CRIS

Permanent URI for this communityhttps://cris.ute.edu.ec/handle/123456789/1

Browse

Settings

Author: search.filters.author.Melannie Toral-Noristz

Search Results

Now showing 1 - 2 of 2
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    The Molecular Mechanisms Underlying Dercum’s Disease: Exploring the Intersection of Obesity, Pain, and Inflammation
    (MDPI AG, 2025-11-18)
    REYTOR GONZÁLEZ, CLAUDIA MARÍA  
    ;
    Emilia Jiménez Flores
    ;
    Melannie Toral-Noristz
    ;
    Campuzano Donoso Martín
    ;
    ROMAN GALEANO, NATHALY MERCEDES  
    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 debilitating 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 DD represents a distinctive model of inflammatory obesity, where adipose tissue actively 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 rehabilitation, 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.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    Innovation and bioethics in surgery: Redefining boundaries for a safe and human-centered future
    (Medwave Estudios Limitada, 2025-03-06)
    Evelyn Frias-Toral
    ;
    Alex Enrique Vásconez García
    ;
    Melannie Toral-Noristz
    ;
    Martín Campuzano-Donoso
    ;
    ZAMBRANO ESPINOSA, ANA KARINA  
    Since surgery is a complex procedure due to multiple factors, it is more difficult to rigorously evaluate innovative processes in this field than clinical trials of new drugs. Being able to carry out an adequate study design with all its corresponding implications, achieving high-quality standards for these studies, ensuring respect for patients' rights, and verifying that their principles of beneficence, minimization of the risk of harm, justice and autonomy are a challenge for many researchers and professionals involved in the surgical process. Hence, it is advantageous to have guides that guarantee the methodological quality of research on innovative surgical procedures and that these guides include the ethical aspects involved in each of their stages. This review aims to make a historical overview of what has been published on the ethical approach to surgical innovation. In addition, the ethical aspects of the stages of the IDEAL framework for surgical innovation will be explained.