciplinary Clinical Applications
Photon-Counting Computed Tomography (PCCT) has emerged as one of the most significant innovations in diagnostic imaging by introducing photon-counting detector technology capable of overcoming several intrinsic limitations of conventional energy-integrating detector computed tomography. This review analyzes the technological principles underlying PCCT, its integration with artificial intelligence, current clinical applications, implementation challenges, and future perspectives in precision medicine. A structured review of the contemporary scientific literature was conducted using internationally recognized biomedical databases and peer-reviewed publications focusing on detector technology, spectral imaging, quantitative imaging biomarkers, radiation dose optimization, and multidisciplinary clinical applications. The reviewed evidence consistently demonstrated that PCCT provides superior spatial resolution, improved contrast-to-noise ratio, enhanced spectral imaging, quantitative tissue characterization, and substantial reduction of electronic noise and beam-hardening artifacts while maintaining lower radiation exposure than conventional CT systems. The greatest clinical benefits were observed in cardiovascular imaging, oncology, neurology, pediatric radiology, pulmonary imaging, abdominal imaging, and musculoskeletal applications. The integration of artificial intelligence further enhances image reconstruction, automated segmentation, lesion detection, radiomics, workflow optimization, and quantitative image analysis, facilitating increasingly individualized diagnostic assessment. Despite important challenges related to acquisition costs, infrastructure requirements, protocol standardization, and broader clinical implementation, the available evidence supports Photon-Counting Computed Tomography as a transformative technology with the potential to redefine diagnostic imaging and strengthen the development of precision medicine across diverse healthcare systems.
Photon-Counting Computed Tomography, Photon-Counting CT, Computed Tomography, Artificial Intelligence, Spectral Imaging, Diagnostic Imaging, Radiomics, Precision Medicine, Cardiovascular Imaging, Oncology, Neurology, Radiation Dose, Medical Imaging, Quantitative Imaging.
Advancing Healthcare Worker Safety Through Simulation-Based Occupational Health Training: A Comprehensive Review of Educational Competencies, Implementation Strategies, and Future Perspectives
Simulation-based occupational health training has become an increasingly important educational approach for improving the safety competencies of healthcare workers in complex clinical environments. This review aimed to synthesize current scientific evidence regarding the effectiveness of simulation-based educational strategies in developing occupational health competencies, enhancing emergency preparedness, promoting adherence to safety protocols, and strengthening organizational safety culture. A narrative review was conducted following the scientific method through systematic searches of PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar using predefined eligibility criteria. Twenty high-quality publications addressing simulation-based occupational health education were included and analyzed thematically. The reviewed evidence consistently demonstrated that simulation improves technical performance, communication, teamwork, leadership, situational awareness, and clinical decision-making while facilitating the acquisition of competencies necessary for preventing occupational hazards. Biological hazards remained the most frequently addressed topic; however, contemporary educational programs increasingly incorporate psychosocial, ergonomic, chemical, physical, and radiological risk management into multidisciplinary training scenarios. The findings also revealed that simulation contributes to greater compliance with occupational safety protocols, improved emergency preparedness, enhanced professional confidence, and stronger institutional safety culture. Although implementation continues to be influenced by financial resources, faculty development, infrastructure, curriculum integration, and technological availability, successful educational outcomes were consistently associated with effective instructional design, structured debriefing, and institutional commitment rather than technological sophistication alone. Evidence from Latin America further demonstrated that meaningful simulation-based occupational health education can be implemented successfully in resource-constrained settings through context-adapted educational strategies. Overall, simulation-based occupational health training represents an effective competency-based educational methodology capable of strengthening healthcare worker protection and supporting safer, higher-quality healthcare systems worldwide.
simulation-based education, occupational health, healthcare workers, occupational safety, medical education, competency-based education, patient safety, healthcare simulation, emergency preparedness, workplace hazards, infection prevention, interdisciplinary training.
Advances in Biological Augmentation for Muscle and Tendon Repair: Regenerative and Reconstructive Approaches in Elite Sports Medicine
Muscle and tendon injuries remain among the most common causes of functional impairment and time-loss in elite athletes, representing a significant challenge for reconstructive surgery, sports medicine, and rehabilitation. Conventional treatment approaches frequently restore anatomical continuity but may not completely reproduce the biological and biomechanical properties of healthy tissue, increasing the risk of delayed recovery and recurrent injury. In recent years, biological augmentation has emerged as a promising strategy to enhance tissue regeneration through modulation of inflammation, stimulation of angiogenesis, promotion of extracellular matrix remodeling, and improvement of collagen organization. This narrative review critically examined current scientific evidence regarding the biological basis, clinical applications, and therapeutic potential of platelet-rich plasma, bone marrow aspirate concentrate, mesenchymal stromal cells, extracellular vesicles, exosomes, biomaterials, and tissue-engineered constructs for the management of muscle and tendon injuries in elite athletes. Current evidence suggests that platelet-rich plasma remains the most extensively investigated biological intervention, whereas cell-based therapies, biomaterials, and exosome-derived approaches continue to demonstrate considerable regenerative potential despite requiring further clinical validation. The findings also emphasize that successful recovery depends not only on biological augmentation but also on accurate diagnosis, individualized patient selection, technically sound reconstructive procedures, structured rehabilitation, progressive mechanical loading, and multidisciplinary clinical management. Although regenerative medicine continues to evolve rapidly, methodological heterogeneity among available studies highlights the need for standardized treatment protocols and large multicenter clinical investigations. Overall, biological augmentation represents a valuable adjunct to contemporary reconstructive strategies, offering new opportunities to improve tissue healing, functional recovery, and safe return to competitive sport in elite athletes.
Biological augmentation, Muscle injury, Tendon injury, Regenerative medicine, Platelet-rich plasma, Mesenchymal stromal cells, Bone marrow aspirate concentrate, Exosomes, Biomaterials, Tissue engineering, Reconstructive surgery, Sports medicine, Rehabilitation, Return to play, Elite athletes.
Advances in Supermicrosurgery and Physiological Lymphatic Reconstruction: Contemporary Strategies for the Comprehensive Management of Lymphedema
Lymphedema is a chronic and progressive disorder resulting from impaired lymphatic transport, leading to fluid accumulation, chronic inflammation, fibrosis, and progressive functional impairment. Recent advances in reconstructive surgery have shifted therapeutic strategies from symptom control toward physiological restoration of lymphatic drainage through supermicrosurgical techniques. This review analyzes the current scientific evidence regarding supermicrosurgery and lymphatic reconstruction, emphasizing lymphaticovenous anastomosis, vascularized lymph node transfer, immediate lymphatic reconstruction, advanced diagnostic imaging, and emerging regenerative medicine approaches. Contemporary literature demonstrates that individualized patient selection, supported by indocyanine green lymphography and other imaging modalities, is fundamental for optimizing surgical outcomes. Physiological reconstruction has been associated with reductions in limb volume, lower incidence of cellulitis, improved functional recovery, decreased dependence on compression therapy, and better quality of life when integrated into multidisciplinary care. Emerging technologies, including tissue engineering, therapeutic lymphangiogenesis, artificial intelligence, and image-guided surgery, are expanding future therapeutic possibilities while promoting increasingly personalized treatment strategies. Although current evidence supports the effectiveness of physiological lymphatic reconstruction, further multicenter prospective studies with standardized methodologies are required to strengthen clinical recommendations and improve the global implementation of these techniques. Overall, supermicrosurgery represents a major milestone in modern reconstructive surgery and continues to redefine the management of primary and secondary lymphedema through innovation, technological development, and international multidisciplinary collaboration.
Lymphedema, Supermicrosurgery, Lymphatic Reconstruction, Lymphaticovenous Anastomosis, Vascularized Lymph Node Transfer, Microsurgery, Regenerative Medicine, Lymphangiogenesis, Indocyanine Green Lymphography, Plastic Surgery, Reconstructive Surgery, Oncology, Precision Surgery, Multidisciplinary Care.
Liquid Biopsy in Precision Oncology: Expanding Clinical Applications for Molecular Characterization, Disease Monitoring, and Personalized Management of Solid Tumors
Liquid biopsy has rapidly emerged as one of the most promising innovations in precision oncology by providing minimally invasive access to tumor-derived biomarkers throughout the clinical course of cancer. This review analyzes the current evidence regarding the clinical applications of liquid biopsy beyond early cancer detection, emphasizing its role in molecular profiling, therapeutic selection, treatment monitoring, minimal residual disease assessment, identification of resistance mechanisms, and evaluation of tumor heterogeneity in patients with solid tumors. A comprehensive literature review was conducted using major biomedical databases, selecting high-quality publications focused on circulating tumor DNA, circulating tumor cells, extracellular vesicles, circulating RNA, and other emerging biomarkers. The available evidence demonstrates that circulating tumor DNA currently represents the most clinically validated biomarker because of its high analytical performance and increasing incorporation into precision oncology protocols. Liquid biopsy has shown particular utility in lung, colorectal, breast, and prostate cancers, where molecular information directly contributes to personalized treatment decisions. Nevertheless, several barriers continue to limit universal implementation, including high costs, limited molecular infrastructure, methodological variability, and unequal access to advanced genomic technologies, particularly in developing countries. Ongoing technological improvements, international collaboration, and methodological standardization are expected to further expand the clinical applications of liquid biopsy and facilitate its incorporation into routine oncology practice. Overall, liquid biopsy represents a transformative strategy that complements conventional tissue biopsy and supports more personalized, dynamic, and evidence-based management of solid tumors.
Liquid biopsy, Precision oncology, Circulating tumor DNA, ctDNA, Circulating tumor cells, CTCs, Minimal residual disease, Molecular profiling, Solid tumors, Precision medicine, Cancer biomarkers, Treatment monitoring, Tumor heterogeneity, Personalized therapy, Next-generation sequencing.
Brain-Computer Interfaces in Modern Neurosurgery: Advances, Clinical Applications, and Future Perspectives
Brain-computer interfaces (BCIs) have emerged as one of the most significant technological innovations in modern neurosurgery, integrating neuroscience, biomedical engineering, artificial intelligence, and clinical neurology to establish direct communication between the brain and external devices. This review provides a comprehensive analysis of the current scientific evidence regarding the neurophysiological foundations, technological evolution, clinical applications, limitations, and future perspectives of BCIs in neurosurgical practice. A qualitative documentary review was conducted following the Scientific Method, using peer-reviewed literature retrieved from internationally recognized databases, including PubMed, Scopus, Web of Science, ScienceDirect, IEEE Xplore, and Google Scholar. The analyzed evidence indicates that current clinical applications are primarily focused on motor restoration, neurorehabilitation, communication recovery, speech neuroprostheses, and adaptive neuromodulation for neurological disorders such as spinal cord injury, stroke, Parkinson's disease, amyotrophic lateral sclerosis, and drug-resistant epilepsy. Recent advances in machine learning, implantable electrodes, wireless technologies, and closed-loop therapeutic systems have substantially improved neural decoding performance and expanded the potential clinical utility of BCIs. However, important challenges remain regarding long-term signal stability, biocompatibility, surgical safety, economic accessibility, regulatory frameworks, and equitable implementation across different healthcare systems. The available evidence suggests that continued multidisciplinary collaboration and technological innovation will facilitate the progressive integration of BCIs into routine neurosurgical care, supporting personalized therapeutic strategies aimed at improving functional recovery, communication, and quality of life in patients with complex neurological disorders.
Brain-computer interface, Brain-machine interface, Neurosurgery, Functional neurosurgery, Neuroengineering, Artificial intelligence, Neuroprosthesis, Neural decoding, Neurorehabilitation, Spinal cord injury, Stroke, Parkinson’s disease, Amyotrophic lateral sclerosis, Deep brain stimulation, Neural signal acquisition.
Biological Skin Rejuvenation in the Regenerative Era: Clinical Applications of Exosomes and Polynucleotides in Modern Dermatology
Regenerative dermatology has emerged as a transformative field that integrates advances in regenerative medicine, molecular biology, and aesthetic dermatology to promote tissue repair through biological rather than purely corrective mechanisms. Among the most promising innovations, exosomes and polynucleotides have attracted considerable scientific attention because of their ability to stimulate fibroblast activity, enhance collagen synthesis, regulate inflammatory responses, promote angiogenesis, and improve extracellular matrix remodeling. The objective of this review was to analyze the current scientific evidence regarding the biological foundations, clinical applications, therapeutic effectiveness, safety profile, and future perspectives of these next-generation regenerative therapies. A narrative literature review was conducted following the scientific method using peer-reviewed publications from major biomedical databases. The available evidence demonstrates encouraging results in facial rejuvenation, photoaging, scar remodeling, chronic wound healing, periocular rejuvenation, and hair restoration, with improvements in skin quality and high patient satisfaction while maintaining a favorable short-term safety profile. Nevertheless, important methodological limitations remain, including heterogeneous treatment protocols, limited randomized clinical trials, and insufficient long-term follow-up. Continued international collaboration, standardized manufacturing processes, rigorous regulatory frameworks, and high-quality multicenter clinical studies will be essential to establish evidence-based therapeutic guidelines and consolidate regenerative dermatology as a mature clinical discipline.
Regenerative dermatology, Exosomes, Polynucleotides, Skin rejuvenation, Regenerative medicine, Aesthetic dermatology, Fibroblasts, Collagen synthesis, Extracellular matrix, Angiogenesis, Tissue repair, Photoaging.
Contemporary Orthogeriatric Care for Fragility Fractures: Advancing Functional Recovery and Multidisciplinary Management in Older Adults
Fragility fractures have become one of the most significant health challenges associated with global population aging, generating substantial consequences for functional independence, healthcare systems, and quality of life. This review aimed to analyze the current scientific evidence regarding the epidemiology, pathophysiology, risk factors, modern orthogeriatric management, and functional recovery of older adults sustaining fragility fractures. A structured literature review was conducted using international scientific databases and evidence-based clinical guidelines published by recognized organizations. The available evidence demonstrates that fragility fractures are multifactorial conditions resulting from the interaction of osteoporosis, sarcopenia, frailty syndrome, multimorbidity, nutritional deficits, and age-related physiological decline. Contemporary orthogeriatric care, based on multidisciplinary collaboration, Comprehensive Geriatric Assessment, timely surgical management, individualized rehabilitation, nutritional optimization, osteoporosis treatment, and secondary fracture prevention, consistently improves mobility, functional independence, postoperative outcomes, and long-term quality of life. Early rehabilitation and coordinated follow-up through structured fracture prevention programs were also associated with lower complication rates and reduced risk of recurrent fractures. Furthermore, the findings emphasize the growing importance of integrating orthopedic surgery, geriatrics, rehabilitation medicine, nutrition, and preventive care into patient-centered management strategies. As demographic aging continues to accelerate worldwide, particularly in Latin America, strengthening orthogeriatric services and implementing evidence-based multidisciplinary models represent essential strategies for preserving autonomy, reducing disability, and improving long-term clinical outcomes among older adults with fragility fractures.
KEYWORDS Fragility fractures, Orthogeriatrics, Older adults, Functional recovery, Hip fracture, Osteoporosis, Sarcopenia, Frailty, Rehabilitation, Secondary fracture prevention.
Optimizing Surgical Outcomes Through Multimodal Prehabilitation: The Role of Nutrition, Exercise, and Functional Conditioning Before Major Abdominal Surgery
Major abdominal surgery remains associated with substantial postoperative morbidity, functional deterioration, and prolonged recovery despite advances in surgical techniques, anesthesia, and perioperative care. Multimodal prehabilitation has emerged as a strategy aimed at increasing physiological reserve before surgery through the integration of nutritional optimization, structured exercise, functional conditioning, psychological preparation, and modification of perioperative risk factors. This review analyzed current international evidence regarding the role of prehabilitation in adult patients undergoing elective major abdominal surgery, with particular emphasis on nutrition, exercise, functional capacity, postoperative complications, and recovery. Evidence from systematic reviews, meta-analyses, randomized clinical trials, clinical guidelines, and international consensus documents indicates that structured exercise and nutritional optimization constitute the most consistently incorporated components of prehabilitation programs. Exercise-based and multimodal interventions were associated with improvements in preoperative functional capacity, while comprehensive programs showed favorable trends in postoperative morbidity, hospital length of stay, and functional recovery. High adherence, professional supervision, early nutritional intervention, individualized risk assessment, and integration with Enhanced Recovery After Surgery pathways were identified as important factors associated with successful implementation. Patients with frailty, sarcopenia, malnutrition, or reduced cardiopulmonary reserve may represent populations with particular potential to benefit from individualized preoperative optimization. Nevertheless, heterogeneity in program duration, intervention intensity, patient selection, and outcome assessment continues to limit direct comparisons between studies. Current evidence supports multimodal prehabilitation as a relevant component of contemporary perioperative medicine and emphasizes the need for standardized, accessible, and patient-centered strategies that can be adapted to different healthcare systems, including Latin American settings.
prehabilitation, major abdominal surgery, clinical nutrition, exercise therapy, functional capacity, perioperative care, ERAS, frailty, sarcopenia, postoperative complications, gastrointestinal surgery, functional recovery
Precision Medicine in Metabolic Dysfunction-Associated Steatotic Liver Disease: Advances in Diagnosis, Risk Stratification, and Personalized Management
Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) has emerged as one of the most prevalent chronic liver diseases worldwide and represents a growing challenge for healthcare systems due to its close relationship with obesity, insulin resistance, type 2 diabetes mellitus, dyslipidemia, and metabolic syndrome. This review aimed to integrate current scientific evidence regarding the epidemiology, pathophysiology, clinical progression, diagnosis, treatment, and emerging role of precision medicine in MASLD. International scientific literature was reviewed through recognized biomedical databases, incorporating original studies, systematic reviews, meta-analyses, clinical practice guidelines, and international consensus statements relevant to the disease. The evidence demonstrates a substantial global burden of MASLD, with particularly high prevalence estimates reported in Latin America and other regions experiencing rapid growth in cardiometabolic disorders. Disease progression is heterogeneous, ranging from hepatic steatosis to metabolic dysfunction-associated steatohepatitis, advanced fibrosis, cirrhosis, and hepatocellular carcinoma, with fibrosis representing one of the most important predictors of adverse clinical outcomes. Advances in non-invasive biomarkers, serum-based fibrosis scores, transient elastography, and magnetic resonance-based techniques have improved risk stratification and reduced dependence on liver biopsy. Lifestyle modification remains fundamental to treatment, while emerging pharmacological therapies provide additional opportunities for patients with specific metabolic and hepatic profiles. The integration of clinical characteristics, metabolic phenotype, fibrosis stage, imaging findings, and biological markers supports the transition toward precision medicine. MASLD should therefore be approached as a multisystem metabolic disease requiring early identification, multidisciplinary management, comprehensive cardiometabolic control, and individualized therapeutic strategies to reduce progression and long-term complications.
Metabolic Dysfunction-Associated Steatotic Liver Disease, MASLD, metabolic dysfunction, hepatic steatosis, metabolic syndrome, insulin resistance, liver fibrosis, non-invasive diagnosis, precision medicine, hepatology
A Global Perspective on Hormonal, Dermatologic, and Metabolic Health Across the Female Lifespan
Women’s health has traditionally been approached from a reproductive perspective; however, growing evidence indicates that hormonal changes exert systemic effects extending beyond reproductive function. The present study analyzed hormonal, dermatologic, and metabolic interactions throughout the female lifespan using data obtained from an international population of 12,600 women representing Asia, Europe, North America, South America, Africa, and Oceania. A quantitative, observational, cross-sectional, descriptive-analytical design based on the Scientific Method was employed. Data were collected through anonymous standardized questionnaires that evaluated dermatologic manifestations, metabolic alterations, hormonal changes, and the perceived impact of these conditions on overall health and well-being. The findings demonstrated a high prevalence of dermatologic alterations across all continents, a progressive increase in metabolic changes from puberty to menopause, frequent coexistence of hormonal, dermatologic, and metabolic manifestations, and a consistently high perception of the multidimensional impact of hormonal transitions. These results support the concept that endocrine regulation influences multiple physiological systems simultaneously and reinforce the need for multidisciplinary healthcare approaches that integrate endocrinology, gynecology, dermatology, nutrition, and preventive medicine. The study contributes to the growing international evidence supporting a life-course approach to women’s health beyond reproduction and highlights the importance of comprehensive strategies aimed at improving quality of life and promoting healthy aging.
Women’s health, Hormonal changes, Endocrinology, Dermatology, Metabolic health, Menopause, Perimenopause, Skin disorders, Hormonal interactions, Healthy aging, International survey, Preventive medicine, Quality of life, Life-course approach, Global health.
Advances in Regenerative Trauma Reconstruction: Integrating Stem Cells and Bioengineered Scaffolds for Functional Tissue Restoration
Complex traumatic injuries remain a major cause of long-term disability worldwide, frequently affecting multiple tissues and anatomical systems simultaneously. Conventional reconstructive approaches have improved survival and anatomical restoration; however, complete functional recovery remains a significant clinical challenge. This review examines the current role of regenerative reconstruction in the management of complex trauma, with particular emphasis on stem cell-based therapies, bioengineered scaffolds, biomaterials, tissue engineering, and emerging biofabrication technologies. Scientific evidence from preclinical and clinical studies demonstrates that regenerative strategies can enhance tissue repair through mechanisms including paracrine signaling, angiogenesis, immunomodulation, extracellular matrix remodeling, and cellular differentiation. Bone regeneration emerged as the most extensively investigated application, followed by soft tissue, cartilage, peripheral nerve, skeletal muscle, and spinal cord reconstruction. Bioengineered scaffolds have shown considerable potential to support cellular survival, tissue integration, and functional recovery by recreating biologically active microenvironments. Furthermore, advances in three-dimensional bioprinting have facilitated the development of patient-specific constructs designed to improve regenerative outcomes in complex anatomical defects. Comparative analysis suggests that regenerative reconstruction offers advantages over conventional approaches in biological integration, functional restoration, and long-term adaptation, while maintaining comparable structural outcomes. Despite promising advances, challenges related to clinical translation, standardization, regulatory approval, and large-scale implementation remain significant. Overall, regenerative reconstruction represents a rapidly evolving multidisciplinary field with the potential to transform trauma care by promoting biological restoration and improving functional outcomes for patients with severe injuries.
Regenerative reconstruction, Complex trauma, Stem cells, Bioengineered scaffolds, Tissue engineering, Biomaterials, Functional recovery, Bone regeneration, Nerve regeneration, Soft tissue reconstruction, Three-dimensional bioprinting, Regenerative medicine
Copyright (c) 2025 International Science Journal
Digital Orthopedics and Smart Rehabilitation: The Expanding Role of Wearable Technologies and Motion Analytics in Musculoskeletal Healthcare
Musculoskeletal disorders remain among the leading causes of disability and functional impairment worldwide, creating significant challenges for healthcare systems and rehabilitation services. Recent advances in wearable technologies, motion analytics, telemedicine, and artificial intelligence have introduced new opportunities for improving orthopedic assessment, rehabilitation monitoring, and long-term patient management. This review examines the current applications of wearable devices in musculoskeletal healthcare, with particular emphasis on gait analysis, postoperative monitoring, rehabilitation support, remote patient management, and predictive analytics. A structured review of scientific literature indexed in major biomedical and multidisciplinary databases was conducted to evaluate the effectiveness, benefits, and limitations of wearable technologies within orthopedic practice. The findings indicate that wearable systems provide continuous and objective measurements of biomechanical and functional parameters, enabling more personalized rehabilitation strategies and supporting data-driven clinical decision-making. Gait analysis and rehabilitation monitoring emerged as the most frequently reported applications, while artificial intelligence demonstrated growing potential for predictive modeling and outcome optimization. The review also identified important implementation challenges, including data privacy concerns, interoperability limitations, device standardization issues, regulatory barriers, and patient adherence factors. Despite these challenges, wearable technologies are increasingly contributing to the development of accessible, patient-centered, and precision-based orthopedic care. The evidence suggests that continued technological innovation and integration of digital health solutions will play a fundamental role in shaping the future of musculoskeletal healthcare worldwide.
Wearable Technology, Motion Analytics, Digital Orthopedics, Musculoskeletal Disorders, Gait Analysis, Rehabilitation Monitoring, Telemedicine, Remote Patient Monitoring, Artificial Intelligence, Precision Medicine, Orthopedic Rehabilitation, Digital Health
Contemporary Therapeutic Approaches in the Cardiorenal-Metabolic Continuum: Current Perspectives on Diabetes, Chronic Kidney Disease, and Cardiovascular Dysfunction
Cardiorenal syndrome associated with type 2 diabetes mellitus has emerged as a major global health challenge due to its increasing prevalence, complex pathophysiology, and significant impact on morbidity and mortality. The interaction between cardiovascular disease, chronic kidney disease, and metabolic dysfunction creates a bidirectional cycle of organ damage mediated by inflammation, oxidative stress, endothelial dysfunction, neurohormonal activation, and fibrosis. This review analyzes current evidence regarding the mechanisms linking diabetes with cardiovascular and renal deterioration, emphasizing the concept of the cardiorenal-metabolic continuum. A comprehensive review of contemporary literature was conducted using international scientific databases and clinical practice guidelines. The findings indicate that recent therapeutic advances, particularly sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, and non-steroidal mineralocorticoid receptor antagonists, have significantly improved cardiovascular and renal outcomes while reducing disease progression and hospitalization rates. Despite these advances, substantial challenges remain regarding early diagnosis, treatment accessibility, therapeutic implementation, and healthcare disparities. These challenges are especially relevant in Latin American countries, including Mexico, Colombia, and Ecuador, where the burden of diabetes and chronic kidney disease continues to rise. Current evidence supports the adoption of integrated multidisciplinary approaches focused on early detection, comprehensive risk assessment, and evidence-based therapeutic interventions. The transition from organ-centered management toward a cardiorenal-metabolic model represents a fundamental paradigm shift that may contribute to improved patient survival, preservation of organ function, and enhanced quality of life.
Cardiorenal syndrome, Type 2 diabetes mellitus, Chronic kidney disease, Heart failure, Cardiorenal-metabolic syndrome, SGLT2 inhibitors, GLP-1 receptor agonists, Finerenone, Cardiovascular disease, Renal protection, Multidisciplinary care, Internal medicine
Medical Misinformation on Social Media and Its Impact on Public Health Campaigns: A Global Review of Challenges, Determinants, and Communication Strategies
Medical misinformation disseminated through social media has become a major global public health challenge, influencing health behaviors, public trust, vaccination acceptance, and the effectiveness of health communication strategies. The rapid expansion of digital platforms has facilitated unprecedented access to health information while simultaneously increasing exposure to inaccurate, misleading, and scientifically unsupported content. This review aimed to analyze the global impact of medical misinformation on public health campaigns and identify evidence-based strategies capable of mitigating its effects. A structured review of scientific literature was conducted using publications indexed in major international databases, including PubMed, Scopus, Web of Science, and ScienceDirect. The evidence examined demonstrated that misinformation significantly affects vaccination programs, adherence to preventive measures, trust in healthcare institutions, risk perception, and healthcare-seeking behaviors. Vaccine-related misinformation emerged as the most prevalent category, followed by false preventive recommendations, conspiracy theories, unsupported treatments, and misleading information regarding infectious diseases. Social media platforms such as Facebook, WhatsApp, YouTube, TikTok, and X were consistently identified as major channels for misinformation dissemination. Evidence from Latin America, including Mexico, Colombia, and Ecuador, revealed patterns similar to those observed globally, although local sociocultural and educational factors influenced vulnerability and response capacity. The literature further highlighted digital health literacy, fact-checking initiatives, institutional communication, healthcare professional engagement, and accuracy-promoting interventions as effective approaches for reducing misinformation-related harms. The findings emphasize the need for multidisciplinary collaboration and sustained investment in evidence-based communication strategies to strengthen public trust, improve health literacy, and enhance the effectiveness of future public health campaigns.
Medical misinformation, Social media, Public health campaigns, Health communication, Infodemic, Vaccine hesitancy, Digital health literacy, Infectious diseases, Public health, Health education, Fact-checking, Vaccination, Risk perception, Digital communication, Global health
Advances in Neurostimulation for Treatment-Resistant Depression and Chronic Pain: Emerging Neuromodulation Strategies in Modern Clinical Neuroscience
Treatment-resistant depression and chronic pain represent major global health challenges due to their high prevalence, significant disability burden, and limited response to conventional therapeutic approaches. Recent advances in neuroscience have improved understanding of the neural networks involved in emotional regulation, cognitive processing, and pain modulation, leading to the development of innovative neuromodulation strategies. This review analyzes current evidence regarding neurostimulation therapies used in the management of treatment-resistant depression and chronic pain, including repetitive transcranial magnetic stimulation, transcranial direct current stimulation, vagus nerve stimulation, deep brain stimulation, spinal cord stimulation, and dorsal root ganglion stimulation. A scientific-method-based literature review was conducted using publications indexed in major biomedical databases. The findings indicate that neurostimulation offers clinically meaningful benefits in selected patients by directly modulating dysfunctional neural circuits associated with symptom persistence. Repetitive transcranial magnetic stimulation demonstrated strong evidence in treatment-resistant depression, while spinal cord stimulation and dorsal root ganglion stimulation showed substantial effectiveness in refractory neuropathic pain conditions. The review also highlights the importance of individualized treatment selection, safety considerations, technological innovation, and multidisciplinary collaboration. Furthermore, emerging developments involving adaptive stimulation systems, artificial intelligence, biomarker-guided interventions, and precision neuromodulation may significantly influence future clinical practice. Neurostimulation is increasingly recognized as a valuable component of modern neurological, psychiatric, neurosurgical, and pain management strategies, with growing implementation across diverse healthcare systems, including Latin America. Continued research and technological advancement are expected to further expand its therapeutic potential and improve outcomes for patients with complex and refractory disorders.
Neurostimulation, Neuromodulation, Treatment-Resistant Depression, Chronic Pain, Repetitive Transcranial Magnetic Stimulation, Deep Brain Stimulation, Vagus Nerve Stimulation, Spinal Cord Stimulation, Dorsal Root Ganglion Stimulation, Psychiatry, Neurology, Neurosurgery, Pain Medicine, Precision Medicine, Neural Networks
Advances in Tissue Bioengineering and Regenerative Aesthetic Medicine: Emerging Strategies for Tissue Restoration, Functional Recovery, and Personalized Healthcare
Tissue bioengineering and regenerative aesthetic medicine have emerged as rapidly evolving interdisciplinary fields that integrate plastic surgery, regenerative medicine, endocrinology, molecular biology, biomaterials science, and biomedical engineering to promote tissue restoration and functional recovery. The objective of this review was to analyze current advances in regenerative technologies and their applications in aesthetic and reconstructive medicine. A comprehensive review of scientific literature indexed in major biomedical databases was conducted, focusing on stem cell therapies, platelet-rich plasma, extracellular vesicles, bioactive scaffolds, biomaterials, and three-dimensional bioprinting. The analyzed evidence demonstrated that adipose-derived stem cells and platelet-rich plasma remain the most established regenerative interventions due to their favorable safety profiles, accessibility, and demonstrated effectiveness in tissue repair and rejuvenation. Emerging technologies such as exosome-based therapies and advanced tissue-engineering platforms exhibited significant innovation potential and may contribute to future therapeutic developments. Angiogenesis, extracellular matrix remodeling, cellular signaling, and endocrine regulation were identified as essential mechanisms underlying successful regenerative outcomes. Furthermore, the findings highlighted the increasing importance of personalized regenerative approaches that incorporate metabolic and hormonal optimization. Despite substantial progress, challenges related to protocol standardization, long-term clinical validation, regulatory frameworks, and accessibility remain significant barriers to widespread implementation. Overall, tissue bioengineering and regenerative aesthetic medicine represent promising strategies capable of transforming contemporary healthcare by promoting biological restoration, improving aesthetic outcomes, and advancing personalized therapeutic interventions.
Tissue Engineering, Regenerative Medicine, Aesthetic Medicine, Plastic Surgery, Adipose-Derived Stem Cells, Platelet-Rich Plasma, Exosomes, Extracellular Vesicles, Biomaterials, Bioactive Scaffolds, 3D Bioprinting, Endocrinology, Tissue Regeneration, Personalized Medicine, Reconstructive Surgery
Advanced Neuromonitoring and Emerging Technologies in Traumatic Brain Injury: Current Evidence, Clinical Applications, and Future Perspectives
Traumatic brain injury (TBI) remains one of the leading causes of mortality and long-term neurological disability worldwide, representing a major challenge for emergency medicine, neurosurgery, radiology, and neurocritical care. In recent years, substantial advances have transformed traditional approaches to TBI management through the incorporation of multimodal neuromonitoring systems, advanced neuroimaging technologies, artificial intelligence, and personalized therapeutic strategies. This review examines current innovations in traumatic brain injury management, focusing on intracranial pressure monitoring, brain tissue oxygen monitoring, cerebral microdialysis, advanced magnetic resonance imaging techniques, machine learning applications, and contemporary neurosurgical interventions. Scientific evidence from international studies demonstrates that multimodal monitoring provides a more comprehensive assessment of cerebral physiology by integrating information related to perfusion, oxygenation, metabolism, and neurological function, facilitating earlier identification of secondary brain injury and supporting individualized treatment decisions. Likewise, advanced neuroimaging modalities such as diffusion tensor imaging, susceptibility-weighted imaging, perfusion imaging, and functional magnetic resonance imaging have improved diagnostic precision and prognostic evaluation. Artificial intelligence has emerged as a promising tool for data integration, predictive analytics, lesion characterization, and clinical decision support. Collectively, these innovations are contributing to the evolution of neurocritical care toward precision medicine models that prioritize personalized monitoring and targeted therapeutic interventions. Although challenges related to accessibility, implementation, infrastructure, and training remain, particularly in low- and middle-income countries, the available evidence suggests that the integration of advanced monitoring technologies and data-driven clinical strategies may significantly improve neurological outcomes, reduce secondary injury, and enhance quality of life among patients affected by traumatic brain injury. Continued research, multidisciplinary collaboration, and equitable adoption of emerging technologies will be essential for advancing the future of neurotrauma care worldwide.
traumatic brain injury, neurocritical care, multimodal neuromonitoring, intracranial pressure monitoring, brain tissue oxygen monitoring, cerebral microdialysis, advanced neuroimaging, diffusion tensor imaging, artificial intelligence, machine learning, precision medicine, neurosurgery, neuroprotection, cerebral perfusion, critical care
Integrating Precision Oncology, Advanced Imaging, and Palliative Care: A Patient-Centered Framework for Advanced Cancer Management Across the Americas
Advanced cancer remains a major challenge for healthcare systems worldwide due to its clinical complexity, increasing therapeutic options, and multidimensional patient needs. Recent advances in precision medicine, molecular diagnostics, genomic profiling, advanced radiological technologies, and comprehensive palliative care have transformed the management of patients with advanced malignancies. The objective of this review was to analyze the current evidence regarding the integration of precision medicine, advanced imaging technologies, and comprehensive palliative care in advanced cancer management throughout the Americas. A narrative review based on the Scientific Method was conducted using evidence obtained from PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, Cochrane Library, and international clinical practice guidelines. The literature was analyzed through thematic synthesis focusing on precision oncology, radiological innovation, patient-centered outcomes, and healthcare implementation. The findings demonstrated that molecular diagnostics, genomic profiling, targeted therapies, immunotherapy, radiomics, and artificial intelligence have significantly improved personalized therapeutic decision-making. Advanced radiological assessment contributes substantially to diagnosis, staging, treatment planning, prognostic evaluation, and response monitoring. Additionally, early integration of palliative care was consistently associated with improved symptom control, quality of life, psychological well-being, communication, and healthcare satisfaction. Important regional differences in access to innovative technologies and specialized supportive care services were identified across the Americas. The evidence supports the development of integrated multidisciplinary models that combine technological innovation with comprehensive supportive care. Such approaches may contribute to improved clinical outcomes, enhanced quality of life, and more equitable cancer care delivery for patients with advanced malignancies.
Precision medicine, Precision oncology, Advanced cancer, Molecular diagnostics, Genomic profiling, Radiomics, Imaging biomarkers, Artificial intelligence, Palliative care, Integrated oncology care, Quality of life, Personalized therapy, Multidisciplinary care, Oncology, Americas
Personalized mRNA Cancer Vaccines: Advancing Precision Oncology Through Neoantigen-Directed Immunotherapy
Cancer remains one of the leading causes of mortality worldwide despite significant advances in diagnosis and treatment. The emergence of personalized messenger RNA (mRNA)-based cancer vaccines has introduced a novel therapeutic strategy capable of integrating genomic medicine, immunology, and biotechnology into precision oncology. The objective of this review was to analyze the current scientific evidence regarding the biological foundations, immunological mechanisms, clinical applications, advantages, limitations, and future perspectives of personalized mRNA cancer vaccines. A scientific method-based narrative review methodology was employed through a structured search of peer-reviewed literature indexed in PubMed, Scopus, Web of Science, ScienceDirect, SpringerLink, and other internationally recognized databases. The evidence demonstrated that personalized mRNA vaccines can encode patient-specific neoantigens, stimulate robust CD4+ and CD8+ T-cell responses, enhance dendritic-cell-mediated antigen presentation, and promote durable immunological memory. Clinical investigations have reported encouraging results in melanoma, pancreatic cancer, glioblastoma, lung cancer, and other malignancies, particularly when vaccines are combined with immune checkpoint inhibitors. The findings also revealed important advantages, including high therapeutic specificity, individualized treatment design, and rapid development capacity. However, challenges related to neoantigen selection, manufacturing costs, regulatory complexity, and healthcare infrastructure remain significant barriers to widespread implementation. From a regional perspective, countries such as Mexico, Colombia, and Ecuador are progressively expanding precision oncology capabilities, although important limitations persist regarding access to genomic technologies and advanced immunotherapies. Overall, personalized mRNA cancer vaccines represent a promising innovation with the potential to transform future cancer treatment through highly individualized and immune-based therapeutic approaches.
Personalized mRNA vaccines, Cancer immunotherapy, Precision oncology, Neoantigens, Messenger RNA, Cancer vaccines, Tumor immunology, Genomic medicine, Immune checkpoint inhibitors, Personalized medicine, Biotechnology, Translatio
Dermatological Implications of Artificial Intelligence, Wearable Technologies, and Digital Health Monitoring: Current Evidence, Clinical Challenges, and Future Perspectives
The integration of artificial intelligence (AI), wearable technologies, and digital health monitoring systems has significantly transformed modern healthcare by enabling continuous patient surveillance, personalized interventions, and improved access to medical services. Despite these advances, increasing evidence suggests that prolonged use of wearable devices may be associated with a variety of cutaneous manifestations that can affect patient comfort, treatment adherence, and overall healthcare outcomes. This review aimed to analyze the current scientific evidence regarding dermatological complications associated with wearable technologies, biosensors, adhesive monitoring systems, and AI-assisted healthcare platforms. A qualitative integrative review was conducted using the Scientific Method as a methodological framework. Scientific literature was identified through searches in PubMed/MEDLINE, Scopus, ScienceDirect, Web of Science, and Google Scholar. Evidence related to dermatological manifestations, immunological mechanisms, clinical implications, artificial intelligence applications, and preventive strategies was critically evaluated and synthesized. The findings indicate that allergic contact dermatitis, irritant contact dermatitis, medical adhesive-related skin injuries, erythema, pruritus, and pressure-associated lesions are the most frequently reported complications. Pathophysiological mechanisms involve adhesive exposure, epidermal barrier disruption, mechanical friction, humidity accumulation, and delayed hypersensitivity reactions. Artificial intelligence demonstrated considerable potential for lesion classification, teledermatology support, remote monitoring, and predictive risk assessment. The review concludes that while wearable technologies and AI provide substantial healthcare benefits, their successful implementation requires greater attention to dermatological safety, patient-centered device design, interdisciplinary collaboration, and preventive strategies aimed at minimizing cutaneous adverse effects.
Artificial intelligence, wearable devices, digital health, dermatology, contact dermatitis, skin manifestations, biosensors, teledermatology, remote monitoring, medical technology, patient safety, adhesive-related skin injury, digital healthcare, precision medicine
Cardiorenal Syndrome: Integrated Pathophysiology, Diagnostic Challenges, and Contemporary Therapeutic Approaches
Organ transplantation remains the definitive treatment for many patients with end-stage organ failure, significantly improving survival and quality of life. Nevertheless, the persistent shortage of donor organs continues to limit access to transplantation worldwide, creating an urgent need for alternative strategies capable of expanding the donor pool. This review aimed to analyze current advances in organ transplantation and xenotransplantation, with emphasis on surgical innovations, immunological developments, clinical outcomes, and bioethical implications. A narrative review was conducted using the Scientific Method as a methodological framework. Scientific evidence was obtained from major biomedical databases, including PubMed, Scopus, Web of Science, ScienceDirect, Google Scholar, and the Cochrane Library. The selected literature was analyzed according to four major domains: surgical innovation, immunological and genetic advances, clinical outcomes, and bioethical considerations. The findings demonstrated that conventional transplantation continues to achieve favorable graft survival and patient outcomes due to improvements in surgical techniques, organ preservation, and immunosuppressive therapy. Furthermore, recent clinical experiences involving genetically modified porcine organs have demonstrated the growing feasibility of xenotransplantation as a potential solution to organ scarcity. However, important challenges remain regarding long-term graft survival, immunological compatibility, infectious disease transmission, animal welfare, informed consent, and equitable access to transplantation services. The review concludes that xenotransplantation represents one of the most promising emerging strategies for addressing the global organ shortage, although its successful integration into clinical practice will require continued scientific advancement, ethical oversight, regulatory preparedness, and international collaboration.
Organ transplantation, Xenotransplantation, Kidney transplantation, Heart transplantation, Liver transplantation, Genetic engineering, Transplant immunology, Organ shortage, Bioethics, Organ allocation, Porcine organs, Surgical innovation, Graft survival, Precision medicine, Healthcare equity
Imaging Biomarkers in Systemic Disease: Quantitative Radiology and Precision Medicine in Clinical Practice
Imaging biomarkers have progressively transformed modern radiology by providing quantitative, functional, and molecular information capable of improving early disease detection, diagnostic precision, therapeutic monitoring, and clinical decision-making in systemic diseases. The present review aimed to analyze the current role of imaging biomarkers in oncology and internal medicine, emphasizing their contribution to precision medicine and multidisciplinary healthcare management. A structured documentary review was conducted using peer-reviewed scientific literature indexed in internationally recognized databases, including PubMed, Scopus, ScienceDirect, and SpringerLink. The analyzed evidence focused on advanced imaging modalities such as computed tomography, magnetic resonance imaging, positron emission tomography, hybrid imaging systems, radiomics, and artificial intelligence-assisted imaging analysis. The reviewed studies demonstrated that imaging biomarkers possess broad applicability in oncology, neurological disorders, cardiovascular diseases, inflammatory conditions, chronic hepatic disease, pulmonary pathology, and metabolic disorders. Functional and molecular imaging techniques showed particular relevance for evaluating metabolism, tissue perfusion, angiogenesis, fibrosis, inflammation, cellular density, and tumor heterogeneity. Radiomics and artificial intelligence were identified as emerging technologies capable of improving predictive analysis, treatment response assessment, and individualized therapeutic planning.
Imaging biomarkers, radiomics, precision medicine, oncology imaging, molecular imaging, artificial intelligence, systemic diseases, magnetic resonance imaging, positron emission tomography, computed tomography, quantitative imaging, clinical decision-making, tumor heterogeneity, internal medicine, hybrid imaging
Pulmonary, Cardiovascular, and Neurological Consequences of Systemic Hypoxia: An Integrative Multidisciplinary Review
Hypoxia is a complex multisystemic condition characterized by insufficient oxygen availability at the tissue level, producing progressive dysfunction involving the pulmonary, cardiovascular, and neurological systems. Although traditionally associated with respiratory failure, contemporary evidence demonstrates that hypoxia activates interconnected physiological, inflammatory, vascular, metabolic, and neurological pathways capable of generating widespread systemic injury. The objective of this review was to analyze the principal mechanisms through which hypoxia contributes to pulmonary, cardiovascular, and neurological dysfunction, emphasizing the integrated interactions between these systems and their clinical implications in modern medicine. This review was developed using a structured narrative methodology based on scientific literature indexed in international databases including PubMed, Scopus, Google Scholar, Europe PMC, Elsevier, and SpringerLink. The investigation integrated evidence from pulmonology, cardiology, neurology, critical care medicine, and vascular physiology in order to evaluate the systemic consequences of acute, chronic, and intermittent hypoxia. Special attention was given to molecular mechanisms such as hypoxia-inducible factor activation, oxidative stress, endothelial dysfunction, autonomic imbalance, mitochondrial injury, inflammatory cytokine release, and vascular remodeling. The findings demonstrate that pulmonary dysfunction initiates hypoxemia through mechanisms including ventilation-perfusion mismatch, diffusion impairment, hypoventilation, and shunt physiology. Cardiovascular adaptation initially attempts to preserve oxygen delivery through sympathetic activation and pulmonary vasoconstriction; however, prolonged hypoxic exposure contributes to pulmonary hypertension, right ventricular overload, endothelial dysfunction, arrhythmogenic instability, and impaired systemic perfusion. Neurological consequences include neuroinflammation, excitotoxicity, cognitive impairment, cerebral autoregulatory dysfunction, and hypoxic-ischemic injury due to the high metabolic vulnerability of neuronal tissue. Intermittent hypoxia, particularly in obstructive sleep apnea, was associated with substantial cardiovascular and neurocognitive consequences related to oxidative stress and autonomic dysregulation.
Hypoxia, Hypoxemia, Pulmonary Dysfunction, Cardiovascular Disease, Neurological Injury, Pulmonary Hypertension, Oxidative Stress, Neuroinflammation, Endothelial Dysfunction, Brain-Lung Interaction, Oxygen Deprivation, Critical Care, Systemic Inflammation, Chronic Obstructive Pulmonary Disease, Obstructive Sleep Apnea
Gut Microbiota as a Systemic Regulator: Immunological and Neurological Implications Beyond Digestive Disease
The gut microbiota has emerged as a fundamental regulator of systemic human physiology, extending its influence far beyond the gastrointestinal tract. Recent advances in microbiome research have demonstrated that intestinal microorganisms participate actively in metabolic regulation, immune homeostasis, neuroimmune communication, inflammatory signaling, and chronic disease progression. The present review aimed to analyze current scientific evidence regarding the relationship between gut microbiota and systemic diseases, with special emphasis on immunological and neurological implications beyond digestive pathology. A structured narrative review methodology based on the Scientific Method was employed through analysis of peer-reviewed literature indexed in internationally recognized scientific databases including PubMed, Scopus, ScienceDirect, and SpringerLink. The review integrated multidisciplinary evidence involving gastroenterology, neurology, immunology, microbiology, metabolism, and translational medicine. The selected studies evaluated mechanisms associated with intestinal dysbiosis, systemic inflammation, gut–brain axis signaling, immune dysregulation, microbial metabolites, and microbiota-targeted therapeutic strategies. The analyzed evidence demonstrated that alterations in gut microbial diversity are strongly associated with chronic inflammatory diseases, obesity, type 2 diabetes mellitus, cardiovascular disease, autoimmune disorders, neurodegenerative pathology, and psychiatric conditions. Key mechanisms identified included increased intestinal permeability, chronic low-grade inflammation, abnormal immune activation, altered short-chain fatty acid production, and neuroimmune dysregulation mediated through the gut–brain axis. Furthermore, microbiota-targeted interventions such as probiotics, prebiotics, dietary modulation, postbiotics, and fecal microbiota transplantation demonstrated promising therapeutic potential in restoring microbial balance and reducing inflammatory activity.
Gut microbiota, Gut-brain axis, Dysbiosis, Systemic inflammation, Neuroinflammation, Immune regulation, Autoimmune disease, Metabolic disease, Cardiovascular disease, Neurodegenerative disease, Microbiome, Chronic inflammation, Intestinal permeability, Probiotics, Fecal microbiota transplantation
Cardiorenal syndrome (CRS) represents a complex bidirectional interaction between the cardiovascular and renal systems in which dysfunction of one organ may induce or worsen dysfunction of the other. The increasing global prevalence of heart failure, chronic kidney disease, hypertension, obesity, and diabetes mellitus has significantly contributed to the growing clinical and epidemiological burden of CRS. This review aimed to analyze the principal pathophysiological mechanisms, diagnostic approaches, and contemporary therapeutic strategies associated with cardiorenal syndrome through an evidence-based analysis of current scientific literature. The study was developed as a narrative and analytical review using scientific evidence obtained from internationally recognized databases, including PubMed, Scopus, Web of Science, and high-impact journals in nephrology, cardiology, and internal medicine. The analysis focused on hemodynamic alterations, neurohormonal activation, venous congestion, inflammatory pathways, endothelial dysfunction, oxidative stress, diagnostic biomarkers, pharmacological therapies, and multidisciplinary management approaches. The reviewed evidence demonstrated that CRS is a multifactorial systemic condition involving complex interactions between cardiac and renal dysfunction. Venous congestion, activation of the renin–angiotensin–aldosterone system, sympathetic nervous system stimulation, chronic inflammation, and endothelial injury were identified as major contributors to disease progression. Biomarkers such as NT-proBNP, cystatin C, NGAL, and KIM-1 showed important diagnostic and prognostic value, although integrated clinical evaluation remains essential. Contemporary therapeutic strategies, particularly sodium-glucose cotransporter-2 inhibitors, demonstrated substantial cardiovascular and renal protective effects. Multidisciplinary care models were also associated with improved patient outcomes and optimization of long-term management. In conclusion, cardiorenal syndrome should be understood as a highly dynamic and multisystemic condition requiring integrated cardiovascular and renal assessment. Early diagnosis, evidence-based therapy, preventive medicine, and multidisciplinary collaboration remain fundamental for improving prognosis and reducing the global burden associated with CRS.
Cardiorenal syndrome, heart failure, chronic kidney disease, nephrology, cardiology, internal medicine, venous congestion, neurohormonal activation, biomarkers, SGLT2 inhibitors, cardiovascular disease, renal dysfunction, inflammation, multidisciplinary care, cardiorenal interaction
Forensic Applications of Magnetic Resonance Spectroscopy and Near-Infrared Spectroscopy in Traumatic Brain Injury: Metabolic and Hemodynamic Perspectives in Invisible Cerebral Damage
Traumatic brain injury (TBI) remains one of the leading causes of neurological disability worldwide and represents a major challenge in forensic medicine, particularly in cases involving persistent symptoms without visible structural abnormalities on conventional neuroimaging. This study analyzed the forensic and clinical relevance of magnetic resonance spectroscopy (^1H-MRS) and near-infrared spectroscopy (NIRS) in the evaluation of traumatic brain injury, emphasizing their role in detecting metabolic, neuronal, and hemodynamic alterations associated with invisible cerebral damage. A qualitative and integrative analytical methodology based on contemporary scientific literature was employed to examine the diagnostic contribution of advanced spectroscopic techniques compared with conventional imaging modalities. The findings demonstrated that spectroscopic methods identified a higher frequency of abnormalities than traditional structural imaging, particularly reductions in N-acetylaspartate, altered metabolic ratios, elevated choline concentrations, lactate peaks, and cerebral oxygenation disturbances. These alterations were associated with persistent neurological manifestations including cognitive impairment, chronic headache, emotional instability, and sleep disturbances. From a forensic perspective, spectroscopy demonstrated significant relevance in causality assessment, injury severity classification, disability evaluation, and support of medico-legal expert reports. The results support the concept that traumatic brain injury should be interpreted as a multidimensional neurometabolic disorder rather than solely as a structural lesion. Although advanced spectroscopic techniques present technical and interpretative limitations, their integration into multidisciplinary forensic evaluation may strengthen diagnostic precision and improve the objective documentation of post-traumatic cerebral dysfunction.
The Skin Microbiome as a Systemic Immunological Regulator: From Dysbiosis to Clinical Applications
ABSTRACT The skin microbiome has emerged as a key regulator of immune function with significant implications for systemic disease. This review aims to analyze the role of cutaneous microbial communities in immune modulation and their contribution to the development, diagnosis, and treatment of systemic conditions. A structured narrative review was conducted using a scientific methodological framework, integrating evidence from dermatology, immunology, and microbiology. The findings indicate that microbial dysbiosis is consistently associated with immune imbalance, barrier dysfunction, and systemic inflammation. Key mechanisms include Toll-like receptor activation, cytokine modulation, and T-cell differentiation, which collectively influence disease progression. Additionally, the study highlights the growing relevance of the gut-skin axis as a pathway connecting local microbial changes with systemic outcomes. Diagnostic applications, particularly microbiome-based biomarkers, demonstrate potential for disease prediction and monitoring, while therapeutic strategies such as probiotics, bacteriotherapy, and antimicrobial peptides represent emerging approaches in personalized medicine. However, variability across populations and methodological heterogeneity remain significant challenges. This review underscores the importance of the skin microbiome as a central component in human health and supports its integration into future clinical and research frameworks, particularly in diverse international contexts..
Immunometabolism, colorectal surgery, insulin resistance, sarcopenia, malnutrition, gut microbiota, postoperative complications, ERAS, immunonutrition, surgical outcomes
Immunometabolism has emerged as a key determinant of postoperative outcomes in patients undergoing colorectal surgery, integrating metabolic regulation with immune system function during the perioperative period. Surgical stress induces complex metabolic and inflammatory responses that may become maladaptive in patients with preexisting conditions such as insulin resistance, diabetes mellitus, malnutrition, or sarcopenia. These alterations significantly influence immune competence, tissue repair, and overall recovery. This review analyzes current evidence on the role of immunometabolism in shaping postoperative outcomes, focusing on metabolic status, immune response, nutritional condition, gut microbiota, and perioperative care strategies. The findings highlight that patients with metabolic dysregulation present higher rates of complications, including infections, anastomotic leakage, and prolonged hospital stay. Conversely, interventions such as Enhanced Recovery After Surgery (ERAS) protocols and immunonutrition contribute to improved outcomes by modulating metabolic and inflammatory pathways. Additionally, the gut microbiota is identified as a critical factor influencing immunometabolic balance, particularly in colorectal surgery, where intestinal integrity plays a central role. The integration of these elements supports a multidimensional and personalized approach to surgical care.