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The Molecular Mechanisms Underlying Dercum’s Disease: Exploring the Intersection of Obesity, Pain, and Inflammation
(MDPI AG, 2025-11-18)
REYTOR GONZÁLEZ, CLAUDIA MARÍA
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Emilia Jiménez Flores
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Melannie Toral-Noristz
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Campuzano Donoso Martín
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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.
Scopus© Citations 2
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Timing matters: lipid intake and its influence on menopausal-related symptoms
(Springer Science and Business Media LLC, 2025-08-18)
Ludovica Verde
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Luigi Barrea
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Evelyn Frias-Toral
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Raynier Zambrano-Villacres
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SIMANCAS RACINES, DANIEL ALEJANDRO
Background Menopause contributes to central obesity and increases cardiovascular risk in women. Diet influences both menopausal symptoms and cardiovascular health, but the impact of chrononutrition, namely food timing, is not well understood. This cross-sectional study investigated whether the timing of food intake affected menopausal symptoms in 100 postmenopausal women with overweight or obesity. Methods Anthropometric and clinical parameters, and lifestyle habits were assessed. Menopausal symptoms were evaluated using the Menopause Rating Scale (MRS). Nutritional assessment utilized 7-day food records. Food intake was divided into morning intake (meals from breakfast to lunch) and evening intake (meals from afternoon snacks to dinner). Results The mean MRS score was 22.7 ± 7.8, showing a high prevalence of symptoms in the study population. Postmenopausal women under the median of morning energy intake showed a significantly a higher score for heart discomfort (p = 0.045), while those under the median of morning intake of lipids showed significantly higher scores for heart discomfort and lower scores for bladder problems (p = 0.013 and p = 0.040, respectively). Postmenopausal women above the median evening intake of lipids showed a significantly higher score for heart discomfort (p = 0.007). The heart discomfort score correlated negatively and positively with the morning (r = -0.210, p = 0.034) and evening (r = 0.210, p = 0.034) intakes of lipids, respectively, even after correction for confounding factors (r = -0.219 and r = 0.219, p = 0.028 for both). Conclusion Consuming most of the energy and lipids later in the day was linked to higher prevalence of menopausal symptoms in postmenopausal women with overweight or obesity. This eating pattern may potentially have adverse effects on the cardiovascular health of these women. Therefore, adopting chrononutrition behaviors, particularly favoring an earlier intake of energy and lipids, could prove beneficial as an additional measure in the nutritional therapy for postmenopausal women dealing with overweight or obesity.
Scopus© Citations 3
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Expert Consensus on the Nutrition Care Process in Guatemalan Hospitals: Findings from a Delphi Study of nutritionDay 2022 Participants
(MDPI AG, 2025-09-30)
Karen Girón
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Isabel Chinchilla
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Christa Gómez
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Marietta Lau
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María René Oroxon
Background: Disease-related malnutrition (DRM) remains an underdiagnosed condition in Latin American hospitals, with substantial clinical and economic consequences. The global nutritionDay initiative, promoted by ESPEN, provides a standardized audit to evaluate and improve hospital nutritional care. This study aimed to develop expert consensus recommendations to optimize the nutritional care process in Guatemalan hospitals, based on the findings from nutritionDay 2022. Methods: A modified Delphi study was conducted, including three meetings held before and after each round to discuss the results. Sixteen clinical nutrition professionals from eleven hospitals participated. A total of 89 items were assessed, with a predefined consensus threshold of 70%. Data were analyzed using R software (version 4.5.0) and Kendall’s W coefficient was applied to evaluate inter-round agreement. Results: Consensus was achieved for 51 key recommendations covering nutritional screening, clinical assessment, anthropometry, body composition, functional assessment, biochemical monitoring, dietary intervention, and post-discharge follow-up. The proposed actions are aligned with international guidelines (ESPEN, ASPEN, GLIM) and adapted to the Guatemalan healthcare context. Conclusions: This consensus provides a comprehensive and context-specific framework for standardizing and improving hospital nutritional care in Guatemala and similar settings. Its implementation could help reduce DRM prevalence and foster the development of quality indicators and digital tools for clinical nutrition management.
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Differential impact of coffee quantity and sweetening on body composition parameters and inflammation
(Frontiers Media SA, 2025-09-17)
Giuseppe Annunziata
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Evelyn Frias-Toral
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Francesco Campa
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Maria Antonieta Touriz Bonifaz
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Ludovica Verde
Background: Coffee is the most consumed and popular beverage worldwide. The health benefits of its regular, moderate consumption are well known, and include antioxidant and anti-inflammatory effects, as well as metabolic effects, reducing the risk of obesity and related diseases. The available literature, however, provides no information about the effect of coffee consumption on body composition (BC) and inflammation. The present cross-sectional observational study aims to investigate the effect of coffee consumption on BC and inflammation-related parameters, as well as the possible impact of adding sugar and the frequency of consumption. Coffee consumption habits, preference for adding sugar and frequency of daily consumption were assessed in 2,556 adults (1,080 men and 1,476 women). BC was assessed using Bioelectrical Impedance Analysis (BIA), whilst high-sensitivity C-reactive protein (hs-CRP) levels were monitored for inflammatory status. Results: A total of 1,855 subjects (680 men and 1,175 women) were included in the statistical analysis. Compared to non-consumers, coffee consumers showed lower body mass index (BMI), waist girth (WG), and hs-CRP levels, and higher skeletal muscle mass (SMM), appendicular SMM (ASMM), phase angle (PhA), and standardised PhA (SPA) (p< 0.001 for all). The same trend was observed for unsweetened coffee consumers compared to subjects consuming sweetened coffee. With increasing coffee consumption, BMI, WG, and hs-CRP generally decreased, whilst SMM and ASMM showed a bell-shaped trend with peak values in those consuming 2–3 cups per day. Similarly, PhA and SPA values were highest among moderate coffee consumers. Conclusion: These findings suggest that moderate coffee consumption, particularly unsweetened coffee, is associated with more favourable body composition and inflammatory profiles. Given the observational design, causality cannot be established. Nevertheless, the results may inform dietary guidance aimed at supporting muscle maintenance and mitigating obesity-related metabolic risk.
Scopus© Citations 2
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Healthcare attitudes toward depression in Latin America: a latent class analysis from Argentina, Chile, Ecuador, Peru, and Venezuela using the Spanish-validated revised depression attitude questionnaire (SR-DAQ)
(Springer Science and Business Media LLC, 2025-10-01)
Marco Faytong-Haro
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Genesis Camacho-Leon
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Robert Araujo-Contreras
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Stephanie Gallegos
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Hans Mautong
Background: Depression significantly impacts health systems worldwide, particularly in Latin America, where cultural stigmatization and misconceptions about mental health deter individuals from seeking help. Healthcare professionals’ attitudes toward depression may affect its prevention, diagnosis and treatment. Objective: To categorize Latin American healthcare professionals’ attitudes towards diagnosis and management of depression in subgroups using the Spanish-validated Revised Depression Attitude Questionnaire (SR-DAQ). Methods: A cross-sectional study surveyed 2,409 professionals using SR-DAQ from 2019 to 2022. Latent class analysis and multinomial logistic regression were used to identify attitude classes and explore demographic influences. Results: Among our sample, four attitude classes were identified: Depression Skeptics (21%), Depression Cautious (33%), Depression Neutrals (18%), and Depression Advocates (28%). Gender and medical subspecialty significantly influenced class membership, with females and mental health specialists more likely to be part of the Advocates. Conclusion: The study reveals varied attitudes towards depression among Latin American healthcare professionals, suggesting the need for tailored public health strategies to enhance effective depression care and management.
Scopus© Citations 2
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Effects of Preoperative Exercise Interventions in Patients Undergoing Metabolic and Bariatric Surgery: A Systematic Review and Meta-Analysis
(MDPI AG, 2025-09-01)
SIMANCAS RACINES, DANIEL ALEJANDRO
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PARISE VASCO, JUAN MARCOS
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ANGAMARCA IGUAGO, JAIME WLADIMIR
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Ashley Carolina Cuzco Macias
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Carlos Soria
Background: Obesity affects over one billion people globally. Bariatric surgery is the most effective long-term intervention for severe obesity. However, postoperative outcomes can vary considerably, with such factors as baseline fitness and cardiorespiratory reserve influencing surgical outcomes. This systematic review aimed to evaluate the effects of preoperative exercise or physical activity, compared to standard care or no intervention, on preoperative fitness parameters and perioperative surgical outcomes in adults with obesity undergoing metabolic and bariatric surgery. Methods: A systematic review was conducted in accordance with the recommendations of the Cochrane Handbook and the PRISMA guidelines. Randomized controlled trials, non-randomized controlled trials, and cohort studies with control groups evaluating preoperative exercise interventions were included. Two independent reviewers conducted study selection, data extraction, and risk of bias assessment using Cochrane tools. Meta-analyses were performed using random effects models, with standardized mean differences calculated for continuous outcomes. Evidence certainty was assessed using the GRADE approach. Results: A total of 15 studies, including 1378 participants, were identified for qualitative synthesis, with 12 contributing data for quantitative meta-analysis. Preoperative exercise interventions significantly improved six-minute walk test distance (SMD 2.01; 95% CI: 0.51 to 3.50; p = 0.009) and VO2 peak (SMD 1.02; 95% CI: 0.52 to 1.51; p < 0.0001). BMI reduction was significant (SMD −0.96; 95% CI: −1.75 to −0.16; p = 0.02), while weight change was not statistically significant (SMD −0.81; 95% CI: −1.72 to 0.09; p = 0.08). One study reported a reduction in hospital length of stay of 0.64 days (95% CI: −0.86 to −0.42; p < 0.00001). Evidence certainty was rated as very low to low across all outcomes. Conclusions: Preoperative exercise interventions have been shown to significantly improve cardiorespiratory fitness in bariatric surgery candidates, with large effect sizes for functional capacity measures. Despite the low certainty of the evidence, these findings suggest that supervised exercise programs should be incorporated into the preoperative care of bariatric surgery patients.
Scopus© Citations 1
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Redefining Chemoresistance: Natural Bioactives as Molecular Modulators at the Cancer–Tumor Microenvironment Interface
(MDPI AG, 2025-08-20)
REYTOR GONZÁLEZ, CLAUDIA MARÍA
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Emilia Jiménez Flores
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GONZALEZ CALZADA, NATALIA
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SIMANCAS RACINES, DANIEL ALEJANDRO
Therapeutic resistance remains a critical barrier in effective cancer treatment, contributing to disease recurrence, progression, and reduced patient survival. In recent years, natural bioactive compounds have emerged as promising adjuncts in oncology due to their ability to modulate multiple biological processes involved in resistance. This review explores current evidence on the role of natural compounds in influencing cancer cell behavior and their interactions with the tumor microenvironment. By organizing these compounds into chemical families, we provide a structured overview of their potential to enhance the efficacy of standard chemotherapy and reduce resistance-related mechanisms. We also highlight innovative strategies, including combination therapies and advanced drug delivery systems, that aim to improve their clinical applicability. Overall, this work underscores the relevance of integrating natural bioactives into modern cancer therapy and calls for further translational research to bridge preclinical findings with clinical implementation.
Scopus© Citations 10
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H5N1 Avian Influenza: A Narrative Review of Scientific Advances and Global Policy Challenges
(MDPI AG, 2025-06-29)
Simancas-racines Alison
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REYTOR GONZÁLEZ, CLAUDIA MARÍA
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Melannie Toral
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SIMANCAS RACINES, DANIEL ALEJANDRO
The H5N1 avian influenza virus continues to evolve into genetically diverse and highly pathogenic clades with increased potential for cross-species transmission. Recent scientific advances have included the development of next-generation vaccine platforms, promising antiviral compounds, and more sensitive diagnostic tools, alongside strengthened surveillance systems in both animals and humans. However, persistent structural challenges hinder global readiness. Vaccine production is heavily concentrated in high-income countries, limiting equitable access during potential pandemics. Economic and logistical barriers complicate the implementation of control strategies such as vaccination, culling, and compensation schemes. Gaps in international coordination, public communication, and standardization of protocols further exacerbate vulnerabilities. Although sustained human-to-human transmission has not been documented, the severity of confirmed infections and the rapid global spread among wildlife and domestic animals underscore the urgent need for robust preparedness. International organizations have called for comprehensive pandemic response plans, enhanced multisectoral collaboration, and investment in targeted research. Priorities include expanding surveillance to asymptomatic animal hosts, evaluating viral shedding and transmission routes, and developing strain-specific and universal vaccines. Strengthening global cooperation and public health infrastructure will be critical to mitigate the growing threat of H5N1 and reduce the risk of a future influenza pandemic.
Scopus© Citations 8
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Fungal biopolymer-based nanoparticles for wound healing: Mechanisms, applications, and future perspectives
(Elsevier BV, 2025-12-01)
Kaakarlu Shivakumar Vinanthi Rajalakshmi
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Balamuralikrishnan Balasubramanian
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Hemanth Hinnakki
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Arun Meyyazhagan
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Wen-Chao Liu
Fungal derived biopolymers have emerged as a promising alternative to the existing synthetic materials and have gained heightened interest in wound healing platforms due to their unique properties, such as durability, biodegradability, biocompatibility, low-toxicity, non-immunogenicity, and analogy to the native extracellular matrix. Major fungal biopolymers such as chitin, chitosan, β-glucan, mannan, and pullulans offer several biomedical and clinical advantages in wound healing to remodel the injured tissue, making them suitable for accelerating the various phases of wound healing. These biopolymers not only support cell proliferation, angiogenesis, and tissue remodelling but also serve as effective carriers for controlled drug delivery, enhancing the efficacy of therapeutic agents to accelerate the cellular responses at the wound site. The review also outlines the biological processes involved in various phases of wound healing to provide insight into future explorations in developing optimized wound dressings that ensure maximal reduction of inflammation and allow skin to remodulate. Fungal-mediated nanoparticles and hybrid nanocomposites have further improved the functional performance of wound dressings by providing increased mechanical stability, biocompatibility, and targeted bioactivity. Collectively, these findings highlight the significant role of fungal biopolymer-based nanoparticles as a novel, sustainable, and effective regime for advanced wound management.
Scopus© Citations 12
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Handgrip strength values and body composition in Ecuadorian university young adults
(Medwave Estudios Limitada, 2025-03-03)
Diana Fonseca-Pérez
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Víctor Sierra Nieto
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Cecilia Arteaga-Pazmiño
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Ludwig Álvarez Córdova
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Evelyn Frias-Toral
Introduction Handgrip strength is a key indicator of functional health and overall muscular strength. These parameters are essential for assessing physical performance and health status. This study aims to assess handgrip strength and body composition in young Ecuadorian university adults. Methods This was a cross-sectional study conducted among university students from the Faculty of Health Sciences at Universidad Católica de Santiago de Guayaquil. Participants completed a self-administered questionnaire for demographic variables. Handgrip strength was assessed in both hands with an hydraulic dynamometer. Body composition was measured using a bioelectrical impedance device. Results 350 participants were included in the study, consisting of 65.5% (n=233) females and 33.4% (n=177) males. The mean age was 22 ± 2.09 years. The mean muscle mass was 24.4 ± 6.9 kg, and the mean fat mass was 22.0 ± 12.9 kg. The visceral fat value was 8.0 ± 3.1 points. The mean handgrip strength for males was 39.6 ± 8.07 kg in the right arm and 38.5 ± 8.07 kg in the left hand, and for females, was 23.0 ±5.57 kg in the right arm and 22.0 ± 5.84 kg in the left arm. Muscle mass positively correlated with handgrip strength in both sexes and both hands, with Rho = 0.813 (p<0.001) for the right arm and Rho = 0.798 (p<0.001) for the left arm. Conclusions We established reference values for handgrip strength and body composition in healthy young Ecuadorian adults, showing handgrip strength’s positive association with muscle mass and anthropometric variables.
Scopus© Citations 24

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