Martín Eduardo Azua Martínez

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.

Hidden hearing loss (HHL) has emerged as an important topic in auditory medicine because many individuals experience significant communication difficulties despite presenting normal pure-tone audiometric thresholds. This review critically analyzes current international evidence regarding the epidemiology, pathophysiology, clinical manifestations, diagnostic challenges, and therapeutic perspectives associated with HHL, with particular emphasis on cochlear synaptopathy and its implications for clinical practice. A narrative literature review was conducted using the Scientific Method as the methodological framework. Scientific publications indexed in PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar were reviewed, prioritizing original investigations, systematic reviews, meta-analyses, and clinical guidelines published in peer-reviewed journals. The evidence indicates that speech-in-noise perception deficits, tinnitus, listening fatigue, and temporal auditory processing impairments represent the most frequently reported manifestations among individuals with suspected HHL. Occupational and recreational noise exposure, together with physiological aging, were consistently identified as the principal risk factors. Although conventional pure-tone audiometry remains essential for hearing assessment, it demonstrates limited sensitivity for detecting early neural dysfunction. Complementary evaluations, including speech-in-noise testing, auditory brainstem responses, extended high-frequency audiometry, and other electrophysiological techniques, provide additional diagnostic information; however, no single method currently constitutes a definitive diagnostic standard. The reviewed literature supports the implementation of multimodal diagnostic strategies integrating behavioral, physiological, and clinical findings. Furthermore, the analysis highlights the need for standardized diagnostic criteria, objective biomarkers, multicenter investigations, and increased scientific participation from Latin America. Hidden hearing loss represents an evolving multidisciplinary concept that expands the understanding of auditory dysfunction beyond conventional audiometry and emphasizes the importance of comprehensive patient-centered evaluation to improve early recognition, clinical management, and future research.

This study analyzes the scientific, ethical, and regulatory dimensions of next-generation regenerative approaches in aesthetic surgery within Mexico, Colombia, and Ecuador. The objective was to evaluate the effectiveness, safety, and ethical implications of platelet-rich plasma (PRP), stromal vascular fraction (SVF), and adipose-derived stem cell (ADSC) therapies. A hybrid methodology combining the Scientific Method and the Delphi Method was applied, integrating literature analysis, retrospective review of 126 anonymized clinical records, and expert consensus from fifteen specialists. Descriptive statistics were performed to assess demographic trends, patient satisfaction, recovery times, and complication rates. The results revealed that PRP was the most frequently used procedure (42%), followed by SVF (33%) and ADSC (25%), achieving an overall satisfaction level above 4.3 on a 5-point scale. Complications were mild and transient, with no severe events reported. Mean recovery time ranged from 2.3 days for PRP to 4.5 days for ADSC, confirming the minimally invasive nature of these interventions. The Delphi consensus demonstrated over 85% agreement among experts regarding patient safety, informed consent, and ethical communication. In conclusion, regenerative aesthetic surgery has proven to be a safe and effective field that combines biomedical innovation with ethical accountability. These findings emphasize the need for harmonized regional regulations, transparent clinical practices, and continued interdisciplinary collaboration to sustain responsible progress in regenerative medicine and aesthetic care.

The present multinational study evaluated the comprehensive metabolic, cardiovascular, renal, and hepatic effects of incretin-based therapies in adults with obesity and type 2 diabetes mellitus (T2DM) across Mexico, Colombia, and Ecuador. After 12 months of treatment, participants exhibited consistent and clinically significant improvements in all outcome domains. Mean body weight decreased by 10.7%, HbA1c by 1.3 percentage points, and fasting glucose by 23.5%, accompanied by favorable reductions in blood pressure and lipid levels. Estimated glomerular filtration rate (eGFR) improved (+2.3 mL/min/1.73 m²), while albuminuria declined (−14 mg/g), reflecting strong renal protection. Hepatic parameters, including ALT, CAP score, and fibrosis indices (FIB-4, NFS), also improved, suggesting regression of steatosis and early fibrosis. The incidence of major adverse cardiovascular events (MACE) was 2.6%, with no significant differences between countries (p > 0.05), confirming regional reproducibility. Collectively, these findings demonstrate that incretin-based pharmacotherapy provides integrated metabolic and multiorgan protection, in line with evidence from pivotal trials such as STEP, SURPASS, SELECT, and FLOW. The uniform outcomes across nations highlight its potential scalability in Latin America, supporting incorporation into regional health programs for diabetes, obesity, and metabolic dysfunction–associated steatotic liver disease (MASLD). Incretin-based therapies therefore represent a transformative paradigm in modern endocrinology—uniting glycemic control, weight management, and organ preservation under a single therapeutic strategy.

Regenerative medicine is transforming aesthetic surgery by shifting its purpose from temporary cosmetic correction to true biological restoration. This multicenter study, conducted in Mexico, Colombia, and Ecuador with 180 participants, evaluated the clinical efficacy, histological performance, safety, and ethical perception of three aesthetic interventions: adipose-derived stem cell (ADSC)-enriched fat grafting, platelet-rich plasma (PRP) therapy, and hyaluronic acid filler. Standardized assessments were carried out at 1, 3, and 6 months, measuring satisfaction, volumetric retention, dermal elasticity, adverse events, histological regeneration, and ethical comprehension using validated instruments. The results demonstrated that ADSC-enriched fat grafting achieved the highest overall outcomes, with a mean satisfaction score of 8.6 ± 0.9, volumetric retention of 72.3%, and superior skin elasticity (0.89 mm), while maintaining the lowest complication rate (28.3%). PRP therapy provided moderate dermal improvement and high safety (38.3% minor events), whereas hyaluronic acid fillers showed reduced durability (28.7% retention) and greater inflammatory response (51.7%). Histological analysis confirmed enhanced angiogenesis, organized collagen alignment, and minimal fibrosis in ADSC-treated tissues. A strong positive correlation was observed between ethical perception and patient satisfaction (r = 0.71, p < 0.001), underscoring the importance of communication and transparency in aesthetic outcomes. Autologous regenerative therapies therefore emerge as superior alternatives, integrating efficacy, biocompatibility, and ethical confidence. The convergence of regenerative biology and bioethical responsibility defines the new paradigm of next-generation aesthetic surgery, merging innovation with integrity to achieve sustainable and patient-centered beauty.