The genus Croton (Euphorbiaceae) encompasses numerous species recognized for their diverse medicinal applications, particularly in pain management. This systematic review aims to compile and analyze the scientific evidence on the antinociceptive properties of Croton species. The review protocol was registered in the Open Science Framework (OSF) associated project: osf.io/z4juf. Using the PRISMA methodology, an exhaustive search was conducted in databases such as PubMed, Scopus, and Web of Science to identify relevant studies published to date. The review includes preclinical studies in animal models that investigate the mechanisms of action and efficacy of Croton extracts and isolated compounds in pain inhibition. The results indicate that 28 Croton species exhibit significant antinociceptive effects, attributed to bioactive compounds such as diterpenes, alkaloids, and flavonoids. These compounds interact with multiple biological pathways, including ion channels, such as TRPV1, K/ATP, and ASIC channels, as well as the inhibition of the synthesis of inflammatory mediators, particularly prostaglandins. This review highlights the potential of Croton as a source of novel analgesic agents and emphasizes the necessity for further clinical studies. Additionally, integrating ethnobotanical and pharmacological knowledge is suggested to develop innovative and effective treatments for pain management.

Coronavirus disease 2019 (COVID-19) can directly or indirectly affect the central and peripheral nervous systems, resulting in cognitive impairment, memory problems, and a wide range of neuromuscular involvement, including neuropathies. However, the long-term neurological complications of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection are not clear. The aim this study was to analyze a case report the presence of neurological sequelae due to post-Coronavirus disease 19 in a patient without apparent previous neurological symptoms. Clinical case: A 46-year-old patient, with no relevant history for the described condition, who, after severe COVID-19 infection, started a mixed neuropathy and mental fog syndrome as the main sequel. Multiple laboratory and imaging studies were performed during and after his hospital stay, and it was corroborated by an electromyography that it occurred from a neuropathy triggered by COVID-19 infection. Conclusions: This case provides additional evidence that mixed neuropathy and brain fog syndrome are potential complications of post-coronavirus disease 2019 syndrome. The neurological sequelae that manifest after a COVID-19 episode can be rapidly enhanced as a consequence of another alteration in some systems of the organism. However, future studies are necessary to elucidate the incidence of these neurological complications, their pathophysiological mechanisms and their therapeutic options.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a multifactorial disorder driven by tightly interconnected metabolic, inflammatory, and lipid dysregulation pathways. Glycyrrhetinic acid, a pentacyclic triterpenoid derived from Glycyrrhiza species, has demonstrated anti-inflammatory and hepatoprotective activities in previous experimental studies. Objectives: This study aimed to systematically investigate the potential molecular targets and signaling pathways of glycyrrhetinic acid in MASLD using an integrated network pharmacology and molecular docking strategy. Methods: Predicted protein targets of glycyrrhetinic acid and MASLD-associated genes were collected from public databases. A protein–protein interaction (PPI) network was constructed, and hub genes were identified using the maximal clique centrality algorithm in Cytoscape. Functional annotation was performed through Gene Ontology and KEGG pathway enrichment analyses. Molecular docking simulations were subsequently conducted to assess the binding affinity of glycyrrhetinic acid with biologically prioritized targets derived from the network analysis. Results: Intersection analysis identified 26 shared targets between glycyrrhetinic acid and MASLD. PPI network analysis highlighted IL6, TNFα, AKT1, and PPARγ as central hub genes. Functional enrichment indicated that these targets were mainly involved in NF-κB, TNFα, and PI3K–Akt signaling pathways. Molecular docking results revealed favorable predicted binding affinities, with glycyrrhetinic acid exhibiting the strongest binding toward PPARγ among the evaluated targets. Conclusions: This integrative in silico analysis suggests that glycyrrhetinic acid may interact with multiple MASLD-related targets involved in inflammatory and metabolic regulation. These findings provide a computational framework for target prioritization and support further experimental investigations to elucidate the pharmacological relevance of glycyrrhetinic acid in MASLD.

Background: Safer analgesic strategies are needed to reduce the adverse effects associated with prolonged use of nonsteroidal anti-inflammatory drugs. The dry juice extract of Agave tequilana (ESPA), a chemically complex matrix with anti-inflammatory potential, may represent a promising adjuvant for modulating inflammatory pain. Objective: This study evaluated the antinociceptive activity of ESPA and its pharmacological interaction with diclofenac in the formalin test. Methods: BALB/c mice received ESPA or diclofenac orally 30 min before pain induction, and nociceptive behavior was quantified by counting paw flinches during the neurogenic and inflammatory phases. The GC–MS-detectable fraction of ESPA was chemically characterized, while the pharmacokinetic and bioactivity profiles of selected compounds were explored in silico using SwissADME and PASSonline. Molecular docking with COX-1 and COX-2 was performed using AutoDock Vina. Acute toxicity was evaluated according to OECD Guideline 423, and the ESPA–diclofenac interaction was examined using isobolographic analysis. Results: ESPA produced significant antinociceptive effects during the inflammatory phase. Although diclofenac exhibited greater potency, ESPA showed consistent efficacy in reducing inflammatory nociceptive behavior. GC–MS analysis identified several compounds within the detectable volatile/lipophilic fraction, including n-hexadecanoic, octadecanoic, and oleic acids. In silico evaluations suggested favorable predicted oral absorption and potential bioactivities related to inflammatory mediator regulation. Docking studies showed moderate predicted affinities for COX-1 and COX-2, lower than those observed for diclofenac. Isobolographic analysis demonstrated a synergistic interaction between ESPA and diclofenac, allowing dose reduction while maintaining antinociceptive efficacy. Acute toxicity testing indicated no signs of toxicity at the evaluated dose. Conclusions: These findings suggest that ESPA may act as a potential adjuvant in diclofenac-based analgesic strategies for inflammatory pain; however, further studies are required to clarify the active constituents and underlying mechanisms.

Pain is a widespread global issue and one of the most common disabling conditions in daily life. A wide range of medications are available to reduce or eliminate pain, with nonsteroidal anti-inflammatory drugs (NSAIDs) being among those most commonly used. Additionally, new analgesic approaches, such as antioxidants (Ascorbic Acid), have been explored for their potential to relieve acute pain after surgery, cancer-related pain, and chronic pain not related to cancer with fewer adverse effects. Furthermore, the use of pharmacological combinations is an alternative treatment strategy to obtain a higher efficacy using lower drug concentrations, at which side effects are minimal. Background/Objectives: The aim of this study was to evaluate the pharmacological synergism of ketorolac and ascorbic acid in an inflammatory pain model. Methods: The individual and combined effects of ketorolac and ascorbic acid were evaluated in a formalin-induced pain model in mice. Four experimental groups were established: control (vehicle), ketorolac (KET), ascorbic acid (AA), and combination (KET/AA). Results: The combination of ketorolac and ascorbic acid produced a greater antinociceptive effect compared to the vehicle and individual treatments in the formalin model. Notably, even the lowest dose of the combination (KET 6.26/AA 3.21 µg/paw) exhibited a stronger effect than the maximum doses of each individual treatment KET (100 µg/paw) and AA (100 µg/paw). The effective concentration that produced 30% of antinociception (EC₃₀) for the tested treatments were determined, and an isobologram analysis confirmed the presence of a synergistic interaction in these combinations. Conclusions: These findings suggest that the combination of ketorolac and ascorbic acid produces a synergistic antinociceptive effect in the formalin-induced pain model. The enhanced efficacy of the combination indicates a potential therapeutic advantage in pain management by reducing the required dosage of each compound while maintaining or improving analgesic effects.

Background: Benzodiazepines are widely prescribed to older adults in primary care despite concerns regarding their potential cognitive adverse outcomes. Evidence on the association between benzodiazepine use and cognitive impairment remains inconsistent and is limited in middle-income countries, particularly in routine primary care settings. Objectives: To evaluate the association between benzodiazepine use and cognitive impairment among older adults in a primary care hospital in Mexico and to explore clinical factors associated with benzodiazepine prescribing patterns. Methods: A cross-sectional analytical study was conducted using non-probabilistic convenience consecutive sampling in a sample of 228 in adults aged ≥60 years attending a primary care hospital in Irapuato, Mexico, during 2025. Cognitive status was assessed using the Mini-Mental State Examination (MMSE) and classified as normal cognition, mild/moderate cognitive impairment, or major cognitive impairment. Benzodiazepine exposure was identified through pharmacy records and categorized by duration of exposure (6 years). Sociodemographic variables were collected. Associations were evaluated using chi-square tests, and crude logistic regression models were used to estimate odds ratios (ORs) with 95% confidence intervals (CIs). An additional exploratory analysis assessed clinical factors associated with benzodiazepine type using a dichotomized outcome to ensure model stability. Results: A total of 228 older adults with documented benzodiazepine use were included. The sample represents the complete population of eligible benzodiazepine users during the study period. Cognitive impairment was identified in 61.8% of participants. Longer duration of benzodiazepine use was significantly associated with worse cognitive status (χ² = 25.81; p < 0.001), with the highest proportion of major impairment observed in individuals with more than six years of use. In exploratory analyses, benzodiazepine prescribing patterns were significantly associated with sleep disorders (χ² = 11.56; p = 0.009), polypharmacy (χ² = 10.28; p = 0.016), and MMSE category (χ² = 13.87; p = 0.031). In adjusted models, polypharmacy was associated with increased odds of receiving the most frequently prescribed benzodiazepine (OR 2.37; 95% CI 1.27–4.41; p = 0.007), while sleep disorders (OR 2.10; 95% CI 1.10–3.90; p = 0.009) and cognitive status (OR 1.85; 95% CI 1.05–3.20; p = 0.031) also showed significant associations. No comparisons with non-users were performed due to lack of comparable cognitive assessment; however, this comparison should be interpreted cautiously due to differences in assessment methods between groups. Conclusions: Among benzodiazepine users in primary care, longer duration of exposure was associated with worse cognitive status. Additionally, prescribing patterns were influenced by clinical factors such as polypharmacy, sleep disorders, and cognitive status, suggesting a predominantly clinically driven approach. These findings highlight benzodiazepine use as an important marker of cognitive vulnerability and underscore the need for careful prescribing, regular medication review, and deprescribing strategies in older adults.