Alejandro Padilla Isassi

Background: Physiological reserve reflects the capacity of the organism to maintain homeostasis under biological stress. We suggest the hypothesis that phase angle derived from bioelectrical impedance analysis could be a potential objective marker of Physiological reserve. Methods: An analytical cross-sectional study was conducted in 45 older adults residing in long-term care units at Hospital Español de México (2025). Frailty was assessed with the FRAIL index, sarcopenia using EWGSOP2 criteria, functionality with the Barthel Index, and quality of life with WHOQOL-OLD. Body composition and phase angle were measured by multifrequency bioelectrical impedance (InBody BWA 2.0^®). Associations were analyzed using ROC curves and regression models. Results: Phase angle (PA) was closely associated with key geriatric domains. Frail participants showed significantly lower PA values (3.1 ± 0.7 vs. 3.8 ± 0.9; p = 0.009), while sarcopenic patients presented lower PA (3.1 ± 0.7 vs. 4.1 ± 0.9; p < 0.001). PA demonstrated a strong positive correlation with functional status (r = 0.668; p < 0.001). A moderate positive correlation was observed with quality of life (r = 0.551; p = 0.001). In an exploratory multivariable analysis, PA was independently associated with age (B = −0.063; p < 0.001), functionality (B = 0.013; p < 0.001), and frailty (B = −0.137; p = 0.044). Conclusions: The phase angle is associated with key geriatric conditions that are related to reduced physiological reserves in older adults in long-term care, addressing the hypothesis that phase angle reflects physiological reserve at the cellular level by providing preliminary cross-sectional evidence.

Fahr syndrome is a rare disorder with basal ganglia calcifications and heterogeneous manifestations. We report a 43-year-old woman with parkinsonism and disabling dyskinesia. GPi deep brain stimulation resulted in near-complete dyskinesia resolution and improved dystonia, supporting its potential as an effective treatment in refractory cases despite extensive calcifications

La enfermedad de Rosai-Dorfman-Destombes es una histiocitosis de células no Langerhans cuya etiología no es totalmente conocida, suele tener un curso crónico, benigno y autolimitado. Actualmente, se considera un trastorno histiocítico no neoplásico reactivo que carece de clonalidad. Suele afectar a niños y adultos jóvenes; más del 80% de los casos ocurre en menores de 20 años y predomina en varones, con una relación de 1.4:1. La presentación clínica clásica es una linfadenopatía cervical bilateral masiva e indolora, con presencia o no de sintomatología asociada como fiebre, pérdida de peso y diaforesis. También puede existir afectación extraganglionar. El diagnóstico definitivo se realiza mediante biopsia con inmunohistoquímica, donde el hallazgo clásico es histiocitosis sinusoidal positiva para S-100 y emperipolesis. Actualmente no existe un tratamiento estandarizado; sin embargo, se utilizan esteroides como primera línea. La importancia de este caso clínico, radica en la respuesta benéfica obtenida, al someter a la paciente a terapia alternativa con cámara hiperbárica. Abriendo la puerta a nuevas áreas de investigación con resultados prometedores, al implementarse como terapia combinada. Así como se ha realizado ya en patologías como coadyuvante en tumores e infecciones. Aumentando la tasa de éxito de respuesta al tratamiento.