Prostate cancer remains an unavoidable presence, being the second most diagnosed cancer and the fifth leading cause of death among men. In 2020, it affected 1.4 million people, with 375,000 deaths globally. In Mexico, it generates 26,000 new cases annually and more than 7,000 deaths, raising the prevalence to more than 90,000 cases. Globally, many diagnoses occur in early stages, but 20% progress to advanced stages, with only 26-30% surviving more than 5 years. Androgen deprivation therapy is crucial, reducing testosterone and slowing malignant progression, although resistance is inevitable, leading to castration-resistant prostate cancer. Early detection of prostate-specific membrane antigen progression using technologies such as prostate-specific membrane antigen labeled with technetium-99m for scintigraphy orfluorine-18 for positron emission tomography is vital. Prior to PSMA, detection was limited. A therapeutic option is now available with lutetium-177 PSMA, offering a more precise treatment, facilitating a better response and less toxicity, providing new hope in this ongoing fight. The diagnostic and therapeutic approach using the same molecule but a different radioisotope is called theragnostic.
Background: The choice of a medical specialty is a personal decision with an impact on individuals and health systems. Objective: To explore the experiences, expectations and doubts of final-year medical students when choosing a specialty. Material and methods: Qualitative study with focus groups. Purposive and convenience sampling was conducted in three cohorts (2020, 2021 and 2022) of students from the UNAM School of Medicine, in the last year of the medical career. The testimonies were coded and categorized with axial coding and constant comparison. The analysis was based on Bourdieu's concepts of habitus and social capital. Results: Six focus groups were held, two per year, with sixty-three participants. Pediatrics, Internal Medicine, and Surgery were the most chosen specialties. The 2020 focus groups were face-to-face; the following ones were online due to the pandemic. Five key dimensions were identified: lifestyle, prestige of the specialty, characteristics of the hospital, and social interactions. The COVID-19 pandemic also influenced decisions. Conclusions: Understanding the habitus and the struggles for sociocultural capital in the choice of specialty can help transform educational and healthcare structures, better meeting the needs of residents.
Background: Initial studies showed higher admission rates, severe disease, and mortality of COVID-19 in kidney transplant recipients (KTR); nevertheless, Mexico has shown contradictory results. Objective: Determine whether Mexican KTRs have an increased risk of adverse outcomes due to COVID-19. Methods: A retrospective cohort study was conducted on KTRs transplanted between 2009 and 2021. Non-exposed participants were matched by age and sociodemographic characteristics. COVID-19 frequency, severity, and outcomes were assessed from 2020 to 2022. Results: A total of 230 participants in each group were enrolled; 55% of them were male. The median age was 33 years (Interquartile range 27-49). KTR showed a higher risk of hospitalization (20% versus 7%, odds ratio [OR] 3.3; 1.4-7.8), severe disease (29% versus 9.6%, OR 3.8; 1.8-8.1), and acute kidney injury (11.8% versus 1%, OR 15.1; 1.94-117). No differences were found in 30-day mortality. After vaccination, COVID-19 frequency decreased in both groups (p < 0.0001); severe disease significantly dropped in non-KTR (11 to 0%, p = 0.04), but not in KTR (31 to 20%, p = 0.28). Mortality trends were non-significant in both groups. Conclusion: KTRs suffering from COVID-19 are at greater risk of severe disease; however, we found no differences in 30-day mortality.
Background: Currently, assessing muscle volume requires invasive techniques and/or imaging methods, which increases costs and delays evaluation. Moreover, anthropometric measurements are often inaccurate. Objective: To develop a mathematical formula to estimate quadriceps volume. Materials and methods: A total of 127 subjects were evaluated: 40 sedentary adults aged 20 to 35 years, 47 adult athletes aged 20 to 45 years, and 40 sedentary adults aged 70 to 94 years. They were divided into development and validation groups. Anthropometric variables and handgrip strength were measured, and a predictive formula for quadriceps volume was developed. The estimated volume was then compared with the muscle volume obtained via computed tomography (CT). Results: A significant linear relationship was found between quadriceps volume and handgrip strength: original group R2 = 0.887 CT and R2 = 0.901, validation group R2 = 0.878 CT and R2 = 0.907, and combined groups R2 = 0.858 CT and R2 = 0.902. Conclusions: Quadriceps volume estimated using the proposed formula aligns closely with measurements obtained through CT.
