Angel Miguel Hernandez Falcon

Trauma is a leading global cause of morbidity and mortality, traditionally understood as a localized physical injury. However, current evidence supports a broader perspective in which trauma triggers a complex systemic response involving inflammatory, neuroendocrine, immune, metabolic, and endothelial mechanisms. This study aimed to analyze Post-Traumatic Systemic Syndrome as an integrative condition that influences recovery beyond the initial injury. A structured narrative review was conducted using international scientific databases, including PubMed, Scopus, and Web of Science, focusing on high-impact literature related to systemic trauma responses. The analysis explored the interaction between inflammatory activation, neuroendocrine regulation, immune dysfunction, and metabolic alterations. The findings demonstrate that trauma induces an immediate inflammatory response characterized by cytokine release, followed by neuroendocrine modulation through activation of the hypothalamic–pituitary–adrenal axis. This interaction may lead to either balanced recovery or dysregulated states such as hyperinflammation, immunosuppression, and persistent inflammation syndromes. Additionally, endothelial dysfunction, coagulopathy, and mitochondrial impairment contribute significantly to systemic complications. Recovery trajectories vary depending on the regulation of these mechanisms, highlighting the importance of early and targeted interventions. .

Precision oncology has traditionally focused on genomic profiling to guide targeted therapies; however, increasing evidence suggests that genetic alterations alone are insufficient to fully explain tumor behavior, therapeutic response, and clinical heterogeneity. This review aims to analyze precision oncology beyond genetics by integrating metabolic flexibility, tumor microenvironment dynamics, immune profiling, and systemic physiological factors, with particular emphasis on dermatology and internal medicine in international contexts, including Mexico, Colombia, and Ecuador. A structured narrative review was conducted using the scientific method as a guiding framework, allowing for the systematic identification, analysis, and integration of relevant literature. The findings demonstrate that tumor metabolism, particularly metabolic flexibility, plays a central role in adaptation and resistance. Additionally, the tumor microenvironment and immune profiling are critical determinants of treatment response, especially in the context of immunotherapy. The concept of the kidney as a sensor organ highlights the importance of systemic physiology in oncologic outcomes, particularly regarding drug clearance, toxicity, and metabolic balance. Furthermore, cardiometabolic conditions such as obesity, diabetes, and chronic inflammation significantly influence tumor progression and therapeutic effectiveness. The integration of these dimensions supports a systems-based model of precision oncology, where tumor biology and host factors interact dynamically. This approach is particularly relevant for dermatology and internal medicine, as it allows for a more comprehensive understanding of both local and systemic disease processes. In addition, the proposed framework offers practical applicability in diverse healthcare settings, including regions with limited access to advanced molecular technologies.

Mechanobiology has emerged as a fundamental discipline in understanding tissue regeneration in orthopedic and reconstructive contexts. This review analyzes how mechanical forces—such as tension, compression, shear stress, and controlled loading—regulate biological processes involved in healing across bone, tendon, cartilage, and skin. A structured narrative approach was used to synthesize current evidence from experimental and clinical studies, focusing on mechanotransduction pathways and their clinical implications. The findings demonstrate that tissue regeneration is optimized within a specific mechanical range, where controlled loading enhances cellular activity, extracellular matrix organization, and functional recovery. Conversely, both insufficient mechanical stimulation and excessive loading negatively impact healing outcomes. Additionally, mechanobiological responses are tissue-specific and vary according to the stage of healing, highlighting the importance of progressive and individualized rehabilitation strategies. In reconstructive surgery, mechanical tension plays a critical role in scar formation, where excessive stress is associated with pathological scarring. Overall, this review supports the integration of mechanobiological principles into clinical practice, emphasizing their relevance in improving outcomes in traumatology, orthopedics, and plastic surgery, particularly in diverse healthcare settings.

Population aging has significantly increased the number of elderly patients undergoing surgical procedures, challenging traditional models of perioperative risk assessment. Frailty has emerged as a multidimensional clinical syndrome that better reflects patient vulnerability than chronological age or comorbidities alone. This review aims to analyze the impact of frailty on surgical risk, perioperative decision-making, and postoperative outcomes, integrating current international evidence with a perspective relevant to healthcare systems in Mexico, Colombia, and Ecuador. A structured integrative review was conducted using major biomedical databases, including PubMed, Scopus, and Web of Science. Studies focusing on frailty in surgical settings, perioperative outcomes, and risk stratification were selected and analyzed. The evidence demonstrates that frailty is strongly associated with increased postoperative complications, higher mortality, and significant functional decline. Additionally, frailty-based assessment tools show superior predictive accuracy compared to traditional models based on age or comorbidities. The findings also highlight the effectiveness of interventions such as Comprehensive Geriatric Assessment and prehabilitation in improving surgical outcomes. These strategies support the concept that frailty is a modifiable condition and emphasize the importance of proactive perioperative management.