Anibal Velasquez

Comparto mi columna en @elcomercio_peru: elcomercio.pe/opinion/column… “IA en salud en el Perú: la reforma que debe venir primero” La IA en salud avanza rápido. Pero en el Perú, el cuello de botella no es la tecnología… es el sistema. Sin datos clínicos interoperables y confiables, la IA no transforma: 👉 amplifica lo que encuentra • Silos → más fragmentación • Calidad concentrada → más inequidad • Sin trazabilidad → más riesgo • Sin liderazgo clínico → más desconfianza Adoptar IA sin reforma no es innovar. Es agravar. Hoy tenemos: • ~300 sistemas sin integración • HCE con barreras estructurales • 58.9% de hogares con internet • <33% de IPRESS MINSA con telesalud Recomiendo una reforma de 3 capas: 1️⃣ Piso habilitante (conectividad + HCE + firma digital) 2️⃣ Interoperabilidad con gobernanza (HL7 FHIR) 3️⃣ Evaluación y supervisión de la IA con rigor clínico Lo discutimos en CADE Salud 2026 de @IPAEPERU El problema no es el algoritmo. 👉 Es la arquitectura del sistema.

A new meta-analysis just flipped the textbook story on sleep apnea and the brain. As a medical school professor, I teach that obstructive sleep apnea damages the brain. This meta-analysis (Sleep Medicine Reviews, April 2026) shows the relationship runs the other way too: - Cognitive impairment = 57% higher odds of OSA - Mild cognitive impairment = 65% higher odds - 50% of cognitively impaired adults had OSA, vs 38% of others - Both findings highly significant (P < 0.0001) The mechanism likely runs through metabolic and vascular biology - the same insulin resistance, inflammation, and small vessel damage that drive cognitive decline also degrade brain regions controlling airway tone in sleep. Brain and breathing disease share a metabolic root - screening one without the other misses the loop. Metabolic dysfunction is the root cause of chronic disease. Full breakdown coming on the Health Longevity Secrets podcast @RobertLufkinMD" target="_blank" rel="nofollow noopener">youtube.com/@RobertLufkinMD Source: medscape.com/viewarticle/co… #SleepApnea #CognitiveHealth #MetabolicHealth #BrainHealth #HealthLongevitySecrets

Meta-análisis de 146 ensayos clínicos (Ageing Research Reviews, 2025) demuestra que el entrenamiento aeróbico es la intervención más eficaz, seguido del entrenamiento de resistencia, y se requieren al menos 3 sesiones por semana (o dos veces por semana durante más de 24 semanas) para lograr adaptaciones metabólicas y antiinflamatorias: Reduce: la masa corporal, la insulina, el HOMA-IR, los triglicéridos, el colesterol total, la IL-6, el TNF-α y la leptina, así como para aumentar la adiponectina y el IGF-1. Artículo completo: doi.org/10.1016/j.arr.… #Longevidad #Ejercicio #EnvejecimientoSaludable #SaludMetabolica #AntiInflamatorio

Your coffee habit is doing more than just waking you up! New research in Nature Communications (2026) shows that coffee actually "rewires" your gut-brain axis. Here is the breakdown of why your daily cup is a health powerhouse: 1️⃣ Coffee promotes "good" bacteria like Eggerthella, which helps your digestion and keeps the "bad" bugs at bay. 2️⃣ Decaf coffee was specifically linked to better memory and learning, thanks to its rich antioxidants (polyphenols). 3️⃣ Regular caffeinated coffee reduced anxiety and improved focus while lowering body-wide inflammation. 4️⃣ Both regular and decaf drinkers reported lower stress and better moods. It is not just the caffeine; it is the coffee itself! ✅The Bigger Picture: Recent studies from Harvard and the UK Biobank (2025-2026) also suggest that 2-3 cups of unsweetened coffee daily could lower the risk of Alzheimer’s and Parkinson’s by nearly 30%. Bottom line: Your coffee is a complex "superfood" for your microbes and your mind. Keep brewing! ☕️ Dr Sudhir Kumar (@hyderabaddoctor)

Los programas Beca 18 y Beca Presidente de la República (hoy Beca Generación del Bicentenario) deben continuar. Diversas evaluaciones rigurosas realizadas por instituciones académicas muestran sus efectos positivos en trayectorias educativas, aspiraciones y rendimiento. Comparto algunos estudios en los siguientes enlaces: 🔗 sciencedirect.com/science/articl… 🔗 intechopen.com/chapters/12035… 🔗 thevoice.bse.eu/2016/09/26/asp… Invertir en talento siempre genera retornos para el país.

La creación de #Beca18 y la creación de Beca Presidente de la República, rebautizada como Beca Generación del Bicentenario, fueron proyectos de nuestro gobierno dirigidos a dar una oportunidad a miles de jóvenes que, teniendo la disciplina y el talento, no tenían el dinero para cumplir sus sueños. Hoy esos sueños se esfuman al reducir y desfinanciar los programas hasta hacerlos desaparecer. Todos los esfuerzos del Ejecutivo deben ir dirigidos a asegurar los fondos para la educación. Becas, COARs, mantenimiento de colegios, personal docente, entre otros. El presupuesto existe, necesitamos ahora la voluntad política. Se lo debemos a nuestros adolescentes y jóvenes. [Texto enviado por el expresidente de la República del Perú, señor Ollanta Humala]

脳はニューロンだけで動いている、という常識が崩れました。 Nature誌（4月22日付）に掲載されたNYU研究チームの論文が、神経科学100年の定説に正面から異議を唱えています。 主役はアストロサイト。日本語で「星状膠細胞」と呼ばれる、これまでずっと「脳のお世話係」「栄養を運んで老廃物を片付けるだけの脇役」とされてきた細胞です。 ところが実際には、この脇役が脳全体にまたがる独自の長距離通信ネットワークを持っていた。 研究チームはマウスの脳に無害なウイルスを注入し、アストロサイト同士をつなぐ微細な通路（ギャップ結合）を分子が通過していく経路を追跡しました。そのうえで脳全体を透明にして3次元マッピングを実施。見えてきたのは、既知のニューロン回路では接続されていない脳領域同士が、アストロサイトのネットワークで直接つながっているという光景でした。 研究チームのLiddelow准教授はこう表現しています。「知らないうちに走っていた、地下の秘密路線です」。 さらに重要なのは、このネットワークが「固定配線」ではないという点です。感覚遮断を行った実験では、ネットワークが短期間で再編成されることが確認されました。経験によって形が変わる、可塑性を持つ回路である可能性が示されたのです。 この発見が医学的に意味するのは何か。アルツハイマー病やパーキンソン病などの神経変性疾患では、ニューロンの損傷に先立ってアストロサイトの機能不全が起きることが以前から示唆されてきました。今回の研究により「アストロサイトのネットワーク崩壊」そのものが病態の一因である可能性を、より精密に調べるための地図が初めて手に入った形です。 もちろん今回はマウスを対象にした基礎研究です。人間の脳で同じ仕組みがどこまで働いているかは、これからの研究が明らかにしていきます。 ただ、1つのことは確実に言えます。脳は私たちが思っていたより、はるかに複雑な通信網を持っています。そしてその設計図の一枚が、昨日初めて描かれました。

Show us the evidence for the value of medical AI nature.com/articles/s4159… via @NatureMedicine

A multimodal AI agentic model that integrates electronic medical records, lifestyle, layers of biologic omics data to predict health outcomes and, with perturbations, "what if" scenarios a person improved lifestyle or took a medication @Cell_Metabolism sciencedirect.com/science/articl…

An interactive graphic in a new Review Article summarizes guidelines for management of the risk of venous thromboembolism and cardiovascular disease in persons receiving hormone therapy. Explore the interactive graphic and read the full review: nejm.org/doi/full/10.10…

In the 1960s, Latin American literature experienced a rapid developmental period that has come to be called El Boom, and Mario Vargas Llosa was at the heart of this explosion. Vargas Llosa was an important figure in Latin American literature and culture with an extensive body of work including over 30 novels, as well as plays, essays, literary critiques, and journalism. His writing reflected his deep love of storytelling, characterised by rich language and spanning a variety of genres – from autobiographical books and historical novels to erotic fiction and thrillers. He was awarded the 2010 Nobel Prize in Literature “for his cartography of structures of power and his trenchant images of the individual's resistance, revolt, and defeat.” Watch him read an excerpt from his book “The Storyteller”: bit.ly/43XUyWd

Biomarkers of ageing of humans and non-human primates nature.com/articles/s4158… "A comprehensive overview of ageing biomarkers in humans and non-human primates, divided into three hierarchical levels: cellular, tissue and organism..."

Exposome and brain aging: your environment may be shaping your brain faster than you think. The exposome refers to the sum of all environmental exposures you experience across your life including air, water, social conditions and policies. Hernandez and colleagues describe in a new paper in Nature Medicine how the exposome across 34 countries influences brain aging and risk for cognitive decline. Key Points: - Combined environmental exposures explained far more about brain aging than any single factor alone. - Physical exposures like air pollution, temperature and limited green space were linked to structural brain aging. - Social exposures like inequality, reduced rights and poverty were linked to functional brain aging and brain network changes. My take: This is one of those papers that shifts how we think. Brain aging is not just about genes or disease, it is about the world we live in. The cumulative burden of exposures may quietly accelerate aging even before symptoms appear. If we want to change brain health, we must think beyond the clinic and into our communities. Here are 5 points that resonated w/ me: 1- Your environment is not background noise, it is an active driver of brain health across your lifetime. 2- Air quality, water, climate and access to green space may directly influence how fast your brain ages. 3- Social factors like inequality, education and community stability matter just as much as biology. 4- Multiple small exposures can combine and amplify risk more than any single factor alone. 5- Improving environments and policies may be one of the most powerful ways to protect brain health for future generations. nature.com/articles/s4159… #parkinson #alzheimer #dementia

2026 AACE Diabetes Algorithm — the comorbidities-first approach is a game changer for T2D management. No longer just “lower the A1C.” We now select therapy based on complications & comorbidities first, independent of glycemic targets. ▸ Heart Failure → SGLT2i (+ GLP-1 RA / GIP/GLP-1 RA) ▸ CKD → SGLT2i (+ GLP-1 RA) ▸ ASCVD / High Risk → GLP-1 RA (+ SGLT2i) ▸ Stroke/TIA → GLP-1 RA or Pioglitazone ▸ MASLD → GLP-1 RA / GIP/GLP-1 RA or Pioglitazone Key pearl: A1C >9%? Start ≥2 agents. Severe hyperglycemia → consider basal insulin early. Don’t let titration lag cost your patient. Bottom line: treat the whole patient, not just the glucose. 💊 #Diabetes #T2D #Endocrinology #AACE2026 #MedEd #ClinicalPearls

The age illusion in medicine: why your number may not reflect your biology. Biologic age refers to how your body functions and adapts to stress, which may differ from the number of years you have lived. Lee and colleagues describe in a new viewpoint in the New England Journal of Medicine how relying on chronologic age can mislead clinical decision making. Key Points: - Chronologic age is frequently used as a shortcut for health status, despite large differences in function between individuals of the same age. - Biologic measures such as physiological reserve, inflammation and epigenetic markers better predict outcomes than age alone. - Overreliance on age can lead to missed treatments in older adults and missed prevention in younger adults. My take: This is a powerful reminder that medicine is still too focused on a number instead of on the person. If we want precision care, we need to measure what truly matters which is resilience, function and biology. Here are 5 points that resonated w/ me: 1- Age alone is a poor proxy for health and may lead to wrong decisions. 2- Two folks the same age can have very different brain and body resilience. 3- Biologic markers may better guide treatment decisions than simple age cutoffs. 4- Personalized care will require moving beyond age based algorithms. 5- The future of medicine will focus on function, biology and reserve rather than just years lived. nejm.org/doi/full/10.10… #parkinson #alzheimer #dementia

⚠️ Prediabetes is not a waiting room for T2D — it’s an intervention window. The 2026 AACE Prediabetes Algorithm makes the roadmap clear. Diagnose it: ▸ A1C 5.7–6.4% | IFG 100–125 mg/dL | IGT 140–199 mg/dL | MetS Goals go beyond glucose: ▸ Prevent T2D & MASLD progression ▸ Reduce ASCVD risk ▸ Promote weight loss & quality of life Overweight/Obesity present? ▸ Target >7–10% weight loss ▸ ASCVD or MASLD → Semaglutide ▸ OSA → Tirzepatide ▸ GIP/GLP-1 RA or Phentermine/Topiramate ER if no comorbidities ▸ BMI ≥40 (or ≥35 + complications) → Consider bariatric surgery No obesity? ▸ Metformin | Pioglitazone | Acarbose to delay progression ▸ Persistent dysglycemia or overt diabetes → escalate 💡 Lean prediabetes? Don’t forget to screen for Stage 2 T1D and other diabetes types. Lifestyle first. Always. But don’t wait to layer in pharmacotherapy when it’s warranted. 🏃‍♂️💊 #Prediabetes #Diabetes #GLP1 #Obesity #AACE2026 #Endocrinology #MedEd #PreventT2D

BBC Published an article. AI chatbots are becoming a real front door for health advice, but new evidence says human-AI conversation breaks their medical accuracy far more than most people realize. The problem is not that these systems always fail when they see a full, neatly written case, because in controlled testing they reached about 95% accuracy. The problem is that real people give messy, partial, distracted symptom descriptions, and in that setting accuracy dropped to about 35% In the area of medical advice, a tiny wording change can flip advice from “rest at home” to “go to hospital now, --- bbc .com/news/articles/clyepyy82kxo

Una revisión sistemática en más de 20.000 pacientes sugiere que el efecto de los anticuerpos monoclonales antiamiloide frente a la enfermedad de Alzheimer es trivial y por lo tanto, no es clínicamente significativo. cochranelibrary.com/cdsr/doi/10.10…

Syncope is defined as transient loss of consciousness due to cerebral hypoperfusion. Most syncope is not cardiac in aetiology, but cardiac syncope is a high risk subgroup. This Practice article looks at how to identify cardiac syncope #MedEd bmj.com/content/393/bm…

Children with prior #CerebralMalaria or severe malarial anemia had lower long-term cognitive ability and math achievement than unaffected children when assessed up to 15 years later, while attention and reading scores were similar. 🧵 #ESCMIDGlobal2026 @ESCMID ja.ma/41KnnD5