Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder causing disabling motor dysfunction and substantial socioeconomic burden. Photobiomodulation (PBM), a noninvasive red/near-infrared light therapy, has shown preclinical promise, but its clinical efficacy and safety in PD remain uncertain. Objectives: To systematically evaluate the efficacy and safety of PBM on motor outcomes in PD. Methods: This PRISMA-compliant systematic review was prospectively registered in PROSPERO (CRD420261411269). Databases were searched through May 2026. Randomized and non-randomized trials in adults with PD were included. Two reviewers independently screened studies, extracted data, and assessed risk of bias (RoB 2.0; ROBINS-I). Where data permitted, random-effects meta-analyses used mean difference (MD) with REML estimation and Hartung–Knapp–Sidik–Jonkman confidence intervals. Results: Eight trials (n = 279) were included, exhibiting substantial heterogeneity in wavelength, device type, stimulation sites, and dosimetry. PBM was safe and well tolerated, with only minor adverse effects. Meta-analysis of four RCTs found no significant effect on MDS-UPDRS-III (MD = −1.37 points, 95% CI: −5.55 to 2.80; I² = 20.6%) or TUG (MD = −0.52 s, 95% CI: −5.03 to 3.99; I² = 55.1%). An exploratory TMWT meta-analysis (k = 2) yielded MD = −0.65 s (95% CI: −1.78 to 0.49; I² = 0.0%), with direction consistently favoring PBM. Individual effect sizes ranged from negligible (d = 0.03–0.06) to small-to-moderate (d = 0.41). Conclusions: PBM appears safe, feasible, and acceptable in PD, but current evidence does not support clinically meaningful motor benefits. Heterogeneous protocols, small samples, and absent target-engagement biomarkers limit definitive interpretation. Well-powered standardized trials with mechanistic endpoints are needed.

Background: Erectile dysfunction (ED) is a prevalent condition impacting men's quality of life and is often linked to cardiovascular and metabolic disorders. Conventional treatments like phosphodiesterase type 5 (PDE5) inhibitors could be ineffective for severe cases, indicating a need for innovative approaches. This study aimed to evaluate the efficacy and safety of a multimodal protocol combining low-intensity shockwave therapy (LiST), intrapenile and intravenous umbilical cord-mesenchymal stem cell (UC-MSCs) therapy, and hyperbaric oxygen therapy (HBOT) in men with ED. A retrospective pragmatic observational study was performed by reviewing medical records of 22 men treated at a private clinic in Costa Rica. Erectile function was measured using the Sexual Health Inventory for Men (SHIM) questionnaire before treatment and three months post-treatment.Results: The protocol significantly improved SHIM scores, with a mean increase of 3 points from baseline (p = 0.0017). No major adverse events were reported during follow-up.Conclusion: The multimodal protocol demonstrated a significant improvement in erectile function with a favorable safety profile, suggesting potential as a viable option for patients with ED. Further prospective randomized controlled trials are needed to validate these findings.

Background: Chronic shoulder pain is a frequent musculoskeletal complaint that significantly affects function, productivity, and quality of life. Mesenchymal stem cell (MSC)-based therapies have emerged as a potential regenerative option due to their anti-inflammatory and tissue-repair properties. This study aims to evaluate the safety and short-term effectiveness of intra-articular injections of umbilical cord-derived MSCs (UC-MSCs) in patients with chronic shoulder pain. Methods: A retrospective pragmatic observational study was conducted at the Regenerative Medicine Institute in Costa Rica. Medical records were reviewed to extract clinical, sociodemographic, and treatment-related variables. The primary outcome was functional improvement measured with the American Shoulder and Elbow Surgeons (ASES) score. Changes between baseline and the 3-month follow-up were analyzed using paired tests, effect size calculations, and regression models to explore predictors of treatment response. Results: Twenty patients met the inclusion criteria. A significant improvement in shoulder function was observed, with a mean ASES increase of 17.17 points, exceeding the minimum clinically important difference of 12. Sixty percent of patients achieved clinically meaningful improvement. Effect size estimates indicated a large magnitude of change. Regression analyses showed that baseline ASES predicted follow-up scores, while higher UC-MSC doses were associated with greater functional improvement. No adverse events were documented during the study period. Conclusions: The study shows that UC-MSC therapy is a safe, minimally invasive, and clinically beneficial option for chronic shoulder pain. These findings support the therapeutic potential of MSCs and highlight the need for larger controlled studies to validate long-term efficacy and optimize treatment protocols.

Axonotmesis often results from trauma, leading to functional impairment, usually managed through physical therapy and pain management; however, outcomes can be unpredictable. This case report is based on the use of umbilical cord-derived mesenchymal stem cells (UC-MSCs) for nerve regeneration and functional recovery. We aimed to provide a novel application of UC-MSCs in promoting motor and sensory recovery following post-surgical axonotmesis, and to share the experience with this potential regenerative strategy for peripheral nerve injuries. A 48-year-old male microsurgeon suffered a humerus fracture and subsequent axillary nerve lesion compatible with axonotmesis, experiencing limited mobility and muscle strength, despite undergoing physical therapy. Given the patient’s professional demands and incomplete recovery, perineural and intramuscular administration of UC-MSCs was employed as a novel approach, resulting in significant improvements in shoulder mobility and muscle strength within 6 days, with continued progress over the subsequent 6 weeks. Improved nerve conduction and electromyography findings with no adverse events reported 4 months after the intervention. This case demonstrates the promising role of UC-MSCs in treating axonotmesis, through rapid and significant functional recovery post-treatment, particularly when conventional therapy fails to yield satisfactory results.

With a higher prevalence rate reported in males and a diagnosis occurring during the fifth decade of life, hepatocellular carcinoma is the highest mortality and most common liver malignancy. Hepatitis B and C virus infections, alcohol consumption, and metabolic diseases have been associated with an increased risk of developing hepatocarcinoma. The aim of this study is to describe the incidence rate of the disease, the seroprevalence of Hepatitis, hepatic impairment at diagnosis, and the overall survival rate in the main reference hospitals of the Social Security Healthcare System. A total of 518 patients were identified during the study period, 52 new diagnoses per year on average, and an incidence of 1. 21 cases per 100, 000 inhabitants. Diagnostic confirmation was carried out mainly by hepatic biopsy and patients had a mean age of 64. 2 years at the time of diagnosis. This tumor presented a predominant distribution in males, and a prevalence of Hepatitis B and C of 15. 4% and 5. 3% respectively, without sex association. In 55. 9% of the cases, a Child-Pugh stage A was recorded at the time of the initial evaluation and the overall survival rate at 5 years was 19. 5%. Overall, the population analyzed in this study shows similar characteristics to data reported worldwide. The difference described regarding the age of confirmation with respect to other western countries could be related to an earlier diagnosis in these populations. Likewise, the low prevalence reported for Hepatitis infections would suggest a non-endemic geographical area, and the implementation of accessible vaccination programs for Hepatitis B. Key words: Carcinoma Hepatocelullar, Hepatitis Antibodies, Survival Analysis, Social Security, Costa Rica. Source:DeCS/MeSH. Presente mayoritariamente en el sexo masculino y con diagnóstico durante la quinta década de vida, el hepatocarcinoma constituye la malignidad hepática más frecuente y de mayor mortalidad. Su desarrollo se relaciona con la presencia de infecciones por virus de Hepatitis B y C, el consumo de alcohol y la prevalencia de enfermedades metabólicas. La presente investigación tuvo como objetivo describir la incidencia de la patología, la seroprevalencia de Hepatitis, el compromiso hepático al diagnóstico y la supervivencia global en los principales hospitales de la Seguridad Social de Costa Rica, a partir de registros médicos. Se identificó un total de 518 pacientes con diagnóstico de hepatocarcinoma, una frecuencia de 52 diagnósticos nuevos por año y una incidencia de 1,21 casos por cada 100 000 habitantes. Los diagnósticos se realizaron, principalmente, mediante biopsia y presentaron una edad media de 64,2 años. La patología presentó una distribución predominante en el sexo masculino y una prevalencia de Hepatitis B y C de 15,4% y 5,3%, sin asociación según sexo. El 55,9% de los casos presentaron un Child-Pugh clase A al diagnóstico y la supervivencia global a los 5 años fue 19, 5%. La población analizada muestra un comportamiento similar a lo reportado mundialmente. La diferencia en la edad de diagnóstico con respecto a países occidentales podría relacionarse a una identificación más temprana en dichas poblaciones. Asimismo, la baja prevalencia de Hepatitis reportada respondería a la ubicación geográfica en una zona no endémica, así como la presencia de programas de vacunación, específicamente, para Hepatitis B. Palabras clave: Carcinoma hepatocelular, Anticuerpos Antihepatitis, Análisis de Supervivencia, Seguridad Social, Costa Rica. Fuente:DeCS/MeSH.