Ana Clemente

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.

Cardiovascular disease remains the leading cause of mortality worldwide despite substantial advances in lipid-lowering therapies. Although achieving recommended low-density lipoprotein cholesterol (LDL-C) targets significantly reduces cardiovascular risk, many patients continue to experience recurrent cardiovascular events, a phenomenon known as residual cardiovascular risk. Increasing evidence indicates that chronic low-grade inflammation is a major contributor to this persistent risk. This review analyzes current scientific evidence regarding the biological mechanisms, inflammatory biomarkers, and emerging therapeutic strategies associated with residual inflammatory risk beyond LDL cholesterol. The literature demonstrates that activation of the NLRP3 inflammasome and the interleukin-1β/interleukin-6 pathway plays a central role in endothelial dysfunction, plaque progression, and atherosclerotic instability. High-sensitivity C-reactive protein (hs-CRP) remains the most widely validated biomarker for identifying persistent inflammatory activity in clinical practice. Landmark clinical trials, including CANTOS, COLCOT, and LoDoCo2, have demonstrated that selective anti-inflammatory therapies reduce recurrent cardiovascular events independently of additional LDL-C lowering, whereas nonspecific anti-inflammatory approaches have shown limited benefit. Furthermore, obesity, type 2 diabetes mellitus, metabolic syndrome, and chronic kidney disease substantially amplify residual inflammatory risk through shared pathophysiological mechanisms. Current evidence supports a transition toward comprehensive cardiometabolic prevention integrating lipid management, lifestyle modification, metabolic optimization, and targeted anti-inflammatory therapy. Future precision medicine strategies incorporating inflammatory biomarkers and individualized risk assessment may further improve cardiovascular outcomes and reduce the global burden of atherosclerotic disease.

Long COVID has become a major global health concern due to the persistence of symptoms that continue for weeks or months after acute SARS-CoV-2 infection. This review aimed to compare the clinical manifestations, pathophysiological mechanisms, diagnostic approaches, risk factors, and management strategies of Long COVID in pediatric and adult populations. An integrative literature review was conducted using publications retrieved from PubMed, Scopus, Google Scholar, and international health organizations, including the World Health Organization, the Centers for Disease Control and Prevention, and the National Institute for Health and Care Excellence. Current evidence indicates that Long COVID is a heterogeneous multisystem condition involving neurological, respiratory, cardiovascular, musculoskeletal, gastrointestinal, and psychological systems. Adults generally present a greater frequency and severity of persistent symptoms; however, children and adolescents also experience clinically significant long-term sequelae that may interfere with growth, education, and psychosocial development. The available evidence supports a multifactorial pathophysiological model involving viral persistence, immune dysregulation, autoimmunity, endothelial dysfunction, dysautonomia, and mitochondrial impairment. Diagnosis remains primarily clinical because no validated biomarker currently exists, making individualized assessment and exclusion of alternative diagnoses essential. Effective management requires multidisciplinary collaboration and rehabilitation strategies adapted to patient age, symptom profile, and functional limitations. Although scientific knowledge has expanded considerably, further standardized prospective studies, particularly in underrepresented regions such as Latin America, are needed to improve diagnosis, treatment, and long-term outcomes.

Women’s health has traditionally been approached from a reproductive perspective; however, growing evidence indicates that hormonal changes exert systemic effects extending beyond reproductive function. The present study analyzed hormonal, dermatologic, and metabolic interactions throughout the female lifespan using data obtained from an international population of 12,600 women representing Asia, Europe, North America, South America, Africa, and Oceania. A quantitative, observational, cross-sectional, descriptive-analytical design based on the Scientific Method was employed. Data were collected through anonymous standardized questionnaires that evaluated dermatologic manifestations, metabolic alterations, hormonal changes, and the perceived impact of these conditions on overall health and well-being. The findings demonstrated a high prevalence of dermatologic alterations across all continents, a progressive increase in metabolic changes from puberty to menopause, frequent coexistence of hormonal, dermatologic, and metabolic manifestations, and a consistently high perception of the multidimensional impact of hormonal transitions. These results support the concept that endocrine regulation influences multiple physiological systems simultaneously and reinforce the need for multidisciplinary healthcare approaches that integrate endocrinology, gynecology, dermatology, nutrition, and preventive medicine. The study contributes to the growing international evidence supporting a life-course approach to women’s health beyond reproduction and highlights the importance of comprehensive strategies aimed at improving quality of life and promoting healthy aging.

Medical misinformation disseminated through social media has become a major global public health challenge, influencing health behaviors, public trust, vaccination acceptance, and the effectiveness of health communication strategies. The rapid expansion of digital platforms has facilitated unprecedented access to health information while simultaneously increasing exposure to inaccurate, misleading, and scientifically unsupported content. This review aimed to analyze the global impact of medical misinformation on public health campaigns and identify evidence-based strategies capable of mitigating its effects. A structured review of scientific literature was conducted using publications indexed in major international databases, including PubMed, Scopus, Web of Science, and ScienceDirect. The evidence examined demonstrated that misinformation significantly affects vaccination programs, adherence to preventive measures, trust in healthcare institutions, risk perception, and healthcare-seeking behaviors. Vaccine-related misinformation emerged as the most prevalent category, followed by false preventive recommendations, conspiracy theories, unsupported treatments, and misleading information regarding infectious diseases. Social media platforms such as Facebook, WhatsApp, YouTube, TikTok, and X were consistently identified as major channels for misinformation dissemination. Evidence from Latin America, including Mexico, Colombia, and Ecuador, revealed patterns similar to those observed globally, although local sociocultural and educational factors influenced vulnerability and response capacity. The literature further highlighted digital health literacy, fact-checking initiatives, institutional communication, healthcare professional engagement, and accuracy-promoting interventions as effective approaches for reducing misinformation-related harms. The findings emphasize the need for multidisciplinary collaboration and sustained investment in evidence-based communication strategies to strengthen public trust, improve health literacy, and enhance the effectiveness of future public health campaigns.

Bone fragility has traditionally been associated with osteoporosis and reduced bone mineral density; however, contemporary evidence indicates that fracture risk is influenced by a broader spectrum of metabolic, nutritional, endocrine, inflammatory, and musculoskeletal factors. The objective of this review was to analyze the metabolic determinants associated with bone fragility beyond osteoporosis and to examine their influence on fracture risk and recovery outcomes. A structured narrative review of scientific literature published in major biomedical databases was conducted, focusing on diabetes mellitus, chronic kidney disease, vitamin D deficiency, malnutrition, osteosarcopenia, endocrine dysfunction, and chronic inflammation. The findings demonstrated that these conditions contribute significantly to alterations in bone quality, remodeling capacity, muscle performance, and tissue repair, thereby increasing susceptibility to fragility fractures independently of bone mineral density measurements. Diabetes mellitus and chronic kidney disease emerged as major determinants of skeletal fragility due to their effects on collagen integrity, mineral metabolism, vascular function, and bone turnover. Nutritional deficiencies and inadequate vitamin D status were consistently associated with impaired mineralization, increased fall risk, and delayed fracture healing. Furthermore, osteosarcopenia highlighted the close biological relationship between bone and muscle health and its contribution to fracture susceptibility and functional decline. The evidence supports a multidimensional understanding of skeletal fragility that incorporates metabolic health into fracture prevention and management strategies. Expanding fracture risk assessment beyond traditional osteoporosis models may improve early identification of vulnerable individuals and facilitate more comprehensive approaches to prevention, treatment, and rehabilitation.

Cardiometabolic diseases, including obesity, type 2 diabetes mellitus, cardiovascular disease, and heart failure, represent a growing public health challenge throughout the Americas. The increasing prevalence of these conditions has generated interest in therapeutic strategies capable of simultaneously addressing multiple interconnected risk factors. This review aimed to analyze the current scientific evidence regarding the impact of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on heart failure and cardiometabolic risk. A structured literature review based on the Scientific Method was conducted using information obtained from PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, Cochrane Library, and major international clinical guidelines. Evidence from randomized controlled trials, systematic reviews, meta-analyses, and cardiovascular outcome studies was critically evaluated and synthesized. The findings demonstrated that GLP-1 receptor agonists consistently reduce major adverse cardiovascular events, promote significant body weight reduction, improve glycemic control, and contribute to favorable cardiometabolic outcomes. Recent studies also reported improvements in symptoms, functional capacity, and quality of life among patients with obesity-related heart failure with preserved ejection fraction. Additionally, emerging evidence suggests beneficial cardiorenal effects that further support their role within the cardiorenal-metabolic continuum. The clinical relevance of these findings is particularly important for countries such as Mexico, Colombia, and Ecuador, where obesity, diabetes, and cardiovascular disease continue to increase. In conclusion, GLP-1 receptor agonists represent an important advancement in contemporary cardiometabolic medicine and may contribute significantly to integrated prevention and management strategies aimed at reducing cardiovascular and metabolic disease burden across the Americas.