RESUMEN INVESTIGADORES-2

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 26525276 TÍTULO: Susceptibility of bacteria isolated from acute gastrointestinal infec- tions to rifaximin and other antimicrobial agents in Mexico PMID: 26626634 AUTORES: Novoa-Farías O, Frati-Munari AC, Peredo MA, Flores-Juárez PMID: 26654670 S, Novoa-García O, Galicia-Tapia J, Romero-Carpio CE. BACKGROUND: Bacterial resistance may hamper the antimicrobial man- agement of acute gastroenteritis. Bacterial susceptibility to rifaximin, an an- tibiotic that achieves high fecal concentrations (up to 8,000μg/g), has not been evaluated in Mexico. OBJECTIVE: To determine the susceptibility to rifaximin and other antimi- crobial agents of enteropathogenic bacteria isolated from patients with acute gastroenteritis in Mexico. MATERIAL AND METHODS: Bacterial strains were analyzed in stool sam- ples from 1,000patients with diagnosis of acute gastroenteritis. The suscep- tibility to rifaximin (RIF) was tested by microdilution (<100, <200, <400 and <800μg/ml) and susceptibility to chloramphenicol (CHL), trimethoprim-sulfa- methoxazole (T-S), neomycin (NEO), furazolidone (FUR), fosfomycin (FOS), ampicillin (AMP) and ciprofloxacin (CIP) was tested by agar diffusion at the concentrations recommended by the Clinical & Laboratory Standards Insti- tute and the American Society for Microbiology. RESULTS: Isolated bacteria were: entero pathogenic Escherichia coli (E. coli)(EPEC) 531, Shigella 120, non-Typhi Salmonella 117, Aeromonas spp. 80,enterotoxigenic E. coli (ETEC) 54, Yersinia enterocolitica 20, Campylo- bacterjejuni 20, Vibrio spp. 20, Plesiomonas shigelloides 20, and enterohe- morrhagic E. coli (EHEC 0:157) 18. The overall cumulative susceptibility to RIF at <100, <200,<400, and <800μg/ml was 70.6, 90.8, 99.3, and 100%, respectively. The overallsusceptibility to each antibiotic was: AMP 32.2%, T-S 53.6%, NEO 54.1%, FUR64.7%, CIP 67.3%, CLO 73%, and FOS 81.3%. The susceptibility to RIF <400 and RIF <800μg/ml was significantly greater than with the other antibiotics (p<0.001). CONCLUSIONS: Resistance of entero pathogenic bacteria to various antibi- otics used in gastrointestinal infections is high. Rifaximin was active against 99-100% of these entero pathogens at reachable concentrations in the intes- tine with there commended dose. CITA: Rev Gastroenterol Mex. 2016 Jan-Mar; 81(1):3-10 DOI: 10.1016/j.rgmx.2015.07.003 TÍTULO: After 14 years of work and progress AUTORES: Méndez-Sánchez N. SUMMARY: Editorial CITA: Ann Hepatol. 2016 Jan-Feb; 15(1):6 DOI: 10.5604/16652681.1184189 TÍTULO: Comparisons of Apparent Diffusion Coefficient Values in Penumbra, Infarct, and Normal Brain Regions in Acute Ischemic Stroke: Confirmatory Data Using Bootstrap Confidence Intervals, Analysis of Variance, and Analy- sis of Means 201

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR AUTORES: Lopez-Mejia M, Roldan-Valadez E. BACKGROUND AND OBJECTIVE: There is no consensus about apparent diffusion coefficient (ADC) values in acute stroke regions that could be used by clinicians in a day-to-day clinical practice; regional measures using confidence intervals (CIs) and a graphic representation of means are scarce in the litera- ture. Our aim in this study was to compare ADC values in infarct, penumbra, and normal brain regions in patients with acute ischemic stroke (AIS). METHODS: This is a retrospective study of 100 magnetic resonance imag- ing datasets from AIS patients. ADC values were measured in the infarct, penumbra, and and normal regions. Three hundred measurements under- went 1-way analysis of variance, analysis of means, and calculation of 95% and 84% CIs. RESULTS: There was a statistically significant difference at the P level less than .025 in ADC values for the 3 regions (F[2, 297] = 168.039, P ≤ .001), with no overlap of the CIs for the means among the regions: normal brain (mean[M] = .847, standard deviation [SD] = .103, 95% CI: .825-.866), in- farct(M = .533, SD = .157, 95% CI: .501-.563), and penumbra (M = .764, SD = .110, 95% CI: .740-.787). CONCLUSIONS: ADC values might be used as reference data in acute stroke-specific populations; CIs would provide radiologists and clinicians with additional quantitative tools to evaluate penumbra, infarct, and normal brain tissue and to tailor follow-up and treatment options for selected patients. CITA: J Stroke Cerebrovasc Dis. 2016 Mar; 25(3):515-22 DOI: 10.1016/j.jstrokecerebrovasdis.2015.10.033 PMID: 26660074 TÍTULO: Allergen immunotherapy for the prevention of allergic disease: pro- tocol for a systematic review AUTORES: Dhami S, Nurmatov U, Halken S, Calderón MA, Muraro A, Rob- erts G, Toit GD, Kleine-Tebbe J, Larenas-Linnemann D, Lau S, Matricardi PM, Pajno G, Papadopoulos NG, Pfaar O, Ryan D, Santos AF, Timmer- manns F, Wahn U, Sheikh A. BACKGROUND: The European Academy of Allergy and Clinical Immunolo- gy (EAACI) is inthe process of developing the EAACI Guidelines for Allergen Immunotherapy (AIT)for the Prevention of Allergic Disease. We seek to crit- ically assess the effectiveness, cost-effectiveness, and safety of AIT in the prevention of allergic disease. METHODS: We will undertake a systematic review, which will involve searching international biomedical databases for published, in progress and unpublished evidence. Studies will be independently screened against pre-defined eligibility criteria and critically appraised using established in- struments. Data will be descriptively and, if possible and appropriate, quan- titatively synthesized. DISCUSSION: The findings from this review will be used to inform the devel- opment of recommendations for EAACI's Guidelines on AIT. CITA: Pediatr Allergy Immunol. 2016 May; 27(3):236-41 DOI: 10.1111/pai.12524 202

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 26755100 TÍTULO: Clinical Evaluation and Management of Patients with Suspected PMID: 26762143 Fungus Sensitivity PMID: 26772896 AUTORES: Larenas-Linnemann D, Baxi S, Phipatanakul W, Portnoy JM ABSTRACT: Fungus-sensitized patients usually present with symptoms that are similar to symptoms presented by those who are sensitized to oth- er aeroallergens. Therefore, diagnosis and management should follow the same pathways used for patients with allergic conditions in general. The physician should consider that a relationship between fungal exposure and symptoms is not necessarily caused by an IgE-mediated mechanism, even when specific fungal IgE is detected. Until recently, IgE-mediated allergy has been documented only for a limited number of fungi. We propose a series of questions to be used to identify symptoms that occur in situations with high fungal exposure and a limited skin-prick-test panel(Alternaria, Cladospori- um, Penicillium, Aspergillus, Candida) that can be amplified only in cases of high suspicion of other fungal exposure(eg, post floods). We also review in vitro testing for fungi-specific IgE. Treatment includes environmental con- trol, medical management, and, when appropriate, specific immunotherapy. Low-quality evidence exists supporting the use of subcutaneous immuno- therapy for Alternaria to treat allergic rhinitis and asthma, and very low quali- ty evidence supports the use of subcutaneous immunotherapy for Cladospo- rium and sublingual immunotherapy for Alternaria. As is the case for many allergens, evidence for immunotherapy with other fungal extracts is lacking. The so-called toxic mold syndrome is also briefly discussed. CITA: J Allergy Clin Immunol Pract. 2016 May-Jun; 4(3):405-14 DOI: 10.1016/j.jaip.2015.10.015 TÍTULO: Tubular Pyloric Gland Adenoma of the Left and Right Hepatic Ducts: Report of a Unique Case With Immunohistochemical and Molecular Studies AUTORES: Hatzibougias DI, Fouzas I, Bobos M, Papanikolaou V, Daoudaki M, Kotoula V, Hytiroglou P, Albores-Saavedra J. SUMMARY: Pyloric gland adenomas (PGAs) of the extrahepatic biliary sys- tem are rare lesions. We report a case of a tubular PGA that led to biliary obstruction. The tumor was located at the confluence of the right and left hepatic ducts, extending to the left hepatic duct. The tumor cells expressed MUC6 and MUC5AC. MUC1 and CD10 were focally positive. MUC2, p53, and CDX2 were not expressed. The Ki67 positivity was estimated at <15%. None of the KRAS, NRAS, BRAF, EGFR coding regions resulted in clinically relevant amino acid substitutions. SNP rs1050171 (EGFR p.Q787Q, silent mutation) corresponding to c.2361G>A transition in exon 20 was noticed. Awareness of this rare lesion is important for pathologists and clinicians alike, because it may cause significant morphologic and clinical difficulties, especially when presenting as an obstructive mass. Because of the possible risk of evolving malignancy, surgical resection is recommended whenever possible. CITA: Int J Surg Pathol. 2016 Jun; 24(4):347-52 DOI: 10.1177/1066896915625110 TÍTULO: [Ultrasound findings in rhabdomyolysis] AUTORES: Carrillo-Esper R, Galván-Talamantes Y, Meza-Ayala CM, Cruz-Santana JA, Bonilla-Reséndiz LI. 203

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR BACKGROUND: Rhabdomyolysis is defined as skeletal muscle necrosis. Ultrasound assessment has recently become a useful tool for the diagnosis and monitoring of muscle diseases, including rhabdomyolysis. A case is pre- sented on the ultrasound findings in a patient with rhabdomyolysis. OBJECTIVE: To highlight the importance of ultrasound as an essential part in the diagnosis in rhabdomyolysis, to describe the ultrasound findings, and review the literature. CLINICAL CASE: A 30 year-old with post-traumatic rhabdomyolysis of both thighs. Ultrasound was performed using a Philips Sparq model with a high-frequency linear transducer (5-10MHz), in low-dimensional scanning mode (2D), in longitudinal and transverse sections at the level of both thighs. The images obtained showed disorganisation of the orientation of the mus- cle fibres, ground glass image, thickening of the muscular fascia, and the presence of anechoic areas. CONCLUSIONS: Ultrasound is a useful tool in the evaluation of rhabdo- myolysis. CITA: Cir Cir. 2016 Nov - Dec; 84(6):518-522 DOI: 10.1016/j.circir.2015.06.036 PMID: 26831847 TÍTULO: Dosing of European sublingual immunotherapy maintenance solutions relative to monthly recommended dosing of subcutaneous im- munotherapy AUTORES: Larenas-Linnemann DE, Mösges R. BACKGROUND: Recently, a series of assays has been conducted in which sublingual immunotherapy (SLIT) maintenance extracts of European manu- facturers were compared with U.S. concentrated extracts by using U.S. Food and Drug Administration recommended in vitro testing. These test results have been published. We here in performed further data analysis to facilitate interpretation of SLIT dosing by U.S. physicians. OBJECTIVE: To express the allergen quantity of maintenance SLIT as rec- ommended by European manufacturers relative to U.S. subcutaneous immu- notherapy (SCIT) maintenance dosing. METHODS: We analyzed the maintenance SLIT solutions of Dermato- phagoides pteronyssinus, timothy grass pollen, cat, and ragweed pollen from four European manufacturers and concentrated extracts from three U.S. manufacturers and from the U.S. Food and Drug Administration. Here, we expressed the potency of these European SLIT solutions in U.S. terms and from there calculated the monthly maintenance dose relative to the rec- ommended monthly SCIT doses per allergen. RESULTS: Over the whole range of allergen extracts analyzed here, one of the manufacturers consistently dosed low (\"EUR1,\" monthly SLIT dose 1-5 times the SCIT dose) and one of the manufacturers dosed high (\"EUR4,\" monthly SLIT dose16-237 times the SCIT dose). DISCUSSION: For more than half of the products, SLIT was not \"high dose\" as has originally been recommended. When reviewing the low- and high-dose products with respect to efficacy in clinical trials included in a me- 204

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR ta-analysis on SLIT, some low-dose extracts showed efficacy. Thus, apart from the allergen dose, it might very well be possible that other factors also play an important role in determining clinical efficacy in SLIT. CITA: Allergy Asthma Proc. 2016 Jan-Feb; 37(1):50-6 DOI: 10.2500/aap.2016.37.3907 PMID: 26845608 TÍTULO: Cystic angiosarcoma of the liver. A previously undescribed neo- plasm AUTORES: Cano-García F, Athie-Athie Ade J, García-Gómez JI, Chablé-Montero F, Albores-Saavedra J. SUMMARY: We report an example of a cystic hepatic angiosarcoma that to our knowledge has not been previously described. The patient was a 70 year old woman who was admitted to the emergency room because of hypovo- lemic shock. A computed tomography showed four heterogeneous hepatic cystic masses varying from 2.5 to11.2 cm; one of these with rupture and formation of a subcapsular hematoma. The cyst wall was lined by several layers of neoplastic epithelioid and spindle shaped endothelial cells that in some areas extended to the underlying stroma. They expressed CD31 and CD34 and were negative for cytokeratin. The patient is alive with residual he- patic cystic angiosarcoma. However, follow up is too short to be significant. CITA: Ann Hepatol. 2016 Mar-Apr; 15(2):283-6 DOI: 10.5604/16652681.1193727 PMID: 26853128 TÍTULO: International Consensus on Allergen Immunotherapy II: Mecha- nisms, standardization, and pharmacoeconomics AUTORES: Jutel M, Agache I, Bonini S, Burks AW, Calderon M, Canonica W, Cox L, Demoly P, Frew AJ, O'Hehir R, Kleine-Tebbe J, Muraro A, Lack G, Larenas D, Levin M, Martin BL, Nelson H, Pawankar R, Pfaar O, van Ree R, Sampson H, Sublett JL, Sugita K, Du Toit G, Werfel T, Gerth van Wijk R, Zhang L, Akdis M, Akdis CA. ABSTRACT: This article continues the comprehensive international consen- sus (ICON) statement on allergen immunotherapy (AIT). The initial article also recently appeared in the Journal. The conclusions below focus on key mechanisms of AIT-triggered tolerance, requirements in allergen standard- ization, AIT cost-effectiveness, and regulatory guidance. Potential barriers to and facilitators of the use of AIT are described in addition to future directions. International allergy specialists representing the European Academy of Al- lergy and Clinical Immunology; the American Academy of Allergy, Asthma & Immunology; the American College of Allergy, Asthma and Immunology; and the World Allergy Organization critically reviewed the existing literature and prepared this summary of recommendations for best AIT practice. The authors contributed equally and reached consensus on the statements pre- sented herein. CITA: J Allergy Clin Immunol. 2016 Feb; 137(2):358-68 DOI: 10.1016/j.jaci.2015.12.1300 205

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 26891292 TÍTULO: Herbal Medicine in Mexico: A Cause of Hepatotoxicity. A Critical Review PMID: 26945479 AUTORES: Valdivia-Correa B, Gómez-Gutiérrez C, Uribe M, Mén- dez-Sánchez N. SUMMARY: In Mexico, herbal products are commonly used as therapeu- tic tools. The analysis of several publications reveals that there are dozens of different herbs and herbal products used for different reasons, some of which have been implicated in causing toxic liver disease. However, meth- odological aspects limit the attribution of causality, and the precise incidence and clinical manifestations of herb-induced liver injury have not been well characterized. This review outlines the history of traditional herbal medicine in Mexico, critically summarizes the mechanisms and adverse effects of commonly used herbal plants, and examines the regulatory issues regarding the legal use of these products. CITA: Int J Mol Sci. 2016 Feb 15; 17(2):235 DOI: 10.3390/ijms17020235 TÍTULO: Hepatic miR-33a/miR-144 and their target gene ABCA1 are associ- ated with steatohepatitis in morbidly obese subjects AUTORES: Vega-Badillo J, Gutiérrez-Vidal R, Hernández-Pérez HA, Vil- lamil-Ramírez H, León-Mimila P, Sánchez-Muñoz F, Morán-Ramos S, Lar- rieta-Carrasco E, Fernández-Silva I, Méndez-Sánchez N, Tovar AR, Cam- pos-Pérez F, Villarreal-Molina T, Hernández-Pando R, Aguilar-Salinas CA, Canizales-Quinteros S. BACKGROUND AND AIM: Abnormal cholesterol metabolism may contrib- ute to the pathogenesis of non-alcoholic steatohepatitis (NASH) and fibrosis. miR-33 andmiR-144 regulate adenosine triphosphate binding cassette trans- porter (ABCA1) and other target genes involved in cholesterol efflux, fatty acid oxidation and inflammation. We explored relationships between non-al- coholic fatty liver disease (NAFLD) and the hepatic expression of ABCA1/ ABCG1, as well as other target genes regulated by miR-33 (carnitine O-oc- tanoyl transferase, CROT and hydroxyacyl-CoA-dehydrogenase β-subunit, HADHB) and miR-144 (toll-likereceptor-2, TLR2). Moreover, we evaluated whether the expression of these genesis correlated with miR-33a/b and miR- 144 expression in Mexican individuals with morbid obesity. METHODS: Eighty-four morbidly obese subjects undergoing bariatric sur- gery were included in this study. Liver biopsies were obtained to measure hepatic triglyceride and free cholesterol contents, as well as ABCA1, ABCG1, CROT, HADHB, TLR2, miR-33a/b and miR-144 expression. RESULTS: Hepatic free cholesterol content was significantly increased in NASH as compared to non-NASH subjects, while ABCA1 and ABCG1 pro- tein levels significantly decreased with NASH and fibrosis progression. The relative expression of miR-33a and miR-144 correlated inversely with ABCA1 but not with ABCG1 protein levels. Moreover, both miRNAs increased signifi- cantly in NASH individuals. miR-33 target genes CROT and HADHB correlat- ed inversely with miR-33a. However, the expression of these genes was not associated with NASH. CONCLUSIONS: miR-33a/144 and their target gene ABCA1 may contribute to the pathogenesis of NASH in morbidly obese subjects. CITA: Liver Int. 2016 Sep; 36(9):1383-91 DOI: 10.1111/liv.13109 206

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 26947460 TÍTULO: Exposure and Health Effects of Fungi on Humans AUTORES: Baxi SN, Portnoy JM, Larenas-Linnemann D, Phipatanakul W ABSTRACT: Fungi are ubiquitous microorganisms that are present in out- door and indoor environments. Previous research has found relationships between environmental fungal exposures and human health effects. We re- viewed recent articles focused on fungal exposure and dampness as risk factors for respiratory disease development, symptoms, and hypersensitiv- ity. In particular, we reviewed the evidence suggesting that early exposure to dampness or fungi is associated with the development of asthma and increased asthma morbidity. Although outdoor exposure to high concentra- tions of spores can cause health effects such as asthma attacks in asso- ciation with thunderstorms, most people appear to be relatively unaffected unless they are sensitized to specific genera. Indoor exposure and damp- ness, however, appears to be associated with an increased risk of develop- ing asthma in young children and asthma morbidity in individuals who have asthma. These are important issues because they provide a rationale for interventions that might be considered for homes and buildings in which there is increased fungal exposure. In addition to rhinitis and asthma, fungus exposure is associated with a number of other illnesses including allergic bronchopulmonary mycoses, allergic fungal sinusitis, and hypersensitivity pneumonitis. Additional research is necessary to establish causality and evaluate interventions for fungal- and dampness-related health effects. CITA: J Allergy Clin Immunol Pract. 2016 May-Jun; 4(3):396-404 DOI: 10.1016/j.jaip.2016.01.008 PMID: 26958491 TÍTULO: Treatment for small cell lung cancer, where are we now?-a review AUTORES: Alvarado-Luna G, Morales-Espinosa D. SUMMARY: Small cell lung cancer (SCLC) represents between 13% and 15% of all diagnosed lung cancers worldwide. It is an aggressive neoplasia, with a 5-year mortality of90% or more. It has historically been classified as limited disease (LD) and extensive disease (ED) in most study protocols. The cornerstone of treatment for any stage of SCLC is etoposide-platinum based chemotherapy; in limited stage (LS), concomitant radiotherapy to thorax and mediastinum. Prophylactic radiotherapy to the central nervous system (CNS) [prophylactic cerebral irradiation (PCI)] has diminished the incidence of brain metastasis as the site for relapse in LD and ED patients, therefore it should be offered to patients with complete response to induc- tion first-line treatment. Regarding second-line treatment, results are more modest and topotecan is accepted as treatment for this scenario offering a modest benefit. CITA: Transl Lung Cancer Res. 2016 Feb; 5(1):26-38 DOI: 10.3978/j.issn.2218-6751.2016.01.13 PMID: 26999105 TÍTULO: Mitochondrial Molecular Pathophysiology of Nonalcoholic Fatty Liv- er Disease: A Proteomics Approach AUTORES: Nuño-Lámbarri N, Barbero-Becerra VJ, Uribe M, Chávez-Ta pia NC. 207

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 27006751 SUMMARY: Nonalcoholic fatty liver disease (NAFLD) is a chronic liver con- dition that can progress to nonalcoholic steatohepatitis, cirrhosis and can- cer. It is considered an emerging health problem due to malnourishment or a high-fat diet (HFD) intake, which is observed worldwide. It is well known that the hepatocytes' apoptosis phenomenon is one of the most important features of NAFLD. Thus, this review focuses on revealing, through a pro- teomics approach, the complex network of protein interactions that promote fibrosis, liver cell stress, and apoptosis. According to different types of in vitro and murine models, it has been found that oxidative/nitrative protein stress leads to mitochondrial dysfunction, which plays a major role in stimu- lating NAFLD damage. Human studies have revealed the importance of nov- el biomarkers, such as retinol-binding protein 4, lumican, transgelin 2 and hemoglobin, which have a significant role in the disease. The post-genome era has brought proteomics technology, which allows the determination of molecular pathogenesis in NAFLD. This has led to the search for biomarkers which improve early diagnosis and optimal treatment and which may effec- tively prevent fatal consequences such as cirrhosis or cancer. CITA: Int J Mol Sci. 2016 Mar 15; 17(3):281 DOI: 10.3390/ijms17030281 TÍTULO: Allergen immunotherapy for allergic rhinoconjunctivitis: protocol for a systematic review AUTORES: Dhami S, Nurmatov U, Roberts G, Pfaar O, Muraro A, Anso- tegui IJ, Calderon M, Cingi C, Demoly P, Durham S, van Wijk RG, Halken S, Hamelmann E, Hellings P, Jacobsen L, Knol E, Larenas-Linnemann D, Lin S, Maggina V, Oude-Elberink H, Pajno G, Panwankar R, Pastorello E, Pitsios C, Rotiroti G, Timmermans F, Tsilochristou O, Varga EM, Wilkinson J, Williams A, Worm M, Zhang L, Sheikh A. BACKGROUND: The European Academy of Allergy and Clinical Immunolo- gy (EAACI) is in the process of developing the EAACI Guidelines for Allergen Immunotherapy (AIT)for the Management of Allergic Rhino conjunctivitis. We seek to critically assess the effectiveness, cost-effectiveness and safety of AIT in the management of allergic rhino conjunctivitis. METHODS: We will undertake a systematic review, which will involve searching international biomedical databases for published, in progress and unpublished evidence. Studies will be independently screened against pre-defined eligibility criteria and critically appraised using established in- struments. Data will be descriptively and, if possible and appropriate, quan- titatively synthesized. CONCLUSION: The findings from this review will be used to inform the de- velopment of recommendations for EAACI's Guidelines on AIT. CITA: Clin Transl Allergy. 2016 Mar 22; 6:12 DOI: 10.1186/s13601-016-0099-6 PMID: 27021632 TÍTULO: Procedures to Assist Health Care Providers to Determine When Home Assessments for Potential Mold Exposure Are Warranted AUTORES: Chew GL, Horner WE, Kennedy K, Grimes C, Barnes CS, Phi- patanakul W, Larenas-Linnemann D, Miller JD 208

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 27027826 ABSTRACT: Drawing evidence from epidemiology and exposure assess- PMID: 27036672 ment studies and recommendations from expert practice, we describe a pro- cess to guide health care providers helping their patients who present with symptoms that might be associated with living in damp housing. We present the procedures in the form of a guided 2-part interview. The first part has 5 questions that triage the patient toward a more detailed questionnaire that reflects features of housing conditions known to be reliably associated with exposures to mold and dampness contaminants. We chose the questions based on the conditions associated with moisture problems in homes across the United States and Canada. The goal is to facilitate the clinician's effort to help patients reduce exposure to environmental triggers that elicit symptoms to better manage their disease. CITA: J Allergy Clin Immunol Pract. 2016 May-Jun; 4(3):417-422.e2 DOI: 10.1016/j.jaip.2016.01.013 TÍTULO: Early diagnosis of Balo's concentric sclerosis by diffusion tensor tractography: a case report and literature review AUTORES: Nader Kawachi JA, Andrade Magdaleno Mde L, Peñaherrera CA, Fernández De Lara Y, Lavenant Borja MI. SUMMARY: Balo concentric sclerosis is an infrequent variant of a demyelin- ating disease related to multiple sclerosis, initially thought to have an acute presentation and a fatal outcome. Recent studies have reported non-fatal forms of Balo concentric sclerosis, focusing on the importance of early di- agnosis using magnetic resonance imaging (MRI), along with spectroscopy and diffusion/perfusion sequences. Recently, we have been able to draw a three-dimensional image of a specific bundle of fibers by means of a diffusion tensor technique of the magnetic resonance imaging tractography (t-MRI). We report the case of a young woman presenting with acute and progressive focal neurological symptoms, including right body paresis, whose diagnosis was suggested by MRI and confirmed by pathology to be Balo concentric sclerosis. She was treated with boluses of methylprednisolone, achieving full neurological remission one year after admission. This is, to our knowledge, the first report describing the use oft-MRI for diagnosing BCS. We consid- er that t-MRI will allow, in a near future, early diagnosis of the disease, its prompt treatment, and establishing new classification criteria. This case con- firms the existence of benign forms of Balo concentric sclerosis with a good response to steroid therapy, where functional recovery is possible. CITA: Medwave. 2016 Mar 14; 16(2):e6402 DOI: 10.5867/medwave.2016.02.6402 TÍTULO: [Colorectal anastomosis using a compression device] AUTORES: González-Contreras QH, de Jesús-Mosso M, Bahena-Aponte JA, Aldana-Martínez O, Pineda-Solís K, Mejia-Arcadia SN. BACKGROUND: The most severe complication following an intestinal anas- tomosis is the dehiscence with the consequent development of sepsis, fistu- las, stenosis, and death. For this reason the compression anastomosis (NiTi) system was developed, with the aim of reducing these complications. MATERIAL AND METHODS: A retrospective study was conducted, from 1 June 2012 to 30 August 2014, on total of 14 patients operated on the Huma- 209

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR nitas Hospital Medical Group Coyoacán, the ASMED, and Clínica Médica Sur. The subjects were predominantly male 65%, a mean age of 58 years, with range 30-79 years. RESULTS: A total of 14 patients were included. The indication for surgery was complicated diverticular disease Hinchey II-III (36%), and the pro- cedures performed were: 6 (43%) left hemicolectomy with primary end to end compression anastomosis, 2 (14%) major complications (dehiscence wall and anastomosis), 1 (7%) minor complication (infection of the soft tis- sues). There was a mean 98ml (range 20-300ml) of intraoperative bleeding, with start of oral feeding on the second day, a mean hospital stay of 4 days (range 2-10), one patient with ileo-rectal anastomosis dehiscence presented on the 4th post-operative day, and performing anastomosis with stapling de- vice and loop ileostomy. Stenosis developed in 7% during follow-up and was resolved with a new anastomosis stapler. CONCLUSIONS: The NiTi device is an additional alternative for colorectal anastomosis, mainly in low anastomosis, obtaining good results in this study without major complications. CITA: Cir Cir. Nov-Dec 2016;84(6):482-486 DOI: 10.1016/j.circir.2016.01.005 PMID: 27049502 TÍTULO: Bile acids and the Risk for Hepatocellular Carcinoma in Primary Biliary Cholangitis AUTORES: Altamirano-Barrera A, Uribe M, Lammert F, Méndez-Sánchez N. SUMMARY: Editorial CITA: Ann Hepatol. 2016 May-Jun; 15(3):453-4 DOI: 10.5604/16652681.1198826 PMID: 27055988 TÍTULO: Direct comparison of efficacy of sublingual immunotherapy tablets PMID: 27068887 for rhinoconjunctivitis AUTORES: Larenas-Linnemann D. ABSTRACT: Review article CITA: Ann Allergy Asthma Immunol. 2016 Apr;116(4):274-86 DOI: 10.1016/j.anai.2016.02.008 TÍTULO: Refractory episodic vertigo: role of intratympanic gentamicin and vestibular evoked myogenic potentials AUTORES: Celis-Aguilar E, Hinojosa-González R, Vales-Hidalgo O, Coutinho-Toledo H. INTRODUCTION: Even today, the treatment of intractable vertigo remains a challenge. Vestibular ablation with intra tympanic gentamicin stands as a good alternative in the management of refractory vertigo patients. OBJECTIVE: To control intractable vertigo through complete saccular and horizontal canal vestibular ablation with intra tympanic gentamicin treatment. 210

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR METHODS: Patients with refractory episodic vertigo were included. The inclusion criteria were: unilateral ear disease, moderate to profound sen- sorineural hearing loss, and failure to other treatments. Included patients underwent 0.5-0.8mL of gentamicin intra tympanic application at a 30mg/ mL concentration. Vestibular ablation was confirmed by the absence of re- sponse on cervical vestibular evoked myogenic potentials and no response on caloric tests. Audiometry, electronystagmography with iced water, and vestibular evoked myogenic potentials were performed in all patients. RESULTS: Ten patients were included; nine patients with Meniere's disease and one patient with (late onset) delayed hydrops. Nine patients showed an absent response on vestibular evoked myogenic potentials and no response on caloric tests. The only patient with low amplitude on cervical vestibular evoked myogenic potentials had vertigo recurrence. Vertigo control was achieved in 90% of the patients. One patient developed hearing loss >30dB. CONCLUSIONS: Cervical vestibular evoked myogenic potentials confirmed vestibular ablation in patients treated with intra tympanic gentamicin. High- grade vertigo control was due to complete saccular and horizontal canal ab- lation (no response to iced water in electronystagmography and no response on cervical vestibular evoked myogenic potentials). CITA: Braz J Otorhinolaryngol. 2016 Nov - Dec; 82(6):668-673 DOI: 10.1016/j.bjorl.2015.11.019 PMID: 27072012 TÍTULO: Standardization of Sonographic Diaphragm Thickness Evaluations in Healthy Volunteers AUTORES: Carrillo-Esper R, Pérez-Calatayud ÁA, Arch-Tirado E, Díaz- Carrillo MA, Garrido-Aguirre E, Tapia-Velazco R, Peña-Pérez CA, Es- pinoza-de Los Monteros I, Meza-Márquez JM, Flores-Rivera OI, Zepe- da-Mendoza AD, de la Torre-León T. BACKGROUND: B-mode ultrasound can be used to measure diaphragm thickness at the zone of apposition. We believe it is necessary to develop normal values for diaphragm thickness at rest in a large group of healthy subjects and compare them with international results. METHODS: Ultrasound measurements of diaphragm thickness at expirato- ry rest were taken in 109 healthy individuals, with results stratified by sex, body mass index, and thorax circumference. The following methods were used for analysis and interpretation. Multivariable databases with descrip- tive statistical analyses were made. The Pearson chi-square test was used to evaluate the distribution between variables. Additionally, mean and SD values were calculated. For standardization, the data were separated by sex within a 95% CI, and we calculated a Z test. A 95% CI was also constructed for proportion analyses. RESULTS: One hundred nine healthy volunteers were included in the study, and the correlation between the body mass index and thorax circumference values with a Pearson chi-square test resulted in an r = 0.69. Additionally, the average value of diaphragmatic thickness was 0.19 ± 0.04 cm (95% CI 0.17-0.20 cm) for men and0.14 ± 0.03 cm (95% CI 0.13-0.15 cm) for women (P = .001). There was no relation between body mass index thorax circum- ference, and diaphragmatic thickness. 211

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 27121416 CONCLUSION: Real-time ultrasound of the diaphragm is a simple, inexpen- PMID: 27143995 sive, and portable imaging technique that can provide qualitative anatomi- cal information.The findings in this study show that sonographic diaphragm evaluations can be applied to the general population. CITA: Respir Care. 2016 Jul; 61(7):920-4 DOI: 10.4187/respcare.03999 TÍTULO: Gallstones AUTORES: Lammert F, Gurusamy K, Ko CW, Miquel JF, Méndez-Sánchez N, Portincasa P, van Erpecum KJ, van Laarhoven CJ, Wang DQ. SUMMARY: Gallstones grow inside the gallbladder or biliary tract. These stones can be asymptomatic or symptomatic; only gallstones with symptoms or complications are defined as gallstone disease. Based on their composi- tion, gallstones are classified into cholesterol gallstones, which represent the predominant entity, and bilirubin ('pigment') stones. Black pigment stones can be caused by chronic haemolysis; brown pigment stones typically de- velop in obstructed and infected bile ducts. For treatment, localization of the gallstones in the biliary tract is more relevant than composition. Overall, up to 20% of adults develop gallstone sand >20% of those develop symptoms or complications. Risk factors for gallstones are female sex, age, pregnancy, physical inactivity, obesity and overnutrition. Factors involved in metabolic syndrome increase the risk of developing gallstones and form the basis of primary prevention by lifestyle changes. Common mutations in the hepatic cholesterol transporter ABCG8 confer most of the genetic risk of developing gallstones, which accounts for ∼25% of the total risk. Diagnosis is mainly based on clinical symptoms, abdominal ultrasonography and liver biochem- istry tests. Symptoms often precede the onset of the three common and potentially life-threatening complications of gallstones (acute cholecystitis, acute cholangitis and biliary pancreatitis). Although our knowledge on the genetics and pathophysiology of gallstones has expanded recently, current treatment algorithms remain predominantly invasive and are based on sur- gery. Hence, our future efforts should focus on novel preventive strategies to overcome the onset of gallstones in at-risk patients in particular, but also in the population in general. CITA: Nat Rev Dis Primers. 2016 Apr 28;2:16024 DOI: 10.1038/nrdp.2016.24 TÍTULO: Hepatocyte Growth Factor Reduces Free Cholesterol-Mediated Lipotoxicity in Primary Hepatocytes by Countering Oxidative Stress AUTORES: Domínguez-Pérez M, Nuño-Lámbarri N, Clavijo-Cornejo D, Luna-López A, Souza V, Bucio L, Miranda RU, Muñoz L, Gomez-Quiroz LE, Uribe-Carvajal S, Gutiérrez-Ruiz MC. SUMMARY: Cholesterol overload in the liver has shown toxic effects by in- ducing the aggravation of nonalcoholic fatty liver disease to steatohepatitis and sensitizing to damage. Although the mechanism of damage is complex, it has been demonstrated that oxidative stress plays a prominent role in the process. In addition, we have proved that hepatocyte growth factor induces an antioxidant response in hepatic cells; in the present work we aimed to figure out the protective effect of this growth factor in hepatocytes overload- ed with free cholesterol. Hepatocytes from mice fed with a high-cholesterol 212

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 27236146 diet were treated or not with HGF, reactive oxygen species present in cho- lesterol overloaded hepatocytes significantly decreased, and this effect was particularly associated with the increase in glutathione and related enzymes, such as γ-gamma glutamylcysteine synthetase, GSH peroxidase, and GSH-S-transferase. Our data clearly indicate that HGF displays an antiox- idant response by inducing the glutathione-related protection system. CITA: Oxid Med Cell Longev. 2016; 2016:7960386 DOI: 10.1155/2016/7960386 TÍTULO: Hepatorenal syndrome: Current concepts related to diagnosis and management AUTORES: de Mattos ÁZ, de Mattos AA, Méndez-Sánchez N. SUMMARY: Renal failure in cirrhotic patients is a very severe condition. Hepatorenal syndrome has the worst prognosis among all causes of kidney failure in such patients. Hepatorenal syndrome is diagnosed especially in cir- rhotic patients with ascites who develop loss renal function, despite diuretic suspension and volume expansion with albumin and for whom other causes of kidney injury have been excluded. Patients with hepatorenal syndrome should be treated with a vasoconstrictor in combination with albumin as a bridge to receiving a liver transplant. The vasoconstrictor of choice is terli- pressin or noradrenaline. In spite of higher drug-related costs associated to terlipressin, initial evidence demonstrates that, considering all direct medical costs involved, the treatment strategy using terlipressin is probably more economical than that using noradrenaline. CITA: Ann Hepatol. 2016 Jul-Aug; 15(4):474-81 DOI: 10.5604/16652681.1202886 PMID: 27260321 TÍTULO: MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis AUTORES: Bousquet J, (…) Larenas-Linnemann D, et al. ABSTRACT: The selection of pharmacotherapy for patients with allergic rhi- nitis (AR) depends on several factors, including age, prominent symptoms, symptom severity, control of AR, patient preferences, and cost. Allergen expo- sure and the resulting symptoms vary, and treatment adjustment is required. Clinical decision support systems (CDSSs) might be beneficial for the assess- ment of disease control. CDSSs should be based on the best evidence and algorithms to aid patients and healthcare professionals to jointly determine treatment and its step-up or step-down strategy depending on AR control. Contre les MA ladies Chroniques pour un VIeillissement Actif en Langued- oc-Roussillon (MACVIA-LR [fighting chronic diseases for active and healthy ageing]), one of the reference sites of the European Innovation Partnership on Active and Healthy Ageing, has initiated an allergy sentinel network (the MACVIA-ARIA Sentinel Network). A CDSS is currently being developed to optimize AR control. An algorithm developed by consensus is presented in this article. This algorithm should be confirmed by appropriate trials. CITA: J Allergy Clin Immunol. 2016 Aug; 138(2):367-374.e2 DOI: 10.1016/j.jaci.2016.03.025 213

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 27313458 TÍTULO: How does the efficacy and safety of Oralair(®) compare to other products on the market? AUTORES: Larenas-Linnemann D. SUMMARY: Due to differences between allergen immunotherapy (AIT) tri- als in patient populations, trial design (including primary efficacy variables), the definition of a pollen season, data analysis, and comparisons between AIT products with existing data, is not possible nor valid. The efficacy of two grass pollen AIT tablets, Oralair (®) and Grazax (®)/Grastek (®), should not be compared by looking at the percentage of score improvement in their respective trials. However, the evidence available concerning the efficacy and safety in trials can be compared by paying close attention to the scientific quality of the trials, details in the administration schedules, and safety issues. It can be concluded due to the high level of evidence available, that Oralair (®) is effective in a pre (2-months)-co seasonal schedule to reduce symptoms and medication use, and improve a patients' quality of life during the treatment season. For the long-term, where the quality of efficacy evidence is moderate at 2-year posttreatment due to a high dropout rate, the pre (4-months)-coseasonal schedule should be used. No clinical efficacy data exists for starting treatment in-season, but the clinical onset of action of Oralair (®) is detectable after only 1 month of treatment. In the pivotal trials in Europe and the USA, no tablet-related epinephrine was needed, though some rare severe local reactions have been reported. Research for Grazax (®)/Grastek (®) showed that the long-term efficacy needs a continuous 3-yearadministration (moderate-low quality evidence available), and in two patients, tablet-related epinephrine was given. Further details on the comparative efficacy of both tablets would only be possible if both were evaluated in the same, adequately powered trial. CITA: Ther Clin Risk Manag. 2016 May 27; 12:831-50 DOI: 10.2147/TCRM.S70363 PMID: 27335184 TÍTULO: Quantitative evaluation proposal of a ultrasonographic protocol for weaning from mechanichal ventilation AUTORES: Pérez-Calatayud ÁA, Carrillo-Esper R, Arch-Tirado E. INTRODUCTION: Mechanical ventilation is a therapy for vital support used in a significant proportion of critically ill patients. The right time to successful- ly discontinue this therapy is a challenge for the intensive care specialist. For this reason it is still a subject for research. The echocardiographic evaluation of the diastolic dysfunction, the diaphragm, and the lung have become an invaluable tool for weaning from mechanical ventilation protocols, especially in patients with difficult or prolonged weaning from mechanical ventilation. There is still a need to validate, in controlled trials, the efficacy of an ultra- sound protocol for weaning from mechanical ventilation that integrates the three modalities in a single protocol. METHODS: Based on current literature, we developed a score justified by a mathematical model based on in equations. When χ 5 the risk of failure in the weaning process rises, the weaning process should be suspended; when χ 1 the risk of failure is low, the weaning process should be continued. CONCLUSIONS: The use of math models for decision-making is of great importance, as it sets an objective parameter within the existing evaluations. 214

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR We proposed the use of in equations to set intervals of solution with the three points of care for ultrasound-guided weaning from mechanical ventila- tion. With this, the inequations proposed generate an area of certainty within the proposed values and the solution intervals. CITA: Gac Med Mex. 2016 May-Jun; 152(3):304-12 PMID: 27478588 TÍTULO: Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Ac- tion Plan B3: Area 5) AUTORES: Bousquet J, (…) PMID: 27487293 TÍTULO: First-line sunitinib versus pazopanib in metastatic renal cell carci- noma: Results from the International Metastatic Renal Cell Carcinoma Data- base Consortium AUTORES: Ruiz-Morales JM, Swierkowski M, Wells JC, Fraccon AP, Pa sini F, Donskov F, Bjarnason GA, Lee JL, Sim HW, Sliwczynsk A, Ptak-Ch- mielewska A, Teter Z, Beuselinck B, Wood LA, Yuasa T, Pezaro C, Rini BI, Szczylik C, Choueiri TK, Heng DY. BACKGROUND: Sunitinib (SU) and pazopanib (PZ) are standards of care for first-line treatment of metastatic renal cell carcinoma (mRCC). However, how the efficacy of these drugs translates into effectiveness on a popula- tion-based level is unknown. PATIENTS AND METHODS: We used the International mRCC Database Consortium (IMDC)to assess overall survival (OS), progression-free survival (PFS), response rate(RR) and performed proportional hazard regression ad- justing for IMDC prognostic groups. Second-line OS (OS2) and second-line PFS (PFS2) were also evaluated. RESULTS: We obtained data from 7438 patients with mRCC treated with either first-line SU (n = 6519) or PZ (n = 919) with an overall median fol- low-up of 40.4months (95% confidence interval [CI] 39.2-42.1). There were no significant differences in IMDC prognostic groups (p = 0.36). There was no OS difference between SU and PZ (22.3 versus 22.6 months, respec- tively, p = 0.65). When adjusted for IMDC criteria, the hazard ratio (HR) of death for PZ versus SU was1.03 (95% CI 0.92-1.17, p = 0.58). There was no PFS difference between SU and PZ (8.4 versus 8.3 months, respectively, p = 0.17). When adjusted for IMDC criteria, the HR for PFS for PZ versus SU was 1.08 (95% CI 0.981-1.19, p = 0.12). There was no difference in RR between SU and PZ (30% versus 28%, respectively, p = 0.15). We also found no difference in any second-line treatment between either post-SU or post-PZ groups for OS2 (13.1 versus 11 months, p = 0.27) and PFS2 (3.7 versus 5.0 months, p = 0.07). CONCLUSIONS: We confirmed in real-world practice that SU and PZ have similar efficacy in the first-line setting for mRCC and do not affect outcomes with subsequent second-line treatment. CITA: Eur J Cancer. 2016 Sep;65:102-8 DOI: 10.1016/j.ejca.2016.06.016 215

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR Larenas-Linnemann D, et al. ABSTRACT: Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5(Care Pathways) was initiated using chronic respi- ratory diseases as a model. The chronic respiratory disease action plan in- cludes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initiative between the Reference site MACVIA-LR(Contre les MAladies Chroniques pour un VIeillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (3) Commitments for Action to the European Innovation Partner- ship on Active and Healthy Ageing and the AIRWAYS ICPs network. It is deployed in collaboration with the World Health Organization Global Alliance against Chronic Respiratory Diseases (GARD). The European Innovation Partnership on Active and Healthy Ageing has proposed a 5-step framework for developing an individual scaling up strategy: (1) what to scale up: (1-a) databases of good practices, (1-b) assessment of viability of the scaling up of good practices, (1-c) classification of good practices for local replication and (2) how to scale up: (2-a) facilitating partnerships for scaling up, (2-b) implementation of key success factors and lessons learnt, including emerg- ing technologies for individualised and predictive medicine. This strategy has already been applied to the chronic respiratory disease action plan of the European Innovation Partnership on Active and Healthy Ageing. CITA: Clin Transl Allergy. 2016 Jul 29; 6:29 DOI: 10.1186/s13601-016-0116-9 PMID: 27484017 TÍTULO: Similar biological activity in skin prick test for Oralair(®) (8200 BAU) and Grazax(®) (6200 BAU) reinforces effective SLIT dosing level AUTORES: Larenas Linnemann DE, Singh J, Rosario N, Esch R, Matta JJ, Maspero J, Michels A, Mösges R. ABSTRACT: In Europe, allergen extracts are standardized based on skin prick wheal size in20-30 allergic subjects. To understand the biological activ- ity of clinically effective Sublingual immunotherapy, we used this method to determine the biological activity of solution and tablet Timothy grass pollen (TIM) extracts, compared to an FDA-approved extract (Reference) of 10 000 BAU/ml. Blinded, quadruplicate skin prick tests with concentrate and three serial half-log dilutions allowed the construction of a semilogarithmic regres- sion line per extract. Bioequivalent allergy units (BAU) values were obtained from the comparison with reference. Extracts and dilutions showed a neat linear dose response (all: R2 > 0.98) in 33 rhinitis patients. Relative poten- cies: Staloral® 12 000 BAU/ml, Soluprick® 10 300 BAU/ml, Oralair® 8200 BAU, and Grazax® 6200 BAU. Even though all extract concentrates differed in wheal size (P = 0.01-0.001),Grazax® producing a 25% smaller wheal size than Oralair®, and the biological activity of these clinically effective TIM tablets led in the same range(6200-8200 BAU; 0.92-1.23 cm2 ). SLIT dose- finding studies for other pollens might start with allergen extracts producing 1.1 cm2 wheal surface. CITA: Allergy. 2016 Dec; 71(12):1782-1786 DOI: 10.1111/all.12998 216

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 27485440 TÍTULO: Role of bioactive fatty acids in nonalcoholic fatty liver disease AUTORES: Juárez-Hernández E, Chávez-Tapia NC, Uribe M, Barbero- -Becerra VJ. SUMMARY: Nonalcoholic fatty liver disease (NAFLD) is characterized by fat deposition in hepatocytes, and a strong association with nutritional factors. Dietary fatty acids are classified according to their biochemical properties, which confer their bioactive roles. Monounsaturated fatty acids have a dual role in various human and murine models. In contrast, polyunsaturated fatty acids exhibit antiobesity, anti steatosic and anti-inflammatory effects. The combination of these forms of fatty acids-according to dietary type, daily in- take and the proportion of n-6 to n-3 fats-can compromise hepatic lipid me- tabolism. A chemosensory rather than a nutritional role makes bioactive fatty acids possible biomarkers for NAFLD. Bioactive fatty acids provide health benefits through modification of fatty acid composition and modulating the activity of liver cells during liver fibrosis. More and better evidence is nec- essary to elucidate the role of bioactive fatty acids in nutritional and clinical treatment strategies for patients with NAFLD. CITA: Nutr J. 2016 Aug 2; 15(1):72 DOI: 10.1186/s12937-016-0191-8 PMID: 27493119 TÍTULO:  An unusual type of biliar cyst: A case report AUTORES: Gidi AD, González-Chávez MA, Villegas-Tovar E, Visag-Castillo V, Pantoja-Millan JP, Vélez-Pérez FM, Cano-García F, Contreras AG. SUMMARY: We present the case of a 56-yr-old woman with vague abdom- inal pain of approximately 5 months duration. An ultrasound study showed moderate dilation of the common bile duct. Magnetic resonance cholan- giopancreatography confirmed a cystic dilatation of the right hepatic duct with intra and extra hepatic component. The patient underwent right hepa- tectomy and complete excision of the cyst. Microscopically, the cyst wall was formed by fibrous tissue with mild acute and chronic inflammatory infiltrate, the inner surface showed a single layer of columnar epithelium and exten- sive squamous metaplasia without atypia, wich expressed p63 and high mo- lecular weight cytoqueratin (34BE12). CITA: Ann Hepatol. 2016 Sep-Oct; 15(5):788-94 DOI: 10.5604/16652681.1212617 PMID: 27527894 TÍTULO: Metabolic Features of Alcoholic Liver Disease AUTORES: Almeda-Valdes P, Altamirano-Barrera A, Uribe M, Méndez- -Sánchez N. BACKGROUND: Alcoholic Liver Disease (ALD) can be defined as the he- patic manifestations caused by excessive alcohol intake. ALD comprises a spectrum from simple steatosis to cirrhosis. 217

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR OBJECTIVE: To review diverse clinical and metabolic characteristics and their impact in ALD. CONCLUSION: The concurrence of metabolic alterations, including obesity and diabetes, and alcohol consumption increase the risk of liver injury and also the morbidity and mortality associated with chronic liver disease. CITA: Rev Recent Clin Trials. 2016; 11(3):220-6 DOI: 10.2174/1574887111666160815102725 PMID: 27551428 TÍTULO: Neisseria meningitidis and Streptococcus pneumoniae as leading causes of pediatric bacterial meningitis in nine Mexican hospitals following 3 years of active surveillance AUTORES: Chacon-Cruz E, Martinez-Longoria CA, Llausas-Magana E, Luevanos-Velazquez A, Vazquez-Narvaez JA, Beltran S, Limon-Rojas AE, Urtiz-Jeronimo F, Castaneda-Narvaez JL, Otero-Mendoza F, Aguilar-Del Real F, Rodriguez-Chagoyan J, Rivas-Landeros RM, Volker-Soberanes ML, Hinojosa-Robles RM, Arzate-Barbosa P, Aviles-Benitez LK, Elenes-Zamora FI, Becka CM, Ruttimann R. OBJECTIVES: Meningococcal meningitis is reported as a rare condition in Mexico. There are no internationally published studies on bacterial causes of meningitis in the country based on active surveillance. This study focuses on finding the etiology of bacterial meningitis in children from nine Mexican Hospitals. METHODS: From January 2010 to February 2013, we conducted a three- year active surveillance for meningitis in nine hospitals throughout Mexico. Active surveillance started at the emergency department for every suspect- ed case, and microbiological studies confirmed/ruled out all potentially bac- terial pathogens. We diagnosed based on routine cultures from blood and cerebrospinal fluid (not polymerase chain reaction or other molecular diag- nostic tests), and both pneumococcal serotyping and meningococcal sero grouping by using standard methods. RESULTS: Neisseria meningitidis was the leading cause, although 75% of cases occurred in the northwest of the country in Tijuana on the US border. Serogroup Cwas predominant. Streptococcus pneumoniae followed Neisse- ria meningitides, bu twas uniformly distributed throughout the country. Sero- type 19A was the most incident but before universal implementation of the 13-valent pneumococcal conjugate vaccine. Other bacteria were much less common, including Enterobacteriaceae and Streptococcus agalactiae (these two affecting mostly young infants). CONCLUSIONS: Meningococcal meningitis is endemic in Tijuana, Mexico, and vaccination should be seriously considered in that region. Continuous universal vaccination with the 13-valent pneumococcal conjugate vaccine should be nationally performed, and polymerase chain reaction should be included for bacterial detection in all cultures - negative but presumably bac- terial meningitis cases. CITA: Ther Adv Vaccines. 2016 Jan; 4(1-2):15-9 DOI: 10.1177/2051013616650158 218

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 27567860 TÍTULO: Cerebrospinal Fluid Biomarkers in Highly Exposed PM2.5 Urban- ites: The Risk of Alzheimer's and Parkinson's Diseases in Young Mexico City Residents AUTORES: Calderón-Garcidueñas L, Avila-Ramírez J, Calderón-Gar- cidueñas A, González-Heredia T, Acuña-Ayala H, Chao CK, Thompson C, Ruiz-Ramos R, Cortés-González V, Martínez-Martínez L, García-Pérez MA, Reis J, Mukherjee PS, Torres-Jardón R, Lachmann I. SUMMARY: Exposure to fine particulate matter (PM2.5) and ozone (O3) above US EPA standards is associated with Alzheimer's disease (AD) risk, while Mn toxicity induces parkinsonism. Mexico City Metropolitan Area (MCMA) children have pre- and postnatal sustained and high exposures to PM2.5, O3, polycyclic aromatic hydrocarbons, and metals. Young MCMA residents exhibit frontal tau hyperphosphorylation and amyloid-β (Aβ) 1 - 42 diffuse plaques, and aggregated and hyperphosphorylated α-synuclein in olfactory nerves and key brainstem nuclei. We measured total prion protein (TPrP), total tau (T-tau), tau phosphorylated at threonine 181 (P-Tau), Aβ1- 42, α-synuclein (t-α-syn and d-α-synuclein), BDNF, insulin, leptin, and/or in- flammatory mediators, in 129 normal CSF samples from MCMA and clean air controls. Aβ1-42 and BDNF concentrations were significantly lower in MCMA children versus controls (p = 0.005 and 0.02, respectively). TPrP increased with cumulative PM2.5 up to 5 μg/m3 and then decreased, regardless of cumulative value or age (R2 = 0.56). TPrP strongly correlated with T-Tau and P-Tau, while d-α-synuclein showed a significant correlation with TNFα, IL10, and IL6 in MCMA children. Total synuclein showed an increment in child- hood years related to cumulated PM2.5, followed by a decrease after age 12 years (R2 = 0.47), while d-α-synuclein exhibited a tendency to increase with cumulated PM2.5 (R2 = 0.30). CSF Aβ1-42, BDNF, α-synuclein, and TPrP changes are evolving in young MCMA urbanites historically showing under- performance in cognitive processes, odor identification deficits, downregula- tion of frontal cellular PrP, and neuropathological AD and PD hallmarks. Neu- roprotection of young MCMA residents ought to be a public health priority. CITA: J Alzheimers Dis. 2016 Sep 6;54(2):597-613 DOI: 10.3233/JAD-160472 PMID: 27600089 TÍTULO: Impact of anthropometric cut-off values in determining the preva- lence of metabolic alterations AUTORES: Almeda-Valdes P, Aguilar-Salinas CA, Uribe M, Canizales- -Quinteros S, Méndez-Sánchez N. BACKGROUND: The prevalence of obesity has increased worldwide in par- allel with associated metabolic disturbances such as diabetes and non-alco- holic fatty liver disease. OBJECTIVE: The objective of this article is to underscore discrepancies in the standard anthropometric cut-off values and the presence of metabolic disturbances including diabetes and non-alcoholic fatty liver disease caused by biological and ethnic variations. MATERIALS AND METHODS: We performed a literature review regarding the diagnosis and prevalence of obesity, diabetes, metabolic syndrome and non-alcoholic fatty liver disease and about the different available indicators to define obesity. 219

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 27626830 RESULTS: There is an ongoing epidemic of these chronic diseases, partially PMID: 27635189 attributed to the increased prevalence of obesity. The available markers to indicate adiposity are imperfect, and the selection of accurate cut-off points is still not clear. CONCLUSION: Methods to quantify adiposity that are useful in clinical prac- tice should be developed to better classify individuals and to reflect metabol- ic risk more appropriately. CITA: Eur J Clin Invest. 2016 Nov;46(11):940-946 DOI: 10.1111/eci.12672 TÍTULO: Choline-to-N-acetyl aspartate and lipids-lactate-to-creatine ratios together with age assemble a significant Cox's proportional-hazards regres- sion model for prediction of survival in high-grade gliomas AUTORES: Roldan-Valadez E, Rios C, Motola-Kuba D, Matus-Santos J, Villa AR, Moreno-Jimenez S. OBJECTIVE: A long-lasting concern has prevailed for the identification of predictive biomarkers for high-grade gliomas (HGGs) using MRI. However, a consensus of which imaging parameters assemble a significant survival model is still missing in the literature; we investigated the significant positive or negative contribution of several MR biomarkers in this tumour prognosis. METHODS: A retrospective cohort of supratentorial HGGs [11 glioblastoma multiforme (GBM) and 17 anaplastic astrocytomas] included 28 patients (9 females and 19 males, respectively, with a mean age of 50.4 years, stan- dard deviation: 16.28 years; range: 13-85 years). Oedema and viable tumour measurements were acquired using regions of interest in T1 weighted, T2 weighted, fluid-attenuated inversion recovery, apparent diffusion coefficient (ADC) and MR spectroscopy (MRS). We calculated Kaplan-Meier curves and obtained Cox's proportional hazards. RESULTS: During the follow-up period (3-98 months), 17 deaths were recorded. The median survival time was 1.73 years (range, 0.287-8.947 years). Only 3 out of 20 covariates (choline-to-N-acetyl aspartate and lip- ids-lactate-to-creatine ratios and age) showed significance in explaining the variability in the survival hazards model; score test: χ2 (3) = 9.098, p = 0.028. CONCLUSION: MRS metabolites overcome volumetric parameters of peri- tumoral oedema and viable tumour, as well as tumour region ADC measure- ments. Specific MRS ratios (Cho/Naa, L-L/Cr) might be considered in a regu- lar follow-up for these tumours. Advances in knowledge: Cho/Naa ratio is the strongest survival predictor with alog-hazard function of 2.672 in GBM. Low levels of lipids-lactate/Cr ratio represent up to a 41.6% reduction in the risk of death in GBM. CITA: Br J Radiol. 2016 Nov; 89(1067):20150502 DOI: 10.1259/bjr.20150502 TÍTULO: Liver Cholesterol Overload Aggravates Obstructive Cholestasis by Inducing Oxidative Stress and Premature Death in Mice AUTORES: Nuño-Lámbarri N, Domínguez-Pérez M, Baulies-Domenech A, Monte MJ, Marin JJ, Rosales-Cruz P, Souza V, Miranda RU, Bucio L, 220

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR Montalvo-Jave EE, Concepción Gutiérrez-Ruiz M, García-Ruiz C, Fernán- dez-Checa JC, Gomez-Quiroz LE. SUMMARY: Nonalcoholic steatohepatitis is one of the leading causes of liv- er disease. Dietary factors determine the clinical presentation of steatohep- atitis and can influence the progression of related diseases. Cholesterol has emerged as acritical player in the disease and hence consumption of choles- terol-enriched diets can lead to a progressive form of the disease. The aim was to investigate the impact of liver cholesterol overload on the progression of the obstructive cholestasis in mice subjected to bile duct ligation surgery. Mice were fed with a high cholesterol diet for two days and then were sub- jected to surgery procedure; histological, biochemical, and molecular anal- yses were conducted to address the effect of cholesterol in liver damage. Mice under the diet were more susceptible to damage. Results show that cholesterol fed mice exhibited increased apoptosis and oxidative stress as well as reduction in cell proliferation. Mortality following surgery was higher in HC fed mice. Liver cholesterol impairs the repair of liver during obstruc- tive cholestasis and aggravates the disease with early fatal consequences; these effects were strongly associated with oxidative stress. CITA: Oxid Med Cell Longev. 2016; 2016:9895176 DOI: 10.1155/2016/9895176 PMID: 27652204 TÍTULO: Histopathological transformation to small-cell lung carcinoma in non-small cell lung carcinoma tumors AUTORES: Dorantes-Heredia R, Ruiz-Morales JM, Cano-García F. SUMMARY: Lung cancer is the principal cause of cancer-related death worldwide. The use of targeted therapies, especially tyrosine kinase inhib- itors (TKIs), in specific groups of patients has dramatically improved the prognosis of this disease, although inevitably some patients will develop resistance to these drugs during active treatment. The most common can- cer-associated acquired mutation is the epidermal growth factor receptor (EGFR) Thr790Met (T790M) mutation. During active treatment with target- ed therapies, histopathological transformation to small-cell lung carcinoma (SCLC) can occur in 3-15% of patients with non-small-cell lung carcinoma (NSCLC) tumors. By definition, SCLC is a high-grade tumor with specific his- tological and genetic characteristics. In the majority of cases, a good-qual- ity hematoxylin and eosin (H&E) stain is enough to establish a diagnosis. Immunohistochemistry (IHC) is used to confirm the diagnosis and exclude other neoplasia such as sarcomatoid carcinomas, large-cell carcinoma, basaloid squamous-cell carcinoma, chronic inflammation, malignant melano- ma, metastatic carcinoma, sarcoma, and lymphoma. A loss of the tumor-sup- pressor protein retinoblastoma 1 (RB1) is found in 100% of human SCLC tumors; therefore, it has an essential role in tumorigenesis and tumor de- velopment. Other genetic pathways probably involved in the histopatholog- ical transformation include neurogenic locus notch homolog (NOTCH) and achaete-scute homolog 1 (ASCL1). Histological transformation to SCLC can be suspected in NSCLC patients who clinically deteriorate during active treatment. Biopsy of any new lesion in this clin- ical setting is highly recommended to rule out a SCLC transformation. New stud- ies are trying to assess this histological transformation by noninvasive measures such as measuring the concentration of serum neuron-specific enolase. CITA: Transl Lung Cancer Res. 2016 Aug; 5(4):401-12 DOI: 10.21037/tlcr.2016.07.10 221

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 27657518 TÍTULO: American Academy of Allergy, Asthma & Immunology membership PMID: 27668233 experience with allergen immunotherapy safety in patients with specific med- ical conditions AUTORES: Larenas-Linnemann DE, Hauswirth DW, Calabria CW, Sher LD, Rank MA. BACKGROUND: Little data in the literature exist concerning patients with certain underlying medical conditions who receive allergen subcutaneous immunotherapy (SCIT). OBJECTIVE: To survey allergists' experience with SCIT in patients with medical conditions considered to impose an elevated risk for untoward out- comes. METHODS: A Web-based survey was conducted among members of the American Academy of Allergy, Asthma & Immunology to query about their experience with SCIT in patients with certain medical conditions. RESULTS: There were 1085 replies (21% response), of whom, 86% were U.S. based, 51% were suburban, 31% were academic, 42% were medi- um-sized practices, and 54%had >15 years' experience. In responders' opinion, SCIT was \"contraindicated\" in patients with the following: acquired immune deficiency syndrome (AIDS) (48%), cancer (and still receiving ac- tive treatment) (33%), severe asthma (32%), and a history of transplantation (30%). Even so, survey responders collectively gave SCIT to >2400 patients for each of these conditions: severe asthma, coronary artery disease, cancer in remission, and autoimmune disorders; and to ≥5400patients with hyper- tension and ≥4100 women who became pregnant. The experience of col- leagues with these patients rarely resulted in major problems (i.e., activation of underlying disease, systemic reactions to SCIT, or SCIT discontinuation), with the exception of severe asthma (12.5%), initiation of SCIT during preg- nancy (5.4%), and AIDS (4.2%). For most other conditions, it was ≤1.5 %( e.g., continue during pregnancy, cancer in remission, history of transplanta- tion, positive human immunodeficiency virus and no AIDS). CONCLUSION: According to the experience of a large group of practicing allergists, the American Academy of Allergy, Asthma & Immunology mem- bers, few medical conditions seemed to pose an elevated risk for untoward outcomes from SCIT. Because these are survey results, prospective re- search might yield even more solid data. CITA: Allergy Asthma Proc. 2016 Sep;37(5):112-22 DOI: 10.2500/aap.2016.37.3981 TÍTULO: Skin communicates what we deeply feel: antibiotic prophylactic treatment to reduce epidermal growth factor receptor inhibitors induced rash in lung cancer (the Pan Canadian rash trial) AUTORES: Arrieta O, Carmona A, de Jesus Vega MT, Lopez-Mejia M, Car- dona AF. SUMMARY: Editorial CITA: Ann Transl Med. 2016 Aug; 4(16):313 DOI: 10.21037/atm.2016.08.19 222

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 27695165 TÍTULO: Usefulness of ultrasonographic measurement of the diameter of the inferior vena cava to predict responsiveness to intravascular fluid admin- istration in patients with cancer AUTORES: Ñamendys-Silva SA, Arredondo-Armenta JM, Guevara-García H, Barragán-Dessavre M, García-Guillén FJ, Sánchez-Hurtado LA, Córdova- -Sánchez B, Bautista-Ocampo AR, Herrera-Gómez A, Meneses-García A. SUMMARY: We conducted an observational, longitudinal prospective study in which we measured the diameters of the inferior vena cava (IVC) of 47 pa- tients using ultrasonography. The aim of our study was to assess the state of blood volume and to determine the percentage of patients who responded to intravascular volume expansion. Only 17 patients (36%) responded to fluid management. A higher number of responding patients had cardiovascular failure compared with nonresponders (82% vs. 50%, P = 0.03). Among the patients with cardiovascular failure, the probability of finding responders was 4.6 times higher than that of not finding responders (odds ratio, 4.66; 95% confidence interval, 1.10-19.6; P = 0.04). No significant difference was ob- served in the mortality rate between the two groups (11% vs. 23%, P = 0.46). In conclusion, responding to intravascular volume expansion had no impact on patient survival in the intensive care unit. CITA: Proc (Bayl Univ Med Cent). 2016 Oct; 29(4):374-377 DOI: 10.1080/08998280.2016.11929474 PMID: 27740513 TÍTULO: Editorial AUTORES: Méndez-Sánchez N. SUMMARY: Editorial CITA: Ann Hepatol. 2016 Nov-Dec 2016;15(6):815 DOI: 10.5604/16652681.1222095 PMID: 27740517 TÍTULO: Frequency of hepatitis C virus infection in a single institution in Mexico with a focus on birth-cohort population AUTORES: Baptista-González H, Noffal-Nuño VM, Méndez-Sánchez N. BACKGROUND AND RATIONALE FOR THE STUDY: The generation of people born before1965 is a high-risk group for developing chronic hepatitis C virus (HCV) infection. AIM: To report the experience on single institution of HCV infection under birth-cohort or baby boomers effect. MATERIAL AND METHODS: We used a cross-sectional design of consec- utive subjects older than 18 years referred for serological evaluation for an- ti-HCV and detection of HCV RNA. RESULTS: A total of 7,658 people were included. The global prevalence of HCV antibody was 4.5% (344/7658). The frequency with anti-HCV anti- bodies were 74(10.9%), 158 (7.3%), and 112 (2.3%) for people born before 1945, 1945-1965, and1966-1992, respectively (p < 0.01). The subjects HCV RNA-positive were 88.9%, 68.7%, and 44.4%, respectively (p < 0.001). The viral load was > 100,000 IU/mL in 74.4% of those positive for HCV RNA. Groups of older patients and anti-VHC, with year of birth before 1965, are 223

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR more likely to show reactivity to HCV RNA and significant viral load (OR 10.0, CI 95% 4.8 to 20.1). CONCLUSION: We observed a high prevalence of unrecognized chronic HCV infection. The prevalence of HCV infection in people born before 1945 was twice the value of those born after 1965. Further studies are needed to deter- mine the impact on health care services. Future work should focus on deter- mining the appropriate model for the care of people at risk of chronic HCV. CITA: Ann Hepatol. 2016 Nov-Dec 2016; 15(6):846-852 DOI: 10.5604/16652681.1222100 PMID: 27740523 TÍTULO: Validation of prognostic scores for clinical outcomes in cirrhotic pa- tients with acute variceal bleeding AUTORES: Motola-Kuba M, Escobedo-Arzate A, Tellez-Avila F, Altamira- no J, Aguilar-Olivos N, González-Angulo A, Zamarripa-Dorsey F, Uribe M, Chávez-Tapia NC. BACKGROUND: The Rockall, Glasgow-Blatchford, and AIMS65 are useful and validated scoring systems for predicting the outcomes of patients with nonvariceal gastrointestinal bleeding. However, there are no validated evi- dence for using them to predict outcomes on variceal bleeding. The aim of this study was to evaluate and compare the prognostic accuracy of different nonvariceal bleeding scores with other liver-specific scoring systems in cir- rhotic patients. MATERIAL AND METHODS: A retrospective multicenter study that included 160 cirrhotic patients with acute variceal bleeding. The AUROC's to predict in-hospital mortality, and rebleeding, were analyzed for each scoring system. RESULTS: Overall in-hospital mortality occurred in 13% and in-hospital re- bleeding in 12% of patients. The systems with the best AUROC value for predicting mortality were MELD (0.828; 95% CI 0.748-0.909), and AIMS65 (0.817; 95% CI0.724-0.909). The best score systems for predicting rebleed- ing were Glasgow-Blatchford (0.756; 95% CI 0.640- 0.827), and Rockall (0.691; 95% CI0.580-0.802). CONCLUSIONS: In addition to liver-specific scores, the AIMS65 score is accurate for predicting in-hospital mortality in cirrhotic patients with acute variceal bleeding. Other scoring systems might be useful for predicting sig- nificant clinical outcomes in these patients. CITA: Ann Hepatol. 2016 Nov-Dec 2016; 15(6):895-901 DOI: 10.5604/16652681.1222107 PMID: 27740534 TÍTULO:  The effect of ursodeoxycholic acid in cystic cholangiopathies AUTORES: Lammert F, Méndez-Sánchez N. SUMMARY: Editorial CITA: Ann Hepatol. 2016 Nov-Dec 2016; 15(6):949-950 DOI: 10.5604/16652681.1222121 224

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 27797879 TÍTULO: Infant born with Robert's syndrome without prenatal care in a de- PMID: 27803928 veloping nation PMID: 27885969 AUTORES: Benardete D, Chandrasekaran N, Cariello L, Meraz D. SUMMARY: Maternal and child well-being during pregnancy can be attribut- ed to receiving optimal prenatal care. However, in developing nations, there are many barriers to receiving this. We present a primi gravid female aged 29 years with severe abdominal pain. She was in active labour at 40 weeks and completely unaware of her pregnancy; hence, she did not receive any prenatal care. The baby was born with significant birth deformities that were consistent with Robert's syndrome. Although early detection could not pre- clude the development of this disorder, proper care would have facilitated in receiving genetic counselling and proper understanding of the prognosis. In this case, we discuss the various barriers to receiving prenatal care and measures taken for improvement in developing nations. CITA: BMJ Case Rep. 2016 Oct 25; 2016 DOI: 10.1136/bcr-2016-216868 TÍTULO: Acute Kidney Injury Classified by Serum Creatinine and Urine Out- put in Critically Ill Cancer Patients AUTORES: Córdova-Sánchez BM, Herrera-Gómez Á, Ñamendys-Silva SA. SUMMARY: Acute kidney injury (AKI) is common in critically ill patients and is associated with higher mortality. Cancer patients are at an increased risk of AKI. Our objective was to determine the incidence of AKI in our critically ill can- cer patients, using the criteria of serum creatinine (SCr) and urine output (UO) proposed by the Kidney Disease: Improving Global Outcomes (KDIGO). Meth- ods. We performed a retrospective cohort analysis of a prospectively collected database at the intensive care unit (ICU) of the Instituto Nacional de Cancer- ología from January 2013 to March 2015. Results. We classified AKI according to the KDIGO definition. We included 389 patients; using the SCr criterion, 192 (49.4%) had AKI; using the UO criterion, 219 (56.3%) had AKI. Using both criteria, we diagnosed AKI in 69.4% of patients. All stages were independently associated with six-month mortality; stage 1 HR was 2.04 (95% CI 1.14-3.68, p = 0.017), stage 2HR was 2.73 (95% CI 1.53-4.88, p = 0.001), and stage 3 HR was 4.5 (95% CI2.25-8.02, p < 0.001). Patients who fulfilled both criteria had a higher mortality compared with patients who fulfilled just one criterion (HR 3.56, 95%CI 2.03-6.24, p < 0.001). Conclusion. We diagnosed AKI in 69.4% of patients. All AKI stages were associated with higher risk of death at six months, even for patients who fulfilled just one AKI criterion. CITA: Biomed Res Int. 2016; 2016:6805169 DOI: 27803928 TÍTULO: 36th International Symposium on Intensive Care and Emergency Medicine : Brussels, Belgium. 15-18 March 2016 AUTORES: Bateman RM, (…) Meza-Márquez J, Nava-López J, Carrillo-Es- per R, (…), Pérez-Calatayud A, Zepeda-Mendoza A, Díaz-Carrillo, et al. SUMMARY: Erratum CITA: Crit Care. 2016 Apr 20;20(Suppl 2):94 DOI: 10.1186/s13054-016-1208-6 225

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 27895895 TÍTULO: Allergy immunotherapy across the life cycle to promote active and PMID: 28031716 healthy ageing: from research to policies: An AIRWAYS Integrated Care Pathways (ICPs) programme item (Action Plan B3 of the European Inno- vation Partnership on active and healthy ageing) and the Global Alliance against Chronic Respiratory Diseases (GARD), a World Health Organization GARD research demonstration project AUTORES: Calderon MA, (…) Larenas-Linnemann DE, et al. ABSTRACT: Allergic diseases often occur early in life and persist through- out life. This life-course perspective should be considered in allergen immu- notherapy. In particular it is essential to understand whether this al treatment may be used in old age adults. The current paper was developed by a work- ing group of AIRWAYS integrated care pathways for airways diseases, the model of chronic respiratory diseases of the European Innovation Partner- ship on active and healthy ageing (DG CONNECT and DG Santé). It consid- ered (1) the political background, (2) the rationale for allergen immunother- apy across the life cycle, (3) the unmet needs for the treatment, in particular in preschool children and old age adults, (4)the strategic framework and the practical approach to synergize current initiatives in allergen immunotherapy, its mechanisms and the concept of active and healthy ageing. CITA: Clin Transl Allergy. 2016 Nov 23; 6:41 DOI: 10.1186/s13601-016-0131-x TÍTULO: Diagnostic accuracy of nodular gastritis for H. pylori infection AUTORES: Romero-Flores JL, Fernandez-Rivero JA, Marroquín-Fabian E, Téllez-Ávila FI, Sánchez-Jiménez BA, Juárez-Hernández E, Uribe M, Chávez-Tapia NC. BACKGROUND: The term nodular is not included in the Sydney classifi- cation and there is no widely accepted histopathological definition. It has been proposed that the presence of antral nodularity could predict Helico- bacter pylori (H. Pylori) infection. The aim of this study was to determine the diagnostic accuracy of nodular gastritis (NG) for H. pylori infection after a rigorous standardization process, and to describe the associated histopatho- logical characteristics. MATERIALS AND METHODS: Endoscopic images of patients submitted to endoscopy with biopsy sampling were included. Endoscopic images were distributed among six endoscopists. The analysis was performed sequential- ly in three rounds: the first round assessed the interobserver variability, the second evaluated the intra observer variability, and the third calculated the interobserver variability after training. A correlation analysis between endo- scopic and histopathological findings was performed. RESULTS: A total of 917 studies were included. In the first analysis of in- terobserver variability, a poor kappa value (0.078) was obtained. The sec- ond evaluation yielded good intra observer variability, with kappa values of 0.62-0.86. The evaluation of interobserver variability after training revealed an improvement in the kappa value of 0.42. A correlation was found between endoscopic images and histopathological reports. CONCLUSION: There was a strong correlation between NG and H. pylori, but only after rigorous evaluation. The use of the term NG requires extensive standardization before it can be used clinically. CITA: Ther Clin Risk Manag. 2016 Dec 16; 13:9-14 DOI: 10.2147/TCRM.S121735 226

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 28050247 TÍTULO: ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle AUTORES: Bousquet J, (…) Larenas-Linnemann D, et al. ABSTRACT: The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The ini- tial goals were (1) to propose a new allergic rhinitis classification, (2) to pro- mote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA-disseminated and implemented in over 70 countries globally-is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Mala- dies Chroniques pour un VieillissementActif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support system. It is associated with an inter-oper- able tablet for physicians and other health care professionals. The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of the novel ARIA approach is to provide an active and healthy life to rhinitis sufferers, whatever their age, sex or socio-economic status, in order to reduce health and social inequalities incurred by the disease. CITA: Clin Transl Allergy. 2016 Dec 30; 6:47 DOI: 10.1186/s13601-016-0137-4 PMID: 28090258 TÍTULO: Echocardiographic and Histologic Correlations in Patients with Se- vere Aortic Stenosis: Influence of Overweight and Obesity AUTORES: Ávila-Vanzzini N, Fritche-Salazar JF, Vázquez-Castro NM, Ri- vera-Lara P, Pérez-Méndez O, Martínez-Herrera H, Gómez-Sánchez M, Aranda-Frausto A, Herrera-Bello H, Luna-Luna M, Arias Godínez JA. BACKGROUND: Severe aortic stenosis (AS), leads to pathological left ven- tricular remodeling that may worsen with concomitant overweight and obesi- ty (OW/O). METHODS: We aimed to prospectively analyze the impact of OW/O on ven- tricular remodeling in severe AS, by evaluating the percentage of intra endo- myocardial fibrosis (PIEF) and the percentage of infiltrating intra endocardial lipid vacuoles (PIELV) and its relationship to global longitudinal strain (GLS) inpatients with OW/O. RESULTS: 44 patients with severe AS were included, 13 non-obese (29%) and 31 OW/O (71%), all of them with left ventricular ejection fraction ≥ 55%. GLS was evaluated with 2D speckle tracking. During valve replacement, an endocardial biopsy was obtained, where PIEF and PIELV were analyzed. Pa- tients with higher PIEF and PIELV had greater body mass index (p < 0.0001) and worse GLS (p <0.0053). A GLS cut-off point < -14% had a sensitivity of 75%, and a specificity of 92.8% to detect important PIEF (AUC: 0.928, 95% confidence interval: 0.798-1.00). On multivariate analysis, OW/O and PIELV were independently associated to the PIEF, and OW/O and PIEF were in- dependently associated to GLS. A high correlation between the amount of PIELV and PIEF were found. 227

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR CONCLUSION: Patients with severe AS and OW/O have greater PIEF and PIELV, suggesting more pathological remodeling. GLS is useful to detect subclinical myocardial injury and is potentially useful for endomyocardial fi- brosis detection. The presence of higher PIELF may be a trigger factor for the development of intra endomyocardial fibrosis. CITA: J Cardiovasc Ultrasound. 2016 Dec; 24(4):303-311 DOI: 10.4250/jcu.2016.24.4.303 PMID: 28549357 TÍTULO: [Hip osteosynthesis with IM nail: lateral decubitus without fracture table] AUTORES: Aguirre-Rodríguez VH, Inzunza-Enríquez G, Bibiano-Escalan- te O, Martínez-Ruiz FJ, Valero-González FS. BACKGROUND: Hip fractures have increased in the last decades, mainly in elderly patients with osteoporosis. The incidence becomes in some coun- tries up to 250thousand new cases per year, generating millions for health systems costs, so it should be considered a public health problem. They are treated in supine position, with a fracture table, through a lateral approach. However, it is important to know that there are other techniques, which can dispense a table of fractures and in a different position. MATERIAL AND METHODS: Show a surgical technique for the treatment of transtrochanteric fractures of hip in lateral decubitus, without a fracture table and define its advantages and precise indications. RESULTS: Eight patients, five women (62.5%) and three men (37.5%). Bleeding average 115 cc and average surgical time of 67 minutes. A patient with detachment of the system that ended in Girdle stone. No neurological complications or early infection was documented. CONCLUSIONS: The reduction and fixation of transtrochanteric hip frac- tures with intramedullary nail without fracture tab le and in lateral decubitus is feasible and with a low level of associated complications. CITA: Acta Ortop Mex. 2016 Nov-Dec; 30(6):279-283 PMID: 31268434 TÍTULO: 36th International Symposium on Intensive Care and Emergency Medicine : Brussels, Belgium. 15-18 March 2016 AUTORES: Bateman RM, (…) Meza-Márquez J, Nava-López J, Carril- lo-Esper R, (…), Pérez-Calatayud A, Zepeda-Mendoza A, Díaz-Carrillo, et al. SUMMARY: Erratum CITA: Crit Care. 2016 Oct 24;20:347 DOI: 10.1186/s13054-016-1358-6 228

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR 2017 PMID: 26769525 TÍTULO: [Wilkie Syndrome. A case report] AUTORES: González Hermosillo-Cornejo D, Díaz Girón-Gidi A, Vélez- Pérez FM, Lemus-Ramírez RI, Andrade Martínez-Garza P. BACKGROUND: Wilkie syndrome, also referred as superior mesenteric ar- tery syndrome, is an unusual cause of a proximal small bowel obstruction. It is characterised by the compression of the duodenum in its third portion due to an arrowing of the space between the superior mesenteric artery and the aorta. Its presentation symptoms are consistent and include the obstruction of the proximal small bowel. However, the physical and laboratory findings are non-specific. Nevertheless, many imaging methods are useful for its di- agnosis. The management of this condition varies between observation and surgery, depending on each particular case. CLINICAL CASE: The case is presented of a 19 year-old male who began with acute, intense abdominal pain, nausea, vomiting, and diarrhoea. On ex- amination, he had abdominal wall rigidity and hyperesthesia. Imaging stud- ies were requested, revealing a decreased superior mesenteric artery angle, a shortening of the aortic mesenteric distance, and a decrease in the calibre of the third duodenal portion, all findings concomitant with Wilkie syndrome. Conservative treatment was applied and the patient was discharged without complications. CONCLUSIONS: Wilkie syndrome continues to be an unknown condition to the general practitioner, and the under diagnosis of this condition may put a patient at risk of serious complications. A high index of suspicion is required to reach a diagnosis. Early treatment should give a good outcome most of the time. CITA: Cir Cir. 2017 Jan - Feb; 85(1):54-59 DOI: 10.1016/j.circir.2015.08.009 PMID: 26920213 TÍTULO: [Neuroendocrine small-cell carcinoma of the gallbladder. An unex- pected finding after diagnostic laparoscopy] AUTORES: González-Chávez MA, Villegas-Tovar E, González Hermosil- lo-Cornejo D, Gutierrez-Ocampo A, López-Rangel JA, Athié-Athié AJ. BACKGROUND: Gallbladder cancer ranks fifth among oncological diseases affecting the gastrointestinal tract; nevertheless, it is the world's most com- mon malignant tumor of the bile ducts. It is usually diagnosed after cholecys- tectomy and tends to have bad prognosis. Adenocarcinoma is the main his- tological finding, although other rare histologic types have been described among the actual literature. Poorly differentiated squamous-cell neuroendo- crine gallbladder carcinoma is an extremely rare neoplasm. A poor prognosis is associated with this histological type. AIM: The aim of this paper is to show that performing a systematic explora- tion of the entire peritoneal cavity in all laparoscopic surgeries can lead to find completely unexpected changes related to an unidentified disease. Also, a detailed review of our unexpected finding is made: The neuroendocrine small cell carcinoma of gallbladder. 229

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR CLINICAL CASE: We hereby report the case of a 40-year-old patient with a rupture dectopic pregnancy that underwent emergency laparoscopic surgery, presenting the incidental finding of a small-cell carcinoma of the gallbladder. CONCLUSIONS: Our surgical group advised that by introducing the lap- aroscope, the entire peritoneal cavity must be systematically reviewed, in search of differential diagnoses and unidentified pathologies. We must use the diagnostic and therapeutic qualities of laparoscopy. Bile duct endocrine tumors tend tore main silent until advanced stages, making the prognosis usually unfavorable, especially when they are unresectable. Endocrine neo- plasias of the gallbladder, although uncommon, should be taken into account as possible diagnoses due to its therapeutic and prognostic implications. CITA: Cir Cir. 2017 Mar - Apr; 85(2):168-174 DOI: 10.1016/j.circir.2015.12.007 PMID: 27246840 TÍTULO: National Registry of Cardiac Rehabilitation Programs in Mexico II (RENAPREC II) AUTORES: Ilarraza-Lomelí H, García-Saldivia M, Rojano-Castillo J, Justi- niano S, Cerón N, Aranda-Ayala ZL, Rodríguez A, Hernández A, Cassaigne ME, Cantero R, Gasca P, Hinojosa T, Alonso J, Romo R, Lara J, Pimentel E, Zavala J, Rius-Suárez MD, Cherebetiu G, Cortés O, Almaraz A, Mendoza P, Silva J, Tirado E, Martínez L. OBJECTIVE: The aim of this paper is to compare the state of Cardiac Reha- bilitation Programs (CRP) in 2009 with 2015. Focus is directed on healthcare, training of health-providers, research, and the barriers to the irimplementa- tion. METHODS: All authors of RENAPREC-2009, and other cardiac rehabilita- tion leaders in Mexico were requested to participate. These centres were distributed into two groups: RENAPREC-2009 centres that participated in 2015, and the new CRP units. RESULTS: In 2009 there were 14 centres, two of which disappeared and another two did not respond. CRP-units increased by 71% (n=24), and their geographic distribution shows a centripetal pattern. The coverage of CRP- units was 0.02centres per 100,000 inhabitants. Only 4.4% of eligible patients were referred to CRP, with a rate of 10.4 patients/100,000 inhabitants in 2015. The ratio of Clinical Cardiologists to Cardiac Rehabilitation Specialists was 94:1, and the ratio of Intervention Specialists to cardiac rehabilitation experts was 16:1. Cardiac rehabilitation activities and costs varied widely. Patient dropout rate in phase II was 12%. Several barriers were identified: financial crisis (83%), lack of skilled personnel (67%), deficient equipment (46%), inadequate areas (42%), and a reduced number of operating centres (38%). CONCLUSIONS: CRPs in Mexico are still in the process of maturing. Mexi- can CRP-centres have several strengths, like the quality of the education of the professionals and the multidisciplinary programs. However, the lack of referral of patients and the heterogeneity of procedures are still their main weaknesses. CITA: Arch Cardiol Mex. 2017 Oct - Dec; 87(4):270-277 DOI: 10.1016/j.acmx.2016.04.010 230

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 27517733 TÍTULO: Elevated cholesterol levels have a poor prognosis in a cholestasis PMID: 27522982 scenario PMID: 27653623 AUTORES: Nuño-Lámbarri N, Barbero-Becerra VJ, Uribe M, Chávez-Ta- pia NC. SUMMARY: Cholestasis results from defective bile flow through the biliary ducts leading to the accumulation of bile acids (BAs) in hepatocytes and serum. It has been seen that cholestasis is associated with hypercholester- olemia, which is a prerequisite for gallstone formation and primary biliary cir- rhosis, being some of the most common gastrointestinal disorders in West- ern societies. Cytotoxic BAs induce proinflammatory mediators, oxidative stress, and apoptosis in hepatocytes, whereas cytoprotective BAs prevent them; they can also modify the plasmatic membrane structure of cells or mitochondrial outer membrane properties as well as the distribution of cho- lesterol, altering various proteins involved in Bas homeostasis. CITA: J Biochem Mol Toxicol. 2017 Jan; 31(1):1-6 DOI: 10.1002/jbt.21831 TÍTULO: Communicating Segment Aneurysm of Internal Carotid Artery Associ- ated with Saltzman's Type III Persistent Trigeminal Artery: A Case Report AUTORES: Alonso-Vanegas MA, Quintero-López E, Moreira-Holguín JC, Martínez-Albarrán AA, Corona-Cedillo R, Gómez-Amador JL. SUMMARY: Persistent trigeminal artery (PTA), also called primitive trigemi- nal artery, represents the most common embryonic remnant of fetal circula- tion in adulthood, (only after fetal pattern of posterior communicating artery [PComA]) with an estimated incidence of between 0.1% and 0.76%. The per- manence of this fetal pattern constitutes an incidental finding in most cases, however, may be associated with aneurysms, arteriovenous malformations, trigeminal neuralgia, and other types of fetal circulation persistency. A pa- tient with giant aneurysm in the communicating segment of the right internal carotid artery, associated with the presence of PTA and fetal pattern of PCo- mA, also on the right side is reported. CITA: Ann Vasc Surg. 2017 Jan; 38:316.e7-316.e12 DOI: 10.1016/j.avsg.2016.05.095 TÍTULO: Allergen immunotherapy for the prevention of allergy: A systematic review and meta-analysis AUTORES: Kristiansen M, Dhami S, Netuveli G, Halken S, Muraro A, Rob- erts G, Larenas-Linnemann D, Calderón MA, Penagos M, Du Toit G, Anso- tegui IJ, Kleine-Tebbe J, Lau S, Matricardi PM, Pajno G, Papadopoulos NG, Pfaar O, Ryan D, Santos AF, Timmermanns F, Wahn U, Sheikh A. BACKGROUND: There is a need to establish the effectiveness, cost-effec- tiveness, and safety of allergen immunotherapy (AIT) for the prevention of allergic disease. METHODS: Two reviewers independently screened nine international biomedical databases. Studies were quantitatively synthesized using ran- dom-effects meta-analyses. 231

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 28043757 RESULTS: A total of 32 studies satisfied the inclusion criteria. Overall, me- PMID: 28051792 ta-analysis found no conclusive evidence that AIT reduced the risk of de- veloping a first allergic disease over the short term (RR = 0.30; 95% CI: 0.04-2.09) and no randomized controlled evidence was found in relation to its longer-term effects for this outcome. There was, however, a reduction in the short-term risk of those with allergic rhinitis developing asthma (RR = 0.40; 95% CI: 0.30-0.54), with this finding being robust to a pre-specified sensitivity analysis. We found inconclusive evidence that this benefit was maintained over the longer term: RR = 0.62; 95% CI: 0.31-1.23. There was evidence that the risk of new sensitization was reduced over the short term, but this was not confirmed in the sensitivity analysis: RR = 0.72; 95% CI: 0.24-2.18. There was no clear evidence of any longer-term reduction in the risk of sensitization: RR = 0.47; 95% CI: 0.08-2.77. AIT appeared to have an acceptable side effect profile. CONCLUSIONS: AIT did not result in a statistically significant reduction in the risk of developing a first allergic disease. There was, however, evidence of a reduced short-term risk of developing asthma in those with allergic rhini- tis, but it is unclear whether this benefit was maintained over the longer term. We are unable to comment on the cost-effectiveness of AIT. CITA: Pediatr Allergy Immunol. 2017 Feb;28(1):18-29 DOI: 10.1111/pai.12661 TÍTULO: Coronary angiography in a patient with a previously implanted trans-catheter aortic CoreValve(®): Technical aspects, challenges and review of the literature AUTORES: Escudero X, López-Meneses M, Ortiz-Fernández P, Miran- da-Malpica E, Crespo-Serje L. SUMMARY: Review article CITA: Arch Cardiol Mex. 2017 Jan - Mar; 87(1):86-88 DOI: 10.1016/j.acmx.2016.12.001 TÍTULO: Management strategies for liver fibrosis AUTORES: Altamirano-Barrera A, Barranco-Fragoso B, Méndez-Sán- chez N. SUMMARY: Liver fibrosis resulting from chronic liver injury are major caus- es of morbidity and mortality worldwide. Among causes of hepatic fibrosis, viral infection is most common (hepatitis B and C). In addition, obesity rates worldwide have accelerated the risk of liver injury due to nonalcoholic fat- ty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). Also liver fibrosis is associated with the consumption of alcohol, or autoimmune hepatitis and chronic cholangiophaties. The response of hepatocytes to in- flammation plays a decisive role in the physiopathology of hepatic fibrosis, which involves the recruitment of both pro- and anti-inflammatory cells such as monocytes and macrophages. As well as the production of other cyto- kines and chemokines, which increase the stimulus of hepatic stellate cells by activating proinflammatory cells. The aim of this review is to identify the therapeutic options available for the treatment of the liver fibrosis, enabling the prevention of progression when is detected in time. CITA: Ann Hepatol. 2017 Jan-Feb; 16(1):48-56 DOI: 10.5604/16652681.1226814 232

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 28122133 TÍTULO: Allergen exposure chambers: harmonizing current concepts and PMID: 28166710 projecting the needs for the future - an EAACI Position Paper AUTORES: Pfaar O, Calderon MA, Andrews CP, Angjeli E, Bergmann KC, Bønløkke JH, de Blay F, Devillier P, Ellis AK, Gerth van Wijk R, Hohlfeld JM, Horak F, Jacobs RL, Jacobsen L, Jutel M, Kaul S, Larché M, Lare- nas-Linnemann D, Mösges R, Nolte H, Patel P, Peoples L, Rabin RL, Rath- er C, Salapatek AM, Sigsgaard T, Thaarup S, Yang J, Zieglmayer P, Zuberbi- er T, Demoly P. BACKGROUND: Allergen exposure chambers (AECs) are clinical facilities allowing for controlled exposure of subjects to allergens in an enclosed envi- ronment. AEC shave contributed towards characterizing the pathophysiology of respiratory allergic diseases and the pharmacological properties of new therapies. In addition, they are complementary to and offer some advantag- es over traditional multicentre field trials for evaluation of novel therapeutics. To date, AEC studies conducted have been monocentric and have followed protocols unique to each centre. Because there are technical differences among AECs, it may be necessary to define parameters to standardize the AECs so that studies may be extrapolated for driving basic immunological research and for marketing authorization purposes by regulatory authorities. METHODS: For this task force initiative of the European Academy of Aller- gy and Clinical Immunology (EAACI), experts from academia and regulatory agencies met with chamber operators to list technical, clinical and regulatory unmet needs as well as the prerequisites for clinical validation. RESULTS: The latter covered the validation process, standardization of challenges and outcomes, intra- and interchamber variability and reproduc- ibility, in addition to comparability with field trials and specifics of paediatric trial sand regulatory issues. CONCLUSION: This EAACI Position Paper aims to harmonize current con- cepts in AECs and to project unmet needs with the intent to enhance prog- ress towards use of these facilities in determining safety and efficacy of new therapeutics in the future. CITA: Allergy. 2017 Jul; 72(7):1035-1042 DOI: 10.1111/all.13133 TÍTULO: Latin-American guidelines for opioid use in chronic nononcologic pain AUTORES: Lara-Solares A, Aguayo Zamora C, Amescua García C, Garcia JBS, Berenguel Cook MDR, Bonilla Sierra P, Campos Kraychete D, Flores Cantisani JA, Guerrero C, Guillén Núñez MDR, Hernández Castro JJ, Hernández Ortíz A, Jreige Iskandar A, Lech O, Macías Guerra J, Ramírez Samayoa G, Rangel Morillo E, Rico Pazos MA, Sempértegui Gallegos M. AIM: Latin-American experts in the use of opioids in patients with chronic nononcologic pain (CNOP) have updated existing recommendations to cur- rent Latin-American reality. METHODS: Several key opinion leaders from Latin America participated in a face-to-face meeting in Guatemala (April 2015) to discuss the use of opioids in CNOP. Subgroups of experts worked on specific topics, reviewed the liter- ature and shaped the final manuscript. 233

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 28188630 RESULTS: The expert panel developed guidelines taking into consideration PMID: 28239450 the utility of both opioid and nonopioid analgesics and factors pertaining to their efficacy, safety, adherence, administration and risks for abuse/addiction. CONCLUSION: Latin-American guidelines for the use of opioids in CNOP should improve pain relief and patients' quality of life by increasing access to these effective agents. CITA: Pain Manag. 2017 May; 7(3):207-215 DOI: 10.2217/pmt-2016-0065 TÍTULO: Genetic analyses of isolated high-grade pancreatic intraepithelial neoplasia (HG-PanIN) reveal paucity of alterations in TP53 and SMAD4 AUTORES: Hosoda W, Chianchiano P, Griffin JF, Pittman ME, Brosens LA, Noë M, Yu J, Shindo K, Suenaga M, Rezaee N, Yonescu R, Ning Y, Al- bores-Saavedra J, Yoshizawa N, Harada K, Yoshizawa A, Hanada K, Yone- hara S, Shimizu M, Uehara T, Samra JS, Gill AJ, Wolfgang CL, Goggins MG, Hruban RH, Wood LD. SUMMARY: High-grade pancreatic intraepithelial neoplasia (HG-PanIN) is the major precursor of pancreatic ductal adenocarcinoma (PDAC) and is an ideal target for early detection. To characterize pure HG-PanIN, we analysed 23 isolated HG-PanIN lesions occurring in the absence of PDAC. Whole-ex- ome sequencing of five of these HG-PanIN lesions revealed a median of 33 somatic mutations per lesion, with atotal of 318 mutated genes. Targeted next-generation sequencing of 17 HG-PanIN lesions identified KRAS muta- tions in 94% of the lesions. CDKN2A alterations occurred in six HG-PanIN lesions, and RNF43 alterations in five. Mutations inTP53, GNAS, ARID1A, PIK3CA, and TGFBR2 were limited to one or two HG-PanINs. No non-syn- onymous mutations in SMAD4 were detected. Immunohistochemistry for p53 andSMAD4 proteins in 18 HG-PanINs confirmed the paucity of alterations in these genes, with aberrant p53 labelling noted only in three lesions, two of which were found to be wild type in sequencing analyses. Sixteen adjacent LG-PanIN lesions from ten patients were also sequenced using targeted sequencing. LG-PanIN harboured KRAS mutations in 94% of the lesions; mutations in CDKN2A, TP53, andSMAD4 were not identified. These results suggest that inactivation of TP53 andSMAD4 are late genetic alterations, predominantly occurring in invasive PDAC. CITA: J Pathol. 2017 May; 242(1):16-23 DOI: 10.1002/path.4884 TÍTULO: Erratum to: Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5) AUTORES: Bousquet J, (…) Larenas-Linneman D, et al. ABSTRACT: Erratum CITA: Clin Transl Allergy. 2017 Feb 20; 7:5 DOI: 10.1186/s13601-016-0116-9 234

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 28298258 TÍTULO: Susceptibility to rifaximin and other antimicrobials of bacteria iso- lated in patients with acute gastrointestinal infections in Southeast Mexico AUTORES: Novoa-Farias O, Frati-Munari AC, Peredo MA, Flores-Juárez S, Novoa-García O, Galicia-Tapia J, Romero-Carpio CE. INTRODUCTION: Enteropathogenic bacteria isolated in Mexico City have shown a high rate of resistance to different antibiotics, with the exception of rifaximin (RIF). RIF is a nonabsorbable antibiotic that reaches high fecal concentrations (≈ 8,000μg/g). Susceptibility to antimicrobials can vary in dif- ferent geographic regions. AIM: To study the susceptibility to rifaximin and other antimicrobials of en- teropathogenic bacteria isolated in patients with acute diarrhea in the south- eastern region of Mexico. MATERIAL AND METHODS: A total of 614 strains of bacteria isolated from patients with acute diarrhea from 4 cities in Southeast Mexico were ana- lyzed. An antibiogram with the following antibiotics was created: ampicillin (AMP), trimethoprim/sulfamethoxazole (T-S), neomycin (NEO), furazolidone (FUR), ciprofloxacin (CIP), chloramphenicol (CHL), and fosfomycin (FOS), assessed through the agar diffusion method at the standard concentrations recommended by the Clinical and Laboratory Standards Institute (CLSI) and the American Society for Microbiology (ASM), and RIF, assessed through microdilution at 4concentrations. RESULTS: The bacteria were Escherichia coli (55%), as the majority, in all its pathogenic variants, Shigella (16.8%), Salmonella (15.3%), Aeromonas (7.8%), and less than 5% Campylobacter, Yersinia, Vibrio, and Plesiomonas. The accumulated overall susceptibility to RIF was 69.1, 90.8, 98.9, and 100% at concentrations of100, 200, 400, and 800μg/ml, respectively. Overall susceptibility to other antibiotics was FOS 82.8%, CHL 76.8%, CIP 73.9%, FUR 64%, T-S 58.7%, NEO 55.8%, and AMP 23.8%. Susceptibility to RIF at 400 and 800μg was significantly greater than with the other antimicrobials (P<.001). CONCLUSIONS: The data of the present study were similar to those of a previous study carried out in Mexico City: susceptibility to RIF in > 98% of the bacterial strains and a high frequency of resistance to several common antimicrobials. CITA: Rev Gastroenterol Mex. 2017 Jul - Sep; 82(3):226-233 DOI: 10.1016/j.rgmx.2016.10.006 PMID: 28318912 TÍTULO: Less liver fibrosis in metabolically healthy compared with metaboli- cally unhealthy obese patients with non-alcoholic fatty liver disease AUTORES: Gutiérrez-Grobe Y, Juárez-Hernández E, Sánchez-Jiménez BA, Uribe-Ramos MH, Ramos-Ostos MH, Uribe M, Chávez-Tapia NC. AIM: This cross-sectional study evaluated liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) and compared the characteristics of metabolically healthy obese (MHO) with metabolically unhealthy obese (MUHO) patients. 235

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 28347162 METHODS: The study was nested within a randomized clinical trial (RCT) PMID: 28356978 and included obese patients with NAFLD, as determined by liver ultrasonog- raphy. Fibrosis was assessed by transient elastography, and AST-to-platelet ratio index (APRI) and NAFLD score. Patients were compared according to obesity phenotype using various accepted criteria. RESULTS: The RCT included 1024 patients with NAFLD, of whom 428 (41.7%) were included in the present study. The prevalence of MHO ranged from 1.2% to 63%, depending on the criteria used. According to various cri- teria for metabolic health, obese patients had less liver fibrosis. MHO pa- tients, as defined by all criteria, showed a significantly lower prevalence of advanced liver fibrosis (F3-F4) than MUHO on transient elastography (16.5% vs. 28%, respectively; P≤0.05). CONCLUSION: MUHO patients are at higher risk of liver fibrosis and, there- fore, the identification of obese patients with 'healthy' characteristics is im- perative as their entire clinical work-ups are likely to differ. CITA: Diabetes Metab. 2017 Sep;43(4):332-337 DOI: 10.1016/j.diabet.2017.02.007 TÍTULO: Biomarkers in hepatocellular carcinoma: an overview AUTORES: Juárez-Hernández E, Motola-Kuba D, Chávez-Tapia NC, Uri- be M, Barbero Becerra V. SUMMARY: Current methods for HCC diagnosis have not an optimal diag- nostic accuracy. The detection of more than one biomarker seems to im- prove their individual performance and provide an accurate HCC diagnosis approach. Individual gene expression seems to influence whether or not the treatment is successful, since several molecules have interfere with cancer associated pathways and have been related to poor prognosis which condi- tion the lack of effective treatment options. Areas covered: Novel biomarkers have been proposed as a useful tool in each patient prognosis. This article aims to review the recent evidence based on HCC biomarkers which seems to have a regulative role according to tumor cell development leading to a specific biological response. Epigenetic regulation, miRNAs, and genome sequencing analysis propose molecular expression signatures as novel bio- markers which allowed achieve the major goal for the use of biomarkers in clinical practice. Moreover, a deeper analysis for determine the diagnostic accuracy of biomarkers has been made. Expert commentary: To improve of methodological designs and sample sizes are needed in order to support the role of biomarkers in HCC. Furthermore, is necessary to consider HCC etiologies and all clinic disease context to carried out clinical phase studies to thrust biomarkers application. CITA: Expert Rev Gastroenterol Hepatol. 2017 Jun;11(6):549-558 DOI: 10.1080/17474124.2017.1311785 TÍTULO: Reproducibility of the EGFR immunohistochemistry scores for tu- mor samples from patients with advanced non-small cell lung cancer AUTORES: Avilés-Salas A, Muñiz-Hernández S, Maldonado-Martínez HA, Chanona-Vilchis JG, Ramírez-Tirado LA, HernáNdez-Pedro N, Dor- antes-Heredia R, Ruíz-Morales JM, Motola-Kuba D, Arrieta O. 236

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 28382128 SUMMARY: Epidermal growth factor receptor (EGFR) is overexpressed in >60% of non-small cell lung cancer (NSCLC) cases. In combination with radiotherapy or chemotherapy, first-line treatments with antibodies against EGFR, including cetuximab and necitumumab, have demonstrated benefits by increasing overall survival (OS), particularly in patients who overexpress EGFR. The present study evaluated the interobserver agreement among three senior pathologists, who were blinded to the clinical outcomes and assessed tumor samples from 85 patients with NSCLC using the H-score method. EGFR immunohistochemistry was performed using a qualitative im- munohistochemical kit. The reported (mean ± standard deviation) H-scores from each pathologist were 111±102, 127±103 and 128.53±104.03. The pa- tients with average H-scores ≥1, ≥100, ≥200 and between 250-300 were 85.9, 54.1, 28.2 and12.9, respectively. Patients who had an average H-score >100 had a shorter OS time compared with those with lower scores. Further- more, patients with EGFR mutations who were treated with EGFR-tyrosine kinase inhibitors (TKIs) and had an average H-score >100 had a longer OS time compared with those with an average H-score <100. The interobserver concordance for the total H-scores were 0.982, 0.980 and 0.988, and for a positive H-score ≥200, the interobserver concordance was 0.773, 0.710 and 0.675, respectively. The determination of EGFR expression bythe H-score method is highly reproducible among pathologists and is a prognostic factor associated with a poor OS in all patients. Additionally, the results of the pres- ent study suggest that patients with EGFR mutations that are treated with EGFR-TKIs and present with a high H-score have a longer OS time. CITA: Oncol Lett. 2017 Feb; 13(2):912-920 DOI: 10.3892/ol.2016.5512 TÍTULO: Endolymphatic Sac Surgery for Ménière's Disease - Current Opin- ion and Literature Review AUTORES: Flores García ML, Llata Segura C, Cisneros Lesser JC, Pane Pianese C. INTRODUCTION:  The endolymphatic sac is thought to maintain the hy- drostatic pressure and endolymph homeostasis for the inner ear, and its dysfunction may contribute to the pathophysiology of Ménière's disease. Throughout the years, different surgical procedures for intractable vertigo secondary to Ménière's disease have been described, and though many authors consider these procedures as effective, there are some who ques- tion its long-term efficacy and even those who think that vertigo control is achieved more due to a placebo effect than because of the procedure itself. OBJECTIVE; To review the different surgical procedures performed in the endolymphatic sac for the treatment of Ménière's disease. Data Sourc- es  PubMed, MD consult and Ovid-SP databases. Data Synthesis  We focus on describing the different surgical procedures performed in the en- dolymphatic sac, such as endolymphatic sac decompression, endolymphat- ic sac enhancement, endolymphatic sac shunting and endolymphatic duct blockage, their pitfalls and advantages, their results in vertigo control and the complication rates. The senior author also describes his experience after 30 years of performing endolymphatic sac surgery. CONCLUSIONS:  The endolymphatic sac surgery, with all its variants, is a good option for patients with incapacitating endolymphatichy drops, provid- ing a high percentage of vertigo control and hearing preservation. CITA: Int Arch Otorhinolaryngol. 2017 Apr; 21(2):179-183 DOI: 10.1055/s-0037-1599276 237

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 28387952 TÍTULO: Work productivity in rhinitis using cell phones: The MASK pilot study PMID: 28395526 AUTORES: Bousquet J, (…) Larenas-Linnemann D, et al. ABSTRACT: Allergic rhinitis often impairs social life and performance. The aim of this cross-sectional study was to use cell phone data to assess the impact on work productivity of uncontrolled rhinitis assessed by visual an- alogue scale (VAS). A mobile phone app (Allergy Diary, Google Play Store and Apple App Store) collects data from daily visual analogue scales (VAS) for overall allergic symptoms(VAS-global measured), nasal (VAS-nasal), ocular (VAS-ocular) and asthma symptoms(VAS-asthma) as well as work (VAS-work). A combined nasal-ocular score is calculated. The Allergy Diary is available in 21 countries. The app includes the Work Productivity and Ac- tivity Impairment Allergic Specific Questionnaire (WPAI: AS) in six EU coun- tries. All consecutive users who completed the VAS-work from 1 June to 31 October 2016 were included in the study. A total of 1136 users filled in 5818 days of VAS-work. Symptoms of allergic rhinitis were controlled (VAS-global <20) in approximately 60% of the days. In users with uncontrolled rhinitis, ap- proximately 90% had some work impairment and over 50% had severe work impairment (VAS-work >50). There was a significant correlation between VAS-global calculated and VAS-work (Rho=0.83, P<0.00001, Spearman's rank test). In 144users, there was a significant correlation between VAS- work and WPAI: AS (Rho=0.53, P<0.0001). This pilot study provides not only proof-of-concept data onthe work impairment collected with the app but also data on the app itself, especially the distribution of responses for the VAS. This supports the interpretation that persons with rhinitis report both the presence and the absence of symptoms. CITA: Allergy. 2017 Oct; 72(10):1475-1484 DOI: 10.1111/all.13177 TÍTULO: Ramucirumab in the treatment of non-small cell lung cancer AUTORES: Arrieta O, Zatarain-Barrón ZL, Cardona AF, Carmona A, Lo- pez-Mejia M. INTRODUCTION: Therapeutic options for treating Non-Small Cell Lung Cancer (NSCLC)have recently increased. Ramucirumab (Cyramza), an an- ti-angionenic agent was approved in 2014 for treatment of several malignan- cies, including second-line treatment of patients with NSCLC with disease progression on or after platinum-based chemotherapy. Areas covered: We performed a comprehensive search of the literature focused on clinical trials with use of ramucirumab, targeting its evolution in the treatment of NSCLC. This review summarizes the results regarding its safety and efficacy. Expert opinion: Angiogenesis has been widely recognized as a quintessential fea- ture in cancer, intrinsically mediating tumor survival and progression. Ra- mucirumab, an anti-VEGFR2 agent, combined with docetaxel, was FDA-ap- proved for NSCLC patients. Results from a phase III trial have demonstrated the usefulness of this combination, with benefits in progression free surviv- al and overall survival for NSCLC patients. A greater magnitude of benefit is seen in patients with aggressive tumor behavior. Treatment with ramu- cirumab is generally tolerable, however, there is potential for severe toxicity. Adverse events reported with this combination include neutropenia, febrile neutropenia and hypertension. Also, there is the intrinsic risk of bleeding re- sulting from the mechanism of action. As such, adverse events should be identified timely, so drug-related complications can be prevented. CITA: Expert Opin Drug Saf. 2017 May; 16(5):637-644 DOI: 10.1080/14740338.2017.1313226 238

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 28400635 TÍTULO: Oral and Cutaneous Lymphomas other than Mycosis Fungoides and Sézary Syndrome in a Mexican Cohort: Recategorization and Evalua- tion of International Geographical Disparities AUTORES: Hernández-Salazar A, García-Vera JA, Charli-Joseph Y, Or- tiz-Pedroza G, Méndez-Flores S, Orozco-Topete R, Morales-Leyte AL, Domínguez-Cherit J, Lome-Maldonado C. BACKGROUND: Nonmycosis fungoides/Sézary syndrome (non-MF/SS) primary cutaneous lymphomas (PCL) are currently categorized under the 2005-World Health Organization/European Organization for Research and Treatment of Cancer (WHO-EORTC) classification for PCL. These differ in behavior from secondary cutaneous lymphomas (SCL) and to lymphomas limited to the oral cavity (primary oral lymphomas [POL]) both categorized under the 2016-WHO classification for lymphoid neoplasms. AIMS: This study aims to report the first series of non-MF/SS PCL, SCL, and POL in a Mexican cohort, examine the applicability of current classification systems and compare our findings with those from foreign cohorts. MATERIALS AND METHODS: Eighteen non-MF/SS PCL, four SCL, and two POL with available tissue for morphology and immunophenotypic as- sessment were reclassified according to the 2005-WHO/EORTC and 2016- WHO classifications. RESULTS: Non-MF/SS PCLs were primarily of T-cell origin (61%) where CD30+lymphoproliferative disorders predominated, followed by Epstein-Barr virus-induced lymphomas, and peripheral T-cell lymphomas, not otherwise specified. Primary cutaneous B-cell lymphomas (BCL) were primarily of fol- licle center cell origin followed by post germinal lymphomas of the diffuse large BCL variety. CONCLUSIONS: Most non-MF/SS PCL, SCL, and POL can be adequately categorized according to the 2005-WHO/EORTC and 2016-WHO classifica- tion systems, even when dealing with clinically atypical cases. The relative frequencies in our cohort hold closer similarities to Asian registries than from those of Europe/USA, supporting the concept of individual and/or racial sus- ceptibility, and the notion of geographical variances in the rate of lymphomas. In particular, such disparity may arise from viral-induced lymphomas which might show partial geographical restriction. CITA: Indian J Dermatol. 2017 Mar-Apr; 62(2):158-167 DOI: 10.4103/ijd.IJD_34_17 PMID: 28401101 TÍTULO: Warm autoimmune hemolytic anemia: experience from a single re- ferral center in Mexico City AUTORES: Alonso HC, Manuel AV, Amir CG, Sergio RR, Allan P, Xavier LK, Juventina TE. BACKGROUND: Autoimmune hemolytic anemia (AIHA) is characterized by an autoimmune-mediated destruction of red blood cells. Warm AIHA (wAIHA) represents 60% of AIHA cases and is associated with the positive detection of IgG and C3d in the direct antiglobulin test (DAT). This study aimed to assess the clinical and laboratorial differences between primary and secondary wAIHA patients from a referral center in Mexico City. 239

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR METHODS: All patients diagnosed with wAIHA in our institution from Janu- ary 1992to December 2015 were included and received corticosteroids as the first-line treatment. We analyzed the response to the first-line treatment, relapse-free survival, and time to splenectomy. RESULTS: Eighty-nine patients were included. Secondary wAIHA represent- ed 55.1% of the cases. At diagnosis, secondary wAIHA patients showed a DAT mixed pattern more frequently than primary wAIHA patients (36.7 vs. 17.5%, P<0.001). In the survival analysis, patients with secondary wAIHA had a lower time to response (18 vs. 37days, P=0.05), median disease-free survival (28.51 vs. 50.95 weeks, P=0.018), and time to splenectomy (43.5 vs. 61 wks, P=0.029) than those with primary wAIHA. Due to economic con- straints, rituximab was considered as the third-line treatment in only two pa- tients. CONCLUSION: Secondary wAIHA may benefit from a longer low-dose ste- roid maintenance period mainly due to its shorter time to relapse and time to splenectomy than primary wAIHA. CITA: Blood Res. 2017 Mar; 52(1):44-49 DOI: 10.5045/br.2017.52.1.44 PMID: 28425400 TÍTULO: The Direct-Acting Antivirals for Hepatitis C Virus and the Risk for Hepatocellular Carcinoma AUTORES: Chinchilla-López P, Qi X, Yoshida EM, Méndez-Sánchez N. SUMMARY: The increase of incidences of Hepatocellular Carcinoma (HCC) will continue in the next decades. The therapies about hepatitis C infection has been questioned as a risk factor. Some authors emphasized that sustained virologic response (SVR) with interferon-based therapy reduced the risk of de- veloping HCC. In contrast, some publications that to suggest an increasing risk of HCC in patients treated with Direct-Acting Antivirals (DAA). Whether these therapies are associated with an increased risk of HCC remains to be stud- ied and continued long-term observational studies will be needed. The goal in HCV care needs to go beyond merely achieving an SVR. CITA: Ann Hepatol. 2017 May - Jun; 16(3):328-330 DOI: 10.5604/16652681.1235473 PMID: 28425413 TÍTULO: Ursodeoxycholic Acid Therapy in Patients with Primary Biliary Cholangitis with Limited Liver Transplantation Availability AUTORES: Melchor-Mendoza YK, Martínez-Benítez B, Mina-Hawat A, Ro- dríguez-Leal G, Duque X, Moran-Villota S. INTRODUCTION: There is little information on survival rates of patients with primary biliary cholangitis (PBC) in developing countries. This is particular- ly true in Latin America, where the number of liver transplants performed remains extremely low for patients with advanced liver disease who fulfill criteria for liver transplantation. The goal of this study was to compare sur- vival rate of patients with PBC in developing countries who were treated with ursodeoxycholic acid (UDCA) versus survival of patients who received other treatments (OT) without UDCA, prescribed before the UDCA era. 240

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 28439896 MATERIAL AND METHODS: A retrospective study was performed, includ- ing records of78 patients with PBC in the liver unit in a third level referral hospital in Mexico City. Patients were followed for five years from initial diag- nosis until death related to liver disease or to the end of the study. Patients received UDCA (15 mg/kg/per day) (n = 41) or OT (n = 37) before introduc- tion of UDCA in Mexico. RESULTS: Response to treatment was higher in the group that received UDCA. In the five years of follow-up, survival rates were significantly higher in the UDCA group than in the OT group. The hazard ratio of death was high- er in the OT group vs. UDCA group, HR 8.78 (95% CI, 2.52-30.61); Mayo Risk Score and gender were independently associated with the risk of death. CONCLUSIONS: The study confirms that the use of UDCA in countries with a limited liver transplant program increases survival in comparison to other treatments used before the introduction of UDCA. CITA: Ann Hepatol. 2017 May - Jun; 16(3):430-435 DOI: 10.5604/16652681.1235486 TÍTULO: Topical corticosteroid phobia in atopic dermatitis: International fea- sibility study of the TOPICOP score AUTORES: Stalder JF, Aubert H, Anthoine E, Futamura M, Marcoux D, Mor- ren MA, Trzeciak M, Szalai Z, Veres K, Deleuran M, Vestergaard C, Boralevi F, Chu CY, De Raeve L, Svensson Å, Fölster-Holst R, Buchner M, Takaoka R, Aoki V, Chernyshov P, Chernyshova L, Murrell DF, Zhao C, Mckinster CD, Von Kobyletzky L, Eichenfield L, Totri C, Lio P, Seneschal J, Moret L, Barbarot S. BACKGROUND: Adherence to topical corticosteroids (TCS) is essential for the effective treatment of atopic dermatitis but can be limited by concerns about their use. This study examined the feasibility of applying the validated TOPICOP score for assessing TCS phobia across different countries. METHODS: This was a prospective multicentre feasibility study conducted in 21hospitals in 17 countries. Patients >3 months of age with atopic dermatitis or their parents or legal representatives completed a validated translation of the TOPICOP questionnaire in the country's native language. Respondents also completed questionnaires collecting opinions about the feasibility and acceptability of the TOPICOP questionnaire. RESULTS: A total of 1564 participants in 15 countries were included in the analysis. 81% of respondents considered the questions clear or very clear, and79% reported that it took less than 5 minutes to complete. Each of the individual items in the TOPICOP questionnaire was considered to be not at all difficult to answer by 49% to 74% of participants. The mean global TOP- ICOP score was44.7%±20.5. Mean TOPICOP subscores were 37.0±22.8% for knowledge and beliefs,54.7±27.8% for fears and 50.1±29.1% for be- haviours. Global scores and subscores differed between countries, although the subscores did not always vary in parallel, suggesting different levels of TCS phobia and different drivers foreach country. CONCLUSIONS: The TOPICOP score can be feasibly applied across coun- tries and may therefore be useful for obtaining qualitative and quantitative data from international studies and for adapting patient education and treatment. CITA: Allergy. 2017 Nov; 72(11):1713-1719 DOI: 10.1111/all.13189 241

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 28441001 TÍTULO: [Mexican Asthma Guidelines: GUIMA 2017] AUTORES: Larenas-Linnemann D, et al. BACKGROUND: The need for a national guideline, with a broad basis among specialists and primary care physicians was felt in Mexico, to try uni- fying asthma management. As several high-quality asthma guidelines exist worldwide, it was decided to select the best three for transculturation. METHODS: Following the internationally recommended methodology for guideline transculturation, ADAPTE, a literature search for asthma guide- lines, published1-1-2007 through 31-12-2015 was conducted. AGREE-II evaluations yielded 3/40 most suitable for transculturation. Their compound evidence was fused with local reality, patient preference, cost and safety considerations to draft the guideline document. Subsequently, this was ad- justed by physicians from 12national medical societies in several rounds of a Delphi process and 3face-to-face meetings to reach the final version. RESULTS: Evidence was fused from British Thoracic Society Asthma Guideline 2014, Global Initiative on Asthma 2015, and Guía Española del Manejo del Asma 2015(2016 updates included). After 3 Delphi-rounds we developed an evidence-based document taking into account patient charac- teristics, including age, treatment costs and safety and best locally available medication. CONCLUSIONS: In cooperation pulmonologists, allergists, ENT physicians, paediatricians and GPs were able to develop an evidence-based document for the prevention, diagnosis and treatment of asthma and its exacerbations in Mexico. CITA: Rev Alerg Mex. 2017; 64 Suppl 1:s11-s128 DOI: 10.29262/ram.v64i0.272 PMID: 28450668 TÍTULO: Impact of Surgery in Ebstein's Anomaly Using Current Surgical Criteria AUTORES: Ávila-Vanzzini N, Fritche-Salazar JF, Herrera-Bello H, Espino- la-Zavaleta N, Kuri Alfaro J, Rodriguez-Zanella H, Álvarez Bran MV, Cossio Aranda J, Gaxiola Macias MBA, Curi-Curi P. BACKGROUND: In Ebstein's anomaly (EA) current surgical criteria may not translate into better long-term survival. The aim of this study was therefore to determine if surgical treatment for EA increases survival, and to analyze factors associated with mortality. METHODS AND RESULTS: A retrospective study was carried out involving 103 patients with surgical indication using current criteria, comparing operat- ed (n=49; 47.5%) and non-operated patients (n=54; 52.4%); the severity of disease was similar in all cases. Overall follow-up was 12 years (range, 1-49 years). There were no differences in mortality: in the surgical and non-sur- gical groups, survival at 10 years was 92.8% vs. 90.7%; 20 years, 85.7%vs. 81.0%; and 30 years, 78.5% vs. 72.2%, respectively. On multivariate analy- sis right ventricular fractional shortening (RVFS) was associated with mortal- ity in both groups. Decreasing RVFS was associated with worse survival ac- cording to severity: when RVFS was <20%, survival at 20, 40 and 60 years was 58%, 39%, and12.5%, respectively (P<0.0013). Left ventricular ejection fraction also correlated with survival (P<0.0013). 242

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 28477792 CONCLUSIONS: Surgery did not translate into benefit in terms of survival, PMID: 28493631 and this was clearly associated with RV function; therefore, this should be a key factor in the surgical decision making. CITA: Circ J. 2017 Aug 25;81(9):1354-1359 DOI: 10.1253/circj.CJ-17-0062 TÍTULO: Physicians' experience and opinion on contraindications to aller- gen immunotherapy: The CONSIT survey AUTORES: Rodríguez Del Rio P, Pitsios C, Tsoumani M, Pfaar O, Paraskev- opoulos G, Gawlik R, Valovirta E, Larenas-Linnemann D, Demoly P, Calderón MA. BACKGROUND: Allergen immunotherapy (AIT) is the only disease-modify- ing treatment in allergy but several contraindications limit its use. OBJECTIVE: To collect the outcome of using AIT in theoretically contraindi- cated situations in real patients in the Contraindications to Specific Immuno Therapy (CONSIT) survey. METHODS: The CONSIT is an electronic European Academy of Allergy and Clinical Immunology survey conducted to gather the safety outcomes of pa- tients undergoing subcutaneous, sublingual, or venom AIT and the opinions of physicians on each of 17 selected conditions: children younger than 5 years; starting AIT during pregnancy; controlled severe asthma; arrhythmias; coronary disease; cancer; autoimmune disease; bone marrow and solid or- gan transplantation; human immunodeficiency virus and acquired immunode- ficiency syndrome; previous anaphylaxis during AIT; use of β-blockers, angio- tensin-converting inhibitors, cyclosporine, and methotrexate; and inability to communicate. Safety using AIT was reported in a 3-point scale: 1, \"no prob- lems\"; 2, \"minor problems\" (requiring only dose modifications); and 3, \"major problems\" (AIT not tolerated). Each physician was asked about the degree of contraindication that each condition should have: no contraindication (score 1), relative contraindication (score 2), or absolute contraindication (score 3). RESULTS: Five hundred twenty physicians (75% Europeans, 89% aller- gists) reported on approximately 45,000 patients undergoing AIT with any of these conditions. Major problems were infrequent, occurring more frequent- ly in patients with asthma (9.9%) and with previous anaphylaxis from AIT (9.5%). Regarding opinions, experienced physicians scored a significantly lower mean for all conditions than non-experienced physicians for all routes. CONCLUSION: Major problems were infrequent and experienced physi- cians were less likely to be restrictive in the use of AIT. CITA: Ann Allergy Asthma Immunol. 2017 May;118(5):621-628.e1 DOI: 10.1016/j.anai.2017.02.012 TÍTULO: Allergen immunotherapy for allergic rhinoconjunctivitis: A systemat- ic review and meta-analysis AUTORES: Dhami S, Nurmatov U, Arasi S, Khan T, Asaria M, Zaman H, Agarwal A, Netuveli G, Roberts G, Pfaar O, Muraro A, Ansotegui IJ, Calderon M, Cingi C, Durham S, van Wijk RG, Halken S, Hamelmann E, Hellings P, Jacobsen L, Knol E, Larenas-Linnemann D, Lin S, Maggina P, Mösges R, 243

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 28571502 Oude Elberink H, Pajno G, Panwankar R, Pastorello E, Penagos M, Pitsios C, Rotiroti G, Timmermans F, Tsilochristou O, Varga EM, Schmidt-Weber C, Wilkinson J, Williams A, Worm M, Zhang L, Sheikh A. BACKGROUND: The European Academy of Allergy and Clinical Immunolo- gy (EAACI) is in the process of developing Guidelines on Allergen Immuno- therapy (AIT) for Allergic Rhino conjunctivitis. To inform the development of clinical recommendations, we undertook a systematic review to assess the effectiveness, cost-effectiveness, and safety of AIT in the management of allergic rhino conjunctivitis. METHODS: We searched nine international biomedical databases for pub- lished, in-progress, and unpublished evidence. Studies were independently screened by two reviewers against predefined eligibility criteria and critically appraised using established instruments. Our primary outcomes of interest were symptom, medication, and combined symptom and medication scores. Secondary outcomes of interest included cost-effectiveness and safety. Data were descriptively summarized and then quantitatively synthesized using random-effects meta-analyses. RESULTS: We identified 5960 studies of which 160 studies satisfied our eligibility criteria. There was a substantial body of evidence demonstrating significant reductions in standardized mean differences (SMD) of symptom (SMD-0.53, 95% CI -0.63, -0.42), medication (SMD -0.37, 95% CI -0.49, -0.26), and combined symptom and medication (SMD -0.49, 95% CI -0.69, -0.30) scores while on treatment that were robust to prespecified sensitivity analyses. There was in comparison a more modest body of evidence on effectiveness post-discontinuation of AIT, suggesting a benefit in relation to symptom scores. CONCLUSIONS: AIT is effective in improving symptom, medication, and combined symptom and medication scores in patients with allergic rhino conjunctivitis while on treatment, and there is some evidence suggesting that these benefits are maintained in relation to symptom scores after dis- continuation of therapy. CITA: Allergy. 2017 Nov; 72(11):1597-1631 DOI: 10.1111/all.13201 TÍTULO: Liver toxicity mechanisms of herbs commonly used in Latin America AUTORES: López-Gil S, Nuño-Lámbarri N, Chávez-Tapia N, Uribe M, Barbero-Becerra VJ. SUMMARY: Mexico owns approximately 4500 medicinal plants species, a great diversity that position it at the second place after China. According to the Mexican health department, 90% of common population consumes them to treat various diseases. Additionally, herbal remedies in Latin America (LA) are considered a common practice, but the frequency of use and the liver damage related to its consumption is still unknown. Despite the high prevalence and indiscriminate herbal consumption, the exact mechanism of hepatotoxicity and adverse effects is not fully clarified and is still questioned. Some herb products associated with herb induced liver injury (HILI) are characterized by presenting a different chemical composition that may vary from batch to batch, also the biological activity of many medicinal plants and other natural products are directly related to their most active component 244

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR and its concentration. There are two main biological components that are associated with liver damage, alkaloids, and flavonoids, which are frequent constituents of commonly used herbs. The interaction with the different cy- tochrome P-450 isoforms, inflammatory, and oxidative activities seem to be the main damage pathway involved in the liver. Itis important to know the herbal adverse effects and mechanisms involved; therefore, this article is focused on the beneficial and deleterious effects as well as the possible tox- icity mechanisms and interactions of the herbs that are frequently used in LA, since the herb-host interaction may not always be the expected or desired depending on the clinical context in which it is administered. CITA: Drug Metab Rev. 2017 Aug; 49(3):338-356 DOI: 10.1080/03602532.2017.1335750 PMID: 28600696 TÍTULO: Efficacy and Safety of Switching from Innovator Rituximab to Bio- similar CT-P10 Compared with Continued Treatment with CT-P10: Results of a 56-Week Open-Label Study in Patients with Rheumatoid Arthritis AUTORES: Park W, Suh CH, Shim SC, Molina FFC, Jeka S, et al. BACKGROUND: CT-P10 is a biosimilar candidate of innovator rituximab (RTX) that demonstrated a comparable clinical profile to RTX in a phase I randomized controlled trial (RCT) in rheumatoid arthritis (RA) (ClinicalTrials. gov identifier: NCT01534884). OBJECTIVE: This open-label extension (OLE) study (NCT01873443) com- pared the efficacy and safety of CT-P10 in patients with RA who received CT-P10 from the outset (i.e., from the start of the RCT and also in the OLE; 'maintenance group') with those who received RTX during the RCT and switched to CT-P10 during the OLE ('switch group'). METHODS: Patients who completed the RCT were recruited. Based on the Disease Activity Score using 28 joints (DAS28) and predefined safety cri- teria, patients could receive up to two courses of CT-P10 during the OLE. Efficacy [DAS28 and European League Against Rheumatism (EULAR) re- sponse], safety and immunogenicity were assessed. RESULTS: Eighty-seven patients were enrolled; 58 and 29 had previous- ly received CT-P10 or RTX, respectively, in the RCT. Of these, 38 (65.5%) and 20 (69.0%) were treated with CT-P10 in the OLE and therefore com- prised the maintenance and switch groups, respectively. The mean change in DAS28-erythrocyte sedimentation rate (ESR) from baseline (week 0 of RCT) at week 24 of the first OLE treatment course in the maintenance and switch groups was -2.7 and -2.4, respectively. The proportion of patients with good/moderate EULAR responses was also comparable between groups. Antidrug antibodies were detected in 13.2 and 15.0% of patients in the main- tenance and switch groups, respectively, at week 24 of the first OLE course. CT-P10 treatment was well-tolerated when administered for up to 2 years or after switching from RTX. CONCLUSION: In this study population, comparable efficacy and safety pro- files were observed in patients who switched from RTX to CT-P10 and those maintained on CT-P10 throughout treatment. CITA: BioDrugs. 2017 Aug;31(4):369-377 DOI: 10.1007/s40259-017-0233-6 245

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 28602936 TÍTULO: Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision AUTORES: Brożek JL, (…) Larenas-Linnemann DE, et al. BACKGROUND: Allergic rhinitis (AR) affects 10% to 40% of the population. It reduces quality of life and school and work performance and is a frequent reason for office visits in general practice. Medical costs are large, but avoid- able costs associated with lost work productivity are even larger than those incurred by asthma. New evidence has accumulated since the last revision of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines in 2010, prompting its update. OBJECTIVE: We sought to provide a targeted update of the ARIA guidelines. METHODS: The ARIA guideline panel identified new clinical questions and selected questions requiring an update. We performed systematic reviews of health effects and the evidence about patients' values and preferences and resource requirements (up to June 2016). We followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) ev- idence-to-decision frameworks to develop recommendations. RESULTS: The 2016 revision of the ARIA guidelines provides both updat- ed and new recommendations about the pharmacologic treatment of AR. Specifically, it addresses the relative merits of using oral H1-antihistamines, intranasalH1-antihistamines, intranasal corticosteroids, and leukotriene re- ceptor antagonists either alone or in combination. The ARIA guideline panel provides specific recommendations for the choice of treatment and the ratio- nale for the choice and discusses specific considerations that clinicians and patients might want to review to choose the management most appropriate for an individual patient. CONCLUSIONS: Appropriate treatment of AR might improve patients' qual- ity of life and school and work productivity. ARIA recommendations support patients, their caregivers, and health care providers in choosing the optimal treatment. CITA: J Allergy Clin Immunol. 2017 Oct; 140(4):950-958 DOI: 10.1016/j.jaci.2017.03.050 PMID: 28611259 TÍTULO: Prevalence, Risk Factors, and Survival of Patients with Intrahepat- ic Cholangiocarcinoma AUTORES: Chinchilla-López P, Aguilar-Olivos NE, García-Gómez J, Hernández-Alejandro KK, Chablé-Montero F, Motola-Kuba D, Patel T, Méndez-Sánchez N. PURPOSE: To investigate the prevalence, related risk factors, and sur- vival of intrahepatic cholangiocarcinoma in a Mexican population. MATERIAL AND METHODS: We conducted a cross-sectional study at Med- ica Sur Hospital in Mexico City with approval of the local research ethics committee. We found cases by reviewing all clinical records of in-patients between October 2005 and January 2016 who had been diagnosed with ma- lignant liver tumors. Clinical characteristics and comorbidities were obtained to evaluate the probable risk factors and the Charlson index. The cases 246

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR were staged based on the TNM staging system for bile duct tumors used by the American Joint Committee on Cancer and median patient survival rates were calculated using the Kaplan-Meier method. RESULTS: We reviewed 233 cases of hepatic cancer. Amongst these, hepa- tocellular carcinomas represented 19.3% (n = 45), followed by intrahepatic cholangiocarcinomas, which accounted for 7.7% (n = 18). The median age of patients with intrahepatic cholangiocarcinoma was 63 years, and most of them presented with cholestasis and intrahepatic biliary ductal dilation. Unfor- tunately, 89% (n = 16) of them were in an advanced stage and 80% had multi- centric tumors. Median survival was 286 days among patients with advanced stage tumors (25th-75th interquartile range, 174-645 days). No correlation was found between the presence of comorbidities defined by the Charlson index, and survival. We evaluated the presence of definite and probable risk factors for the development of intrahepatic cholangiocarcinoma, that is, smoking, alcohol consumption, and primary sclerosing cholangitis. DISCUSSION: We found an overall prevalence of intrahepatic cholangiocar- cinoma of 7.7%; unfortunately, these patients were diagnosed at advanced stages. Smoking and primary sclerosing cholangitis were the positive risk factors for its development in this population. CITA: Ann Hepatol. 2017 Jul-Aug; 16(4):565-568 DOI: 10.5604/01.3001.0010.0293 PMID: 28611269 TÍTULO: The Role of TIPS in patients with Refractory Ascites and Portal Vein Thrombosis AUTORES: Chinchilla-López P, Hamdan-Pérez N, Guerrero-Ixtlahuac J, Barranco-Fragoso B, Méndez-Sánchez N. SUMMARY: Nowadays the contraindication for Transjugular intrahepatic portosystemic shunt (TIPS) in patients with portal vein thrombosis (PVT) had been modify. The experience and technology have reduced the complica- tions for this procedure. We report a case of refractory ascites and portal vein thrombosis to emphasize the role of TIPS in the treatment for this condi- tion. CITA: Ann Hepatol. 2017 Jul-Aug; 16(4):619-620 DOI: 10.5604/01.3001.0010.0310 PMID: 28612179 TÍTULO: Efficacy, Safety and Pharmacokinetics of Up to Two Courses of the Rituximab Biosimilar CT-P10 Versus Innovator Rituximab in Patients with Rheumatoid Arthritis: Results up to Week 72 of a Phase I Randomized Con- trolled Trial AUTORES: Yoo DH, Suh CH, Shim SC, Jeka S, Molina FFC, et al. BACKGROUND: CT-P10 is a biosimilar of innovator rituximab (RTX), a bio- logical therapy used to treat patients with rheumatoid arthritis (RA) who have responded inadequately to anti-tumor necrosis factor agents. OBJECTIVE: Our objective was to compare the clinical profile of CT-P10 versus RTX in patients with RA who received up to two courses of treatment and were followed for up to 72 weeks. 247

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 28617960 METHODS: In this multicenter double-blind phase I study, patients were ran- domized 2:1 to receive CT-P10 1000 mg or RTX 1000 mg at weeks 0 and 2. Based on disease activity, patients could receive a second course of treat- ment between weeks 24 and 48. Efficacy endpoints, including mean change from baseline in Disease Activity Score using 28 joints (DAS28), safety, im- munogenicity, pharmacokinetics, and pharmacodynamics were evaluated. RESULTS: In total, 154 patients were randomized to CT-P10 or RTX (n = 103 and 51, respectively); 137 (n = 92 and 45) completed the first course of treatment, of whom 83 (n = 60 and 23) were re-treated. Improvements from baseline in all efficacy endpoints were highly similar between the CT-P10 and RTX groups over both treatment courses. At week 24 after the second course, mean change from week 0 of the first course in DAS28 erythrocyte sedimentation rate was -2.47 and -2.04 for CT-P10 and RTX, respectively, (p = 0.1866) and in DAS28 C-reactive protein was -2.32 and -2.00, respectively (p = 0.3268). The proportion of patients positive for antidrug antibodies at week 24 after the second treatment course was 20.0% and 21.7% in the CT- P10 and RTX groups, respectively. The safety profile of CT-P10 was compa- rable to that of RTX, and pharmacokinetic and pharmacodynamic properties were similar. CONCLUSIONS: In patients with RA, efficacy, safety, and other clinical data were comparable between CT-P10 and RTX after up to two courses of treat- ment over 72 weeks. (ClinicalTrials.gov identifier NCT01534884). CITA: BioDrugs. 2017 Aug;31(4):357-367 DOI: 10.1007/s40259-017-0232-7 TÍTULO: Low prevalence of IgG antibodies against antigens of HEV geno- types 1 and 3 in women with a high-risk pregnancy AUTORES: Baptista-González H, Trueba-Gómez R, Rosenfeld-Mann F, Roque-Álvarez E, Méndez-Sánchez N. SUMMARY: The aim of the study was to assess whether high-risk pregnant women have a higher prevalence of HEV during the perinatal period. This was a cross-sectional study of 428 patients: Group 1, 127 women with a high-risk pregnancy; Group 2, 97asymptomatic people with reactivity to HCV or HBV; Group 3, 94 patients with clinical symptoms suggestive of HEV infection; and Group 4, 110 healthy blood donors from an urban area of Mexico City. ELISA was used to measure antibody to HEV genotypes 1 and 3. The prevalence rates of anti-HEV IgG antibodies were 0.79%in Group 1, 2.1% in Group 2, 7.4% in Group 3, and 0% in Group 4. Women with ahigh-risk pregnancy did not have a higher prevalence of HEV infection in this clinical setting. CITA: J Med Virol. 2017 Nov; 89(11):2051-2054 DOI: 10.1002/jmv.24878 PMID: 28675619 TÍTULO: Rivaroxaban recanalized occlusive superior mesenteric vein throm- bosis, but increased the risk of bleeding in a cirrhotic patient AUTORES: Qi X, Yoshida EM, Mendez-Sanchez N, Guo X. SUMMARY: Letter to the editor CITA: Liver Int. 2017 Oct; 37(10):1574-1575 DOI: 10.1111/liv.13511 248

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 28696784 TÍTULO: The role of tramadol in pain management in Latin America: a report by the Change Pain Latin America Advisory Panel AUTORES: Santos Garcia JB, Lech O, Campos Kraychete D, Rico MA, Hernández-Castro JJ, Colimon F, Guerrero C, Sempértegui Gallegos M, Lara-Solares A, Flores Cantisani JA, Amescua-Garcia C, Guillén Núñez MDR, Berenguel Cook MDR, Jreige Iskandar A, Bonilla Sierra P. OBJECTIVE: Change Pain Latin America (CPLA) was created to enhance chronic pain understanding and develop pain management improving strat- egies in this region. During its seventh meeting (August 2016), the main objective was to discuss tramadol's role in treating pain in Latin America. Furthermore, potential pain management consequences were considered, if tramadol was to become more stringently controlled. METHODS: Key topics discussed were: main indications for prescribing tramadol, its pharmacological characteristics, safety and tolerability, ef- fects of restrictions on its availability and use, and consequent impact on pain care quality. RESULTS: The experts agreed that tramadol is used to treat a wide spec- trum of non-oncological pain conditions (e.g. post-surgical, musculoskeletal, post-traumatic, neuropathic, fibromyalgia), as well as cancer pain. Its rele- vance when treating special patient groups (e.g. the elderly) is recognized. The main reasons for tramadol's high significance as a treatment option are: its broad efficacy, an inconspicuous safety profile and its availability, consid- ering that access to strong analgesics - mainly controlled drugs (classical opioids) – is highly restricted in some countries. The CPLA also agreed that tramadol is well tolerated, without the safety issues associated with long- term nonsteroidal anti-inflammatory drug (NSAID) use, with fewer opioid-like side effects than classical opioids and lower abuse risk. CONCLUSIONS: In Latin America, tramadol is a valuable and frequently used medication for treating moderate to severe pain. More stringent regu- lations would have significant impact on its availability, especially for outpa- tients. This could cause regression to older and frequently inadequate pain management methods, resulting in unnecessary suffering for many Latin American patients. CITA: Curr Med Res Opin. 2017 Sep; 33(9):1615-1621 DOI: 10.1080/03007995.2017.1354821 PMID: 28705040 TÍTULO: Minimal (Limited) Pseudohyperplastic Prostatic Adenocarcinoma in Needle Prostatic Biopsy AUTORES: Arista-Nasr J, Martinez-Benitez B, Mijangos-Trejo A, Born- stein-Quevedo L, Albores-Saavedra J. BACKGROUND: Study of minimum adenocarcinoma has been done almost exclusively on conventional acinar adenocarcinoma. Pseudohyperplastic ad- enocarcinoma can be confused with benign lesions because of its well-differ- entiated appearance and has not been studied when the biopsy shows few malignant glands (limited carcinoma). 249

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR METHODS: We reviewed 94 pseudohyperplastic adenocarcinomas diag- nosed in prostatic biopsies for a period of 12 years and selected those mea- suring less than 1 mm or involving less than 5% of the biopsied tissue. We also reviewed 200 consecutive consultations. RESULTS: Four (4.2%) of the 94 cases were limited pseudohyperplastic adenocarcinomas, and 3 were from consultations. Three of them were mis- taken for hyperplastic nodules, prostatic adenosis, or prostatic intraepithelial neoplasm. The number of glands varied between 6 and 50 (average 23). Three nodular histological patterns were identified-nodular, adenosis-like, and pseudohyperplastic carcinoma resembling prostatic intraepithelial neo- plasia. The diagnosis of adenocarcinoma was not related to the number of neoplastic glands. Histological criteria that were useful included: crowded medium to large glands, papillary infoldings, branching glands, straight lu- minal borders, hyperchromatic nuclei, nucleomegaly, and apparent nucleoli. Areas of transition to conventional acinar adenocarcinoma were useful in recognizing four of these neoplasms, but were barely apparent in 2 of them. Hyperchromatic nuclei were found in all cases, whereas apparent nucleoli and nucleomegaly were only present in 4. CONCLUSIONS: The architectural and cytological criteria for limited acinar adenocarcinoma are only partially useful in interpreting minimum pseudohy- perplastic adenocarcinomas. Knowledge of the criteria for malignancy in both neoplasms is important in order to avoid under diagnosis of malignancy. CITA: Int J Surg Pathol. 2017 Oct; 25(7):576-584 DOI: 10.1177/1066896917715910 PMID: 28741324 TÍTULO: [Endoscopic treatment for the posterior impingement of the ankle] AUTORES: Cuéllar-Avaroma A, King-Hayata MA, Martínez-de Anda MC, King-Martínez M, King-Martínez AC. BACKGROUND: Chronic pain on the posterior portion of the ankle is often due to posterior impingement between bony or soft tissue structures. The presence of an os trigonum or a prominent posterior apophysis of the talus can produce this impingement. The purpose of this study was to assess the outcome of hindfoot endoscopy in patients with a diagnosis of posterior an- kle impingement. MATERIAL AND METHODS: We studied 24 individuals who underwent a posterior ankle endoscopic procedure during the period between 2008 and 2012, with the diagnosis of posterior ankle impingement. We analyzed vari- ables such as: sport, level of sports activity according to the CLAS classifica- tion, return to sport. All patients were classified in accordance to the AOFAS and SFMCP (Société Française de Médecine et Chirurgie du Pied) scores for ankle pathology. We measured patient satisfaction to the procedure with the Linkert scale. RESULTS: The average follow-up was 27.13 ± 5.26 months. The average age of our patients was 31.8 ± 5.26 years. We had 19 male (79.2%) and five female (20.8%) patients. The average preoperative Visual Analog Scale of pain (VAS) 5.75 and postoperative was 0.95. The average preoperative AO- FAS scale of 76.22 ± 5.29 rose to 97.21 ± 1.96. The average preoperative SFCMP scale of 77.16 ± 3.53 became98.54 ± 1.38. Our patients had their ankles immobilized for an average of 19.75 ±2.48 days. They returned to 250