Browsing by Autor "Jose Luis Diaz-Guerrero"

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Application of artificial intelligence in the field of legal and forensic medicine: advances and future challenges
(2025) Themis Karim Ocampo Gamboa; Jhossmar Cristians Auza-Santiváñez; E Fernández; Freddy Ednildon Bautista-Vanegas; Blas Apaza-Huanca; Ingrid Neysa Cabezas-Soliz; Jose Luis Diaz-Guerrero; Ruben Marco Antonio Soliz-Mendoza
Introduction: Artificial intelligence (AI) has emerged as a profoundly transformative tool in numerous fields of knowledge, and its application in legal and forensic medicine is opening a new chapter in forensic science. The development of the “JL-IDIF” system by the Forensic Research Institute (IDIF) has been recognized as an innovative step, setting precedents for the use of advanced technology for the recording and analysis of forensic data. AI represents an unprecedented opportunity to transform legal and forensic medicine, making these processes faster, more efficient, and more accurate. Methodology. An information search was conducted from January to May 2025. Information was collected from scientific articles, books, technical reports, and publications in specialized media, using databases such as PubMed, Scopus, Google Scholar, and websites of forensic and government institutions. This approach allowed for a comprehensive and well-founded synthesis of the available information. Conclusions. The emergence of artificial intelligence (AI) has transformed multiple areas of medicine, and its incursion into forensic and legal medicine marks the beginning of a new era in forensic practice. This review has shown that, while technological advances have demonstrated great potential, significant limitations remain related to data quality, the need for external validation, and the availability of adequate technological infrastructure. In Bolivia, initiatives such as the JL-IDIF project or the experimental implementation of generative AI models demonstrate the interest and initial capacity to explore these emerging technologies. AI should not be viewed as a substitute for human judgment, but rather as a powerful tool that enhances the work of experts, allowing them to focus on critical interpretation and decision-making.
Bioprocess Engineering: Advances in Cell Culture Systems, Reactor Design, Scale-up Strategies, and Intensification Processes for the Production of Biological and Bioactive Compounds
(2025) Freddy Ednildon Bautista-Vanegas; Jose Luis Diaz-Guerrero; Ingrid Neysa Cabezas-Soliz; Blas Apaza-Huanca; E Fernández; Jhossmar Cristians Auza-Santiváñez; Themis Karim Ocampo Gamboa; Rodolfo R. Rosales; Luis Mariano Tecuatl Gómez; Pablo Carías
Bioprocess engineering is undergoing an unprecedented transformation, driven by the growing demand for complex and bioactive biological products across diverse industries, from pharmaceuticals to food and energy. Recent advances have redefined the efficiency, scalability, and sustainability of biomanufacturing. Key elements of this evolution include the widespread adoption of single-use systems, the integration of automation and artificial intelligence (AI) for precise control and predictive optimization, and the fundamental shift toward continuous bioprocessing. These innovations not only reduce costs and production times but also improve product quality and consistency, enabling the manufacturing of personalized therapies and high-value compounds. Scaling strategies have diversified to include both scale-up and parallel expansion (scale-out), tailored to specific product needs. Together, these developments are laying the foundation for more agile, cost-effective, and environmentally responsible biomanufacturing, preparing the industry to address global challenges in health and sustainability.
Detection and evaluation of vascular calcifications using Duplex Doppler ultrasound, in patients with Chronic Kidney Disease at the Centro Integral Hemodialisis y Trasplantes S.R.L. in Tarija Bolivia
(2024) Jhossmar Cristians Auza-Santiváñez; Jose Luis Diaz-Guerrero; Blas Apaza-Huanca; Elier Carrera González; Jorge Márquez-Molina; R. Sarmiento; Edwin Cruz Choquetopa
Introduction: Chronic Kidney Disease represents a systemic pathology with important consequences on patient survival, mainly through the development of vascular calcifications. Early detection of these calcifications is crucial for the assessment of cardiovascular risk and timely therapeutic management. The present study aims to evaluate the usefulness of Duplex Doppler ultrasound in the detection and evaluation of vascular calcifications in patients with CKD.Methods: Study design. Descriptive observational, which was carried out at the Centro Integral Hemodialisis y Trasplantes S.R.L. in Tarija, Bolivia. The research universe was 60 patients with Chronic Kidney Disease, who undergo hemodialysis at the Center, the sample was 32 patients, selected according to inclusion and exclusion criteria. Exclusion Criteria: Any patient who does not meet the inclusion criteria. Inclusion Criteria: Patients with CKD who undergo Hemodialysis at Centro Integral Hemodialisis y Trasplantes S.R.L.Results: Table 1 shows that, of 32 patients, the predominant age group is 61 to 70 years. The presence of chronic diseases is evident in patients with CKD, with arterial hypertension and type II diabetes mellitus being the most frequent. Table 3 shows that of the total number of patients in the study population, 75% had a mild vascular calcification score (0-25 points), 21.87% had a moderate vascular calcification score (26-39 points), and only 3.12% had a severe score (40-63 points).Conclusions: Duplex Doppler ultrasound is a noninvasive, safe and effective technique for the evaluation of vascular calcifications in patients with chronic kidney disease. Its ability to detect subtle changes in arterial morphology allows for early diagnosis and better management of cardiovascular risk. The presence of vascular calcifications in patients with CKD increases cardiovascular risk
Impact of Altitude on Cardiovascular Physiology: Literature Review and Update
(2025) Jhossmar Cristians Auza-Santiváñez; Henrry Temis Quisbert Vasquez; Freddy Ednildon Bautista-Vanegas; Delly Espejo-Alanoca; Ponciano Chiri-Chambi; Victor Hugo Mamani Huarachi; Benito Aguirre-Cruz; Katrin Daniela Sivila-Marquez; Jose Luis Diaz-Guerrero
Introduction: More than 140 million people in the world live at high altitudes, above 2,500 meters (m) above sea level. Oxygen is vital for cellular metabolism; therefore, hypoxic conditions found at high altitude affect all physiological functions. Metods: A search for information was carried out in the SciELO, Scopus, PubMed/MedLine databases, the Google Scholar search engine, as well as in the ClinicalKeys services. Advanced search strategies were used to retrieve the information, by structuring search formulas using the terms "Cardiovascular Physiology", "Cardiovascular Physiology at Altitude", as well as their translations into Spanish " Fisiología Cardiovascular " and " Fisiología Cardiovascular en la altitud ". Results discussion: The heart is composed of three main types of cardiac muscle: atrial muscle, ventricular muscle, and specialized excitatory and conductive muscle fibers. The efficiency and work of the heart as a pump is often measured in terms of cardiac output, or the amount of blood the heart pumps per minute. Cardiac output is the product of stroke volume and heart rate Cardiovascular Changes at Altitude It is possible to think of the goal of acclimatization as maintaining oxygen delivery to the tissues as close to normal as possible. The cardiovascular system is central to this. Acute exposure to high altitude produces an increase in heart rate and cardiac output both at rest and for a given amount of work compared with sea level. In general, the normal heart tolerates even severe hypoxia very well. The heart, as a hemodynamic pump, has two mechanisms at its disposal to enhance its performance: heart rate and stroke volume, which together constitute cardiac output. The altitude electrocardiogram shows a variably increased amplitude of the P wave, deviation of the QRS axis to the right, and signs of right ventricular overload and hypertrophy. Conclusions: Advances in high-altitude research have shown that the cardiovascular system deploys some efficient mechanisms of acclimatization to oxygen deprivation, and the healthy heart adapts to hypoxia, even when severe, with preservation of systolic function and only minor impairment of LV and RV diastolic function. With acclimatization, desensitization of the adrenergic system, together with increased parasympathetic influence, leads to a decrease in maximum heart rate and protection of the myocardium against potentially damaging energy imbalances. Acute exposure to high altitude stimulates the adrenergic system, increasing heart rate and cardiac output; although arterial pressure remains stable, pulmonary artery pressure increases due to hypoxic pulmonary vasoconstriction. Our improved understanding of the effect of altitude hypoxia on the cardiovascular system will allow better-informed, evidence-based advice for patients with pre-existing cardiovascular disease
Paracoccidioidomycosis in a 16-year-old adolescent patient. A case report from Bolivia
(2025) C. Roman; Jhossmar Cristians Auza-Santiváñez; Daniel Ramiro Elías Vallejos-Rejas; D. Padilla; Marlon Carbonell González; Jose Luis Diaz-Guerrero; L. Castedo; J. Triana
Introduction: Paracoccidioidomycosis (PCM) is the most common systemic mycosis in Latin America. Case: A 16-year-old female patient from Bolivia presented with a 6-month history of ulcerative nasal lesions and cervical lymphadenopathy. Initial histopathology suggested tuberculosis with a positive Ziehl-Neelsen stain. Direct KOH examination revealed characteristic "steering wheel" yeasts of Paracoccidioides brasiliensis. Antituberculosis treatment was discontinued and itraconazole was started with a favorable response. Discussion: Juvenile paracoccidioidomycosis represents a significant diagnostic challenge due to its variable clinical presentation and its ability to mimic other more prevalent pathologies such as tuberculosis and lymphoproliferative syndromes. This case illustrates the importance of maintaining a high index of clinical suspicion in adolescent patients from endemic areas who present with lymphadenopathy and mucocutaneous lesions, especially when tuberculosis studies are negative. A broad differential diagnosis is important, as is the need for specific complementary testing in the event of clinical discrepancies. Direct mycological examination is crucial as a rapid and definitive diagnostic method for paracoccidioidomycosis.
Point-of-care ultrasound guided Pericardiocentesis in cardiac tamponade: case report
(2024) Adrián Avila Hilari; Jhossmar Cristians Auza-Santiváñez; Digmar Ortiz Huiza; Sara Milca Robles-Nina; Ludovico Lucenti; Jose Luis Diaz-Guerrero
We present the case of a patient with a history of penetrating chest trauma, complicated by hemopneumothorax, resolved by pleurostomy tube. Subsequently, the patient progresses unfavorably with hemodynamic instability and is transferred to the Intensive Care Unit, where POCUS (Point of Care Ultrasound) ultrasonography is performed, showing significant pericardial effusion which is caused by cardiac tamponade, which causes a state of shock. obstructive type, so it was decided to perform ultrasonography-guided pericardiocentesis, showing a favorable evolution after the procedure.
Point-of-care ultrasound guided Pericardiocentesis in cardiac tamponade: case report
(2024) Adrián Avila Hilari; Jhossmar Cristians Auza-Santiváñez; Digmar Ortiz Huiza; Robles-Nina Robles-Nina; Alex Omar Franco Lacato; Jose Luis Diaz-Guerrero
We present the case of a patient with a history of penetrating chest trauma, complicated by hemopneumothorax, resolved by pleurostomy tube. Subsequently, the patient progresses unfavorably with hemodynamic instability and is transferred to the Intensive Care Unit, where POCUS (Point of Care Ultrasound) ultrasonography is performed, showing significant pericardial effusion which is caused by cardiac tamponade, which causes a state of shock. obstructive type, so it was decided to perform ultrasonography-guided pericardiocentesis, showing a favorable evolution after the procedure
Relevance of ultrasound detection and assessment of vascular calcifications in chronic kidney disease
(2024) Jhossmar Cristians Auza-Santiváñez; Blas Apaza-Huanca; Jose Luis Diaz-Guerrero; Daniel Ramiro Elías Vallejos-Rejas; Yenifer Zelaya-Espinoza; Ismael Vargas Gallego; Ariel Sosa Remón
Introduction: Chronic kidney disease (CKD) affects approximately 10% of the Spanish population and constitutes an independent cardiovascular risk factor. Vascular calcifications, especially in the abdominal aorta, are significantly associated with increased cardiovascular mortality in patients with CKD. This systematic review evaluates the evidence on the usefulness of ultrasound to detect and assess vascular calcifications in patients with CKD, and its relevance as a cardiovascular risk factor.Methods: A systematic search of multiple electronic databases was conducted until July 2024. Original studies published between 2000 and 2024 evaluating the use of ultrasound to detect vascular calcifications in adult patients with CKD at any stage were included. Reviews, letters, editorials, animal studies and those not published in English or Spanish were excluded. Methodological quality was assessed using the Newcastle-Ottawa scale for observational studies and the Cochrane tool for clinical trials.Results: Twenty-eight studies were included with a total of 50 to 3,000 participants per study. Most were observational studies, with 3 randomised clinical trials. Ultrasound showed good correlation with computed tomography (r=0.65-0.82) to quantify aortic and femoral calcifications. The presence of aortic calcifications was associated with increased risk of cardiovascular mortality (HR 1.8-3.2) in patients with advanced CKD and on haemodialysis. Iliac/femoral calcifications were associated with increased risk of cardiovascular events (RR 1.6-2.4) in patients with stage 3-5 CKD. Incorporation of ultrasound assessment of calcifications into CKD-specific risk algorithms significantly improved their predictive performance.Discussion: Ultrasonography emerges as a valuable tool for the detection of vascular calcifications due to its non-invasive nature, low cost and ability to perform repeated assessments. However, limitations such as heterogeneity in assessment methods, variable sample sizes and lack of long-term follow-up in some studies were identified. Further research is needed to standardise protocols and assess the long-term impact of interventions based on ultrasound detection of calcifications.Conclusions: Ultrasonography is an effective and accessible tool for detecting and assessing vascular calcifications in patients with CKD, providing relevant prognostic information for cardiovascular risk stratification. Its consideration as a first-line tool in nephrological practice is recommended. However, large-scale prospective studies are needed to definitively validate its prognostic value in different stages of CKD and to evaluate the efficacy of early interventions based on these findings.