Rev Invest Clin
-
Systemic autoimmune diseases are complex clinical conditions that arise in genetically predisposed individuals as a result of the interplay between their immune system and their environment. In this perspective, we briefly discuss our current understanding of the pathogenesis of autoimmunity and indicate four research avenues whose exploration will bring us closer to resolving fundamental questions that remain unanswered in this enigmatic field.
-
In the past three decades, several technologies designed for other purposes, have been applied in surgery to provide more precision to the surgical procedures and better outcomes. In surgery, innovation requires evidence before widespread implementation of novelties and a continuous quality improvement process to assess benefits and risks. ⋯ Innovation and technology should help to accomplish these conditions, but it must not be the center of surgical practice. We present here our perspective on the main issues related to technology and robotics focusing on evidence-based surgery.
-
In recent decades, there has been an increase in the presence of metabolic disorders associated with obesity. Central in the treatment of these conditions, including abnormalities in glucose and lipid metabolism, dietary strategies play an important role. ⋯ The concept of personalized nutrition or precision nutrition has been recently developed, which states that diet is not the only factor accountable for metabolic responses such as postprandial glucose peaks, but that other factors are also involved, one of the most important of which is the gut microbiota. Therefore, the future of nutritional interventions is to generate algorithms based on the type of food consumed, biochemical parameters, physical activity, genetic variability, and especially the gut microbiota to predict the type of diet a person requires according to his or her metabolic alterations.
-
The purpose of this perspective is to analyze the use of precision medicine and its potential for the next few decades with a special focus on the low- and middle-income countries, using diabetes as a paradigm. Precision medicine has improved the diagnosis, prevention, treatment, and prognosis of several malignant neoplasia. ⋯ Precision medicine has not fulfilled the expectations because it implies a long-term process composed by several feedback loops, and a number of internal and external validations and calibrations to target specific populations. If we want to obtain the expected benefits, the academic community and science agencies should work together to create the budgets and infrastructure that warrant the transfer of knowledge to the whole of society.