Background: Kounis syndrome (KS), also known as allergic myocardial infarction, presents in three variants. This condition is often underrecognized due to limited knowledge and its variable presentation. To address these limitations, the present review aims to describe the triggers, types, management, and patient outcomes of KS. Methods: In this systematic review, PubMed and Scopus were used to identify publications of clinical case reports; variables included sociodemographic characteristics, clinical manifestations, triggers, treatments, and outcomes. Data from the articles´ abstracts were assessed by two corresponding authors, and subsequently, each case was analyzed by two coauthors, validated and analyzed with Stata 12. To categorize each Kounis type, mean and proportion comparison tests were performed, and measures of association were obtained using logistic regression and expressed as odds ratios. Results: A global distribution was identified, with predominance in the Northern Hemisphere. Type I KS was the most reported variant, and most of the patients were adult men. Most of the patients presented variability in the treatment and outcomes. Conclusions: KS may represent a diagnostic challenge, and underdiagnosis could explain the lack of uniformity in the diagnostic and assessment process. Our results highlight a need for improved approaches based on patient history for correct diagnosis and preventing recurring events.

Background/Objectives: Lactate, traditionally considered a byproduct of anaerobic metabolism, is increasingly recognized as a biomarker of tissue perfusion and systemic stress. While hyperlactatemia is frequent after pediatric cardiac surgery, evidence regarding its prognostic role remains controversial. This study aimed to evaluate whether serial lactate measurements predict mortality in children undergoing surgery for congenital heart disease in Southeast Mexico. Methods: We conducted a retrospective cohort study including children aged 0–210 weeks with confirmed congenital heart disease who underwent first-time cardiac surgery between January 2022 and December 2024. Serum lactate was measured intraoperatively, at intensive care unit (ICU) admission, and at 12 and 24 h postoperatively using a Gem^® Premier™ 3500 analyzer. Sociodemographic, clinical, and surgical data were recorded. Associations between lactate levels and mortality were analyzed with Cox regression, adjusting for RACHS-2 category and intraoperative complications. Predictive performance was assessed with ROC curves and Harrell’s C-index. Results: 103 patients were included (median age 49.2 weeks; 60% female). Lactate levels overlapped intraoperatively but significantly discriminated against survivors from non-survivors thereafter. ICU admission lactate ≥ 4.2 mmol/L predicted mortality with 100% sensitivity and 60% specificity (AUC = 0.84). Hazard ratios confirmed that lactate at ICU admission (HR 2.17, 95% CI 1.16–4.06; p = 0.015), 12 h (HR 6.37, 95% CI 1.02–39.6; p = 0.047), and 24 h (HR 1.81, 95% CI 1.07–3.09; p = 0.028) were significant predictors of mortality. The model showed excellent discrimination (Harrell’s C = 0.986), though optimism due to the limited number of deaths should be considered. Conclusions: Serial lactate monitoring, particularly upon ICU admission, provides strong prognostic information for in-hospital mortality in pediatric cardiac surgery patients. Incorporating early postoperative lactate into routine monitoring may allow timely therapeutic adjustments. Preoperative lactate assessment warrants further evaluation as a potential risk stratification tool.

We aimed to analyze the association between the average lumbar subcutaneous fat tissue thickness (LSFTT) at each intervertebral level and the presence of hernias in patients with low back pain from an insurance network hospital in Mexico. This observational prospective study included 174 patients with non-traumatic lumbago who underwent magnetic resonance imaging with a 1.5T resonator. Two independent radiologists made the diagnosis, and a third specialist provided a quality vote when needed. The sample size was calculated with a 95% confidence interval using random order selection. Anonymized secondary information was used. Percentages and means with confidence intervals were tabulated. The area under the curve, specificity, and sensitivity of LSFTT were calculated. A regression analysis was performed to analyze the presence of hernias with LSFTT using each intervertebral level as a predictor. The odds of herniation at any intervertebral level increased directly with LSFTT. The average LSFTT predicted the overall presence of hernias; however, the LSFTT at each intervertebral level better predicted hernias for each intervertebral space. The area under the curve for LSFTT in predicting hernias was 68%. In conclusion, the average LSFTT was associated with the overall presence of hernias; patients with more hernias had higher LSFTT values.

Infant mortality is a key indicator of population health and health system performance. This national study analyzed infant mortality in Mexico, examining temporal trends, leading causes of death, territorial inequalities, and indicators of surveillance quality. Using official mortality microdata for 224 212 deaths, we assessed patterns by cause of death, sex, health system affiliation, city size, and state of residence. Infant mortality remained largely stable during the study period (10.7 per 1000 live births in 2014 to 10.6 in 2023), despite an increase in reported medical attendance at death to 99.5% in 2023. Neonatal conditions including respiratory disorders, sepsis, prematurity, and congenital heart malformations accounted for most deaths. Territorial gradients were evident: smaller localities had lower probabilities of medical attendance and autopsy performance and higher proportions of deaths recorded as presumed external causes. Nearly 88% of infant deaths occurred among infants without social security affiliation, highlighting persistent inequities.

Background/Objectives: Mirizzi syndrome (MS) alters biliary anatomy, complicating diagnosis and treatment. We characterized diagnostic pathways in reported cases and compared Csendes type I with types II–V. Methods: PubMed and Scopus were searched through 1 July 2026, supplemented by citation searching. Reports of five or fewer patients were eligible. Patient-level diagnostic, treatment, and outcome data were summarized; groups were compared using Fisher’s exact and Mann–Whitney U tests. Results: We included 133 publications reporting 141 patients. MS was diagnosed preoperatively in 115/138 patients (83.3%). Recognition was more frequent in type I than types II–V (92.5% vs. 76.7%; p = 0.037) and among patients with conventional imaging (94.0% vs. 76.0%; p = 0.014). ERCP use and the number of modalities did not differ by diagnostic status. Compared with type I, types II–V more frequently required bile-duct exploration (37.1% vs. 17.0%), underwent open surgery (43.5% vs. 24.5%), and developed bile leak (24.1% vs. 8.5%) or treatment-related bile-duct injury (24.1% vs. 4.3%). Conclusions: Preoperative recognition was common but less frequent in fistulizing forms. Anatomical classification and conventional imaging may assist operative planning, whereas accumulating modalities showed no diagnostic advantage.