Universidad Del Valle De Cuernavaca

Cutaneous oncology has entered a new phase defined by the integration of early detection strategies, molecular risk stratification, and biologically guided systemic therapies. Melanoma, although less frequent than keratinocyte cancers, remains the most lethal form of skin cancer, while basal cell carcinoma and Merkel-cell carcinoma contribute significantly to global oncologic burden. This review analyzes the contemporary transformation of cutaneous oncology within the precision medicine framework, focusing on three core domains: stage-based prognosis, genomic characterization, and targeted and immune-based therapeutic interventions. Evidence from landmark clinical trials demonstrates that BRAF-mutated melanoma benefits from combined BRAF/MEK inhibition, while immune checkpoint blockade—particularly PD-1–based regimens—achieves durable survival in advanced disease. Long-term survival data confirm sustained benefit in a subset of patients, redefining expectations for metastatic melanoma outcomes. In addition, immunotherapy has shown meaningful activity in other aggressive cutaneous malignancies such as Merkel-cell carcinoma. The integration of staging systems, molecular diagnostics, and systemic therapies illustrates a dual therapeutic paradigm in which tumor genotype and immune context guide treatment selection. From an international perspective, including healthcare systems in Mexico, Colombia, and Ecuador, the implementation of precision oncology requires structured integration of early detection, standardized pathology, essential genomic testing, and multidisciplinary therapeutic access. Cutaneous oncology in the precision era is therefore characterized by coordinated biological insight and clinical application, forming the basis for advanced academic instruction and evidence-based oncologic practice.

Clinical decision-making under extreme time pressure represents one of the most demanding cognitive challenges in emergency medicine. This review analyzes how temporal compression, cognitive load, workflow interruptions, and stress exposure interact to influence diagnostic accuracy and patient safety. Drawing on foundational literature in diagnostic reasoning, cognitive psychology, and patient safety research, the study synthesizes evidence demonstrating that increasing interruption frequency and cognitive burden are associated with measurable rises in task error and progressive declines in diagnostic reliability. Temporal constraints appear to accelerate reliance on intuitive processing, increasing susceptibility to premature closure, particularly in ambiguous or evolving clinical presentations. Additionally, elevated stress levels are associated not only with reduced mean diagnostic accuracy but also with greater variability in performance. The findings suggest that diagnostic vulnerability in emergency settings is not random but emerges predictably from the interaction between cognitive architecture and system design. Structured mitigation strategies—including micro-reflective checkpoints, diagnostic prompts, workflow protection from unnecessary interruptions, and simulation-based reasoning training—are associated with reductions in error patterns without compromising response time. The implications are particularly relevant for emergency departments operating under structural constraints, including middle-income health systems in Latin America. Strengthening diagnostic safety requires an integrated approach that aligns clinical expertise, environmental design, and institutional safety culture.

Se analiza el proceso de extracción de las plantas útiles del bosque tropical caducifolio (BTC), en 3 municipios aledaños entre sí del centro de México para su comercialización; y la importancia cultural que tienen estas especies en municipios con diferencias culturales. A través de recorridos etnobotánicos en mercados y puestos fijos y ambulantes se identificaron las especies comercializadas procedentes del BTC, se realizaron entrevistas semiestructuradas a los vendedores para conocer formas y tiempos de colecta, usos, partes usadas y frecuencia de venta, con esta información se realizó el índice de valor cultural y se generó el listado de plantas útiles. Para probar si la composición de plantas comercializadas cambia entre los poblados, se realizaron dos análisis de escalamiento multidimensional. En el primero, se usó una matriz de similitudes pareadas entre los poblados con el índice de Jaccard y en el segundo con el índice de similitud de Morisita-Horn. Se encontraron 56 especies de plantas comercializas provenientes del bosque tropical caducifolio, pertenecientes a 31 familias y 49 géneros. Las familias más diversas fueron FABACEAE con 13 especies, y ASTERACEAE con 9. Las similitudes basadas en el índice de Jaccard fueron entre un 22.2% y un 30.4% más bajas que las calculadas con el índice de Morisita-Horn indicando que la diversidad de plantas que se ofertan entre poblados se diferencia por la identidad de las especies, pero se homogeniza por el valor cultural de las mismas. Se observa que, a pesar de sus diferencias, por la cercanía de los municipios se mantienen formas de vida rural tradicional, principalmente en los municipios de Xoxocotla y Puente de Ixtla; Jojutla a pesar de ser un municipio urbano armoniza patrones de uso originario como el uso de plantas medicinales y comestibles con elementos modernos, para solventar algunas necesidades.

Abstract Ternstroemia huasteca is an endangered tree species endemic to the southern Sierra Madre Oriental in Mexico, primarily confined to tropical montane cloud forests. Two population groups of this species are known: one in the Sierra Gorda region, spanning Querétaro and the northern part of Hidalgo, and another occurs in the Zacualtipán region of Hidalgo, extending into the Huayacocotla region of Veracruz. The conservation status of these populations and their degree of genetic diversity remain unknown. Given that habitat conservation forecasts are not optimistic and T. huasteca is already threatened, it is urgent to generate information about the conservation status, specifically regarding the genetic diversity of montane tree species. We genetically evaluated T. huasteca across its distribution range using a robust set of 16 microsatellite markers. Our results reveal relatively high genetic diversity (mean H O = 0.64; mean H E = 0.64) and moderate genetic differentiation ( F ST = 0.142). Genetic clustering revealed a clear separation between the Sierra Gorda and Zacualtipán populations, with substructure within the Zacualtipán group. We also detected a significant isolation-by-distance pattern, suggesting that gene flow decreases with increasing geographic distance. We found evidence of inbreeding and low genetic diversity in one population under silvicultural management. Our findings highlight the urgent need for conservation strategies that enhance connectivity and genetic diversity to ensure the long-term viability of montane forest species, given the ongoing anthropogenic pressures and climate change.

Advances in genomics and immunology have redefined the understanding of immune regulation, disease susceptibility and therapeutic response. This review synthesizes evidence across multiple biological scales—including germline variation, somatic mutations, epigenomic architecture and single-cell immune heterogeneity—to elucidate how genomic mechanisms shape immune function in health and disease. Emphasis is placed on the translational relevance of these mechanisms, particularly in the context of cancer immunotherapy, autoimmune risk stratification and emerging engineered-immunity platforms such as CRISPR-based editing and CAR T-cell therapies. The analysis also highlights the persistent underrepresentation of populations from Mexico, Colombia and Ecuador in genomic datasets, underscoring the need for inclusive precision-medicine strategies. By integrating mechanistic, technological and clinical dimensions, this review outlines the conceptual foundations of immunogenomics and identifies the opportunities and challenges that will shape its evolution as a global, population-relevant discipline.

El auge de ChatGPT en la comunidad académica ha transformado las interacciones que poseen los estudiantes universitarios con respecto a sus proyectos, tareas, planificaciones y sus investigaciones, lo que resalta la relevancia de este estudio. Este estudio se centra en las recomendaciones que ofrecen los estudiantes en la utilización de la herramienta en sus procesos de investigación. Es necesario analizar este fenómeno actual y pionero para comprender mejor cómo las inteligencias artificiales, como ChatGPT, están impactando en la adquisición de conocimientos y en la eficiencia de los proyectos de investigación. El objetivo de esta investigación es describir como ChatGPT ha influenciado en el proceso de investigación de los futuros licenciados de lenguas. Al examinar las recomendaciones que los estudiantes de lenguas que expresan al utilizar esta herramienta, se busca ofrecer una base para el desarrollo de futuros cursos sobre el manejo eficiente y ético de las diversas inteligenciar artificiales, en consecuencia, contribuiría a la mejora de las competencias de investigación de los alumnados y asimismo de las recomendaciones de su uso en la docencia. Esta investigación se llevó a cabo en la Facultad de Lenguas Extranjeras de la Universidad de Colima, así como en otras instituciones, involucrando a un total de 31 estudiantes de licenciatura provenientes de la Universidad de Colima, la Universidad Autónoma de Querétaro y la Universidad de Vigo, en programas relacionados con la enseñanza de lenguas. Dichos participantes, de diversas procedencias, proporcionaron una perspectiva diversa sobre la influencia de ChatGPT en sus proyectos académicos.

Pharmacogenomics has emerged as an essential component of personalized therapy in internal medicine, offering a framework to understand how genetic variability influences drug response, safety, and treatment effectiveness. This review synthesizes international evidence to identify clinically relevant gene–drug interactions, evaluate global implementation strategies, and examine their applicability to healthcare systems in Mexico, Colombia, and Ecuador. The analysis demonstrates that cytochrome P450 enzymes—particularly CYP2C19, CYP2D6, and CYP3A4—continue to play a dominant role in predicting therapeutic outcomes, with strong evidence supporting interactions such as CYP2C19–clopidogrel, CYP2D6–codeine, and SLCO1B1–simvastatin. These associations consistently appear in international guidelines and represent high-impact opportunities for improving cardiovascular, psychiatric, and oncologic care. Global implementation models from North America, Europe, and Asia highlight the importance of structured policies, laboratory capacity, and electronic health record integration, while emerging experiences from Africa and Southeast Asia emphasize scalable, resource-adapted strategies. In Latin America, Mexico demonstrates the highest readiness for pharmacogenomic adoption, followed by Colombia with promising institutional initiatives, and Ecuador with early-stage development requiring capacity-building. The review also discusses the expansion of pharmacogenomics into multi-omic approaches, including epigenetics and nutrigenomics, which are expected to refine predictive accuracy but require advanced informatic infrastructure and clinician training. Overall, pharmacogenomics provides a powerful opportunity to enhance therapeutic precision, reduce adverse drug reactions, and promote equitable and efficient healthcare delivery. Its successful implementation in Latin America will depend on coordinated policy development, investment in infrastructure, and the integration of genomic education into clinical training programs.

Background: Child sexual abuse (CSA) is a serious public health concern that violates the rights of children. In Mexico, little is known about the actual figures for this type of violence. Objective: This study aimed to determine trends in the prevalence and case characteristics of CSA in a representative sample of children in Mexico. Materials and Methods: Data from the National Health and Nutrition Survey (ENSANUT) for 2018, 2020, 2021, 2022 and 2023 were used (n = 24,179). Proportions of CSA were estimated using the weighted mean of a binary variable, and the variance of the estimated proportion was calculated using the Taylor linearization method. Logistic regression models were estimated, and Adjusted Odds Ratios (AORs) with 95% Confidence Intervals (95% CIs) were obtained. Results: The prevalence of CSA ranged from 2.22% (2018) to 5.66% (2023). There was an increasing trend in CSA between 2018 and 2021, which was even more pronounced (154.95%) between 2018 and 2023 (p < 0.001). The main perpetrator in CSA cases was a family member (78.51%), and most victims did not report the abuse to the authorities. Girls were more likely to experience CSA (AOR = 2.83, 95% CI: 1.72-4.68), and as years passed (from 2018 to 2023), the likelihood of becoming a victim of CSA increased. Conclusions: CSA is a problem that has increased in recent years in Mexico. It is noteworthy that the main perpetrator is within the family, which may influence the lack of reporting of these cases. In view of this situation, it is necessary to implement strategies to prevent CSA in children, involving mothers, fathers, and caregivers.

Heart failure (HF) is a leading cause of morbidity, mortality, and healthcare utilization worldwide. β-blockers are a cornerstone of guideline-directed medical therapy, yet uncertainties remain regarding their impact on hospitalization frequency, particularly when therapy is suboptimally dosed. In this retrospective study, we analyzed 480 patients with HF treated at two tertiary hospitals between January 2022 and June 2024, stratified into three groups: no β-blocker therapy, suboptimal therapy, and optimal therapy (≥50% of the target dose). The primary outcome was hospitalization frequency within 12 months, while secondary outcomes included 30-day readmission and median length of stay. Patients without β-blocker therapy had the highest hospitalization rate (62.1%), compared with 47.3% in the suboptimal group and 33.7% in the optimal therapy group. Rehospitalization within 30 days occurred in 22.9%, 15.8%, and 8.0% of patients, respectively, and median length of stay declined progressively from 8 days in untreated patients to 6 days in those optimally treated. Multivariate analysis confirmed that absence of β-blockers and suboptimal therapy were strong predictors of hospitalization, along with diabetes mellitus and reduced ejection fraction. These findings confirm that optimal β-blocker therapy is associated with fewer hospitalizations, reduced early readmissions, and shorter hospital stays, underscoring the importance of both initiation and dose optimization as key strategies in HF management.