Pub Date : 2025-11-01Epub Date: 2025-06-30DOI: 10.1016/j.arcmed.2025.103252
Karla Barrera-Perales , Héctor Pérez-Cano , Sergio Rojas-Juárez , Oscar Morales-López , Alin Somilleda-Ventura , Miguel Angel Cuevas-Budhart , Rogelio Ivan Silva Rueda
Background and Aims
Diabetic retinopathy (DR) is a significant ocular complication. The insertion/deletion (I/D) polymorphism in the angiotensin-converting enzyme (ACE) gene has been associated with its development.
Objective
To evaluate the relationship between the ACE gene I/D polymorphism and the presence of DR to identify the highest-risk allele.
Methods
79 patients with diabetic retinopathy and 75 healthy controls were studied. Metabolic and anthropometric measurements were performed, and DNA was extracted to identify the polymorphism using C-reactive protein. Fisher’s exact test was used for comparative analysis of allele and genotypic frequencies.
Results
The I/I genotype was more frequent in patients with DR (43 %) and was associated with a 3.22-fold increased risk of developing the disease (p = 0.0123). The I allele frequency was 67 % in patients and 56 % in controls, though no significant difference was found (p = 0.073).
Conclusions
The higher frequency of the I/I genotype in patients with DR suggests that this genotype may be a risk factor for developing the disease in patients with type 2 diabetes (T2DM). Further studies are recommended to confirm these findings.
{"title":"Association Between ACE Gene I/D Polymorphism and Diabetic Retinopathy in Mexican Population","authors":"Karla Barrera-Perales , Héctor Pérez-Cano , Sergio Rojas-Juárez , Oscar Morales-López , Alin Somilleda-Ventura , Miguel Angel Cuevas-Budhart , Rogelio Ivan Silva Rueda","doi":"10.1016/j.arcmed.2025.103252","DOIUrl":"10.1016/j.arcmed.2025.103252","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Diabetic retinopathy (DR) is a significant ocular complication. The insertion/deletion (I/D) polymorphism in the angiotensin-converting enzyme (ACE) gene has been associated with its development.</div></div><div><h3>Objective</h3><div>To evaluate the relationship between the ACE gene I/D polymorphism and the presence of DR to identify the highest-risk allele.</div></div><div><h3>Methods</h3><div>79 patients with diabetic retinopathy and 75 healthy controls were studied. Metabolic and anthropometric measurements were performed, and DNA was extracted to identify the polymorphism using C-reactive protein. Fisher’s exact test was used for comparative analysis of allele and genotypic frequencies.</div></div><div><h3>Results</h3><div>The I/I genotype was more frequent in patients with DR (43 %) and was associated with a 3.22-fold increased risk of developing the disease (<em>p</em> = 0.0123). The I allele frequency was 67 % in patients and 56 % in controls, though no significant difference was found (<em>p</em> = 0.073).</div></div><div><h3>Conclusions</h3><div>The higher frequency of the I/I genotype in patients with DR suggests that this genotype may be a risk factor for developing the disease in patients with type 2 diabetes (T2DM). Further studies are recommended to confirm these findings.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 7","pages":"Article 103252"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-07-10DOI: 10.1016/j.arcmed.2025.103255
Nicole Lobos-Villatoro, Carlos Güida, Osvaldo Artaza
{"title":"Strengthening Access to Post-Pandemic Mental Health Care: An Action Proposal","authors":"Nicole Lobos-Villatoro, Carlos Güida, Osvaldo Artaza","doi":"10.1016/j.arcmed.2025.103255","DOIUrl":"10.1016/j.arcmed.2025.103255","url":null,"abstract":"","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 7","pages":"Article 103255"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The molecular and cellular mechanisms underlying endometriosis are still under investigation. Cyclophilin A (CypA) is an inflammatory marker secreted by various types of cells in an inflammatory condition. During inflammation, CypA exacerbates the inflammatory response by activating calcineurin signaling, which increases cytokine secretion and tissue degradation in the inflammatory region. This study investigated the effect of inhibiting calcineurin signaling in treating endometriosis in rats.
Methods
Thirty-two albino Wistar rats were used in this study. All rats were divided into three groups: cyclosporin A (n = 10), tacrolimus (n = 10) and a control group (n = 12). The cyclosporin A (CsA) group received two intraperitoneal doses two weeks apart, and the tacrolimus group received the same two doses intravenously, also two weeks apart. All studies lasted eight weeks. The processed endometrial tissues were cut in half and embedded in paraffin. Histological sections (5 µm) were stained with Ki-67, Bcl-2, caspase-3 and VEGF.
Results
The endometriotic focus size was 204.7 ± 153.4 mm3, 71.9 ± 85.4 mm3, and 30.6 ± 36.7 mm3 in the control, CsA, and tacrolimus groups, respectively. Compared to the control group, the endometriotic focus size was smaller in the CsA and tacrolimus groups (p = 0.002). Microscopically, Ki-67 (p = 0.010) and VEGF (p = 0.007) immunoreactivity were lower in the CsA and tacrolimus groups than in controls.
Conclusions
The inhibition of calcineurin signaling with CsA or tacrolimus treatment causes regression of the endometriotic focus by decreasing endometriotic cell proliferation and angiogenesis in ectopic endometriotic tissue.
{"title":"Efficacy of Cyclosporin A and Tacrolimus in The Treatment of Endometriosis of Rats","authors":"Cagla Bahar Bulbul , Gulay Turan , Ceyda Sancakli Usta , Ozgur Bulmus , Akin Usta","doi":"10.1016/j.arcmed.2025.103258","DOIUrl":"10.1016/j.arcmed.2025.103258","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The molecular and cellular mechanisms underlying endometriosis are still under investigation. Cyclophilin A (CypA) is an inflammatory marker secreted by various types of cells in an inflammatory condition. During inflammation, CypA exacerbates the inflammatory response by activating calcineurin signaling, which increases cytokine secretion and tissue degradation in the inflammatory region. This study investigated the effect of inhibiting calcineurin signaling in treating endometriosis in rats.</div></div><div><h3>Methods</h3><div>Thirty-two albino Wistar rats were used in this study. All rats were divided into three groups: cyclosporin A (<em>n</em> = 10), tacrolimus (<em>n</em> = 10) and a control group (<em>n</em> = 12). The cyclosporin A (CsA) group received two intraperitoneal doses two weeks apart, and the tacrolimus group received the same two doses intravenously, also two weeks apart. All studies lasted eight weeks. The processed endometrial tissues were cut in half and embedded in paraffin. Histological sections (5 µm) were stained with Ki-67, Bcl-2, caspase-3 and VEGF.</div></div><div><h3>Results</h3><div>The endometriotic focus size was 204.7 ± 153.4 mm<sup>3</sup>, 71.9 ± 85.4 mm<sup>3</sup>, and 30.6 ± 36.7 mm<sup>3</sup> in the control, CsA, and tacrolimus groups, respectively. Compared to the control group, the endometriotic focus size was smaller in the CsA and tacrolimus groups (<em>p</em> = 0.002). Microscopically, Ki-67 (<em>p</em> = 0.010) and VEGF (<em>p</em> = 0.007) immunoreactivity were lower in the CsA and tacrolimus groups than in controls.</div></div><div><h3>Conclusions</h3><div>The inhibition of calcineurin signaling with CsA or tacrolimus treatment causes regression of the endometriotic focus by decreasing endometriotic cell proliferation and angiogenesis in ectopic endometriotic tissue.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 7","pages":"Article 103258"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-08-20DOI: 10.1016/j.arcmed.2025.103277
ARUNSUNDAR MOHANASUNDARAM , JEREMIAH OLUWATOMI ITODO DANIEL , BHUSHAN PATIL
{"title":"Comment on “Loneliness and Cognitive Function in Older Adults Living in Latin America: A Systematic Review”","authors":"ARUNSUNDAR MOHANASUNDARAM , JEREMIAH OLUWATOMI ITODO DANIEL , BHUSHAN PATIL","doi":"10.1016/j.arcmed.2025.103277","DOIUrl":"10.1016/j.arcmed.2025.103277","url":null,"abstract":"","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 7","pages":"Article 103277"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-06-21DOI: 10.1016/j.arcmed.2025.103260
Marta Lopez-Garcia , Manuel Martinez-Bebia , Alejandro Lopez-Moro , Nuria Gimenez-Blasi , José Antonio Latorre , Miguel Mariscal-Arcas
The increasing prevalence of attention deficit hyperactivity disorder (ADHD) in children has prompted more research on both genetic and environmental risk factors, including endocrine-disrupting chemicals (EDCs) such as bisphenol A (BPA) and polychlorinated biphenyls (PCBs). This review focuses on studies published between 2013 and December 2023 that explore the potential impact of BPA and PCBs on ADHD. The review draws from databases such as WOS, PubMed, and Scopus. BPA, a chemical commonly used in plastics and resins, has raised concerns due to its potential neurodevelopmental effects, particularly when exposure occurs prenatally. Multiple studies have suggested an association between prenatal BPA exposure and an increased risk of ADHD in offspring, though more research is needed. Similarly, PCBs, which are persistent environmental pollutants primarily found in contaminated food sources, have been linked to cognitive and behavioral issues, including attention deficits and hyperactivity. Both BPA and PCBs have been shown to disrupt neurodevelopment, underscoring the importance of regulating these chemicals to safeguard children’s health. While these findings highlight a potential risk, further studies are required to clarify the underlying mechanisms and the precise role these EDCs play in the development of ADHD and other neurobehavioral disorders.
{"title":"Endocrine Disruptors and Attention Deficit Hyperactivity Disorder: A Systematic Review","authors":"Marta Lopez-Garcia , Manuel Martinez-Bebia , Alejandro Lopez-Moro , Nuria Gimenez-Blasi , José Antonio Latorre , Miguel Mariscal-Arcas","doi":"10.1016/j.arcmed.2025.103260","DOIUrl":"10.1016/j.arcmed.2025.103260","url":null,"abstract":"<div><div>The increasing prevalence of attention deficit hyperactivity disorder (ADHD) in children has prompted more research on both genetic and environmental risk factors, including endocrine-disrupting chemicals (EDCs) such as bisphenol A (BPA) and polychlorinated biphenyls (PCBs). This review focuses on studies published between 2013 and December 2023 that explore the potential impact of BPA and PCBs on ADHD. The review draws from databases such as WOS, PubMed, and Scopus. BPA, a chemical commonly used in plastics and resins, has raised concerns due to its potential neurodevelopmental effects, particularly when exposure occurs prenatally. Multiple studies have suggested an association between prenatal BPA exposure and an increased risk of ADHD in offspring, though more research is needed. Similarly, PCBs, which are persistent environmental pollutants primarily found in contaminated food sources, have been linked to cognitive and behavioral issues, including attention deficits and hyperactivity. Both BPA and PCBs have been shown to disrupt neurodevelopment, underscoring the importance of regulating these chemicals to safeguard children’s health. While these findings highlight a potential risk, further studies are required to clarify the underlying mechanisms and the precise role these EDCs play in the development of ADHD and other neurobehavioral disorders.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 7","pages":"Article 103260"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-06-14DOI: 10.1016/j.arcmed.2025.103243
Mónica Valenzuela , Osvaldo Artaza , Javier Santa Cruz , Marcelo Fagalde , Mónica Espinoza , Sandra Oyarzo , Erich V. De Paula , Rogelio Pizzi
{"title":"Interdisciplinary Vocational Training for Resilient, Integrated, and Person-Centered Health Systems","authors":"Mónica Valenzuela , Osvaldo Artaza , Javier Santa Cruz , Marcelo Fagalde , Mónica Espinoza , Sandra Oyarzo , Erich V. De Paula , Rogelio Pizzi","doi":"10.1016/j.arcmed.2025.103243","DOIUrl":"10.1016/j.arcmed.2025.103243","url":null,"abstract":"","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 7","pages":"Article 103243"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-07-10DOI: 10.1016/j.arcmed.2025.103254
David Zarate-Lopez , Rosendo García-Carrillo , Luis Castro-Sánchez , Alma Y. Galvez-Contreras , Oscar Gonzalez-Perez
Background and Aims
Autism spectrum disorder (ASD) is a condition resulting from a combination of genetic and environmental influences that lead to atypical brain development, particularly in regions such as the striatum and prefrontal cortex. There is increasing evidence linking the epidermal growth factor (EGF) and its receptor (EGFR or ErbB1) to the etiopathogenesis of ASD. However, ErbB4, another ErbB member, has also been implicated in this process. To investigate whether dysregulation of ErbB4 and its downstream mTOR signaling pathway in the striatum and prefrontal cortex contributes to stereotypical behaviors and social deficits in an autism-like rodent model.
Methods
We analyzed the phosphorylation levels of ErbB4and mTOR in the prefrontal cortex and striatum of 31 d old mice that were prenatally exposed to valproate (VPA; 500 mg/kg) or the control vehicle (0.9 % NaCl). Social and stereotypic behaviors were assessed using the three-chamber social test and the marble burying test, respectively. Then, the VPA groups were treated with 50 mg/kg of spironolactone, a selective ErbB4 antagonist.
Results
Prenatal exposure to VPA induced deficits in social interaction and an increase in repetitive behaviors. These behaviors coexist with dysregulation of the ErbB4 phosphorylation and modifications in the mTOR signaling pathway in both brain regions. Treatment with spironolactone reduced repetitive behaviors, which was consistent with reduced ErbB4 phosphorylation and mTOR signaling.
Conclusions
These results support the idea that ErbB4 has abnormal expression and activity levels in the striatum and prefrontal cortex. Antagonizing ErbB4 with spironolactone improves repetitive behavioral patterns associated with ASD.
{"title":"Spironolactone Partially Reverses Autism-Like Behaviors Linked to ErbB4 and mTOR Phosphorylation in the Mouse Prefrontal Cortex and Striatum","authors":"David Zarate-Lopez , Rosendo García-Carrillo , Luis Castro-Sánchez , Alma Y. Galvez-Contreras , Oscar Gonzalez-Perez","doi":"10.1016/j.arcmed.2025.103254","DOIUrl":"10.1016/j.arcmed.2025.103254","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Autism spectrum disorder (ASD) is a condition resulting from a combination of genetic and environmental influences that lead to atypical brain development, particularly in regions such as the striatum and prefrontal cortex. There is increasing evidence linking the epidermal growth factor (EGF) and its receptor (EGFR or ErbB1) to the etiopathogenesis of ASD. However, ErbB4, another ErbB member, has also been implicated in this process. To investigate whether dysregulation of ErbB4 and its downstream mTOR signaling pathway in the striatum and prefrontal cortex contributes to stereotypical behaviors and social deficits in an autism-like rodent model.</div></div><div><h3>Methods</h3><div>We analyzed the phosphorylation levels of ErbB4and mTOR in the prefrontal cortex and striatum of 31 d old mice that were prenatally exposed to valproate (VPA; 500 mg/kg) or the control vehicle (0.9 % NaCl). Social and stereotypic behaviors were assessed using the three-chamber social test and the marble burying test, respectively. Then, the VPA groups were treated with 50 mg/kg of spironolactone, a selective ErbB4 antagonist.</div></div><div><h3>Results</h3><div>Prenatal exposure to VPA induced deficits in social interaction and an increase in repetitive behaviors. These behaviors coexist with dysregulation of the ErbB4 phosphorylation and modifications in the mTOR signaling pathway in both brain regions. Treatment with spironolactone reduced repetitive behaviors, which was consistent with reduced ErbB4 phosphorylation and mTOR signaling.</div></div><div><h3>Conclusions</h3><div>These results support the idea that ErbB4 has abnormal expression and activity levels in the striatum and prefrontal cortex. Antagonizing ErbB4 with spironolactone improves repetitive behavioral patterns associated with ASD.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 7","pages":"Article 103254"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-05-11DOI: 10.1016/j.arcmed.2025.103236
Omar Dewidar , Juan Pablo Peña-Rosas , Jordi Pardo Pardo , Vivian Welch , Kevin Pottie , Peter Tugwell
{"title":"Balancing Priorities in Guideline Development: Consideration of Health Equity in WHO’s Normative Products on Obesity","authors":"Omar Dewidar , Juan Pablo Peña-Rosas , Jordi Pardo Pardo , Vivian Welch , Kevin Pottie , Peter Tugwell","doi":"10.1016/j.arcmed.2025.103236","DOIUrl":"10.1016/j.arcmed.2025.103236","url":null,"abstract":"","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 7","pages":"Article 103236"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143931366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-06-15DOI: 10.1016/j.arcmed.2025.103251
Pablo Daniel Cruces , Pedro David Arini
Background and Aims
Torsade de Pointes (TdP), a side effect of many marketed drugs, can lead to sudden cardiac death. Regulatory guidelines require quantification of hERG channel block by QT interval prolongation on ECG, although its predictive value remains low. To propose a novel normalization technique for vectorcardiographic loops, enabling improved derivation of conventional and new indices for the robust identification of multiple cardiac ion channel blockades associated with TdP risk.
Methods
A robust method was developed to obtain angular parameters from ECG loops by normalizing for baseline drift using principal component analysis. Linear (via differentiation) and angular (via quaternion algebra) velocities were assessed to identify differential features between multichannel and selective hERG-blocking drugs. Furthermore, bidirectional baseline correction allowed more accurate extraction of ECG wave extrema and peaks, improving the robustness of the QT interval and other temporal measurements. The proposed dynamic biomarkers were evaluated in 22 subjects enrolled in a clinical trial of four known QT-prolonging drugs.
Results
The two high-risk drugs exhibited drug-induced changes (p < 0.0005) in velocity during ventricular repolarization. Strong calcium or sodium blockers reduced the effect on velocity caused by hERG potassium channel block. A tendency to symmetry of angular values was observed with high-risk drugs. The alternative temporal indices showed a high correlation (r > 0.9) with standard indices. Differences emerged between the T-wave end and the angular velocity marker of ventricular repolarization end.
Conclusion
Spatial analysis of cardiac signals and the new dynamic measures could complement current standards and support safer drug development.
背景和AimsTorsade de Pointes （TdP）是许多上市药物的副作用，可导致心源性猝死。调节指南要求通过心电图QT间期延长来量化hERG通道阻滞，尽管其预测价值仍然很低。提出一种新的矢量心动图回路归一化技术，能够改进传统和新指标的推导，以可靠地识别与TdP风险相关的多个心脏离子通道阻塞。方法利用主成分分析对基线漂移进行归一化，建立了一种鲁棒的心电回路角参数获取方法。评估了线性（通过微分）和角速度（通过四元数代数），以确定多通道和选择性heg阻断药物之间的差异特征。此外，双向基线校正可以更准确地提取心电波极值和峰值，提高QT间期和其他时间测量的稳健性。该动态生物标志物在22名受试者中进行了评估，这些受试者参加了四种已知的延长qt药物的临床试验。结果两种高危药物均表现出药物性改变(p <；0.0005)心室复极时的速度。强钙或钠阻滞剂降低了hERG钾通道阻滞对流速的影响。观察到高危药物的角值趋于对称。各备选时间指标均表现出较高的相关性(r >；0.9)，指标标准。t波端与心室复极端角速度标志存在差异。结论心脏信号的空间分析和新的动态测量方法可以补充现行标准，支持更安全的药物开发。
{"title":"Spatial Approach to Cardiac Electrical Dynamics: Evaluation of Surrogate Biomarkers of Differences in Drug-Induced Multichannel Block","authors":"Pablo Daniel Cruces , Pedro David Arini","doi":"10.1016/j.arcmed.2025.103251","DOIUrl":"10.1016/j.arcmed.2025.103251","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Torsade de Pointes (TdP), a side effect of many marketed drugs, can lead to sudden cardiac death. Regulatory guidelines require quantification of hERG channel block by QT interval prolongation on ECG, although its predictive value remains low. To propose a novel normalization technique for vectorcardiographic loops, enabling improved derivation of conventional and new indices for the robust identification of multiple cardiac ion channel blockades associated with TdP risk.</div></div><div><h3>Methods</h3><div>A robust method was developed to obtain angular parameters from ECG loops by normalizing for baseline drift using principal component analysis. Linear (via differentiation) and angular (via quaternion algebra) velocities were assessed to identify differential features between multichannel and selective hERG-blocking drugs. Furthermore, bidirectional baseline correction allowed more accurate extraction of ECG wave extrema and peaks, improving the robustness of the QT interval and other temporal measurements. The proposed dynamic biomarkers were evaluated in 22 subjects enrolled in a clinical trial of four known QT-prolonging drugs.</div></div><div><h3>Results</h3><div>The two high-risk drugs exhibited drug-induced changes (<em>p</em> < 0.0005) in velocity during ventricular repolarization. Strong calcium or sodium blockers reduced the effect on velocity caused by hERG potassium channel block. A tendency to symmetry of angular values was observed with high-risk drugs. The alternative temporal indices showed a high correlation (<em>r</em> > 0.9) with standard indices. Differences emerged between the T-wave end and the angular velocity marker of ventricular repolarization end.</div></div><div><h3>Conclusion</h3><div>Spatial analysis of cardiac signals and the new dynamic measures could complement current standards and support safer drug development.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 7","pages":"Article 103251"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-04-12DOI: 10.1016/j.arcmed.2025.103222
Claudio A. Dávila-Cervantes
Background and Aims
To analyse the burden of young-onset cardiovascular disease (CVD) in Mexico for the years 1990 and 2021, as well as trends from 1990 to 2021, and to evaluate its association with the sociodemographic index (SDI) and the Healthcare Access and Quality Index (HAQI).
Methods
A secondary analysis of data from the Global Burden of Disease (GBD) study was conducted, stratified by sex, age groups, states, and CVD subcauses. Metrics included mortality, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY).
Results
There was an increase in age-standardized young-onset CVD DALY rates in men and a decrease in women. The leading causes of young-onset CVD deaths were ischemic heart disease, and stroke. Males showed a higher burden for all CVD causes, except for rheumatic heart disease and pulmonary arterial hypertension. The burden of premature mortality was higher in men, while disability was more pronounced in women. Complex associations were observed between SDI, HAQI, and CVD burden, highlighting a heterogeneous situation among Mexican states.
Conclusions
Recognizing the unique cardiovascular profiles of young men and women and effectively engaging them in healthcare systems may lead to targeted interventions that reduce risk factors, improve health outcomes, and further decrease the burden of young-onset CVD in Mexico.
{"title":"Cardiovascular disease in adolescents and young adults in Mexico: Secondary analysis of the 2021 global burden of disease study","authors":"Claudio A. Dávila-Cervantes","doi":"10.1016/j.arcmed.2025.103222","DOIUrl":"10.1016/j.arcmed.2025.103222","url":null,"abstract":"<div><h3>Background and Aims</h3><div>To analyse the burden of young-onset cardiovascular disease (CVD) in Mexico for the years 1990 and 2021, as well as trends from 1990 to 2021, and to evaluate its association with the sociodemographic index (SDI) and the Healthcare Access and Quality Index (HAQI).</div></div><div><h3>Methods</h3><div>A secondary analysis of data from the Global Burden of Disease (GBD) study was conducted, stratified by sex, age groups, states, and CVD subcauses. Metrics included mortality, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY).</div></div><div><h3>Results</h3><div>There was an increase in age-standardized young-onset CVD DALY rates in men and a decrease in women. The leading causes of young-onset CVD deaths were ischemic heart disease, and stroke. Males showed a higher burden for all CVD causes, except for rheumatic heart disease and pulmonary arterial hypertension. The burden of premature mortality was higher in men, while disability was more pronounced in women. Complex associations were observed between SDI, HAQI, and CVD burden, highlighting a heterogeneous situation among Mexican states.</div></div><div><h3>Conclusions</h3><div>Recognizing the unique cardiovascular profiles of young men and women and effectively engaging them in healthcare systems may lead to targeted interventions that reduce risk factors, improve health outcomes, and further decrease the burden of young-onset CVD in Mexico.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 6","pages":"Article 103222"},"PeriodicalIF":4.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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