Life expectancy is increasing globally, but if people are to age healthily, they must do so with fewer limitations in their daily activities. However, information on either the frequency or risk factors for limitations to walking ability or other key activities across different regions of the world is limited. Our aim was to describe the incidence, trajectories, risk factors, and population-attributable fraction of new-onset walking limitations in 25 countries at all socioeconomic levels. PURE is an ongoing, prospective cohort study. The current analysis included community-dwelling participants who lived in four high-income countries (HICs), 16 middle-income countries (MICs), and five low-income countries (LICs). Individuals aged 35-70 years at baseline who completed a baseline questionnaire about activity limitations between Jan 12, 2001, and May 6, 2019, were included in our analysis. The activity limitation screen included questions on self-reported difficulty with walking, grasping, bending, seeing close-up, seeing distance, and hearing. The primary outcome was incident walking limitation and our analytic sample comprised those with no walking limitation at baseline. We estimated the incidence rates, adjusted for age and sex, per 100 person-years in the overall PURE population, by country income level (and separately for China) and sex. We used multistate modelling to evaluate trajectories across the life course, analysed across continuous age, through three distinct sequential states: no limitation, walking limitation, and death. We used survival models to evaluate the associations of socioeconomic status, vascular and behavioural factors, community walkability, and incident adverse events, with incident walking limitations. We then calculated the population-attributable fraction of selected modifiable factors and compared the risk factors for walking limitation and mortality. 172 889 people from the PURE cohort answered questions on walking limitations at baseline, 150 221 of whom reported no walking limitation and were included in the multistate model. Of these 150 221 individuals, 122 538 had at least one follow-up assessment with walking limitations data (mean age at baseline 49·7 years [SD 9·5]; 71 424 [58·3%] female and 51 114 [41·7%] male). Mean follow-up was 14·5 years (SD 3·3). Incidence of a new walking limitation per 100 person-years was higher in LICs (3·34 [95% CI 3·27-3·41]), and lowest in China (0·58 [0·56-0·60]), compared with other MICs (1·80 [1·77-1·84]) and HICs (1·31 [1·27-1·37]). The incidence of walking limitation was higher in female participants (1·84 [1·81-1·87]) than in male participants (1·25 [1·22-1·28]). In multistate models, state transitions from no walking limitation to walking limitation and death occurred at a higher rate and earlier in LICs, where the age at which the probability of transitioning to a walking limitation was reached by an estimated one-third of people at 64 years compared with age 76 years in HICs. Female participants had a higher probability of incident walking limitation across the age spectrum compared with male participants. Many socioeconomic, vascular, and behavioural risk factors, community walkability, and incident adverse events, especially incident stroke, were associated with incident walking limitations. The population-level risk factors with the highest population-attributable fractions for walking limitation were low education (11·1% [95% CI 9·9-12·4]), obesity (5·2% [4·7-5·8]), hypertension (3·6% [2·2-5·0]), and low recreational physical activity (4·3% [2·3-6·3]), with obesity being the highest in HICs (12·9% [11·2-14·6]) and low education being the highest elsewhere. Potentially modifiable individual-level risk factors explained approximately 32·9% of the population's risk of walking limitations and approximately 47·4% of mortality, and four of the top five factors were shared for both outcomes (low education, low recreational activity, poor diet, and hypertension). Individuals in LICs had an accelerated transition to walking limitation, which was approximately 12 years earlier than those in HICs. Walking limitation and mortality shared a common set of modifiable risk factors, accounting for almost one-third of the population-level risk of walking limitations and highlighting opportunities for integrated prevention strategies in mid-life that simultaneously target disability and premature mortality across socioeconomic settings. Funding sources are listed at the end of the Article.
Population aging has markedly increased the burden of cancer in older adults, in whom frailty, sarcopenia, and reduced physiological reserve limit tolerance to treatment and worsen clinical outcomes. Aging is accompanied by progressive functional decline and by biological processes such as cellular senescence, characterized by irreversible cell cycle arrest, chronic low-grade inflammation, and impaired immune surveillance. The accumulation of senescent cells and the persistence of a senescence-associated secretory phenotype contribute to tissue dysfunction and generate a microenvironment that favors tumor initiation and progression. Physical exercise has been associated with attenuation of inflammation, improvements in metabolic and immune function, and with lower levels of senescence-related biomarkers. Although aerobic exercise has been extensively studied in this setting, resistance training holds relevance for older adults due to its capacity to counteract sarcopenia, preserve muscle strength and power, and sustain functional independence. Structured and periodized approaches to resistance exercise may further enhance these benefits by delivering targeted stimuli aligned with age-related physiological deficits. Block strength training (BST), a periodized model that concentrates training adaptations into sequential phases of maximal strength, power, and muscular endurance, has demonstrated consistent improvements in functional performance and reductions in frailty risk in community-dwelling older adults. BST improves physical function. It may also influence biological processes related to aging and cancer; however, mechanistic evidence specific to BST remains to be established. We hypothesized that the exercise in block as a targeted, a structured and physiologically grounded resistance training intervention highlights the potential of BST to promote functional aging and healthy. In the case of cancer biology, and the environment near to tumour, the relationship between aging mechanisms in older adults and controlled exercise effects are currently in advance, but mechanistic trials are still lacking. Finally, we propose a novel training method, structured and personalized, that could impact different clinical outcomes in older patients with cancer.
Adults with intellectual disabilities (ID) often exhibit higher adiposity , increasing their risk of cardiometabolic conditions. Therefore, simple and non-invasive methods for estimating body fat in this population are needed. This study aimed to examine the associations between body fat percentage (BF%) estimated by the Clínic Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) equation and cardiometabolic risk indicators in adults with ID. This cross-sectional study included 133 adults with ID (mean age 23.0 ± 6.7 years; 69.9% were men) from five special education centers in Santiago, Chile. BF% was estimated using the CUN-BAE equation. Cardiometabolic indicators included body mass index (BMI), waist circumference (WC), neck circumference (NC), waist-to-height ratio (WtHR), and submandibular skinfold (SS thickness). Mean BF% was 15.6% in men and 27.7% in women, respectively. Significant positive associations were observed between BF% and BMI (men: β = 0.77, R² = 0.77; women: β = 0.54, R² = 0.52), WC (men: β = 0.29, R² = 0.56; women: β = 0.21, R² = 0.31), NC (men: β = 0.95, R² = 0.43; women: β = 0.57, R² = 0.17), WtHR (men: β = 53.02, R² = 0.62; women: β = 27.54, R² = 0.26), and SS (men: β = 0.99, R² = 0.45; women: β = 1.15, R² = 0.49). Overall, BF% estimated by the CUN-BAE equation demonstrated consistent relationships with multiple cardiometabolic indicators in both sexes. These findings suggest that the CUN-BAE equation is a practical tool for estimating body fat in adults with ID; however, further validation against direct measures of body composition is warranted.
Lymphadenopathy (LAD) can emerge as an initial manifestation of systemic lupus erythematosus (SLE); however, establishing an accurate differential diagnosis remains challenging due to the wide spectrum of infectious, malignant, and autoimmune conditions associated with this presentation. We report the case of a 47-year-old man admitted with a two-month history of persistent fever (approximately 38 °C), night sweats, chills, and diffuse generalized lymphadenopathy. Physical examination revealed enlarged, mobile, non-tender, soft cervical, axillary, and inguinal lymph nodes measuring approximately 2-3 cm in diameter, along with hepatomegaly and splenomegaly. An extensive diagnostic workup was initially undertaken to exclude malignant and infectious causes. Two weeks after admission, the patient developed inflammatory arthritis, hemolytic anemia, severe thrombocytopenia, leukopenia, and lymphopenia. Given the evolving clinical findings, SLE was suspected, and comprehensive lupus-specific serological testing confirmed the diagnosis. The patient fulfilled the 2019 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria for SLE based on immunological abnormalities and multisystem involvement. Treatment with high-dose corticosteroids, intravenous immunoglobulin, and immunosuppressive therapy led to significant clinical improvement. This case underscores that extensive generalized LAD may represent an initial presentation of SLE and should be included in the differential diagnosis of patients presenting with LAD and constitutional symptoms.
To compare the short-term effects of pharmacologic treatment and manual neurodynamic therapy on pain, upper-limb function, and kinesiophobia in adults with mild-to-moderate carpal tunnel syndrome (CTS). Randomized, controlled clinical trial. A single tertiary care hospital. One hundred ninety-six adults (aged 18-70 years) with mild-to-moderate CTS confirmed by clinical and electrophysiological criteria. Participants were randomly assigned to receive gabapentin (GABA), ibuprofen (IBU), manual neurodynamic therapy (MNT), or control for 4 weeks. Pain intensity (visual analog scale [VAS]), upper-limb disability (QuickDASH), and kinesiophobia (TSK-17). Outcomes were assessed at baseline and at 4 weeks. Compared with the control group, all active interventions were associated with greater short-term improvements in patient-reported outcomes. The largest reduction in pain intensity (VAS) was observed in the IBU group (-19.3 mm [95% CI, -21.4 to -17.3]), followed by the GABA group (-10.0 mm [-12.2 to -7.9]) and the MNT group (-4.7 mm [-6.9 to -2.4]). Similar patterns were observed for upper-limb disability (QuickDASH) and kinesiophobia (TSK-17), with greater improvements in the intervention groups than in the control group. Reductions in pain intensity were independently associated with improvements in disability and kinesiophobia, respectively. In adults with CTS, pharmacologic and neurodynamic interventions were associated with short-term improvements in symptoms and functional outcomes compared with control, although the durability of these effects beyond the immediate follow-up period remains uncertain.
Long-term stability in mastopexy and augmentation-mastopexy remains challenging, particularly in patients with dense or ptotic glandular tissue, where skin-based reshaping alone may result in recurrent ptosis or contour distortion. We evaluated a glandular tissue-specific constraining element release technique designed to improve breast shape durability and nipple-areola complex (NAC) elevation. A multicenter retrospective analysis was performed in Venezuela, Mexico, and Peru, including 417 consecutive patients who underwent mastopexy or augmentation-mastopexy between January 2017 and December 2021. The technique consisted of selective release of glandular and aponeurotic restrictive elements while preserving key vascular pedicles, with implant placement when indicated. Outcomes assessed included NAC elevation, postoperative complications, and patient satisfaction at 1-year follow-up. Patients ranged from 17 to 64 years; 67.63% presented glandular hypertrophy with ptosis, and 32.37% had ptosis or hypotrophy. Mean NAC elevation was 7.5 cm (range, 5-9 cm). Complications included 3 cases of total NAC necrosis (all secondary procedures), 13 cases of partial NAC compromise, 10 hematomas, 11 partial wound dehiscences, 3 seromas, and 5 reoperations for shape-related issues. At 1 year, 78% of patients were very satisfied, 18% were satisfied, and 4% were dissatisfied. Selective glandular release with preservation of vascular pedicles provides reliable NAC elevation and stable breast shaping, with complication rates comparable to established techniques.
Post-intensive care syndrome (PICS) encompasses physical, cognitive, and psychological sequelae that may persist for months or years after ICU discharge, affecting survivors' reintegration and long-term functioning. Although extensively studied in high-income countries, evidence from Latin America remains limited. To describe the sociodemographic and clinical characteristics of PICS in adult ICU survivors in southwestern Colombia, assessing functional, cognitive, and psychological domains using the Spanish-validated Healthy Aging Brain Care Monitor (HABC-M). This cross-sectional study was conducted between December 2024 and March 2025. Fifty-seven adults (≥18 years) discharged from the ICU for at least 14 days provided informed consent. Patients with pre-existing cognitive impairment were excluded using the telephone version of the Montreal Cognitive Assessment (MoCA-t). Data were obtained through medical record review and subsequently through structured telephone assessment for the administration of validated quantitative instruments, conducted by trained physiotherapists. Sociodemographic variables (age, sex, socioeconomic stratum, health insurance) and clinical data (admission diagnosis, APACHE II, SOFA, need and type of ventilation) were recorded. PICS was assessed using the Spanish-validated Healthy Aging Brain Care Monitor (HABC-M). Descriptive statistics, logistic regression, and Spearman's correlations were applied. The study included 57 patients, 29 were women (50.9%), with a mean age of 53.7 ± 17.3 years. All patients presented some degree of sequelae, with the functional domain showing the greatest severity (15.8% classified as severe). No significant associations were observed between the presence or severity of PICS and SOFA scores or the use of mechanical ventilation. PICS was present in all participants, with greater involvement in the functional domain and mild symptoms in the cognitive and psychological domains. The lack of associations with age, clinical severity, or mechanical ventilation may be related to sample size and clinical heterogeneity. The predominant socioeconomic context provides relevant information for interpreting the findings, although no statistical associations were identified. All evaluated patients presented some degree of PICS, with greater involvement in the functional domain in a population characterized by socioeconomic vulnerability. No associations were observed with age, severity scores, or mechanical ventilation.
This study applied statistical shape modeling to 284 DXA hip scans from Mexican women, identifying proximal femur morphotypes characterized by long, narrow necks and valgus orientation. These shape patterns showed directionally lower regional BMD in vulnerable areas, although associations were modest. The findings describe femoral configurations that resemble those previously associated with fracture risk in international cohorts, supporting the potential role of morphometric analysis as a complementary, population-specific approach to skeletal fragility assessment. Hip fractures are a major cause of disability and mortality in older adults, particularly among women with osteoporosis. Bone mineral density (BMD) is a cornerstone of fracture risk assessment but does not fully capture biomechanical and structural vulnerability. This study is aimed at characterizing proximal femur morphology in Mexican women using statistical shape modeling and at examining its relationship with regional BMD. In this exploratory cross-sectional analysis, 284 dual-energy X-ray absorptiometry (DXA) hip scans were processed with BoneFinder software to generate morphometric profiles. Active Shape Models (ASM) identified the main modes of shape variation, which were analyzed in relation to site-specific BMD. Seventeen femoral configurations were identified, with three representative morphotypes: long, narrow necks with valgus alignment, short and wide necks, and intermediate morphologies. Shape patterns characterized by long, narrow, valgus-oriented femoral necks showed directionally lower regional BMD in the superior neck and Ward's triangle-sites critical for fracture initiation-although associations were modest in regression analyses. Automated morphometry identified structural traits linked to mechanical disadvantage beyond traditional cortical indices. This is the first study to apply statistical shape modeling to Latin American women, identifying recurring femoral shape patterns that resemble morphologies previously associated with fracture risk in international cohorts. While prospective validation with fracture outcomes is needed, this exploratory study provides foundational evidence for anatomically informed, population-specific approaches to skeletal fragility assessment.
Congenital thumb hypoplasia impairs hand function. Surgical reconstruction may cause long-term muscle overload and chronic pain. A 33-year-old woman with a history of bilateral thumb hypoplasia, treated during childhood, developed myofascial pain. Ultrasound examination confirmed trigger points and hypertrophy in the brachialis and finger flexor muscles. Injections of botulinum toxin type A (BoNT-A, 60U) reduced pain by 60% for four months without compromising functional capacity. Biomechanical adaptations post-reconstruction cause myofascial pain. BoNT-A is effective. BoNT-A aids pain management in thumb reconstruction. Ultrasound enhances diagnosis.
Despite advancements in prosthetic design, many lower limb amputees continue to experience discomfort and report abandonment rates between 25% and 57%. Issues at the residual limb-socket interface, such as pressure, friction, and poor fit, remain critical challenges affecting long-term prosthesis use. Objective: This study introduces a comprehensive protocol to collect and analyze quantitative data from transtibial amputees, incorporating thermal imaging and biomechanical measures to enhance prosthesis fitting in clinical settings.Study Design: Cross-sectional quantitative clinical study evaluating thermal and biomechanical parameters of prosthetic socket fitting in unilateral transtibial amputees. This is a cross-sectional study that employs quantitative analysis of thermal and biomechanical parameters in transtibial amputees. The study, conducted in a clinical setting, included independent unilateral transtibial amputees. Participants underwent a series of evaluations that included thermograms of the residual limb captured with a thermal camera, weight distribution using a plantar pressure platform, gait symmetry via an inertial sensor, and the 2-minute walk test (2MWT). The protocol aimed to compare the effectiveness of different suspension systems on prosthetic fit. The analysis targets temperature variations at the stump-socket interface and between-system differences in thermal and biomechanical metrics. We hypothesize that suction-based systems demonstrate better thermal consistency and symmetry, pin-lock systems exhibit higher proximal temperature, and valve systems achieve the longest 2-minute walk test distances. Variability in weight distribution and symmetry will inform individualized socket adjustments. The integration of thermal imaging and biomechanical analysis provides a more comprehensive evaluation of prosthesis fitting. Infrared thermography (IRT), although underused, is a promising tool for identifying critical adjustments in prosthetic design. Further research and standardization of such protocols can enhance clinical outcomes and user satisfaction.
暂无摘要（点击查看详情）
This study aimed to analyze the evolution and trends of scientific research on wheelchair rugby. A comprehensive search of the Scopus database was conducted from inception to January 2026. In total, 190 articles published between 1998 and 2025 were analysed, yielding a compound annual growth rate of 7.47%. Output increased markedly in recent years, with 2021-2025 representing 35.79% of the total production, and peak annual volumes observed in 2022 (n=21) and 2018/2021/2023 (n=14 each). Based on corresponding-author country, the United Kingdom led productivity, followed by Poland, Canada. Highly cited studies focused on psychosocial determinants of participation, competition demands, and wheelchair configuration/coaching. Keyword co-occurrence identified three clusters: (i) performance and wheelchair-sport constructs, (ii) demographic and study-design descriptors, and (iii) exercise physiology. Overall, the field has consolidated, while core and emerging topics may guide future research, and evidence-informed practice in adapted sport.
X-linked myotubular myopathy (XLMTM) is a severe, rare, familial neuromuscular disease caused by mutations in the MTM1 gene. XLMTM presents a wide spectrum of clinical manifestations, including neuromuscular symptoms such as hypotonia and severe generalised muscle weakness, which lead to respiratory and orthopaedic complications; and extramuscular manifestations such as hepatobiliary and gastrointestinal involvement. As there is no curative treatment for XLMTM, and given the complications associated with the disease and its high morbidity and mortality, survival and quality of life in these patients rely on a comprehensive, multidisciplinary approach. A group of paediatric neurologists, one pulmonologist, one hepatologist, one intensivist, and rehabilitation specialists from Spain and Portugal with in-depth understanding and experience in XLMTM management present a multicentre series of 24 patients with XLMTM and problems and experience on its clinical management. Severe phenotypes showed significant neuromuscular and non-neuromuscular involvement. Multidisciplinary management, including respiratory support, nutritional interventions, and rehabilitation, is essential. Unmet needs include better neurocognitive assessment tools, improved access to multidisciplinary care, and resources for physical therapy. Communication aids are crucial for patient development. Multidisciplinary management of XLMTM is essential for improving outcomes, with significant unmet needs in several areas of clinical care.
Introduction: Breast cancer-related lymphedema (BCRL) affects quality of life (QoL) and increases healthcare costs. Resistance training (RT) is proposed as a preventive strategy, although its safety and effectiveness remain uncertain. Objective: To evaluate the effectiveness and safety of RT in preventing BCRL in women at risk. Methods: MEDLINE, Embase, CENTRAL, PEDro, and LILACS databases were searched from their inception to January 2025, along with the gray literature, trial registries, and preprints. Risk of bias was assessed using RoB 2, and certainty of the evidence (CoE) was assessed using GRADE. Primary outcomes were the occurrence of lymphedema and overall QoL; secondary outcomes included pain, upper limb function, range of motion (ROM), grip strength, and adverse events. Results: Eight RCTs (n = 1131) were included. The effects of RT on lymphedema and arm volume are very uncertain (very low CoE). For QoL, pain, ROM, and grip strength, the findings were inconsistent and uncertain (low to very low CoE). Adverse events were mild and transient, with no serious complications. Conclusion: RT is probably safe in women at risk of developing BCRL. Its preventive effectiveness is highly uncertain. Well-designed RCTs with standardized diagnostic criteria, patient-centered outcomes, and long-term follow-up are needed to establish their role in BCRL prevention with greater certainty. Ethics and dissemination: This study did not require ethical approval. The results will be disseminated through publications in peer-reviewed journals and academic presentations. Registration: PROSPERO (CRD42023455720).
暂无摘要（点击查看详情）
Rheumatoid arthritis associated interstitial lung disease (RA-ILD) is a serious extra-articular manifestation, being the second cause of death in patients with RA. Usual interstitial pneumonia is the most frequent form of ILD with several factors resembling idiopathic pulmonary fibrosis. Early recognition of ILD through screening could change treatment strategies and prognosis in patients with RA. In this sense achieving articular activity remission included in the treat to target strategy becomes one of the most important factors not only to diminish the risk for developing ILD but also disease progression. Disease-modifying antirheumatic drugs (DMARDs) became the cornerstone for treating patients with RA-ILD together with antifibrotics for those with progressive pulmonary fibrosis. Therefore, this guideline aims to support early recognition and evidence -based management of this condition.
Whole-brain models are valuable tools for understanding brain dynamics in health and disease by enabling the testing of causal mechanisms and identification of therapeutic targets through dynamic simulations. Among these models, biophysically inspired neural mass models have been widely used to simulate electrophysiological recordings, such as MEG and EEG. However, traditional models face limitations, including susceptibility to over-saturation of the sigmoid function by model hyperexcitability, which constrains their ability to capture the full richness of neural dynamics. Here, we thoroughly characterize a previously introduced multi-frequency Jansen-Rit neural mass model with inhibitory synaptic plasticity (ISP) aimed at overcoming these limitations. The ISP adjusts inhibitory feedback onto pyramidal neurons to clamp their firing rates around a target value. This mechanism allows for fine control of neuronal firing rates, preventing over-saturation in whole-brain simulations. In this model, we analyzed how different model parameters modulate oscillatory frequency and connectivity. As a demonstration, we considered simultaneously fitting EEG and fMRI recordings during NREM sleep. Bifurcation analysis showed that ISP widened the range of parameters in which the model exhibited sustained oscillations; the target firing rate can modulate oscillatory dynamics, producing different oscillatory regimes, from slower (δ, θ and α) to faster (β and γ) oscillations. High-frequency activity emerged from low global coupling, high firing rates, and a high proportion of γ versus α subpopulations. The ISP was necessary in the multi-frequency model to successfully fit EEG functional connectivity across frequency bands. Finally, ISP-controlled reductions in excitability reproduced both the slow-wave activity and the reduced connectivity in NREM sleep. Altogether, our model is compatible with biological evidence of the effects of excitability on modulating brain rhythms and connectivity, as observed in sleep, neurodegeneration, and chemical neuromodulation. This biophysical model with ISP provides a springboard for realistic brain simulations in health and disease.
To make informed health choices, and avoid waste and unnecessary suffering, people need critical thinking skills. However, like health interventions, educational interventions can have adverse effects. In this systematic review, the objective was to assess the extent to which researchers have included potential adverse effects in studies of interventions intended to improve the critical thinking of laypeople about health choices. This study was a systematic review, in which we updated the search for an earlier systematic review of intended effects of relevant interventions. The earlier review did not address potential adverse effects. We did not update the analysis of intended effects. We searched Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Epistemonikos, Medical Literature Analysis and Retrieval System Online (MEDLINE), Education Resources Information Center (ERIC) and Web of Science up to March 2025. In addition to studies from the original review and updated search, we included any additional studies included in a similar, even earlier review. Our unit of analysis was study report (eg, journal article). We included all studies from the original review. We applied the same inclusion criteria to the results of the updated search: the study included a comparison, the population was laypeople and the intervention was intended to improve understanding of ≥1 key concept for informed health choices. We extracted data about study design (randomised trial or other), participants (children, adolescents or adults), study setting (countries), main intervention (resources delivered to participants) and comparator (usual/no intervention or other). For the analysis, we extracted verbatim text describing any assessment of a potential adverse effect of the intervention. We conducted a narrative synthesis of the extracted data. We included 35 reports of quantitative studies (including multi-method and mixed-methods studies). Most often, the study was a randomised trial, the setting was a high-income country, the population included adults (including university students) and the intervention was school-based (including university). In one of the 35 reports, authors described assessing a potential adverse effect. To our knowledge, this is the first systematic review assessing the extent to which researchers have assessed adverse effects of any category of educational interventions. Our review shows that researchers generally have not assessed potential adverse effects of interventions to improve critical thinking about health choices. Researchers should pay more attention to such effects, while policymakers and educators making decisions about implementing relevant interventions should consider the lack of evidence. The findings of this study suggest a need for research that facilitates assessing potential adverse effects of interventions to improve critical thinking about health choices.
Water buffalo (Bubalus bubalis) milk is the second most important dairy source worldwide. It is characterized by a higher content of total solids, fat, protein, calcium, and phosphorus than Bos taurus and Bos indicus milk. Its physicochemical properties include high viscosity, buffer capacity, thermal stability, and a lower freezing point, attributes that favor its conservation and industrial processing. Likewise, its lipid profile, rich in triacylglycerides and fatty acids such as palmitic, oleic and stearic, contributes to improving the texture and quality of dairy products, while its exclusive A2 β-casein content, together with high levels of antioxidant vitamins (A, C, E and B12), minerals (Ca, P, Mg, Zn) and bioactive peptides with antioxidant, anti-inflammatory, antihypertensive and immunomodulatory effects, reinforces its potential as a functional food. This review aims to integrate this evidence to provide a unified overview that serves as a basis for future research, technological development, and the optimization of buffalo milk use in nutrition and the dairy industry. Buffalo milk has shown significant anti-inflammatory activity due to the presence of peptides and the reduction of reactive oxygen species. Natural antioxidants present in buffalo milk have been shown to neutralize free radicals and significantly inhibit oxidative activity. Moreover, the presence of protein hydrolysates and α-glucosidase inhibitors can reduce blood serum glucose levels, as well as cholesterols and triacylglycerol levels, suggesting its anti-diabetic properties. Finally, buffalo milk has potential implications on bone metabolism, gastrointestinal health, and antineoplastic processes related to its high content of calcium, presence of lactic acid bacteria, and participation in cytotoxicity and reduced cell viability, respectively.
Introduction: The histaminergic pathway has been implicated in Parkinson's disease (PD). Histamine is metabolized by histamine N-methyltransferase (HNMT), and the gene encoding this enzyme has a C314T polymorphism, in which cytosine is replaced by thymine. This results in reduced enzymatic activity. Objective: To analyze the C314T polymorphism of the HNMT gene in Mexican patients with idiopathic PD. Materials and Methods: In this study, peripheral blood samples were collected from patients with PD and healthy controls for genomic DNA extraction. HNMT genotyping was performed using the restriction fragment length polymorphism (RFLP) technique. Quantitative variables were compared using Student's t test, and categorical variables were compared using Pearson's χ2 test. The risk of PD was estimated using odds ratios (ORs) and 95% confidence intervals (CIs). Results: According to the results of the bivariate analysis, compared with the controls, the patients were significantly older (p = 0.001) and had a higher incidence of hypertension (p = 0.020). HNMT RFLP analysis suggested an association between the C allele and PD development, with an OR (95% CI) of 7.424 (0.866-63.646). In contrast, the T allele appeared to confer a protective effect, with an OR of 0.134. In the age-adjusted Mantel-Haenszel stratified analysis of the HNMT C314T polymorphism, the C allele was identified as a risk factor for PD development in this small cohort, with an OR (95% CI) of 12.0 (0.8-160.4; p = 0.041). Conclusions: Advanced age, hypertension, and the C allele of the HNMT gene were associated with an increased risk of PD, whereas the T allele appeared to be associated with a protective role.