Browsing by Author "Simancas Racines , Daniel Alejandro"

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    Biopsia líquida y biomarcadores multiómicos en el cáncer de mama: innovaciones en la detección temprana, la orientación terapéutica y el seguimiento de la enfermedad
    (2026) Reytor Gonzalez , Claudia Maria; Simancas Racines , Daniel Alejandro; Román Galeano , Náthaly Mercedes; Vásquez , Juan Pablo; Jima Gavilanes , Dolores Alexandra; Rupalakshmi , Vijayan; Reytor Gonzalez , Claudia Maria
    Liquid biopsy and multi-omic biomarker integration are transforming precision oncology in breast cancer, providing real-time, minimally invasive insights into tumor biology. By analyzing circulating tumor DNA, circulating tumor cells, exosomal non-coding RNAs, and proteomic or metabolomic profiles, clinicians can monitor clonal evolution, therapeutic response, and recurrence risk in real time. Recent advances in sequencing technologies, methylation profiling, and artificial intelligence–driven data integration have markedly improved diagnostic sensitivity and predictive accuracy. Multi-omic frameworks com bining genomic, transcriptomic, and proteomic data enable early detection of resistance, molecular stratification, and identification of actionable targets, while machine learning models enhance outcome prediction and therapy optimization. Despite these advances, key challenges persist. Pre-analytical variability, lack of standardized protocols, and disparities in access continue to limit reproducibility and clinical adoption. High costs, incomplete regulatory validation, and the absence of definitive evidence for mortality reduction un derscore the need for larger, prospective trials. Integrating multi-omic assays into clinical workflows will require robust bioinformatics pipelines, clinician-friendly reporting sys tems, and interdisciplinary collaboration among molecular scientists, data engineers, and oncologists. In the near future, liquid biopsy is expected to complement, not replace, traditional tissue analysis, serving as a cornerstone of adaptive cancer management. As sequencing becomes faster and more affordable, multi-omic and AI-driven analyses will allow earlier detection, more precise treatment adjustments, and continuous monitoring across the disease course. Ultimately, these innovations herald a shift toward real-time, data-driven oncology that personalizes breast cancer care and improves patient outcomes.
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    Evaluación crítica de la calidad de la Guía OMS Tuberculosis 2025 mediante el instrumento AGREE II
    (2026) Angamarca Iguago , Jaime Wladimir; Parise Vasco, Juan Marcos; Cagua Ordoñez , Jaen Carlos; Reytor González , Claudia María; Simancas Racines , Daniel Alejandro; Angamarca Iguago , Jaime Wladimir
    Objetivo: Evaluar la calidad metodológica de la Guía Consolidada de la OMS sobre tuberculosis (Módulo 4: Tratamiento y Cuidado, 2025) mediante el instrumento AGREE II. Métodos: Se realizó un estudio descriptivo de evaluación metodológica transversal. Tres evaluadores independientes (JWAI, JMPV, JCCO) con experiencia certificada en el instrumento AGREE II calificaron los 23 ítems en una escala Likert de 7 puntos. Se calcularon puntuaciones escaladas de dominio según la fórmula oficial de AGREE II, estadística descriptiva (media, desviación estándar, rango) y confiabilidad interevaluador mediante el coeficiente kappa de Fleiss. Resultados: La Guía de Práctica Clínica (GPC) demostró una alta calidad metodológica. Las puntuaciones medias escaladas fueron: Dominio 1: Alcance y Propósito, 100.0% (DE=0.0); Dominio 2: Implicación de Implicados, 88.89% (DE=6.43); Dominio 3: Rigor en el Desarrollo, 95.14% (DE=4.17); Dominio 4: Claridad de Presentación, 100.0% (DE=0.0); Dominio 5: Aplicabilidad, 80.56% (DE=6.29); Dominio 6: Independencia Editorial, 91.67% (DE=14.43). La confiabilidad interevaluador global fue buena (Kappa de Fleiss κ=0.65). Se identificaron discrepancias significativas en el Ítem 14 (Procedimiento de actualización, κ=0.35) y en el Ítem 22 (Influencia del financiador, κ=0.18, clasificado como "pobre"). La puntuación global de calidad fue 7/7, unánime, con una recomendación mayoritaria de uso sin modificaciones (2/3 de los evaluadores). Conclusiones: La GPC OMS TB 2025 representa un estándar de oro para el desarrollo de guías de práctica clínica internacionales. Su rigor metodológico (95.14%), transparencia editorial (91.67%) y claridad de presentación (100.0%) la hacen confiable para la práctica global. Las áreas de mejora identificadas se focalizan en la integración de herramientas de implementabilidad (Dominio 5: 80.56%) y la clarificación de procedimientos prospectivos de actualización. Las discrepancias observadas en Independencia Editorial (Dominio 6) revelan ambigüedad interpretativa en el instrumento AGREE II sobre cómo evaluar la independencia del financiador cuando la documentación es implícita más que explícita.
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    Los mecanismos moleculares subyacentes a la enfermedad de Dercum: exploración de la intersección entre obesidad, dolor e inflamación.
    (2026) Reytor González Claudia María; Jiménez Flores , Emilia; Campuzano Donoso , Martín; Toral Noristz , Melannie Denisse; Román Galeano , Náthaly Mercedes; Simancas Racines , Daniel Alejandro; Reytor González Claudia María
    Obesity is increasingly recognized not only as a metabolic disorder, but also as a state of chronic low-grade inflammation that predisposes to systemic complications. Within this context, Dercum’s disease (DD), or adiposis dolorosa, emerges as a rare yet debilitat ing disorder characterized by painful subcutaneous lipomas, most commonly affecting middle-aged women. Despite its clinical impact, DD remains underdiagnosed and is often misclassified as lipedema, fibromyalgia, or lipomatosis, complicating prevalence estimates and hindering the development of targeted interventions. Current evidence suggests that DDrepresents a distinctive model of inflammatory obesity, where adipose tissue actively AcademicEditor: Ching-YiChen Received: 16September2025 Revised: 27October2025 Accepted: 28October2025 Published: 18 November2025 Citation: Reytor-González, C.; Jiménez-Flores, E.; Toral-Noristz, M.; Campuzano-Donoso,M.;Román Galeano, N.M.;Simancas-Racines, D. The Molecular Mechanisms Underlying Dercum’sDisease: Exploring the Intersection of Obesity, Pain, andInflammation. Int. J. Mol. Sci. 2025, 26, 11130. https://doi.org/ 10.3390/ijms262211130 Copyright: ©2025bytheauthors. Licensee MDPI,Basel,Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY)license (https://creativecommons.org/ licenses/by/4.0/). contributes to pain generation rather than serving as a passive fat reservoir. Histological and molecular findings point to adipose tissue dysfunction, immune cell infiltration, and elevated secretion of pro-inflammatory adipokines, signals which appear to fuel systemic low-grade inflammation, perineural immune interactions, and nociceptor sensitization. Peripheral mechanisms further shape the clinical phenotype. While familial clustering suggests possible genetic contributions, no definitive markers have been identified, and the role of obesity-induced epigenetic modifications remains unexplored. Therapeutic strategies remain largely symptomatic, including analgesics, antidepressants, physical re habilitation, and surgical excision of lipomas, whereas molecularly targeted and diet-based interventions are still experimental. This article discusses the pathophysiology of DD, current treatments, and future perspectives, emphasizing that advancing patient registries, omics-based analyses, and interdisciplinary clinical trials will be crucial to elucidate disease mechanisms and guide novel therapies. Improved understanding of DD may not only enhance patient care, but also provide broader insights into the interplay between obesity, inflammation, and chronic pain.
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    Tumor odontogénico adenomatoide en una localización maxilar posterior inusual: reporte de un caso raro en un varón joven.
    (2026) Reytor González , Claudia María; González, Natalí; Chávez Mestanza , Estefanía Alexandra; Román Galeano , Náthaly Mercedes; Simancas Racines , Daniel Alejandro; Reytor González , Claudia María
    The adenomatoid odontogenic tumor is a rare benign epithelial odontogenic neoplasm that most frequently affects young women and typically occurs in the anterior maxilla. Its presentation in the posterior maxilla, especially in male patients, is uncommon and can create diagnostic challenges. This case describes a large posterior maxillary adenomatoid odontogenic tumor in a 16-year-old male who presented with a one-year history of progressive, painless swelling of the right cheek. Clinical examination revealed facial asymmetry, obliteration of the right nasolabial fold, and intraoral swelling extending from tooth 1.5 to the posterior maxilla. Panoramic radiography and computed tomography showed a multilocular radiolucent lesion with a “soap bubble” appearance, internal calcifications, and displacement of tooth 1.8 toward the floor of the right orbit, which remained intact. The lesion caused root resorption of adjacent teeth and extensive destruction of the maxillary bone. Surgical treatment consisted of enucleation and extraction of teeth 1.5–1.8, followed by histopathological confirmation of adenomatoid odontogenic tumor. Due to the degree of bone involvement, a subsequent wide resection of critical maxillofacial structures was necessary. Postoperative follow-up at five months showed no recurrence but significant residual anatomical changes. This case emphasizes the importance of including adenomatoid odontogenic tumor in the differential diagnosis of posterior maxillary lesions in male patients, and the need for careful surgical planning, histopathological confirmation, and long-term follow-up.