Alexa Fernanda Uriostegui Navarro

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.

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.

Chronic non-communicable diseases and occupational risk exposures increasingly converge within the modern workforce, particularly in middle-income countries such as Mexico, Colombia, and Ecuador. This review analyzes the integration of Primary Care, Occupational Health, and Surgical Services as a coordinated strategy to strengthen chronic disease prevention and improve functional outcomes among economically active adults. Using a structured scientific framework and evidence from internationally recognized literature, the study examines prevention levels, integration mechanisms, occupational risk pathways, and system-level outcomes associated with coordinated care models. The findings indicate that integrated systems prioritize primary prevention and early detection while maintaining structured referral pathways and return-to-work protocols. Occupational stress, sedentary behavior, ergonomic overload, and sleep disruption were identified as major contributors to cardiometabolic and surgical outcomes. When services operate cohesively, improvements are observed in early disease identification, reduction of preventable surgical complications, decreased disability rates, and enhanced value-based efficiency. The results support a model in which primary care serves as the coordinating hub, occupational health as the preventive operational arm, and surgical services as partners in complication management and functional restoration. The integration of these domains provides a sustainable pathway for reducing morbidity, preserving workforce productivity, and strengthening health system performance in contemporary labor environments.

Anesthesia is a complex physiological intervention capable of producing significant neurophysiological and systemic alterations that influence perioperative and postoperative patient outcomes. Contemporary evidence suggests that anesthetic agents affect cortical connectivity, thalamocortical communication, neurotransmitter regulation, cardiovascular stability, respiratory physiology, inflammatory pathways, and metabolic homeostasis. The objective of this review was to analyze the neurophysiological and systemic effects of anesthesia and evaluate their implications for perioperative recovery, postoperative complications, and patient-centered outcomes. A narrative review methodology supported by the Scientific Method framework was employed. Scientific literature indexed in internationally recognized databases including PubMed, Scopus, ScienceDirect, and specialized anesthesiology journals was analyzed. The review focused on studies published between 2015 and 2025 involving neurophysiological mechanisms of anesthesia, postoperative neurocognitive disorders, hemodynamic instability, systemic physiological alterations, perioperative brain health, and individualized anesthetic management strategies. The analyzed evidence demonstrated that anesthesia produces coordinated alterations involving neural networks, organ perfusion, inflammatory activation, respiratory dynamics, and metabolic regulation. Excessive anesthetic depth was associated with increased postoperative delirium and cognitive dysfunction, particularly among elderly and vulnerable patients. Intraoperative hypotension demonstrated a strong relationship with postoperative organ dysfunction and perioperative morbidity. Furthermore, individualized strategies such as electroencephalography-guided anesthesia, regional anesthesia, multimodal analgesia, and precision-based hemodynamic management were associated with improved recovery profiles and better postoperative outcomes.

Emergency medicine requires rapid and accurate clinical decision-making in environments characterized by uncertainty, cognitive overload, overcrowding, and limited time availability. The present review analyzes the principal factors influencing decision-making under time pressure in emergency departments, with emphasis on neurological and internal medicine emergencies. The study explores the relationship between diagnostic reasoning, cognitive biases, treatment delay, risk stratification, organizational stressors, and patient outcomes. A narrative review methodology based on the Scientific Method and evidence-based analysis was employed. Scientific literature was obtained from internationally recognized databases including PubMed, Scopus, NCBI, and peer-reviewed medical journals. The review incorporated studies related to emergency medicine, cognitive psychology, patient safety, neurological emergencies, internal medicine emergencies, triage systems, and healthcare management. The analysis included evidence from international healthcare systems with special consideration of emergency care realities in Mexico, Colombia, and Ecuador. The findings demonstrate that increasing time pressure is associated with reduced diagnostic accuracy and greater vulnerability to cognitive biases such as anchoring bias, premature closure, confirmation bias, and availability bias. Overcrowding was identified as one of the principal systemic factors negatively affecting emergency department workflow, contributing to diagnostic delay, treatment postponement, prolonged length of stay, and increased physician workload. Acute ischemic stroke, sepsis, and acute coronary syndrome showed the strongest association between delayed intervention and adverse patient outcomes.