Trujillo Lopez, Gisselle

Preferred name
Trujillo Lopez, Gisselle
Main Affiliation
Quito

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    Inflammasome–Interferon Convergence in Elite HIV Controllers and Autoimmune Diseases: A Critical Integrative Reflection
    (MDPI AG, 2026-08-21)
    Torres Rodriguez, Ariel Antonio  
    ;
    González, Paloma
    ;
    Fors, Martha
    ;
    Trujillo Lopez, Gisselle  
    Background: Elite HIV controllers exhibit persistent immune activation despite sustained viral suppression, a phenomenon that challenges the traditional view of immunological equilibrium. In parallel, autoimmune diseases are characterised by chronic inflammation driven by dysregulated immune responses. Objective: This study aimed to analyse the potential pathophysiological convergence between both conditions and to identify a shared inflammatory axis with possible translational implications. Methods: A critical narrative and integrative reflection was conducted using a purposive, concept-driven selection of evidence from PubMed/MEDLINE, Scopus, and Web of Science. A total of 43 sources were included: 28 studies informing mechanistic findings (14 on elite HIV controllers and 14 on autoimmune diseases), 12 addressing modulatory strategies (pharmacological and lifestyle-based), and 3 providing contextual frameworks. Results: Both conditions demonstrate sustained activation of innate immunity, characterised by elevated pro-inflammatory cytokines (IL-1β, IL-6, TNF, type I interferons), increased inflammatory biomarkers (e.g., sCD14, IP-10), and activation of pathways such as NLRP3 inflammasome and NF-κB signalling. Collectively, these findings suggest convergence towards a potential shared inflammatory axis mediated by the inflammasome–interferon pathway, which may contribute to persistent systemic inflammation and tissue damage. Evidence from pharmacological and non-pharmacological interventions suggests that components of this axis may be susceptible to modulation. Conclusions: The observed convergence supports a conceptual model of shared innate inflammatory activation across both conditions. Rather than implying a unified therapeutic approach, the findings suggest a framework of convergent modulation targeting the inflammasome–interferon axis. This hypothesis warrants further investigation to determine its clinical and translational relevance. © 2026 by the authors.
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    Artificial intelligence in physical examination teaching in Latin America: a critical narrative review and conceptual model proposal
    (Frontiers Media SA, 2026-04-13)
    Torres Rodriguez, Ariel Antonio  
    ;
    González, Paloma
    ;
    Fors, Martha
    ;
    Trujillo Lopez, Gisselle  
    Artificial intelligence (AI) is reshaping medical education, particularly in the teaching of physical examination and the development of clinical judgement in digitally mediated contexts. This study presents a critical narrative review examining the ethical, pedagogical, and humanistic implications of AI integration into physical examination training in Latin America. A structured search of literature published between 2018 and 2025 was conducted across PubMed, Scopus, Web of Science, SciELO, and Google Scholar. Thirty-one peer-reviewed studies and three institutional documents met predefined relevance criteria and were analyzed through thematic synthesis. Four thematic domains emerged: (1) AI-assisted clinical simulation and automated feedback, (2) curricular integration and institutional implementation strategies, (3) governance and ethical supervision frameworks, and (4) emerging challenges related to digital literacy, technological dependence, and preservation of clinical judgement. Evidence suggests that AI enhances procedural precision and formative feedback; however, its educational value remains complementary and dependent on structured human-in-the-loop supervision. Based on these findings, the Modelo Educativo Digital basado en Inteligencia Artificial (or Medical Education with Artificial Intelligence) (MED-IA) conceptual model is proposed, framing clinical competence development across three interconnected levels: technical execution, experiential patient interaction, and reflective judgement. The model integrates technological mediation with ethical oversight and humanistic formation. These findings highlight the need for transparent governance frameworks, teacher digital literacy, and context-sensitive institutional policies to ensure responsible AI implementation in Latin American medical education. Copyright © 2026 Torres, González, Fors and Trujillo.
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    Rethinking Tuberculosis Treatment Abandonment in Latin America: A Biopsychosocial Perspective and an Integrated Model for Continuity of Care
    (MDPI AG, 2026-07-24)
    Torres Rodriguez, Ariel Antonio  
    ;
    González, Paloma
    ;
    Fors, Martha
    ;
    Trujillo Lopez, Gisselle  
    Background: Tuberculosis remains a major public health challenge in Latin America, where social inequalities, fragmented health systems, and barriers to care continue to undermine disease control. Although effective treatment is available, treatment abandonment and loss to follow-up remain persistent obstacles to successful outcomes. Methods: A structured critical analysis of the contemporary literature on tuberculosis treatment abandonment and retention in care was conducted using a narrative evidence synthesis approach. Forty scientific documents published between 2018 and 2026 were included. Of these, 23 Latin American studies informed the results synthesis, while 13 international studies supported the comparative critical reflection. Results: Findings were organised into five domains: social vulnerability, clinical complexity, health system barriers, priority populations, and protective factors and innovation. The evidence indicates that treatment abandonment is not an isolated individual behaviour, but a phenomenon associated with the convergence of social, clinical, and institutional determinants across the care trajectory. Poverty, migration, drug resistance, incarceration, weak follow-up systems, and fragmented care were repeatedly associated with discontinuity, whereas social support, active follow-up, digital tools, and economic measures were linked to improved adherence and retention in care. Conclusions: From a biopsychosocial perspective, treatment abandonment should be understood as a systemic and preventable failure across the tuberculosis care continuum. The proposed Latin American Integrated Model for Retention in Tuberculosis Care (MILERTB) offers an anticipatory, equity-oriented, and person-centred framework to strengthen retention in care and guide future implementation research. © 2026 by the authors.
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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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