Revista medica del Instituto Mexicano del Seguro Social最新文献

{"title":"[When the one who heals dies. The physician at the end of life].","authors":"Eduardo Daniel Anica-Malagón, Yareni Natividad Salgado-Abrego","doi":"10.5281/zenodo.19076238","DOIUrl":"10.5281/zenodo.19076238","url":null,"abstract":"<p><p>A physician's death represents a critical point of tension between the values of modern medicine and the ethical limits of care. This review article analyzes how physicians face their own end of life and the type of care they receive compared with the general population. A narrative review of literature published between 2014 and 2025 was conducted using PubMed, Scopus, and SciELO databases with the MeSH and DeCS descriptors: \"Terminal care\", \"Palliative care\", \"Attitude to death\", \"Health personnel\", \"Right to die\". Findings show that although physicians express a preference for a dignified death with therapeutic proportionality and symptom control, many still die under highly technological and interventionist schemes. Mexico lacks systematic data documenting how its physicians die, revealing a gap between ethical intention and institutional practice. This analysis proposes developing a observational study to characterize therapeutic intensity, respect for autonomy, and the moral distress experienced by healthcare teams as bioethical and occupational issues within the health system.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e6961"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Incidence of the progression and remission of cognitive decline in older adults].","authors":"Diana Aide González-Sotelo, Arelhi Yosajandhi Bermúdez-Rojas, María Guadalupe Berumen-Lechuga, Violeta Castro-Leyva, María Esther Bobadilla-Serrano, Yazmin Jocelyn Julián-Hernández, Mauricio Espinosa-Lugo, Jaime Juárez-González, Arturo Hernández-Esquivel, Jessica Camacho-Ruiz, Rosalinda Sánchez-Arenas","doi":"10.5281/zenodo.19076204","DOIUrl":"10.5281/zenodo.19076204","url":null,"abstract":"<p><strong>Background: </strong>In communities with higher social inequality, tracking the progression and remission of cognitive dysfunction (PR-CD) and its associated factors provides an epidemiological overview of dementia risk.</p><p><strong>Objective: </strong>To investigate the incidence and factors associated with PR-CD in older adults (OAs) at three clinics of the Mexican Social Security Institute in an industrial area of Western Mexico State.</p><p><strong>Material and methods: </strong>A two-year longitudinal study of 231 OAs (≥ 60 years) assessed cognitive function using the Montreal Cognitive Assessment (MoCA). After 2 years, outcomes were categorized into three groups: healthy cognitive function (MoCA scores > 20 on all three measurements), remitting cognitive impairment (one or two measurements with MoCA scores < 20), and progressive cognitive impairment (MoCA scores < 20 on all three measurements). Additionally, sociodemographic, clinical, and functional data were collected. Cumulative incidence and relative risk factors were analyzed using regression.</p><p><strong>Results: </strong>The sample consisted of individuals with six or fewer years of schooling, and 70% identified as female. The incidence of P-CD was 28.1%, while that of R-CD was 32.5%. Factors associated with R-CD included low cognitive reserve and diminished physical performance. In contrast, factors linked to P-CD included age, low educational attainment, low cognitive reserve, age-related sarcopenia, education-related sarcopenia, age-related instrumental Activities of Daily Living (IADLs), and the interaction among age, cognitive reserve, IADLs, and SPBB.</p><p><strong>Conclusion: </strong>In a region of social inequality in Western Mexico State, there is a high incidence of R-CD and P-CD, associated with risk factors that contribute to cognitive dysfunction among OAs.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e6979"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert consensus validation of an instrument to improve the timely detection of developmental dysplasia of the hip in children.","authors":"George Benjamin Edgar, Jesús Vértiz-Ramírez, Juan Molina-Rodríguez, Humberto León-Soto, Luis Loyo-Soriano, Mario Sánchez-Domínguez","doi":"10.5281/zenodo.19076260","DOIUrl":"10.5281/zenodo.19076260","url":null,"abstract":"<p><strong>Background: </strong>Developmental Dysplasia of the Hip (DDH) is the most common human congenital malformation. When diagnosed and treated before five months of age, it has a high cure rate. If not, surgical management is required with high economic costs, a great impact on morbidity and sequelae that can generate permanent disability.</p><p><strong>Objective: </strong>To design and validate an instrument to timely detect DDH.</p><p><strong>Material and methods: </strong>An instrument developed from a literature review on the timely diagnosis of DDC, using the PRISMA methodology. To validate it, an expert panel was formed comprising specialists from different healthcare institutions.</p><p><strong>Results: </strong>All participants in the expert panel agreed that DDH is a public health problem. They consider that there are many patients with late diagnosis and sequelae due to a lack of timely treatment. There was consensus on the feasibility of implementing the proposal. The expressed need to update the current regulations regarding diagnostic means was identified.</p><p><strong>Conclusions: </strong>It is necessary to promote epidemiology, risk factors, correct physical examination, ideal imaging methods according to the patient's age, and timely referral pathways for patients. Add our DDH instrument to the section to the healthy child card. This should include risk factors: pelvic presentation, female sex, and family history of DDH. As well as the marking of a normal vs abnormal physical examination.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e6886"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Cataract Secondary to High-Voltage Electrical Burn: Case Report and Literature Review.","authors":"Karla Orozco-Juarez, Gabriela Thomassiny-Bautista","doi":"10.5281/zenodo.19076310","DOIUrl":"10.5281/zenodo.19076310","url":null,"abstract":"<p><strong>Background: </strong>Electrical cataracts are an uncommon but clinically significant consequence of high-voltage injuries. Their onset may occur within weeks or months, and, without timely recognition, they may cause severe visual impairment. Electrical current induces thermal and direct cellular damage to the lens epithelium, leading to accelerated opacification distinct from age-related cataracts.</p><p><strong>Clinical case: </strong>A 52-year-old electrician sustained a 23,000-volt electrical burn during a workplace accident, with the current entering through the left arm and exiting through the facial and cervical regions. Two months later, he developed rapidly progressive bilateral visual loss. Ophthalmologic examination revealed mature cataracts in both eyes, normal intraocular pressure, without ultrasonography evidence of posterior segment abnormalities. Visual evoked potentials demonstrated moderate conduction delay with intact pathways. Bilateral phacoemulsification with intraocular lens implantation was performed, resulting in significant improvement, with visual acuity increasing from hand-motion perception to 20/40.</p><p><strong>Conclusions: </strong>High-voltage trauma can produce rapidly progressive bilateral cataracts even in the absence of retinal or optic nerve injury. Early ophthalmologic evaluation is essential in patients with electrical burns, as timely surgical management allows meaningful visual restoration and prevents long-term disability.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e6967"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Inflammatory depression: a review of advances in pathophysiology, clinical implications, and treatment].","authors":"Francisco Carlos Juárez-Paredes, Jessica Juárez-Ugalde","doi":"10.5281/zenodo.19076243","DOIUrl":"10.5281/zenodo.19076243","url":null,"abstract":"<p><p>Major depressive disorder (MDD) is a highly prevalent and disabling condition, and although conventional treatments focused on monoaminergic neurotransmission have been helpful for many individuals, a substantial proportion of patients fail to achieve adequate symptom remission. Over the past decade, accumulating evidence has highlighted systemic inflammation as a central component in the pathophysiology of MDD, suggesting that immune dysregulation may characterize a distinct subgroup of patients. Activation of the immune system can adversely influence neurotransmission, impair neuroplasticity, disrupt the hypothalamic-pituitary-adrenal (HPA) axis, and promote glial cell activation, all of which can contribute to chronicity and resistance to standard therapies. This understanding has led to the proposal of \"inflammatory depression\" as a specific endotype within the broader depressive spectrum. Recognizing this profile is essential for advancing precision medicine and improving clinical decision-making. It is increasingly postulated that these patients may benefit from targeted anti-inflammatory strategies, including pharmacologic agents, nutraceuticals, structured physical exercise, and dietary interventions with immunomodulatory effects. Despite these promising avenues, more rigorous clinical trials are needed to establish standardized protocols and refine patient selection based on inflammatory biomarkers, ensuring more effective and personalized treatment approaches.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e6996"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Epidemiological surveillance and mass events: lessons learned ahead of the 2026 FIFA™ World Cup].","authors":"Alfonso Vallejos-Parás, David Alejandro Cabrera-Gaytán, Porfirio Felipe Hernández-Bautista, Leticia Jaimes-Betancourt, Lumumba Arriaga-Nieto, Gabriel Valle-Alvarado, Oscar Cruz-Orozco","doi":"10.5281/zenodo.19076154","DOIUrl":"10.5281/zenodo.19076154","url":null,"abstract":"<p><p>The FIFA World Cup™ 2026 in Mexico will be a major public health challenge worldwide. Large gatherings can facilitate the spread of diseases, raise the number of cardiovascular emergencies caused by stress, and require careful monitoring of vaccine-preventable illnesses, particularly given ongoing concerns about measles and pertussis. This editorial article reviews lessons learned from past events and highlights the need to improve food safety, mental health support, and active disease surveillance. The healthcare system's success will depend on how well it can respond and plan to manage the risks that come with people traveling from around the world.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e7375"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13378685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Transformation of Epidemiology in the Age of Artificial Intelligence].","authors":"Juan Rodrigo Gómez-Bernal","doi":"10.5281/zenodo.19076288","DOIUrl":"10.5281/zenodo.19076288","url":null,"abstract":"<p><p>Epidemiology has been fundamental for analyzing health problems and supporting decision-making in healthcare systems and public health. However, traditional epidemiological methods, designed fundamentally to identify causal associations at the population level through aggregate data measures, present inherent limitations in capturing individual heterogeneity in response to specific exposures. This population-based approach hinders personalized prediction of outcomes in a particular individual whose risk factors may manifest differently from the group average, particularly when multiple contextual variables and unique biological profiles are involved. Advances in artificial intelligence have generated tools capable of integrating large volumes of information, identifying complex patterns in specific subgroups, and producing more personalized estimates, transitioning from a reactive approach based on population averages toward predictive models centered on individual trajectories. However, these developments do not replace the methodological foundations of epidemiology, as the identification of exposures, outcomes, and causal relationships continues to depend on the epidemiological conceptual framework. From this perspective, current tensions do not represent a disciplinary crisis, but rather a transition toward broader approaches that combine population-based analyses with advanced predictive tools. This integration is particularly relevant for large-scale healthcare institutions and national health systems, which require models capable of leveraging diverse data to improve understanding of health processes and support clinical and operational decisions.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e7010"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Scientific output of the Revista Médica del IMSS in PubMed (2005-2025): a bibliometric analysis].","authors":"Omar Chávez-Martínez, Miritza Villaseñor-Aguirre, Francisco Cano-Román","doi":"10.5281/zenodo.19101746","DOIUrl":"10.5281/zenodo.19101746","url":null,"abstract":"<p><strong>Background: </strong>Bibliometrics allows for the evaluation of the editorial performance and thematic organization of health journals with an institutional function.</p><p><strong>Objective: </strong>To analyze the scientific output of the IMSS Medical Journal, indexed in PubMed (2005-2025), to describe its temporal evolution and publication patterns (productivity, typology, authorship, citations, and topics).</p><p><strong>Materials and methods: </strong>A descriptive and longitudinal bibliometric study was conducted using records retrieved from PubMed. Indicator processing was performed using Anne O' Tate; thematic analysis was based on the co-occurrence of keywords and MeSH terms, with clustering and visualization in VOSviewer.</p><p><strong>Results: </strong>A total of 2,661 articles were identified. Annual output showed variations, with a peak in 2023 (205), followed by 2024 (171) and 2025 (107). Observational clinical-epidemiological designs predominated. Authorship was primarily collaborative (average: 4.1; median: 4), with a concentration in teams of 3-6 authors. Production was centralized in Mexico, particularly in Mexico City (1276). 47.65% of articles received ≥ 1 citation (iCite), with an estimated 3,592 citations and 1.35 citations per article.</p><p><strong>Conclusions: </strong>The journal exhibits a predominantly national, territorially centralized, and methodologically observational profile, with concentrated citations and a broad thematic agenda. These findings provide evidence to guide thematic priorities and actions to strengthen editorial quality and visibility.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e7237"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical spectrum, neuroimaging and therapeutic response to neurological syndromes associated with anti-GAD65].","authors":"Luis Felipe Hernández-Salomón, Diana Mayela Sinaí Sánchez-Galván, Penelope Galván-Heredia, José Antonio Mejía-Chávez, Salma Monserrat Solís-Luna, Christian Emmanuelle Aguayo Jiménez","doi":"10.5281/zenodo.19076356","DOIUrl":"10.5281/zenodo.19076356","url":null,"abstract":"<p><p>Neurological syndromes associated with anti-GAD65 antibodies include limbic encephalitis, cerebellar ataxia, drug-resistant epilepsy, stiff-person syndrome spectrum, and overlap syndromes. Their pathophysiology is linked to GABAergic dysfunction and neuronal hyperexcitability. In Latin America, evidence is limited; in a regional review, cases associated with anti-GAD antibodies represented 2.37% of antibody-confirmed autoimmune encephalitis, suggesting underreporting and incomplete clinical characterization. The objective of this study is to describe the clinical characteristics, neuroimaging findings, and therapeutic response in a series of anti-GAD65 cases, as well as to conduct a literature review. This is a retrospective series of four patients from the High Specialty Medical Unit No. 71, Torreón, Coahuila, Mexico. Clinical, imaging, and treatment variables were analyzed. Anti-GAD65 antibodies were determined in serum using ELISA. Diverse phenotypes were observed, with involvement of the hippocampus, cerebellum, and brainstem. Intravenous immunoglobulin, corticosteroids, and rituximab were used, with variable response. The heterogeneity of the anti-GAD65 spectrum hinders timely diagnosis and management, which is still not standardized. Larger regional studies are needed to improve characterization and optimize therapeutic strategies.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e6817"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Interaction between oxidative stress and inflammatory processes in fetal membranes: One Health].","authors":"Venus Penélope Velázquez-Esquivel, Luis Javier Ramírez-Jirano, Tania Zenteno-Savín, Daniela Alejandra Murillo-Cisneros, Carlos Angulo, Ramón Gaxiola-Robles","doi":"10.5281/zenodo.19076292","DOIUrl":"10.5281/zenodo.19076292","url":null,"abstract":"<p><p>The balance between oxidative mechanisms and inflammatory responses is essential for the proper progression of pregnancy, as it preserves the functionality and integrity of the fetal membranes. Among them, the amnion plays a key protective role by regulating maternal-fetal exchange and interpreting chemical and mechanical signals from the uterine microenvironment. However, various adverse stimuli, particularly bacterial infections mediated by lipopolysaccharide (LPS), environmental contaminants, sustained physiological stress, or metabolic disturbances, can disrupt this homeostasis, increasing the generation of reactive oxygen species (ROS) and promoting the release of proinflammatory cytokines that compromise cellular and tissue stability. When these pathways remain imbalanced over time, a dysfunction known as the redox-inflammatory axis emerges, which is associated with structural damage, extracellular matrix degradation, premature aging of amniotic cells, and a considerable increase in the risk of preterm birth. Examining these interactions through a One Health perspective enables integration of biological, environmental, and social factors, providing a more comprehensive understanding of the determinants of maternal-fetal health and guiding the development of more effective preventive strategies, such as zoonotic surveillance and food safety, to mitigate risks during pregnancy.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 4","pages":"e7008"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}