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T he interplay between osteoarthritis and cardiovascular disease: shared pathophysiological mechanisms
(2026)
Jaya Larraga, Lorena Paola
The relationship between osteoarthritis (OA) and cardiovascular disease (CVD) is complex. Epidemiologically, both OA and CVD have displayed rising trends in the last decades, largely attributed to consistent increases in the prevalence of overlapping risk factors. Furthermore, subjects with OA appear to have a greater cardiovascular risk. As a result, these conditions are associated with a significant burden for public health systems. Both OA and CVD have traditionally been studied as distinct conditions, yet growing epidemiological and molecular evidence suggests these two highly prevalent chronic diseases are linked not merely by shared risk factors such as aging, obe-sity, and sedentary lifestyle, but also by deeply interconnected biological mechanisms. In ensemble, a plethora of pathophysiologic phenomena, such as chronic inflammation, oxidative stress, adipokine dysregulation, endothelial dysfunction, and extracellular matrix remodeling form a complex and overlapping network of processes that can jointly drive both articular degradation and vascular injury. Bridging the gap between musculoskeletal and cardiovascular research offers the promise of innovative therapies and integrated care strategies that can improve both mobility and longevity for millions of patients worldwide by improving clinical outcomes of both OA and CVD. In this narrative review, we revise the pathophysiological interconnections between OA and CVD. © 2026, Venezuelan Society of Pharmacology and Clinical and Therapeutic Pharmacology. All rights reserved.
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Jaya Larraga, Lorena Paola
Docente facultad
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Trujillo Lopez, Gisselle
Docente de Facultad
32
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Drug-Resistant Tuberculosis in Prisons of Latin America and the Caribbean: A Critical Reflection on Structural Challenges and Gaps
(2026)
Torres Rodriguez, Ariel Antonio
;
Sánchez Redrobán, José
;
Trujillo Lopez, Gisselle
Drug-resistant tuberculosis (DR-TB) represents a major public health threat, particularly in the prisons of Latin America and the Caribbean, where rates are up to 40 times higher than those observed in the general population. These facilities act as community amplifiers due to overcrowding, poor ventilation, diagnostic delays, and treatment discontinuity. This study offers a critical reflection on the magnitude, determinants, and implications of DR-TB in regional penitentiary contexts. A reflective analytical review was conducted in PubMed, Scopus, Web of Science, SciELO, and LILACS, complemented by WHO and PAHO reports, prioritising studies from 2019 to 2024. The findings reveal MDR-TB and pre-extensively drug-resistant (pre-XDR) outbreaks in Peru, Paraguay, and the Dominican Republic, as well as community transmission linked to prisons in Brazil and Colombia. Persistent gaps remain in systematic screening, drug susceptibility testing coverage, and post-release follow-up. Scientific production continues to be uneven and predominantly biomedical, with limited consideration of social and human rights determinants. DR-TB in prisons reflects the structural deficiencies of health and justice systems; its control requires intersectoral policies, genomic surveillance, and strategies that ensure early diagnosis, treatment continuity, and dignified detention conditions. © 2026 by the authors.
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Face-to-face versus virtual education in biostatistics: a comparative study among medical students in Ecuador during the COVID-19 pandemic
(2026)
Paloma González
;
Martha Fors
;
Torres Rodriguez, Ariel Antonio
Introduction: The abrupt shift from face-to-face to virtual teaching during the COVID-19 pandemic challenged universities worldwide. In this study, we examine how this transition affected learning outcomes and student experiences in a biostatistics course for medical students at the Universidad de Las Américas in Quito, Ecuador. Methods: We surveyed 57 students (34 face-to-face in 2019, 23 virtual in 2020–21) to explore perceptions of learning facilitation, teacher and peer interaction, and self-regulated learning. Additionally, we compared academic performance across modalities using statistical analysis. Results: We found that students taught in person reported significantly higher levels of instructor contact and peer collaboration (p ≤ 0.05), while no statistically significant difference emerged in final grades between modalities (face-to-face mean = 8.89 ± 0.89; virtual mean = 9.01 ± 0.56; p = 0.967). Conclusion: These findings suggest that although virtual instruction can achieve comparable academic outcomes, the student experience differs markedly and may favor in-person formats for interaction and collaboration. For medical education contexts, our results highlight the value of integrating robust instructional design and peer collaboration in online environments. Future research should adopt longitudinal designs and explore mixed-mode (blended) strategies to harness the strengths of both modalities. Copyright © 2026 González, Fors and Torres.
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Bioactive Natural Compounds in Triple-Negative Breast Cancer: Molecular Targets and Therapeutic Perspectives
(2026)
Emilia Jiménez-Flores
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Reytor González, Claudia
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Dolores Jima Gavilanes
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Cesar Carrillo
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Raquel Horowitz
Triple-negative breast cancer represents one of the most aggressive and therapeutically challenging subtypes of breast malignancies, characterized by marked biological heterogeneity, rapid progression, and limited targeted treatment options. Conventional therapies are frequently constrained by drug resistance, systemic toxicity, and high rates of recurrence. In this context, natural products have gained increasing attention as multifunctional agents capable of modulating several hallmarks of triple-negative breast cancer. Bioactive compounds, including polyphenols, terpenoids, alkaloids, and marine-derived molecules, exhibit pleiotropic antitumor effects by interfering with key oncogenic pathways. Importantly, these compounds have demonstrated the ability to counteract major mechanisms of therapeutic resistance, modulate the tumor immune microenvironment, and enhance the efficacy of standard chemotherapy and immunotherapy. Advances in drug delivery strategies, such as nanoparticle-based systems and tumor-targeted formulations, together with patient-specific molecular profiling, further expand the potential of these agents within personalized treatment approaches. This narrative review critically examines the role of natural compounds in targeting the hallmarks of triple-negative breast cancer and their potential synergistic use to improve therapeutic efficacy while reducing treatment-related toxicity. Overall, the integration of natural product-based strategies into precision oncology frameworks may offer more effective, less toxic, and individualized therapeutic options for this aggressive breast cancer subtype.
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Alcohol and Substance Use After Bariatric Surgery: Nutritional Risks and Clinical Implications in Long-Term Postoperative Care
(2026)
Martín Campuzano-Donoso
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Reytor González, Claudia
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Gerardo Sarno
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Martha Montalvan
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Luigi Barrea
Metabolic and bariatric surgery (MBS) has evolved into a highly effective neurohormonal intervention for severe obesity; however, it introduces unique long-term vulnerabilities, particularly regarding alcohol (AUD) and substance use disorders (SUD). This review synthesizes the epidemiological, pharmacokinetic, and neurobiological drivers of postoperative substance misuse. Procedures like Roux-en-Y gastric bypass (RYGB) radically alter ethanol metabolism, eliminating first-pass metabolism and accelerating gastric emptying, while simultaneously recalibrating reward pathways, creating a “reward gap” that facilitates addiction transfer. These physiological shifts exacerbate critical micronutrient deficiencies (thiamine, B12, iron), increase the risk of post-bariatric hypoglycemia, and correlate with higher rates of liver cirrhosis and suicide. Furthermore, substance use is a primary driver of suboptimal weight loss trajectories and weight regain. Mitigation requires a lifelong, multidisciplinary framework involving preoperative risk stratification, validated screening (e.g., AUDIT-C), and targeted nutritional supplementation to safeguard the long-term metabolic and psychological benefits of MBS.
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The Role of Gut Microbiota in Postmenopausal Women: Implications for Lipid Metabolism and Targeted Nutritional Interventions
(2026)
Reytor González, Claudia
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Ludovica Verde
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Giuseppe Annunziata
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Náthaly Mercedes Román-Galeano
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Raquel Horowitz
Purpose of Review: This review explores the complex interplay between menopause, estrogen decline, lipid metabolism, and gut microbiota alterations. It highlights the physiological and metabolic changes that predispose postmenopausal women to dyslipidemia and increased cardiovascular disease risk, with particular emphasis on the emerging role of the gut microbiota in modulating lipid homeostasis and inflammatory pathways. In addition, it examines the therapeutic potential of microbiota-targeted nutritional strategies to restore metabolic balance and improve cardiometabolic outcomes in postmenopausal women. Recent Findings: Recent clinical and experimental evidence indicates that menopause-related hormonal changes and aging are associated with gut microbiota dysbiosis, which may contribute to adverse lipid profiles through mechanisms involving bile acid metabolism, short-chain fatty acid production, and low-grade systemic inflammation. Associations between specific microbial taxa and lipid metabolic patterns have been reported; however, findings remain heterogeneous and causal relationships are difficult to establish due to confounding factors such as diet, lifestyle, and medication use. Nutritional interventions aimed at modulating the gut microbiota—including Mediterranean, plant-based, and DASH dietary patterns, increased dietary fiber intake, and supplementation with prebiotics, probiotics, polyphenols, phytoestrogens, and omega-3 fatty acids—have shown potential to improve lipid profiles and cardiometabolic risk markers. Summary: The gut microbiota emerges as a relevant contributor to menopause-associated dyslipidemia and cardiovascular risk. While microbiota-targeted nutritional strategies are promising, further longitudinal and interventional studies are needed to clarify causal pathways and identify clinically actionable microbial signatures. Integrating microbiome-informed nutritional approaches into clinical practice may represent a future strategy to improve cardiometabolic health in postmenopausal women. © The Author(s) 2026.
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Sleep disorders and menopausal symptoms: a Latin American perspective on postmenopausal health
(2025)
Eugenio E. Arteaga
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Juan E. Blümel
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María S. Vallejo
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Carlos Salinas
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Konstantinos Tserotas
Objective: This cross-sectional, observational study, conducted in nine Latin American countries, aimed to examine the association between hot flashes and insomnia, and whether the severity of vasomotor symptoms (VMS) correlates with sleep disturbances. Method: The study collected sociodemographic and clinical data, and evaluated the presence of sleep disorders using Jenkin’s Sleep Scale (JSS-4) and menopausal symptoms using the Menopause Rating Scale (MRS) questionnaire. Results: The study included 1185 postmenopausal women with average age 56.9 ± 5.7 years, body mass index (BMI) of 26.5 ± 5.2 kg/m² and 8.6 ± 6.4 years since menopause. Overall, 20.6% reported sleep disturbances. Compared to those without sleep problems, affected women had longer postmenopausal duration (12 ± 9.0 vs. 10.8 ± 7.8, p < 0.03), had higher BMI (27.9 ± 5.6 vs. 26.1 ± 5.0, p < 0.001), were more often smokers and homemakers, and had more comorbidities. They were also less likely to have a partner or have used menopausal hormone therapy. Sleep disturbances increased proportionally with VMS severity (p < 0.01). In multivariate analysis, sleep disorders were associated with VMS (odds ratio [OR] 4.47), psychotropic use (OR 1.84), obesity (OR 1.45) and comorbidities (OR 1.45). Conclusion: Women with VMS were more likely to experience sleep disorders and this effect was proportional to the magnitude of the hot flashes. The study also presents several factors associated with sleep disorders in postmenopausal women that should be considered to help prevent these disturbances. © 2025 International Menopause Society.
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Unraveling the association between obesity and climacteric symptoms: a generalized structural equation modeling approach
(2025)
Sócrates Aedo
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Juan Enrique Blümel
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María Soledad Vallejo
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Claudia Rey
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Marcio Alexandre Rodrigues
Objective: – To assess the direct and indirect associations between obesity and the severity of menopausal symptoms in postmenopausal women, considering related conditions such as chronic diseases and physical activity. Methods: – This observational subanalysis utilized data from the REDLINC XII multinational study, which included 722 postmenopausal women aged 70 or younger from 9 Latin American countries. Menopausal symptoms were measured using the Menopause Rating Scale (MRS). Clinical, behavioral, and sociodemographic data were obtained through physician-administered surveys. Generalized Structural Equation Modeling was employed to examine the direct and indirect relationships between obesity, chronic cardiovascular and respiratory diseases, chronic hypertension, diabetes mellitus, and physical activity, and MRS scores. Odds ratios (ORs) were calculated to enhance interpretability. Results: – A total of 722 participants were included. Obesity was directly associated with higher MRS scores (OR = 1.75). In addition, obesity exhibited indirect associations with MRS scores, with an odds ratio of 19.07, through chronic arterial hypertension, diabetes mellitus, physical inactivity, and chronic cardiovascular or respiratory diseases. The total association between obesity and MRS scores was reflected in an OR of 33.45. Furthermore, physical inactivity and the use of antidepressants were associated with greater symptom severity, whereas higher educational attainment, regular physical activity, and menopausal hormone therapy were associated with lower MRS scores. Conclusions: – Obesity is strongly associated with more severe menopausal symptoms, both directly and through related chronic conditions and behavioral factors. Longitudinal studies are needed to establish temporal and causal inferences. © 2025 by The Menopause Society
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