Search Results (103)

Tuberculosis (TB) is a global public health issue requiring early and accurate diagnosis. The loop-mediated isothermal amplification (LAMP) assay is a promising alternative recommended by the WHO for the initial diagnosis of pulmonary TB, particularly in resource-limited settings. This study evaluated the sensitivity and specificity of a commercial LAMP assay for TB detection using 198 samples from different countries including Mexico. The LAMP assay results were compared to the results of standard tests: AFB smear microscopy, cell culture, and Xpert PCR. Across all samples, LAMP showed a sensitivity of 96.20% and a specificity of 84.61%. When compared specifically to “true positives” and “true negatives” (defined by the consistency across the standard tests), LAMP demonstrated 100% sensitivity and 92.30% specificity. For context, the sensitivity of AFB smear microscopy against the culture and Xpert tests was 79.04%. A significant finding was that the LAMP test detected a high percentage (92.5%) of samples found positive by the culture and Xpert tests but negative by the AFB smear, highlighting its ability to identify cases missed by traditional microscopy. This study concluded that the LAMP assay is a sensitive and specific tool for TB diagnosis with potential for rapid and accurate diagnosis, especially in resource-limited areas. Full article

Artocarpus heterophyllus (jackfruit) is widely distributed in subtropical and tropical regions, and some phytochemicals isolated from this species have demonstrated anti-proliferative effects. However, its impact on triple-negative breast cancer (TNBC) and HPV-related cervical cancer models remains unclear. This study evaluated the phytochemical profile and anticancer activity of an ethanolic extract from A. heterophyllus leaves (AHEE) in the TNBC cell line MDA-MB-231 and in the HPV-16⁺ murine cancer cell line TC-1. Phytochemical screening and spectroscopic analyses (UV-Vis, IR, ¹H, and ¹³C NMR) revealed the presence of tannins, alkaloids, steroids, coumarins, and flavone-type flavonoids, with a total phenolic content of 3.34 µg GAE/mg and flavonoid content of 0.44 mg QE/g extract. In 2D cultures, AHEE reduced cell viability by 49% in TC-1 and 24% in MDA-MB-231 at 300 µg/mL, inhibited colony formation and migration in TC-1, and impaired survival but not migration in MDA-MB-231. In 3D cultures, 250 µg/mL inhibited proliferation, migration, and anchorage-independent growth in both cell lines. Furthermore, the combination of AHEE with one-fifth of the IC₅₀ of doxorubicin or cisplatin produces an effect comparable to that observed with the full IC₅₀ of these drugs. These findings suggest that AHEE possesses anticancer activity with cell-type-specific effects and highlight its potential as an adjuvant therapy. Further studies are warranted to elucidate its mechanisms of action. Full article

Dengue mortality has traditionally been associated with severe thrombocytopenia and hemorrhagic complications. However, during 2024, dengue virus serotype 3 (DENV-3) increased significantly in western Mexico, leading to the emergence of a distinct clinical pattern. We conducted a retrospective cohort study of hospitalized dengue patients at the General Hospital of Colima (January–August 2024). Clinical features, laboratory parameters, and outcomes were compared between survivors and non-survivors. Among 201 hospitalized patients, 6 (3.0%) died. All deceased patients presented with generalized seizures, polyserositis (pleural effusion and/or ascites), and required mechanical ventilation. Contrary to classical patterns, they did not have severe thrombocytopenia. Instead, they showed significantly higher white blood cell counts and notably increased levels of serum urea and BUN, suggesting early renal impairment. ROC analysis indicated that BUN (AUC 0.904) and urea (AUC 0.906) were good to excellent discriminators of mortality. During 2024, with an increase in DENV-3 circulation, mortality was associated with neurological and systemic complications, including seizures and polyserositis, as well as biochemical evidence of renal dysfunction—but not with severe thrombocytopenia. These findings challenge current paradigms and highlight the need for early recognition of atypical clinical patterns. Full article

Objective: To test whether hypervitaminosis B12 is useful for prognosis of all-cause mortality. Methods: Meta-analysis of longitudinal, observational, epidemiologic studies. PubMed, Scopus, Web of Science, Google Scholar, and ProQuest One Academic were searched from inception to 30 June 2024. Studies including humans aged ≥18 years with hypervitaminosis B12, and in whom the outcome variable was all-cause mortality, were included. Two reviewers screened, abstracted (using standardized data collection sheet), and appraised articles (ROBINS-E framework) independently. Frequentist and Bayesian approaches were used for the meta-analysis. Results: A total of 28 studies were included in the meta-analysis (among the 69,610 participants, 15,815 all-cause deaths were reported). High serum levels of B12 increased marginally the risk of all-cause mortality specifically among chronic diseases (RR = 1.40; 95% IC = 1.05 to 1.85) and hospitalized (RR = 1.57; 95% IC = 1.19 to 2.07). In the meta-regression, these results were not statistically significant. The Bayesian analysis confirmed the risks of the mentioned groups; however, it was limited by the number of studies that contained the necessary information. The methodology applied and the clinical heterogeneity of each included study bring up the idea that artefacts might be involved when mortality is found to be high for hypervitaminosis B12. Conclusions: This meta-analysis did not show that hypervitaminosis B12 represents a higher risk of all-cause mortality in adults. Full article

Background/Objectives: Sexual attitudes, particularly those on the erotophilia (positive openness) to erotophobia (negative fear) scales, play a critical role in shaping behaviors and health decisions. While associations between sexual behavior and substance use have been documented, limited research has explored how sexual attitudes relate to mental health and substance use among Latin American university populations. This study aimed to examine the associations among erotophilic attitudes, mental health symptoms (anxiety and depression), substance use risk, and sexual behaviors in Mexican university students. Methods: A cross-sectional observational study was conducted between 2019 and 2023 with 1475 undergraduate students aged 17–25 years. Participants completed the Revised Sexual Opinion Survey (R-SOS) to assess sexual attitudes, the Hospital Anxiety and Depression Scale (HADS) for mental health evaluation, and adapted items from the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) to measure substance use risk. Erotophilic attitudes were defined as R-SOS scores ≥ 70. Statistical tests included the Kolmogorov–Smirnov test for normality, t-tests or Mann–Whitney U tests for group comparisons, Fisher’s exact test for categorical variables, and Spearman’s correlations. Multivariate binary logistic regression was used to calculate adjusted odds ratios (AdORs) and 95% confidence intervals (CIs), with a significance level of p < 0.05. Results: Erotophilic students were more likely to be male, older, initiate sexual activity earlier, and report a greater number of sexual partners. Erotophilia was positively associated with anxiety and tobacco, alcohol and marijuana use, and negatively associated with depressive symptoms. Multivariate analysis indicated that erotophilia was independently associated with male sex, age ≥ 20, higher anxiety, lower depression, low socioeconomic status, and increased risk of tobacco and marijuana use. Lower rates of consistent condom use were also reported among erotophilic individuals. Conclusions: Erotophilia may serve as a behavioral risk marker linked to anxiety symptoms and increased substance use, but not to depression. These findings highlight the need for integrated interventions addressing sexual health, substance use, and mental well-being in university populations. Full article

Currently, approximately 40% of patients with dementia develop some form of sleep disorder. Benzodiazepines are widely prescribed but pose the risk of tolerance and cognitive decline; however, Z-drugs may offer safer alternatives. Therefore, this systematic review aimed to analyze the effect of benzodiazepines and Z-drugs on sleep disorders in patients with dementia. Two authors conducted a systematic search in PubMed, Scopus, Web of Science, Espistemonikos, and ACCESSSS for studies published between 2019 and 2024 using the MeSH terms “dementia”, “sleep disorders”, and “pharmacotherapy”. Randomized clinical trials comparing benzodiazepines, Z-drugs, or innovative medications with placebo or other drugs were included. Sleep and cognitive outcomes were assessed using validated instruments; the ROB-2 tool evaluated the risk of bias. The protocol was registered in “PROSPERO”. Three randomized clinical trials involving a total of 192 patients were included in the review. Zopiclone increased the main duration of nighttime sleep by 81 min, Zolpidem reduced nighttime awakenings by 21 min, and Eszopiclone improved sleep quality, benefited the progression of sleep architecture, and reduced mental symptoms such as fear and anxiety. Z-drugs show superior efficacy and safety over benzodiazepines, improving sleep and cognitive symptoms in dementia. Personalized treatment and further research across dementia subtypes are needed to optimize long-term outcomes. Full article

Specialized mental health services (SMHS) should be accessible to all populations. This study investigated the accessibility of public SMHS for children and adolescent patients, as well as their caregivers, in Mexico. A cross-sectional survey was conducted with 400 patient–caregiver dyads receiving care at two primary SMHS facilities. The survey included indicators within four dimensions of accessibility: (1) organizational entry into SMHS; (2) organizational processes within SMHS; (3) ecological factors; (4) financial aspects. Additionally, six outcome variables were explored, including perceived health conditions and quality of care indicators. A principal component analysis (PCA) was utilized to construct four accessibility indices. Subsequently, multiple linear regression models were applied to examine the relationship between these accessibility indices and the outcome variables. Several indicators yielded notable results. The average emergency ward waiting time was 74.3 min (SD = 95.99), the post-hospitalization wait time was 1.28 weeks (SD = 1.85), and the average medical costs amounted to 962.6 Mexican pesos (SD = 2555.1). Several of the tested relationships between accessibility indices and outcome variables were statistically significant; organizational processes within SMHS and financial indices had a higher number of these significant relationships. These findings highlight the significant challenges in improving accessibility to public SMHS for children and adolescents in Mexico. Full article

During the 2017–2018 influenza season, there was high influenza activity, with a predominance of influenza A(H1N1)pdm09 circulation in the country. The influenza circulation pattern in the area of the Yucatan Peninsula was different from that of the rest of the country. However, in the summer of 2018, there was a sudden increase in the number of identified cases. A retrospective analysis was performed using data generated by four molecular diagnostic laboratories of the Mexican Social Security Institute. Demographics, influenza positivity, seasonality and case fatality rates were recorded. We used odds ratios to compare outpatients who were confirmed by laboratory tests to be positive with those who were confirmed to be negative. The Kaplan–Meier method and Cox multivariate analysis were used to calculate cumulative risk. There were 4460 cases of ILI/SARI between Yucatan and Quintana Roo, which represented 53.1% of the total number of cases reported. Compared with that in 2009, the epidemic wave in 2018 was shorter and more expansive, with a greater number of reported cases, as well as a greater number of people who required hospitalization. The dominant pattern of A(H1N1)pdm09 influenza activity on the Yucatan Peninsula in the summer of 2018 has not been observed since the influenza pandemic of 2009. Full article

The relationship between telomere shortening and patients with chronic kidney disease (CKD) has recently been investigated. Although most patients respond adequately to erythropoiesis-stimulating agents (ESAs), approximately 10% do not, and this is referred to as ESA resistance. The aim of our study was to investigate the relationship between telomere shortening and erythropoietin resistance in patients with CKD on hemodialysis. This cross-sectional, comparative, analytical, and observational study was conducted in patients of both sexes over 18 years of age diagnosed with CKD. Two groups of patients were identified. The first group consisted of 40 patients receiving erythropoiesis-stimulating agents with erythropoietin resistance. The second group consisted of 40 patients with the same characteristics but without erythropoietin resistance. Telomere length was measured by real-time PCR. Eighty patients were included in the study. Mean hemoglobin levels were lower in the erythropoietin resistance group (8.8 ± 1.67 vs. 11.95 ± 1.81, p = 0.001). Differences were observed in hematocrit and albumin levels, which were lower in patients with erythropoietin resistance, while PTH levels were higher in this group (788 ± 538.47 vs. 535.65 ± 603.06, p = 0.001). A significant difference in telomere length (T/S) was observed between the two groups, with shorter telomere length in the erythropoietin resistance group (0.45 ± 0.04 vs. 0.56 ± 0.03, p = 0.01). Telomere shortening may be associated with anemia and erythropoietin resistance in patients with CKD undergoing hemodialysis. This relationship suggests the need to explore whether telomere length recovery improves the response to ESAs. Full article

Background and Objectives: Arteriovenous fistulas (AVFs) are the preferred vascular access for hemodialysis due to their impact on patient outcomes, including survival, infection rates, and overall quality of life. Despite strong recommendations favoring AVF, gaps in AVF utilization remain, influenced by clinical, demographic, and systemic factors. This study is the first to analyze survival outcomes associated with different dialysis vascular access types, adjusting for key clinical, demographic variables, and other comorbidities over extended periods. Materials and Methods: This ambispective cohort study followed 428 hemodialysis patients over seven years. Patients were categorized based on their access type: AVF (n = 189), tunneled central venous catheter (CVC) (n = 178), and non-tunneled CVC (n = 61). Kaplan–Meier survival analysis was used to estimate survival curves, and Cox proportional hazards regression adjusted for potential confounders, including age, diabetes, and hypertension. Results: The 2-year survival rates were as follows: AVF 94.1%, tunneled CVC 70.0%, and non-tunneled CVC 36.6%. The 7-year survival rates were as follows: AVF 65.5%, tunneled CVC 26.4%, and non-tunneled CVC 11.0%. Compared to AVF, tunneled CVC use was associated with a 2.8-fold increased risk of mortality (adjusted hazard ratio [AdHR] 2.8, 95% CI 2.0–4.1), while non-tunneled CVC increased the risk 5-fold (AdHR 5.0, 95% CI 3.3–7.6). Notably, older adults, women, and diabetic patients were disproportionately represented in the groups with tunneled and non-tunneled catheters. Conclusions: Adjusted survival analyses highlight the significantly lower survival rates associated with CVC use compared to AVF. Non-tunneled catheters are generally not used for prolonged periods, and this cohort provides evidence of their prognosis for long-term use. These findings reinforce the need to prioritize AVF placement whenever feasible, reinforcing health education on this topic, to improve long-term outcomes for hemodialysis patients. Full article

Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide, with growing concerns about the impact of omega-6 polyunsaturated fatty acids (n-6 PUFAs) on cardiovascular health. This study aims to evaluate the relationship between serum linoleic acid (LA) levels and waist-to-height ratio (WHtR), a recognized cardiovascular risk marker, in children. The research was conducted in two parts. First, a global analysis of publicly available data (2019–2021) explored the association between nutritional factors and CVD prevalence across 183 countries. Second, a cross-sectional study involving 67 children (33 with obesity and 34 with healthy weight, classified using BMI Z-scores) examined the correlation between serum LA levels and WHtR. Global analysis revealed a moderate correlation between low seafood omega-3 fatty acid intake and CVD incidence (rho = 0.341), while low polyunsaturated fatty acid consumption showed a weak correlation (rho = 0.228). In children, a significant positive correlation was observed between serum LA levels and WHtR (rho = 0.716, p < 0.001), with similar correlations found when stratified by sex (girls: rho = 0.690; boys: rho = 0.709). Serum LA levels also correlated positively with weight (rho = 0.684). These findings are consistent with the existing literature, that high serum LA levels may contribute to early cardiometabolic risk in children, emphasizing the need for dietary interventions to mitigate cardiovascular risks in early life. Full article

Background/Objectives: Metastatic prostate cancer remains a major clinical challenge, with limited therapeutic options. Doxycycline, a tetracycline antibiotic with anti-inflammatory properties, has shown potential as an adjunctive therapy. This study aimed to evaluate its efficacy in reducing prostate-specific antigen (PSA) levels and improving quality of life in patients receiving standard treatment for metastatic prostate cancer. Methods: This phase II, double-blind, randomized controlled trial included 45 participants (aged 57–81 years) assigned to doxycycline (100 mg daily) or a placebo for six months. The primary outcome was the percentage change in PSA levels at 3 and 6 months. Secondary outcomes included quality of life (EQ-5D-5L), cognitive function (Mini-Mental State Examination), and glucose levels. Additionally, a structure–activity relationship (SAR) analysis was performed through an extensive bibliographic review to identify pharmacophores responsible for doxycycline’s biological activity, particularly its tetracyclic core. The SAR analysis included tetracyclines and derivatives, androgen-targeting agents, and other pharmacologically relevant molecules used in prostate cancer therapy. Statistical analysis was conducted using multivariate logistic regression. Results: At six months, the doxycycline group showed a median PSA reduction of 60% compared to 10% in the placebo group (p = 0.043). A ≥50% reduction in PSA levels was observed in 71.4% of patients receiving doxycycline versus 20.8% in the placebo group (p = 0.001), with an adjusted relative risk of 10.309 (95% CI: 2.359–45.055, p = 0.002). Quality of life improved, with 7.1% of doxycycline-treated patients reporting poor quality of life compared to 42.9% in the placebo group (p = 0.028). A slight improvement in cognitive function was also noted (p = 0.037). SAR analysis suggested that the tetracyclic ring of doxycycline may play a crucial role in its observed biological effects. Conclusions: Doxycycline demonstrates potential as an adjunctive therapy in metastatic prostate cancer by reducing PSA levels and improving quality of life. The SAR analysis supports the hypothesis that its tetracyclic structure may be responsible for its therapeutic effects. Further large-scale trials are warranted to confirm these findings. Full article

Physical functional impairment generates pain, fear and anguish, impacting the activities of daily living (ADLs) of older adults (OAs); The background was to design an instrument that can measure pain in OA living with pain. Methods: mixed analytical and cross-sectional study in two non-probabilistic samples: 15 experts in the care of OAs and 185 OAs from day homes in three municipalities of the State of Mexico. The instruments used included an integrated scale of 30 items, elaborated with the Delphi technique over three rounds, and the Scale for Measuring Pain in Older Adults (SMPOA), with 30 items divided into four factors. An analysis was conducted using content validity ratios and the Lawshe´s method adapted by Tristán for qualitative studies, with a minimum of 0.87 and a maximum of 1.0. An exploratory factor analysis (EFA) was conducted to structure the underlying factors into a data matrix, addressing the relationships between a set of variables, and a confirmatory factor analysis (CFA) was conducted to validate the scale using the main axis method and rotation via Quartimax with Kaiser normalisation. Results: proposal of a scale to measure pain in MA (EMEDAM). Conclusion: the adapted scale assesses sensory and affective intensity and the influence on the ADLs and can be used in OAs living with acute or chronic pain. Full article

Background and Objective: Primary Progressive Aphasias (PPAs) are rare neurodegenerative disorders classified within frontotemporal lobar degeneration (FTLD) and typically manifest between 45 and 70 years of age. In Mexico—and many other countries—reliable epidemiological data are lacking; however, estimates suggest that PPA accounts for 0.5–2.5% of neurodegenerative disease cases in Memory Clinics, with an incidence of approximately 1 per 100,000 and an average survival of 8 years. This review aims to provide clinicians with an overview of PPA’s epidemiology, clinical features, and classification, thereby enhancing understanding of its subtypes and distinguishing characteristics from other aphasic conditions, such as vascular aphasia. Methods: This narrative review was conducted through a literature search using databases such as PubMed and Scopus. Relevant studies addressing the epidemiology, clinical presentation, and classification of PPA were identified, selected, and synthesized to offer a broad, clinically oriented overview of the condition. This approach was chosen to inform clinical practice and highlight the need for further targeted investigations, such as future systematic reviews focusing on specific aspects like therapeutic strategies. Key Contents and Findings: (a) Epidemiology: PPA is estimated to affect 0.5–2.5% of patients with neurodegenerative diseases in Memory Clinics, with an incidence of roughly 1 per 100,000. Average survival time is around 8 years (ranging from 3 to 17 years), with a generally balanced gender ratio, though some studies indicate a predominance of men. A positive family history is observed in 20–40% of cases, with about 10% following an autosomal dominant inheritance pattern. (b) Clinical Characteristics and Classification: PPA is marked by a gradual decline in language abilities, differentiating it from vascular aphasias. Subtypes include non-fluent forms (non-fluent progressive aphasia [nfPPA] and logopenic progressive aphasia [lPPA]), fluent forms (progressive fluent aphasia [PFA] and semantic dementia [SD]), and mixed forms (progressive mixed aphasia [PMA]). The neurodegenerative process in PPA extends beyond vascular boundaries, often resulting in presentations that deviate from classical Broca’s and Wernicke’s aphasias. Common symptoms include difficulties in word finding and naming, sometimes mistaken for memory loss, and, in the case of semantic dementia, personality changes that may go unnoticed by the patient. Conclusions: PPA is a heterogeneous and complex group of neurodegenerative disorders with significant clinical variability and a profound impact on patients and their families. While current epidemiological data are limited, this review emphasizes the need for further research to better delineate disease progression and refine diagnostic and therapeutic approaches. Future systematic reviews will be essential to address specific aspects of PPA, such as treatment strategies, to further improve patient care. Full article

Traditional and complementary medicine (T&CM) plays a significant role in healthcare practices among healthcare professionals and oncology patients in Mexico, reflecting its cultural importance. This study aimed to analyze the prevalence, frequency, and factors associated with T&CM use in these two groups, highlighting the differences in practices and perceptions. A total of 382 individuals participated, including 152 healthcare professionals and 230 oncology patients. The findings revealed that while T&CM use was similarly prevalent among healthcare professionals (85.7%) and oncology patients (90.8%), frequent use (≥2 times per week) was significantly higher among patients (46.3%) compared to healthcare professionals (19.1%, p < 0.001). Healthcare professionals showed a preference for non-conventional nutritional interventions (32.5%) and yoga (14.6%) while oncology patients favored plant-based remedies (73.6%) and the consumption of exotic animals and venoms (4.8%). Females were more likely to use T&CM across both groups, with a stronger association among healthcare professionals (AdOR 3.695, 95% CI 1.8–7.4). Oncology patients were less likely to understand T&CM concepts and were more commonly associated with lower socioeconomic status and educational attainment. These findings underscore the importance of considering cultural and demographic factors when integrating T&CM into conventional medical care, especially in regions where T&CM remains widely practiced and trusted. Full article