RESUMEN INVESTIGADORES-2

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR METHODS: Systematic literature search in PubMed and GREAT. With meth- odological support and using the Delphi method, a formal consensus was developed among 16experts in Dermatology and Allergology, based on the current evidence and its applicability in the Mexican context. Apart from in- tense electronic communication, several issues of disagreement were dis- cussed in two face-to-face meetings. RESULTS: The clinical experts reached consensus on 46 statements relat- ed to the definition, classification, diagnostic strategies and treatment of AD. For the diagnosis we suggest the Williams criteria and for severity scoring the SCORAD (by the doctor) and POEM (by the patient). In addition to gen- eral care and treatment education (workshops), we suggest four steps for treatment, depending on severity: 1. Topical treatment with anti-inflammatory agents (and systemic: antihistamines/antileukotrienes -low level evidence-) 2. Phototherapy, 3. Cyclosporin A and 4. Dupilumab, with the possibility of managing this biological earlier on if a fast effect is needed. In extrinsic AD we suggest evaluating the addition of allergen immunotherapy or an elimina- tion diet, if there is an IgE-mediated respiratory or food allergy, respectively. CONCLUSION: The panel of experts reached consensus on relevant as- pects of AD with a focus on the transcultural adaptation of recent evidence. CITA: Rev Alerg Mex. 2018;65 Suppl 2:s8-s88 DOI: 10.29262/ram.v65i6.526 PMID: 30280635 TÍTULO: Pembrolizumab plus Chemotherapy for Squamous Non-Small-Cell Lung Cancer AUTORES: Paz-Ares L, Luft A, Vicente D, Tafreshi A, Gümüş M, Mazières J, Hermes B, Çay Şenler F, Csőszi T, Fülöp A, Rodríguez-Cid J, Wilson J, Sugawara S, Kato T, Lee KH, Cheng Y, Novello S, Halmos B, Li X, Lubiniecki GM, Piperdi B, Kowalski DM BACKGROUND: Standard first-line therapy for metastatic, squamous non- small-cell lung cancer (NSCLC) is platinum-based chemotherapy or pem- brolizumab (for patients with programmed death ligand 1 [PD-L1] expression on ≥50% of tumor cells). More recently, pembrolizumab plus chemotherapy was shown to significantly prolong overall survival among patients with non squamous NSCLC. METHODS: In this double-blind, phase 3 trial, we randomly assigned, in a 1:1ratio, 559 patients with untreated metastatic, squamous NSCLC to re- ceive 200 mg of pembrolizumab or saline placebo for up to 35 cycles; all the patients also received carboplatin and either paclitaxel or nanoparticle albumin-bound[nab]-paclitaxel for the first 4 cycles. Primary end points were overall survival and progression-free survival. RESULTS: After a median follow-up of 7.8 months, the median overall sur- vival was 15.9 months (95% confidence interval [CI], 13.2 to not reached) in the pembrolizumab-combination group and 11.3 months (95% CI, 9.5 to 14.8) in the placebo-combination group (hazard ratio for death, 0.64; 95% CI, 0.49 to 0.85; P<0.001). The overall survival benefit was consistent re- gardless of the level of PD-L1 expression. The median progression-free sur- vival was 6.4 months (95% CI,6.2 to 8.3) in the pembrolizumab-combination group and 4.8 months (95% CI, 4.3 to5.7) in the placebo-combination group (hazard ratio for disease progression or death, 0.56; 95% CI, 0.45 to 0.70; P<0.001). Adverse events of grade 3 or higher occurred in 69.8% of the pa- tients in the pembrolizumab-combination group and in68.2% of the patients in the placebo-combination group. Discontinuation of treatment because of 301

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 30288280 adverse events was more frequent in the pembrolizumab-combination group PMID: 30290691 than in the placebo-combination group (13.3% vs. 6.4%). CONCLUSIONS: In patients with previously untreated metastatic, squa- mous NSCLC, the addition of pembrolizumab to chemotherapy with car- boplatin plus paclitaxel or nab-paclitaxel resulted in significantly longer overall survival and progression-free survival than chemotherapy alone. (Funded by Merck Sharp &Dohme; KEYNOTE-407 ClinicalTrials.gov num- ber, NCT02775435.). CITA: N Engl J Med. 2018 Nov 22;379(21):2040-2051 DOI: 10.1056/NEJMoa1810865 TÍTULO: Association of proton pump inhibitors with the risk of hepatic en- cephalopathy during hospitalization for liver cirrhosis AUTORES: Zhu J, Qi X, Yu H, Yoshida EM, Mendez-Sanchez N, Zhang X, Wang R, Deng H, Li J, Han D, Guo X. BACKGROUND: Hepatic encephalopathy is associated with altered gut mi- crobiota. Proton pump inhibitors increase the risk of small bowel bacterial overgrowth. OBJECTIVES: This was a case-control study aimed at exploring the rela- tionship of proton pump inhibitor use with the risk of hepatic encephalopathy during hospitalization in liver cirrhosis. METHODS: Case and control groups were defined as cirrhotic patients who developed hepatic encephalopathy during hospitalization and those without hepatic encephalopathy at admission or during hospitalization, respective- ly. Age, gender, and Child-Pugh score were matched between the groups. Odds ratios with 95%confidence intervals were calculated to express the association of proton pump inhibitors with the risk of hepatic encephalopathy. Four subgroup analyses were performed after excluding patients with acute upper gastrointestinal bleeding, infections, and in-hospital death, and after matching model for end-stage liver disease score. RESULTS: In the overall analysis, 128 patients were included in each group of cases and controls. The proportion of proton pump inhibitor use was sig- nificantly higher in the case group than the control group (79.7% vs 43%, p < 0.001). Proton pump inhibitor use (odds ratio = 3.481, 95% confidence interval: 1.651-7.340,p = 0.001) was independently associated with the de- velopment of hepatic encephalopathy in the multivariate analysis. In the four subgroup analyses, proton pump inhibitor use remained independently asso- ciated with the risk of hepatic encephalopathy. CONCLUSION: Proton pump inhibitor use might increase the risk of hepatic encephalopathy during hospitalization. CITA: United European Gastroenterol J. 2018 Oct;6(8):1179-1187 DOI: 10.1177/2050640618773564 TÍTULO: Management of primary biliary cholangitis: the importance to identi- fy patients' non-responders to standard treatment AUTORES: Méndez-Sánchez N. 302

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 30363965 SUMMARY: Editorial PMID: 30386555 CITA: Minerva Med. 2018 Dec;109(6):407-409 DOI: 10.23736/S0026-4806.18.05869-X TÍTULO: Vasoconstrictors in combination with proton pump inhibitors as an initial treatment of acute upper gastrointestinal bleeding in liver cirrhosis: is it evidence based? AUTORES: Gao F, Méndez-Sánchez N, Qi X. SUMMARY: Editorial CITA: Ann Transl Med. 2018 Aug;6(16):327 DOI: 10.21037/atm.2018.08.07 TÍTULO: MASK 2017: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma multimorbidity using real-world-evidence AUTORES: Bousquet J, (…) Larenas-Linnemann D, et al. ABSTRACT: mHealth, such as apps running on consumer smart devices is becoming increasingly popular and has the potential to profoundly af- fect healthcare and health outcomes. However, it may be disruptive and results achieved are not always reaching the goals. Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline using the best evidence-based approach to care pathways suited to real-life using mobile technology in allergic rhinitis (AR) and asthma multimorbidity. Patients large- ly use over-the-counter medications dispensed in pharmacies. Shared de- cision making centered around the patient and based on self-management should be the norm. Mobile Airways Sentinel networK (MASK), thePhase 3 ARIA initiative, is based on the freely available MASK app (the Allergy- Diary, Android and iOS platforms). MASK is available in 16 languages and deployedin 23 countries. The present paper provides an overview of the methods used inMASK and the key results obtained to date. These include a novel phenotypiccharacterization of the patients, confirmation of the im- pact of allergic rhinitison work productivity and treatment patterns in real life. Most patients appear toself-medicate, are often non-adherent and do not follow guidelines. Moreover, theAllergy Diary is able to distinguish between AR medications. The potentialusefulness of MASK will be further explored by POLLAR (Impact of Air Pollution onAsthma and Rhinitis), a new Horizon 2020 project using the Allergy Diary. CITA: Clin Transl Allergy. 2018 Oct 25;8:45 DOI: 10.1186/s13601-018-0227-6 PMID: 30399395 TÍTULO: Varenicline for long term smoking cessation in patients with COPD AUTORES: Hernández Zenteno RJ, Lara DF, Venegas AR, Sansores RH, Pineda JR, Trujillo FF, Pérez Padilla JR, Matera MG, Cazzola M. BACKGROUND: Quitting smoking is key for patients with Chronic Obstruc- tive Pulmonary Disease (COPD). Standard recommendations for quitting 303

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR smoking are implemented for COPD as well. Varenicline Tartrate (VT) is the most effective drug to help quit smoking, but few studies have analysed its effectiveness. AIM OF THE STUDY: To determine the Abstinence Rate (AR) at 12 months, in COPD and non-COPD smokers. METHODS: Observational study in 31 COPD (post bronchodilator-BD FEV1/FVC <0.70) and in 63 non-COPD smokers, were invited to receive treatment with Varenicline Tartrate (VT). Fourteen subjects with COPD and 46 non-COPD subjects received additionally Cognitive-Behavioral Therapy (CBT). Abstinence rate (AR) was validated by exhaled carbon monoxide CO (COe), in addition to a phone or face-to-face interview. Motivation score was measured with a visual analogue scale (MS). RESULTS: Differences between COPD and non-COPD, mean FEV1/FVC ratio 0.52 ± 0.10vs. 0.90 ± 0.15, age 60 ± 10 vs. 47 ± 10 years, smoking pack-years 37 ± 3.5 vs. 22 ± 12, and COe 16 ± 11 vs. 12 ± 9 ppm were sta- tistically significant (p < 0.05); for MS the score was 93 ± 11 vs. 93 ± 11 and for attempts to quit (AQ) 2 ± 2 vs. 2 ± 3 were not. AR was not significantly different at 12 months (61.2 vs. 42.8% p = 0.072). Motivation was the only significant one-year AR predictor. CONCLUSIONS: COPD smokers had a similar response (higher tendency) to VT regardless of the presence of airflow obstruction and stronger nicotine addiction. CITA: Pulm Pharmacol Ther. 2018 Dec;53:116-120 DOI: 10.1016/j.pupt.2018.11.001 PMID: 30483506 TÍTULO: Macrophage Exposure to Polycyclic Aromatic Hydrocarbons From Wood Smoke Reduces the Ability to Control Growth of Mycobacterium tuber- culosis AUTORES: Sada-Ovalle I, Chávez-Galán L, Vasquez L, Aldriguetti S, Ro- sas-Perez I, Ramiréz-Venegas A, Perez-Padilla R, Torre-Bouscoulet L. SUMMARY: Use of solid fuels for cooking or home heating has been related to various diseases of the respiratory tract. Wood smoke contains a mixture of carcinogenic polycyclic aromatic hydrocarbons (PAHs) and volatile or- ganic compounds. Inhalation of these materials induces local and systemic changes in the immune system which may impair critical cell defense mech- anisms; however, few studies have investigated the early effects that PAH exposures have on immune cells as macrophages. The aim of this study was to analyze if the pre-exposure to PAHs derived from wood smoke dete- riorates macrophage ability to control the intracellular growth of Mycobacte- rium tuberculosis. By using an in vitro experimental model, we analyzed the phenotype and some metabolic changes on THP-1and monocyte-derived macrophages. Our results demonstrated that exposure to PAHs leads to cell activation and deteriorates mitochondrial function of the macrophage thus facilitating growth of M. tuberculosis. CITA: Front Med (Lausanne). 2018 Nov 13;5:309 DOI: 10.3389/fmed.2018.00309 304

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 30507894 TÍTULO: Demographic and clinical characteristics, and adverse reactions of people with overweight and obesity consumers of orlistat, attended by a call center (2009 - 2017) AUTORES: Rizo Treviño S. INTRODUCTION: Chronic diseases are on the rise and are associated with weight gain. Multidisciplinary strategies are required for its control. METHODS: The design was descriptive, observational and retrospective. The objectives of this communication were to describe the demographic and clinical characteristics and adverse reactions of overweight and obese people who were consumers of orlistat, attended by a call center during the period 2009 to 2017; and to identify the healthcare professional most con- sulted by them. The information was obtained from an existing database of a program of attention to people with overweight or obesity, interested in using orlistat (prospects) or users (patients). The study was carried out in Mexico and lasted seven years. The variables studied were demographic, clinical and adverse reactions. RESULTS: A total of 311,913 requests were collected from 126 607 subjects (104711 prospects interested in consuming orlistat and 21 896 patients who already took it). The main activities were phone calls to the subject (35.9%). There were104 711 requests: 82 810 (79.1%) prospects and 21 896 (20.9%) patients. 79.9% of all were female. The predominant age interval was 32 to 45 years. 43 adverse reactions (0.02%) were detected; the most common were abdominal pain (0.05%) and headache (0.03%). CONCLUSIONS: The population most interested in weight control in this study was the female population (79.9%) and the age group from 32 to 45 years. The most consulted healthcare professional was the nutritionist. Only the body mass index (29.2 kilograms per square meter) of the subjects who developed 43 adverse reactions was obtained. There were 43 adverse reac- tions, the most common being abdominal pain and headache. CITA: Medwave. 2018 Oct 16;17(6):e7288 DOI: 10.5867/medwave.2018.06.7288 PMID: 30534017 TÍTULO: Chemotherapy and molecular therapy in cervical cancer AUTORES: Regalado Porras GO, Chávez Nogueda J, Poitevin Chacón A. SUMMARY: In recent years, the treatment of locally-advanced and metastat- ic cervical cancer has improved greatly due to the introduction of targeted therapies, new chemotherapy combinations, and emerging treatments. Can- didates for potentially curative treatment are those patients with good func- tional status without associated comorbidities. Numerous trials have demon- strated that chemotherapy prolongs survival versus supportive care alone. In addition, polychemotherapy schemes are superior to single agent regimens. Targeted molecular agents have proven beneficial in the treatment of cervi- cal cancer. Second-line treatment should be considered standard practice in patients with good functional status. Finally, given the poor survival out- comes in patients with metastatic disease, participation in clinical studies should always be considered the best option. CITA: Rep Pract Oncol Radiother. 2018 Nov-Dec;23(6):533-539 DOI: 10.1016/j.rpor.2018.09.002 305

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 30534018 TÍTULO: The role of para-aortic nodal irradiation in cervical cancer PMID: 30568947 AUTORES: Poitevin Chacón A, Chavez-Nogueda J, Ramos-Prudencio R, Villavicencio-Queijeiro MA, Lozano-Ruiz F. SUMMARY: The current standard of care for locally advanced cervical can- cer is whole pelvis and para-aortic radiation when indicated, delivered con- comitantly with chemotherapy and brachytherapy. Para-aortic node involve- ment is a predictor of survival in locally advanced disease but presence of metastases is difficult to determine because the currently available imaging methods lack enough sensitivity to be able to detect accurately para-aortic metastases when surgical staging is not feasible. The objective of this re- view is to describe the current status of para-aortic lymph node irradiation in locally advanced cervical cancer. It includes analysis of the diagnostic imaging and surgical approaches for assessment of para-aortic lymph node dissemination, together with indications for radiotherapy and radiotherapeu- tic techniques. CITA: Rep Pract Oncol Radiother. 2018 Nov-Dec;23(6):540-546 DOI: 10.1016/j.rpor.2018.09.009 TÍTULO: Current trends of liver cirrhosis in Mexico: Similitudes and differ- ences with other world regions AUTORES: Méndez-Sánchez N, Zamarripa-Dorsey F, Panduro A, Purón- González E, Coronado-Alejandro EU, Cortez-Hernández CA, Higuera de la Tijera F, Pérez-Hernández JL, Cerda-Reyes E, Rodríguez-Hernández H, Cruz-Ramón VC, Ramírez-Pérez OL, Aguilar-Olivos NE, Rodrí- guez-Martínez OF, Cabrera-Palma S, Cabrera-Álvarez G. AIM: To investigate the main current etiologies of cirrhosis in Mexico. METHODS: We performed a cross-sectional retrospective multicenter study that included eight hospitals in different areas of Mexico. These hospitals provide health care to people of diverse social classes. The inclusion criteria were a histological, clinical, biochemical, endoscopic, or imaging diagno- sis of liver cirrhosis. Data were obtained during a 5-year period (January 2012-December2017). RESULTS: A total of 1210 patients were included. The mean age was 62.5 years (SD = 12.1), and the percentages of men and women were similar (52.0% vs 48.0%). The most frequent causes of liver cirrhosis were hepatitis C virus (HCV) (36.2%), alcoholic liver disease (ALD) (31.2%), and nonalco- holic steatohepatitis (23.2%), and the least frequent were hepatitis B virus (1.1%), autoimmune disorders (7.3%), and other conditions (1.0%). CONCLUSION: HCV and ALD are the most frequent causes of cirrhosis in Mexico. However, we note that non-alcoholic fatty liver disease (NAFLD) as an etiology of cirrhosis increased by 100% compared with the rate noted pre- viously. We conclude that NAFLD will soon become one of the most frequent etiologies of liver cirrhosis in Mexico. CITA: World J Clin Cases. 2018 Dec 6;6(15):922-930 DOI: 10.12998/wjcc.v6.i15.922 306

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR 2019 PMID: 28521684 TÍTULO: The Role of Diet in Patients with Metabolic Syndrome PMID: 29678362 AUTORES: Almeda-Valdes P, Herrera-Mercadillo RJ, Aguilar-Salinas CA, Uribe M, Méndez-Sánchez N. SUMMARY: Metabolic syndrome is a frequent metabolic disorder character- ized by obesity and insulin resistance seems to be the main pathophysiolog- ical alteration. The goal of treating metabolic syndrome is to reduce the risk of coronary heart disease and the development of type 2 diabetes. The life- style modification therapy combines specific recommendations on diet alone or combined with other strategies. In this review, we address the following topics: 1) the importance of the high prevalence of metabolic syndrome and obesity, and 2) the role of lifestyle modification focusing on dietary fat intake in the management of MS. CITA: Curr Med Chem. 2019; 26(19):3613-3619 DOI: 10.2174/0929867324666170518095316 TÍTULO: Bowel symptoms in patients that receive proton pump inhibitors. Results of a multicenter survey in Mexico AUTORES: Schmulson MJ, Frati-Munari AC. INTRODUCTION: Proton pump inhibitors (PPIs) have been associated with small intestinal bacterial overgrowth (SIBO), which increases with prolonged PPI use, and SIBO has been associated with irritable bowel syndrome (IBS). OBJECTIVE: The aim of the present study was to study the prevalence of bowel symptoms in patients treated with PPIs in Mexico. METHODS: Gastroenterologists in 36 cities surveyed patients treated with PPIs, utilizing an ad hoc questionnaire to determine the presence of bowel symptoms and IBS. RESULTS: Two hundred and fifteen physicians interviewed 1,851 patients. PPI indications were gastritis (48.8%), gastroesophageal reflux (38.5%), peptic ulcer (6.2%), and others (6.5%). A total of 77.5% of the patients re- ceived treatment for ≤6 months and 11.9% for ≥1 year. Symptoms were reported in 92.3% of the patients: abnormal bowel habits (90%), bloating (82%), abdominal pain (63%), flatulence (58%), and abdominal discomfort (53%). A total of 67.5% of the patients fit the Rome III criteria for IBS. Symp- toms presented in 55.9% of the patients before PPI intake and in 44.1% of the patients after PPI use (P<.005). Constipation (63.8%) predominated in the former, and diarrhea (56.5%) in the latter (P<.0001). The treatments prescribed for managing those symptoms were antispasmodics, antibiotics, prokinetics, and anti flatulents, but patients stated greater satisfaction with antibiotics (mainly rifaximin) (P<.0001). CONCLUSION: The association of PPIs with bowel symptoms and IBS is frequent in Mexico. Diarrhea and bloating predominate, and antibiotics pro- duce the greatest treatment satisfaction, suggesting that SIBO or dysbiosis is the cause of the PPI-related bowel symptoms. However, that remains to be confirmed. CITA: Rev Gastroenterol Mex. 2019 Jan - Mar; 84(1):44-51 DOI: 10.1016/j.rgmx.2018.02.008 307

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 30001639 TÍTULO: Hematoxylin: Mesoamerica's Gift to Histopathology. Palo de Campeche (Logwood Tree), Pirates' Most Desired Treasure, and Irreplace- able Tissue Stain AUTORES: Ortiz-Hidalgo C, Pina-Oviedo S. SUMMARY: Hematoxylin is a basic dye derived from the heartwood of Palo de Campeche (Haematoxylum campechianum), the logwood tree native to Mexico and Central America. Haematoxylum means \"bloodwood\" in refer- ence to its dark-red heart wood and campechianum refers to its site of origin, the coastal city of Campeche on the Yucatan Peninsula, Mexico. Hematox- ylin is colorless but it turns into the color dye hematein after oxidation (rip- ening). The dyeing property of logwood was well-known to the natives of the Yucatan Peninsula before the arrival of the Spaniards who brought it to Europe shortly after the discovery of the Americas. An important trade soon developed related to growing and preparing hematoxylin for dyeing fabrics. Pirates discovered that one shipload of logwood was equivalent to a year's value from any other cargo, and by 1563, more than 400pirate vessels wan- dered the Atlantic Ocean and attacked Spanish galleons transporting gold, silver, and logwood from the Americas to Europe. Hematoxylin and eosin is a staining method that dates back to the late 19th century. In 1865 and 1891, Böhmer and Meyer, respectively, first used hematoxylin in combination with a mordant (alum). Later, with the use of anilines by Ehrlich, the repertoire of stains expanded rapidly resulting in the microscopic descriptions of multiple diseases that were defined by their stainable features. Today hematoxylin, along with eosin, remains the most popular stain in histology. CITA: Int J Surg Pathol. 2019 Feb;27(1):4-14 DOI: 10.1177/1066896918787652 PMID: 30131604 TÍTULO: Androgen-targeted therapy in men with prostate cancer: evolving practice and future considerations AUTORES: Crawford ED, Heidenreich A, Lawrentschuk N, Tombal B, Pompeo ACL, Mendoza-Valdes A, Miller K, Debruyne FMJ, Klotz L. BACKGROUND: Androgen deprivation therapy (ADT) is foundational in the management of advanced prostate cancer (PCa) and has benefitted from a recent explosion in scientific advances. These include approval of new therapies that suppress testosterone (T) levels or inactivate its function, improvements in diagnostic and assay technologies, identification of low- er therapeutic targets for T, discovery of the relevance of germline genetic mutations and identification of the benefits of sequential and combination therapies. METHODS: This review discusses the clinical profiles of the most up-to-date options for ADT, best practices for managing patients with advanced PCa and future directions in therapy. RESULTS AND CONCLUSIONS: Modern assay technologies reveal that bilateral orchiectomy results in a serum T level of approximately 15 ng/dL as compared to the historical definition of castration of T < 50 ng/dL. Evidence shows that lowering T levels to <20 ng/dL improves patient survival and de- lays disease progression. Routine monitoring of T in addition to prostate-spe- cific antigen throughout treatment is important to ensure continuing efficacy of T suppression. New drugs that inhibit androgen signaling in combination 308

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 30196155 with traditional ADT suppress T activity to near zero and have significant- ly improved patient survival. When personalizing ADT regimens physicians should consider a number of factors including initiation and duration of ADT, monitoring of T levels and PSA, the possibility of switching monotherapies if a patient does not achieve adequate T suppression, and consideration of in- termittent vs. continuous ADT according to patients' lifestyles, comorbidities, risk factors and tolerance to treatment. CITA: Prostate Cancer Prostatic Dis. 2019 Mar;22(1):24-38 DOI: 10.1038/s41391-018-0079-0 TÍTULO: Range of Normal Liver Stiffness and Factors Associated With Increased Stiffness Measurements in Apparently Healthy Individuals AUTORES: Bazerbachi F, Haffar S, Wang Z, Cabezas J, Arias-Loste MT, Crespo J, Darwish-Murad S, Ikram MA, Olynyk JK, Gan E, Petta S, Berzuini A, Prati D, de Lédinghen V, Wong VW, Del Poggio P, Chávez-Tapia NC, Chen YP, Cheng PN, Yuen MF, Das K, Chowdhury A, Caballeria L, Fabrellas N, Ginès P, Kumar M, Sarin SK, Conti F, Andreone P, Sirli R, Cortez-Pinto H, Carvalhana S, Sugihara T, Kim SU, Parikh P, Chayama K, Corpechot C, Kim KM, Papatheodoridis G, Alsebaey A, Kamath PS, Murad MH, Watt KD. BACKGROUND & AIMS: Transient elastography (TE) is a noninvasive technique used to measure liver stiffness to estimate the severity of fibrosis. The range of liver stiffness measurements (LSMs) in healthy individuals is unclear. We performed a systematic review to determine the range of LSMs, examined by TE, in healthy individuals and individuals who are susceptible to fibrosis. METHODS: We collected data from 16,082 individuals, in 26 cohorts, iden- tified from systematic searches of Embase, Ovid MEDLINE, Cochrane Cen- tral Register of Controlled Trials, and Cochrane Database of Systematic Re- views for studies of liver stiffness measurements. Studies analyzed included apparently healthy adults (normal levels of liver enzymes, low-risk alcohol use patterns, and negative for markers of viral hepatitis). The presence of diabetes, hypertension, dyslipidemia, or steatosis, based on ultrasound ex- amination, was known for most participants. We performed a meta-analysis of data from individual participants. The cohort was divided into 4 groups; participants with a body mass index <30kg/m2 were examined with the me- dium probe and those with a body mass index ≥30kg/m2 were examined with the extra-large probe. Linear regression models were conducted after adjusting for potential confounding factors of LSMs. We performed several sensitivity analyses. RESULTS: We established LSM ranges for healthy individuals measured with both probes-these did not change significantly in sensitivity analyses of individuals with platelets ≥150,000/mm3 and levels of alanine amino- transferase ≤33 IU/L in men or ≤25 IU/L in women. In multivariate analysis, factors that modified LSMs with statistical significance included diabetes, dyslipidemia, waist circumference, level of aspartate aminotransferase, and systolic blood pressure at examination time. Significant increases in LSMs were associated with the metabolic syndrome in individuals examined by either probe. Diabetes in obese individuals increased the risk of LSMs in the range associated with advanced fibrosis. CONCLUSIONS: In a systematic review and meta-analysis of data from in- dividual participants, we established a comprehensive set of LSM ranges, 309

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 30222900 measured by TE in large cohorts of healthy individuals and persons sus- PMID: 30239004 ceptible to hepatic fibrosis. Regression analyses identified factors associat- ed with increased LSMs obtained by TE with the medium and extra-large probes. CITA: Clin Gastroenterol Hepatol. 2019 Jan;17(1):54-64.e1 DOI: 10.1016/j.cgh.2018.08.069 TÍTULO: Granular cell astrocytoma: an aggressive IDH-wildtype diffuse glio- ma with molecular genetic features of primary glioblastoma AUTORES: Vizcaino MA, Palsgrove DN, Yuan M, Giannini C, Cabrera-Al- dana EE, Pallavajjala A, Burger PC, Rodriguez FJ. SUMMARY: Granular cell astrocytoma (GCA) is a rare adult infiltrating glio- ma subtype. We studied a series of 39 GCAs. Median age of presentation was 57.8 years and most cases developed in the frontal or temporal lobes. Tumors included grade II(n = 14), grade III (n = 11), and grade IV (n = 14) by WHO criteria. Granular cell morphology was diffuse in 31 (79%) cases and partial in eight (21%). Immunohistochemistry showed frequent positivity for GFAP (28 of 31), OLIG2 (16 of16), and CD68 (27 of 30), but HAM56, CD163, and IBA-1 histio- cytic markers were all negative (22 of 22). IDH1(R132H) was negative in all the cases tested (16 of 16), while ATRX expression was retained (12 of 12). Cytogenetics demonstrated monosomy 10 (6 of 6) cases, +7 in 4 (of 6), -13q in 4 of 6, and -14 in 4 of 6. Next-generation sequencing demonstrated muta- tions in PTEN/PIK3 genes in 6/13(46%), NF1 in 3 of 10 (30%), TP53 in 3 of 13 (23%), PALB2 in 3 of 10 (30%), STAG2in 3 of 10 (30%), EGFR mutation/ amplification in 3 of 13 (23%), and AR in 2 of 10(20%). CDKN2A/B deletion was identified in 5 of 13 (30%) cases (homozygous deletion in 4). The TERT C228T mutation was identified in 9 of 13 (69%). No mutations were encoun- tered in IDH1, IDH2, CIC, FUBP1, H3F3A, BRAF or ATRX genes. The mean overall survival was 11.3 months. Patients >60 years old at diagnosis had a worse survival than patients <60 years (P = 0.001). There were no statisti- cally significant differences in survival by WHO grade, extent of granular cell change, sex or MIB-1 (P > 0.05). GCA is a variant of IDH-wild type diffuse glioma with aggressive behavior irrespective of grade and extent of granular cell morphology, and with molecular genetic features corresponding to pri- mary glioblastoma. CITA: Brain Pathol. 2019 Mar;29(2):193-204 DOI: 10.1111/bpa.12657 TÍTULO: Cholesterol burden in the liver induces mitochondrial dynamic changes and resistance to apoptosis AUTORES: Domínguez-Pérez M, Simoni-Nieves A, Rosales P, Nuño-Lám- barri N, Rosas-Lemus M, Souza V, Miranda RU, Bucio L, Uribe Carvajal S, Marquardt JU, Seo D, Gomez-Quiroz LE, Gutiérrez-Ruiz MC. SUMMARY: Non-alcoholic fatty liver disease (NAFLD) encompasses a broad spectrum of histopathological changes ranging from non-inflammato- ry intracellular fat deposition to non-alcoholic steatohepatitis (NASH), which may progress into hepatic fibrosis, cirrhosis, or hepatocellular carcinoma. 310

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR Recent data suggest that impaired hepatic cholesterol homeostasis and its accumulation are relevant to the pathogenesis of NAFLD/NASH. Despite a vital physiological function of cholesterol, mitochondrial dysfunction is an important consequence of dietary-induced hypercholesterolemia and was, subsequently, linked to many pathophysiological conditions. The aim in the current study was to evaluate the morphological and molecular changes of cholesterol overload in mouse liver and particularly, in mitochondria, induced by a high-cholesterol (HC) diet for one month. Histopathological studies re- vealed microvesicular hepatic steatosis and significantly elevated levels of liver cholesterol and triglycerides leading to impaired liver synthesis. Further, high levels of oxidative stress could be determined in liver tissue as well as primary hepatocyte culture. Transcriptomic changes induced by the HC diet involved disruption in key pathways related to cell death and oxidative stress as well as upregulation of genes related to glutathione homeostasis. Impaired liver function could be associated with a decrease in mitochondri- al membrane potential and ATP content and significant alterations in mito- chondrial dynamics. We demonstrate that cholesterol overloading the liver leads to mitochondrial changes which may render damaged hepatocytes proliferative and resistant to cell death whereby perpetuating liver damage. CITA: J Cell Physiol. 2019 May;234(5):7213-7223 DOI: 10.1002/jcp.27474 PMID: 30273709 TÍTULO: Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018): Change management in allergic rhinitis and asthma multimorbidity using mo- bile technology AUTORES: Bousquet J, (…) Larenas-Linnemann D, et al. ABSTRACT: Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways us- ing mobile technology in patients with allergic rhinitis (AR) and asthma mul- timorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second change management strategy is proposed by ARIA Phase 4 to increase self-medication and shared decision making in rhinitis and asthma multimorbidity. An innovation of ARIA has been the development and validation of information technology evidence-based tools (Mobile Airways Sentinel Network [MASK]) that can inform patient decisions on the basis of a self-care plan proposed by the health care professional. CITA: J Allergy Clin Immunol. 2019 Mar;143(3):864-879 DOI: 10.1016/j.jaci.2018.08.049 PMID: 30391954 TÍTULO: Intralymphatic Immunotherapy: Update and Unmet Needs AUTORES: Senti G, Freiburghaus AU, Larenas-Linnemann D, Hoffmann HJ, Patterson AM, Klimek L, Di Bona D, Pfaar O, Ahlbeck L, Akdis M, Wein- feld D, Contreras-Verduzco FA, Pedroza-Melendez A, Skaarup SH, Lee SM, Cardell LO, Schmid JM, Westin U, Dollner R, Kündig TM. 311

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR ABSTRACT: Allergen-specific immunotherapy (AIT) is the only allergy treat- ment that confers long-term symptom amelioration for patients suffering from allergy. The most frequently used allergen application route is subcutaneous injection (SCIT), commonly taken as the gold standard, followed by sublin- gual (SLIT) or oral (OIT) application of allergen preparations. This is an up- to-date review of the clinical evidence for a novel route of allergen applica- tion, i.e., directly into lymph nodes – intra lymphatic immunotherapy (ILIT). The major advantages of ILIT over the current AIT approaches are its short duration and the low allergen doses administered. The whole treatment con- sists of merely 3 ultrasound-guided injections into inguinal lymph nodes 1 month apart. While the number of patients included in randomized controlled trials is still limited, the clinical results for ILIT are encouraging, but more clinical trials are needed, as well as more preclinical work for optimizing for- mulations. CITA: Int Arch Allergy Immunol. 2019;178(2):141-149 DOI: 10.1159/000493647 PMID: 30395744 TÍTULO: The characterization of asthma with blood eosinophilia in adults in Latin America AUTORES: Bedolla-Barajas M, Raúl Ortiz-Peregrina J, Daniel Hernán- dez-Colín D, Morales-Romero J, Ramses Bedolla-Pulido T, Lare- nas-Linnemann D. OBJECTIVE: To identify and characterize asthma with blood eosinophilia in adults. METHODS: This cross-sectional study consisted of 164 asthma patients, aged18 years or older. Multivariate analyses by logistic regression were performed to identify clinical characteristics and biomarkers associated with asthma with blood eosinophilia (defined as asthma and a peripheral blood eosinophil count≥400 cells/mm3). To evaluate the diagnostic accuracy of these biomarkers, the sensitivity, specificity and predictive values were calculated. Additionally, the area under the receiver operating characteristic (ROC) curve (AUC) was estimated for each biomarker. RESULTS: Overall, 37.8% (95%CI: 30.7-45.4%) of asthma patients had blood eosinophilia. The following factors were associated with this charac- teristic: patient age <50 years (OR 3.25; 95% CI: 1.33-7.94), a serum level of IgE ≥300 UI/mL (OR 2.32; 95%CI: 1.14-4.75), and an Asthma Control Test (ACT)score <20 points (OR 3.10; 95%CI: 1.35-4.75); asthma with blood eosinophilia was also associated with a baseline FEV1/FVC <70% (OR 2.68; 95%CI: 1.28-5.59). On the other hand, age <50 years and ACT score <20 showed the highest sensitivity (above80% each). Serum IgE level ≥300 UI/mL had the highest specificity (almost 68%). Finally, those with an ACT score <20 had the highest AUC (68%). CONCLUSIONS: In our study population, one-third of asthmatic adults had asthma with blood eosinophilia. Furthermore, the prevalence was greater in those ≤50 years of age; these patients experienced more severe, more poor- ly controlled asthma and had higher total serum IgE levels. CITA: J Asthma. 2019 Nov;56(11):1138-1146 DOI: 10.1080/02770903.2018.1520863 312

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 30476585 TÍTULO: Effects of Alcohol Consumption and Metabolic Syndrome on Mor- tality in Patients With Nonalcoholic and Alcohol-Related Fatty Liver Disease AUTORES: Younossi ZM, Stepanova M, Ong J, Yilmaz Y, Duseja A, Egu- chi Y, El Kassas M, Castellanos-Fernandez M, George J, Jacobson IM, Bu- gianesi E, Wong VW, Arrese M, de Ledinghen V, Romero-Gomez M, Men- dez-Sanchez N, Ahmed A, Wong R, Papatheodoridis G, Serfaty L, Younossi I, Nader F, Ziayee M, Afendy A BACKGROUND & AIMS: Non-alcoholic and alcohol-related fatty liver dis- ease are overlapping diseases in which metabolic syndrome and alcohol consumption each contribute to progressive liver disease. We aimed to as- sess the effects of alcohol consumption and metabolic syndrome on mortali- ty in individuals with fatty liver. METHODS: We searched the National Health and Nutrition and Examina- tion Survey III for adults (20-74 years old) with hepatic steatosis, detected by ultrasound, for whom mortality and follow-up data were available. We collected data from the alcohol use questionnaire (self-reported number of days a participant drank alcohol; the number of drinks [10 g alcohol] per day on a drinking day; the number of days the participant had 5 or more drinks) and calculated the average amount of alcohol consumption in drinks/day for each participant during the year preceding enrollment. Excessive alcohol consumption for men was >3 drinks/day and for women was >1.5 drinks/day. We also collected clinical data, and mortality data were obtained from the National Death Index. Demographic and clinical parameters were compared among consumption groups using the χ2 test for independence or survey regression models. We used Cox proportional hazard models to identify in- dependent predictors of all-cause and cause-specific mortality. RESULTS: The study cohort included 4264 individuals with hepatic ste- atosis (mean age, 45.9 years; 51% male; 76% white; 46% with metabolic syndrome; 6.2% with excessive alcohol use). There was no significant dif- ference in mean age between individuals with vs without excessive alcohol consumption (P=.65). However, overall mortality was significantly higher among participants with excessive alcohol consumption (32.2%) vs partici- pants with non-excessive alcohol use (22.2%) after mean 20 years of follow up (P=.003), as well as after 5 years of follow up. In multivariate analysis, the presence of metabolic syndrome (adjusted hazard ratio [aHR], 1.43; 95% CI, 1.12-1.83) and excessive alcohol consumption (aHR, 1.79; 95% CI, 1.21-2.66) were independently associated with an increased risk of death in individuals with hepatic steatosis; any lower average amount of alcohol consumption was not associated with mortality (all P>.60). In a subgroup analysis, the association of excessive alcohol use with mortality was signifi- cant in individuals with metabolic syndrome (aHR, 2.46; 95% CI, 1.40-4.32) but not without it (P=.74). CONCLUSION: In review of data from the National Health and Nutrition and Examination Survey III, we associated alcohol consumption with increased mortality in participants with fatty liver and metabolic syndrome. These find- ings indicate an overlap between non-alcoholic and alcohol-related fatty liver disease. CITA: Clin Gastroenterol Hepatol. 2019 Jul;17(8):1625-1633.e1 DOI: 10.1016/j.cgh.2018.11.033 313

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 30565275 TÍTULO: ARIA pharmacy 2018 \"Allergic rhinitis care pathways for community pharmacy\": AIRWAYS ICPs initiative (European Innovation Partnership on Active and Healthy Ageing, DG CONNECT and DG Santé) POLLAR (Impact of Air POLLution on Asthma and Rhinitis) GARD Demonstration project AUTORES: Bosnic-Anticevich S, (…) Larenas-Linnemann DE, et al. ABSTRACT: Pharmacists are trusted health care professionals. Many pa- tients use over-the-counter (OTC) medications and are seen by pharmacists who are the initial point of contact for allergic rhinitis management in most countries. The role of pharmacists in integrated care pathways (ICPs) for allergic diseases is important. This paper builds on existing studies and provides tools intended to help pharmacists provide optimal advice/interven- tions/strategies to patients with rhinitis. The Allergic Rhinitis and its Impact on Asthma (ARIA)-pharmacy ICP includes a diagnostic questionnaire spe- cifically focusing attention on key symptoms and markers of the disease, a systematic Diagnosis Guide (including differential diagnoses), and a simple flowchart with proposed treatment for rhinitis and asthma multimorbidity. Key prompts for referral within the ICP are included. The use of technology is crit- ical to enhance the management of allergic rhinitis. However, the ARIA-phar- macy ICP should be adapted to local healthcare environments/situations as regional (national) differences exist in pharmacy care. CITA: Allergy. 2019 Jul;74(7):1219-1236 DOI: 10.1111/all.13701 PMID: 30583826 TÍTULO: [The histopathology and immunohistochemistry of granular cell tu- mour. A study of 12 cases with a brief historical note] AUTORES: Ortiz-Hidalgo C, Frías-Soria CL. INTRODUCTION AND OBJECTIVE: Granular cell tumour (GCT) is a be- nign neoplasm of neural/schwannian origin, usually presenting as a single asymptomatic lesion, mainly located in the dermis and subcutaneous tissue or submucosa, although multiple tumours may occur. Microscopically, GCTs are composed of large cells with abundant eosinophilic, granular cytoplasm arranged in sheets, nests, cords or trabeculae. Based on the cytological characteristics and the presence of necrosis, three types are recognized: benign, atypical and malignant. We aim to present the cytological and immu- nohistochemical characteristics of 12 granular cell tumours. MATERIALS AND METHODS: 12 cases of GCT were selected from the consultation files of one of the authors (COH) The paraffin embedded tis- sue was processed for immunostaining with S-100 protein, calretinin, CD68, α-inhibin, PGP9.5, CD57(Leu7), CD63 (NKI / C3), Gap43 (growth-associat- ed protein-43), SOX10, TFE-3 andKi-67. RESULTS AND CONCLUSIONS: 6 male and 6 female patients, with an av- erage age of 40, made up the study group. The most frequent location for the tumours was in the subcutaneous soft tissues of the arms. There were no malignant cases. All tumours were positive for S-100, CD57, SOX10, cal- retinin, CD68, PGP9.5, α-inhibin andTFE-3, with a low Ki-67 (1-5%). Addi- tionally, we reported, for the first time, the positive immunoreaction to Gap43 (growth-associated protein-43) in GCT. CITA: Rev Esp Patol. 2019 Jan - Mar;52(1):11-19 DOI: 10.1016/j.patol.2018.05.004 314

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 30597673 TÍTULO: Adherence to treatment in allergic rhinitis using mobile technology. PMID: 30635055 The MASK Study AUTORES: Menditto E, (…) Larenas-Linnemann D, et al.. OBJECTIVES: To assess the adherence to treatment in allergic rhinitis pa- tients using the Allergy Diary App. METHODS: An observational cross-sectional study was carried out on all users who filled in the Allergy Diary from 1 January 2016 to 1 August 2017. Secondary adherence was assessed by using the modified Medication Pos- session Ratio (MPR)and the Proportion of days covered (PDC) approach. RESULTS: A total of 12 143 users were registered. A total of 6 949 users re- ported at least one VAS data recording. Among them, 1 887 users reported ≥7 VAS data. About 1 195 subjects were included in the analysis of adherence. One hun- dred and thirty-six (11.28%) users were adherent (MPR ≥70% and PDC ≤1.25), 51 (4.23%) were partly adherent (MPR ≥70% and PDC = 1.50) and 176 (14.60%) were switchers. On the other hand, 832 (69.05%) users were non-adherent to medications (MPR <70%). Of those, the largest group was non-adherent to medications and the time interval was increased in 442 (36.68%) users. CONCLUSION AND CLINICAL RELEVANCE: Adherence to treatment is low. The relative efficacy of continuous vs on-demand treatment for allergic rhinitis symptoms is still a matter of debate. This study shows an approach for measuring retrospective adherence based on a mobile app. This also represents a novel approach for analyzing medication-taking behavior in a real-world setting. CITA: Clin Exp Allergy. 2019 Apr;49(4):442-460 DOI: 10.1111/cea.13333 TÍTULO: Superior silybin bioavailability of silybin-phosphatidylcholine com- plex in oily-medium soft-gel capsules versus conventional silymarin tablets in healthy volunteers AUTORES: Méndez-Sánchez N, Dibildox-Martinez M, Sosa-Noguera J, Sánchez-Medal R, Flores-Murrieta FJ. BACKGROUND: Fibrosis is a response to chronic liver disease that results in excessive accumulation of extracellular matrix proteins and formation of scart issue. Fibrosis represents a clinical challenge of worldwide significance. METHODS: We enrolled 23 healthy volunteers to participate in a prospec- tive, balanced, blind, single-dose, two-way crossover study with a one-week washout period. Fasting participants received either 45 mg silybin-phospha- tidylcholine complex or 70 mg silymarin to assess which formulation provid- ed better bioavailability of silybin. Plasma was obtained and analysed for silybin concentration using a validated ultra-performance liquid chromatog- raphy-tandem mass spectroscopy method. Pharmacokinetic parameters were obtained by non-compartmental analysis and values were compared by analysis of variance for a crossover design. Ratios of maximum plasma drug concentration and area under the curve (AUC) were obtained and 90% confidence intervals were calculated. 315

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR RESULTS: The 23 healthy subjects (11 women, 12 men) who participated in the study were aged 22-31 years old (average: 28), average weight 64.8 kg, height 1.65 mand body mass index 23.5 kg/m2. Plasma levels of silybin were higher after the administration of silybin-phosphatidylcholine complex cap- sules compared with that after conventional silymarin tablets (P <  0.0001). CONCLUSIONS: The silybin-phosphatidylcholine complex in oily-medium soft-gel capsules seems to provide superior bioavailability. However, clinical studies must be performed to demonstrate its clinical relevance in the treat- ment of liver diseases. CITA: BMC Pharmacol Toxicol. 2019 Jan 11;20(1):5 DOI: 10.1186/s40360-018-0280-8 PMID: 30647899 TÍTULO: Spontaneous regression as a 'burned-out' non-seminomatous tes- ticular germ cell tumor: a case report and literature review AUTORES: Dorantes-Heredia R, Motola-Kuba D, Murphy-Sanchez C, Iz- quierdo-Tolosa CD, Ruiz-Morales JM. SUMMARY: Testicular germ cell tumors (TGCTs) are the most frequent type of cancer in young adults. An exceptional event is the spontaneous regres- sion (SR) of the primary tumor. Herein, we describe a burned-out non-sem- inomatous TGCT case and relevant literature review. A 34-year-old male presenting with low back pain was found to have a retroperitoneal mass upon urotomography. During workup, a heterogeneous testicular mass was evident, and its biopsy showed findings that support the diagnosis of spon- taneous tumoral regression. The patient underwent unilateral orchiectomy and a chemotherapy protocol was later initiated, with 85% regression of the retroperitoneal metastatic mass. No progression of the primary tumor has been found. The etiology of SR across different cancer types appears to be associated with the host's immune response and an angiogenic disturbance of the tumor microenvironment. The burned-out phenomenon is a rare event that needs further research into its molecular sequencing. CITA: J Surg Case Rep. 2019 Jan 9;2019(1):rjy358 DOI: 10.1093/jscr/rjy358 PMID: 30683586 TÍTULO: Challenges in HIV infection control in transgender women sex PMID: 30711302 workers AUTORES: Panopoulou G, Gonzalez-Pier E. SUMMARY: Comment CITA: Lancet Public Health. 2019 Mar;4(3):e117-e118 DOI: 10.1016/S2468-2667(18)30259-7 TÍTULO: The Mexican consensus on nonalcoholic fatty liver disease AUTORES: Bernal-Reyes R, Castro-Narro G, Malé-Velázquez R, Carmo- na-Sánchez R, González-Huezo MS, García-Juárez I, Chávez-Tapia N, 316

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR Aguilar-Salinas C, Aiza-Haddad I, Ballesteros-Amozurrutia MA, Bosques-Pa- dilla F, Castillo-Barradas M, Chávez-Barrera JA, Cisneros-Garza L, Flores- Calderón J, García-Compeán D, Gutiérrez-Grobe Y, Higuera de la Tijera MF, Kershenobich-Stalnikowitz D, Ladrón de Guevara-Cetina L, Lizardi-Cervera J, López-Cossio JA, Martínez-Vázquez S, Márquez-Guillén E, Méndez-Sán- chez N, Moreno-Alcantar R, Poo-Ramírez JL, Ramos-Martínez P, Rodrí- guez-Hernández H, Sánchez-Ávila JF, Stoopen-Rometti M, Torre-Delgadillo A, Torres-Villalobos G, Trejo-Estrada R, Uribe-Esquivel M, Velarde-Ruiz Velasco JA. SUMMARY: Nonalcoholic fatty liver disease (NAFLD) affects nearly one third of the population worldwide. Mexico is one of the countries whose popula- tion has several risk factors for the disease and its prevalence could surpass 50%. If im mediateaction is not taken to counteract what is now considered a national health problem, the medium-term panorama will be very bleak. This serious situation prompted the Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Hepatología to produce the Mexican Con- sensus on Fatty Liver Disease. It is an up-to-date and detailed review of the epidemiology, pathophysiology, clinical forms, diagnosis, and treatment of the disease, whose aim is to provide the Mexican physician with a useful tool for the prevention and management of nonalcoholic fatty liver disease. CITA: Rev Gastroenterol Mex. 2019 Jan - Mar;84(1):69-99 DOI: 10.1016/j.rgmx.2018.11.007 PMID: 30738094 TÍTULO: Genetic variants as risk factors for cigarette smoking at an early age and relapse to smoking cessation treatment: A pilot study AUTORES: Pérez-Rubio G, López-Flores LA, García-Carmona S, García-Gómez L, Noé-Díaz V, Ambrocio-Ortiz E, Nava-Quiroz KJ, Mo- rales-González F, Del Angel-Pablo AD, Ramírez-Venegas A, Sansores RH, Falfán-Valencia R. OBJECTIVES: Tobacco smoking is a complex and multifactorial disease in- volving both environmental and genetic factors. In the Mexican mestizo pop- ulation, single-nucleotide polymorphisms (SNPs) associated with cigarette smoking and a greater degree of nicotine addiction have been identified; however, no possible roles have been explored in regard to the age of onset of smoking or in the success of quitting. METHODS: In this study, 151 Mexican mestizo, who smoke cigarettes, were included. They were grouped according to the age at which they started smoking: those who started smoking before 18 years of age (early smokers, ES) and those who started smoking ≥18 years of age (late smokers, LS). In addition, relapse in smoking was evaluated at the first month after the end of treatment. Genetic association was evaluated characterizing 10 SNPs in 4 genes (CHRNA5, CHRNA3, NRXN1, and HTR2A). RESULTS: According to the dominant model of genetic inheritance, rs6313 (CT+TT) of the HTR2A gene was associated (p = 0.0201) with cigarette con- sumption at early ages (OR = 2.68, CI = 1.18-6.07). When the risk of relapse was analyzed one month after the end of treatment, regardless of the age of onset, the T allele (rs6313) of HTR2A appeared to be a risk factor for relapse (OR = 2.92, 95%CI = 1.06-8.11); the T allele was found more frequently in those who relapsed (50.0%) compared with people who maintained absti- nence (25.4%) (p = 0.0332). 317

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR CONCLUSIONS: Our findings suggest that in Mexican mestizos who smoke cigarettes, the presence of the T allele in rs6313 of the HTR2A gene increas- es the risk for the early onset of cigarette smoking as well as the risk for relapsing one month after completing smoking cessation treatment. CITA: Gene. 2019 Apr 30;694:93-96 DOI: 10.1016/j.gene.2019.01.036 PMID: 30795809 TÍTULO: Correction to: Superior silybin bioavailability of silybin-phospha- PMID: 30799452 tidylcholine complex in oily-medium soft-gel capsules versus conventional silymarin tablets in healthy volunteers PMID: 30810542 AUTORES: Méndez-Sánchez N, Dibildox-Martinez M, Sosa-Noguera J, Sánchez-Medal R, Flores-Murrieta FJ. SUMMARY: Erratum CITA: BMC Pharmacol Toxicol. 2019 Feb 22;20(1):14 DOI: 10.1186/s40360-019-0290-1 TÍTULO: [Reporte de la Primera Reunión Nacional de Consenso para la In- munofenotipificación de Leucemias Agudas] AUTORES: Arriaga-Pizano L, Ramírez-Ramírez D, Prieto-Chávez J, Pelayo R, Ruiz-Argüelles A, Ruiz-Delgado GJ, Marín y López RA. SUMMARY: En 2005 se publicaron recomendaciones para la tipificación de hemopatías malignasen Latinoamérica. Se consideró necesario realizar una reunión nacional para actualizarlas. Se convocaron y reunieron 95 profesio- nales expertos en el tema para analizar y contrastar alternativas y llegar a un consenso. Se alcanzaron opiniones de consenso en lo relativo a indica- ciones, tipos y manejo de muestras, anticuerpos, nomenclatura e informe de resultados para el diagnóstico y seguimiento de las leucemias agudas. Las recomendaciones se describen en este artículo y se hace hincapié en la necesidad de que los laboratorios nacionales se apeguen a ellas. CITA: Gac Med Mex. 2019;155(1):20-29 DOI: 10.24875/GMM.18004418 TÍTULO: Small Airway Disease In Copd Associated To Biomass Exposure AUTORES: Ramírez-Venegas A, Torres-Duque CA, Guzmán-Bouilloud NE, González-García M, Sansores RH. SUMMARY: Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous entity that may result from different causative agents and risk factors and may follow diverse clinical courses, including COPD secondary to biomass smoke exposure. At present, this phenotype is be- coming more important for two reasons: first, because at least almost half of the world's population is exposed to biomass smoke, and second, because the possibility of it being diagnosed is increasing. Biomass smoke exposure COPD affects primarily women and is related with insults to the airways occurred during early life. Although constituents of biomass smoke and to- 318

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 30837150 bacco smoke are similar, the physiopathological changes they induce differ depending not only on the chemical composition (related with the type of fuel used) but also on the particle size and the inhalation pattern. Evidence has shown that biomass smoke exposure affects the airway, pre- dominantly the small airways causing anthracofibrosis and peribronchiolar fibrosis changes that will clinically translate into chronic bronchitis symptoms, with a high impact on the quality of life. In this review, we focus especially on the main epidemiological and clinical differences between COPD secondary to biomass exposure and COPD caused by tobacco exposure. CITA: Rev Invest Clin. 2019;71(1):70-78 DOI: 10.24875/RIC.18002652 TÍTULO: Rogue \"stem cell clinic\" leads to Mycobacterium abscessus infection AUTORES: Olmedo-Reneaum A, Garcia-Juarez I, Toapanta-Yanchapaxi L, De La Peña-López R, Rodríguez-Covarrubias F, Contreras AG, Cuellar-Ro- driguez JM. SUMMARY: Case report CITA: Lancet. 2019 Mar 2;393(10174):918 DOI: 10.1016/S0140-6736(19)30299-5 PMID: 30861515 TÍTULO: Risk of Pneumonitis with the Use of Different Immune Checkpoint Inhibitors in a Mexican Population AUTORES: Dávila-Dupont D, Motola-Kuba D, Dorantes-Heredia R, González-Alonso BK, Alcántara-Velarde T, García-Santisteban R, Martínez-Sámano JE, Grimaldo-Roque HJ, Ruiz-Morales JM. PURPOSE: The incidence of pneumonitis reported in previous trials in pa- tients with advanced cancer and use of programmed cell death protein 1 (PD-1) immunotherapy inhibitors was 2.7-3.6%. However, none of these tri- als included Mexican populations. METHODS: This was a retrospective analysis involving 87 patients with advanced cancer who received PD-1 inhibitors as part of their therapy. The primary outcome was the incidence of pneumonitis after using PD-1 inhib- itors. The secondary outcomes were major risk factors and radiological patterns of pneumonitis. RESULTS: We found 13 cases of pneumonitis, giving an overall incidence of 15%; three of the cases were high-grade (grade 3). A ground-glass pattern was the major form found by chest computed tomography scans. We did not find any significant risk factor for pneumonitis. CONCLUSION: The incidence of pneumonitis secondary to treatment with PD-1inhibitors in our Mexican population was 15%, which is 5 times higher than that found in other studies. No risk factor was identified for this increased incidence of drug-induced pneumonitis following the use of PD-1 inhibitors. CITA: Oncology. 2019;96(5):268-272 DOI: 10.1159/000497405 319

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 30885354 TÍTULO: Radical consolidative treatment provides a clinical benefit and long-term survival in patients with synchronous oligometastatic non-small cell lung cancer: A phase II study AUTORES: Arrieta O, Barrón F, Maldonado F, Cabrera L, Corona-Cruz JF, Blake M, Ramírez-Tirado LA, Zatarain-Barrón ZL, Cardona AF, García O, Arén O, De la Garza J. OBJECTIVES: Evidence is rapidly accumulating for the use of radical con- solidative treatment (RCT) for patients with oligometastatic non-small cell lung cancer(NSCLC). Nonetheless, published studies have several limita- tions, including a selection of patients whose favorable characteristics might dictate therapeutic success, as well as scarce prospective data regarding overall survival (OS). The objective of this study was to determine whether RCT increases OS in patients with oligometastatic NSCLC. MATERIALS AND METHODS: In this prospective, single-arm phase II study, we sought to evaluate the efficacy of RCT in patients with oligometastatic NSCLC in terms of OS. Patients with pathologically confirmed stage IV NS- CLC who presented ≤5synchronous, any-site metastases (including central nervous system [CNS]metastases), as assessed by PET-CT, were includ- ed. All patients received four initial cycles of systemic treatment. Following, those with stable disease/partial response received RCT to the primary site and metastases. The response to RCT was evaluated with PET-CT. The primary end-point was OS. Secondary end-points included progression-free survival (PFS) and best response by PET-CT. The study is registered in clin- icaltrials.gov (NCT02805530). RESULTS: Thirty-seven patients were included in the analysis. The mean age was55.8 years (range: 33-75 years). At diagnosis, 43.2% of patients pre- sented with CNS metastases. Following RCT, 19 (51.4%) patients achieved a complete-response (CR) by PET-CT, while 18 (48.6%) had a non-complete response (NON-CR). The median OS was non reached (NR) and was posi- tively affected by CR on PET-CT (NR vs. 27.4[95% CI: 16.4-38.3]; p = 0.011). The median PFS was 23.5 months (95% CI:13.6-33.3) and was positively affected by CR on PET-CT (NR vs. 14.3 [95% CI:11.7-16.9]; p < 0.001; HR: 0.19 [0.07-0.52]; p=0.001). CONCLUSION: Patients with oligometastatic NSCLC who undergo RCT have a high response rate and favorable OS. Patients with a CR by PET-CT have significantly longer OS, rendering this an important potential prognostic marker. CITA: Lung Cancer. 2019 Apr;130:67-75 DOI: 10.1016/j.lungcan.2019.02.006 PMID: 30887267 TÍTULO: Pre-operative apparent diffusion coefficient values and tumour region volumes as prognostic biomarkers in glioblastoma: correlation and progression-free survival analyses AUTORES: Durand-Muñoz C, Flores-Alvarez E, Moreno-Jimenez S, Roldan-Valadez E. OBJECTIVES: Glioblastoma (GB) contains diverse histologic regions. Ap- parent diffusion coefficient (ADC) values are surrogates for the degree of number of cells within the tumour regions. Because an assessment of ADC values and volumes within tumour sub-compartments of GB is missing in the literature, we aimed to evaluate these associations. 320

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR METHODS: A retrospective cohort of 48 patients with GB underwent seg- mentation to calculate tumour region volumes (in cubic centimetre) and ADC values in tumour regions: normal tissue, enhancing tumour, proximal oede- ma, distal oedema, and necrosis. Correlation, Kaplan-Meier, and Cox hazard regression analyses were performed. RESULTS: We found a statistically significant difference among ADC values for tumour regions: F (4, 220) = 166.71 and p ≤ .001 and tumour region vol- umes(necrosis, enhancing tumour, peritumoural oedema): F (2, 141) = 136.3 andp ≤ .001. Post hoc comparisons indicated that the only significantly dif- ferent mean score was the peritumoural volume in oedema region (p < .001). We observed a positive significant correlation between ADC of distal oede- ma and peritumoural volume, r = .418, df = 34, and p = .011. Cox proportional hazards regression analysis considering only tumour region volumes pro- vided an almost significant model: - 2 log-likelihood = 146.066, χ2 (4) = 9.303, and p = .054 with a trend towards significance of the hazard function: p = .067 and HR = 1.077 for the non-enhancing tumour volume. CONCLUSIONS: ADC values together with volumes of oedema region might have a role as predictors of progression-free survival (PFS) in patients with GB; were commend a routine MRI assessment with the calculation of these biomarkers in GB. CITA: Insights Imaging. 2019 Mar 18;10(1):36 DOI: 10.1186/s13244-019-0724-8 PMID: 30890287 TÍTULO: Quality of Pulmonary Function Tests in Participants with Down Syn- drome AUTORES: Fernández-Plata R, Pérez-Padilla R, Del Río-Hidalgo R, García-Sancho C, Gochicoa-Rangel L, Rodríguez-Hernández C, Torre-Bouscoulet L, Martínez-Briseño D. INTRODUCTION: People with Down syndrome (DS) have high respiratory morbidity, evaluating their respiratory health with standardized, objective tests is desirable. Thus, the objective of this study was to evaluate the tech- nical quality of Pulmonary Function Tests (PFTs) to determine which ones are most suitable for this population. METHODS: Participants included children, teenagers and adults with DS, 5 years of age or older (n=302). The technical quality of the impulse oscil- lometry system(IOS), forced spirometry, lung-diffusing capacity for carbon monoxide (DLCO), and6-min walk test (6MWT) were analyzed by age group. Capnography and pulse oximetry were included in the study. Technical quali- ty was determined on the basis of current international PFTs standards. RESULTS: Fifty-one percent of participants were males. A total of 184par- ticipants (71%) who completed the IOS fulfilled the quality criteria, while210 (70%) completed the 6MWT. Performance on forced spirometry and DLCO was poor. All pulse oximetries and 96% percent heart rates obtained had good quality, but exhaled carbon dioxide (PetCO2) and respiratory rate (RR) showed deficient repeatability. CONCLUSIONS: IOS appears to be the most reliable instrument for evaluat- ing lung mechanics in individuals with DS. CITA: Arch Bronconeumol. 2019 Oct;55(10):513-518 DOI: 10.1016/j.arbres.2019.02.010 321

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 30899297 TÍTULO: Impact of spider nevus and subcutaneous collateral vessel of PMID: 30905208 chest/abdominal wall on outcomes of liver cirrhosis AUTORES: Li H, Wang R, Méndez-Sánchez N, Peng Y, Guo X, Qi X. INTRODUCTION: Spider nevus and subcutaneous collateral vessel of the chest/abdominal wall are common in liver cirrhosis. This prospective study aimed to evaluate the impact of spider nevus and subcutaneous collateral vessel of the chest/abdominal wall on the outcomes of cirrhotic patients. MATERIAL AND METHODS: We prospectively enrolled patients with a diagnosis of liver cirrhosis consecutively admitted to our department. We recorded the number and location of spider nevi and subcutaneous collat- eral vessels of the chest/abdominal wall. Clinical profiles and survival were compared according to the presence of spider nevus and subcutaneous collateral vessel of the chest/abdominal wall. The study was registered (NCT02468479). RESULTS: Overall, 198 patients were enrolled between June 2015 and May 2016. The median follow-up duration was 350 days. The prevalence of spi- der nevus and subcutaneous collateral vessel of the chest/abdominal wall was 47% and 29.8%, respectively. Patients with spider nevi had a signifi- cantly higher proportion of alcohol abuse (54.84% vs. 26.67%, p < 0.001). Both spider nevus and subcutaneous collateral vessel of the chest/abdom- inal wall were significantly associated with higher Child-Pugh (8.35 ±2.19 vs. 7.47 ±1.91, p = 0.005; 8.57 ±2.20 vs. 7.60±1.98, p = 0.002) and MELD scores (9.91 ±6.41 vs. 7.43 ±5.40, p = 0.008; 10.77±6.76 vs. 7.68 ±5.42, p = 0.003). The cumulative survival was not significantly different between patients with and without spider nevi of the chest/abdominal wall (p = 0.951). Patients with subcutaneous collateral vessels of the chest/abdominal wall had significantly worse cumulative survival (p = 0.018). CONCLUSIONS: Presence of spider nevus and subcutaneous collateral vessel of the chest/abdominal wall indicated more severe liver dysfunction. Subcutaneous collateral vessel of the chest/abdominal wall should be a sim- ple and important predictor for the overall survival of cirrhotic patients. CITA: Arch Med Sci. 2019 Mar;15(2):434-448 DOI: 10.5114/aoms.2018.74788 TÍTULO: Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis in HIV infection: a metabolic approach of an infectious disease AUTORES: Coronel-Castillo CE, Qi X, Contreras-Carmona J, Ramírez- Pérez OL, Méndez-Sánchez N. SUMMARY: With the successes of antiretroviral therapy, patients infected with human immunodeficiency virus (HIV) living longer. Regarding this, the common diseases of HIV population (i.e., opportunistic infections) are now losing ground in front of metabolic alterations. This phenomenon is related to the delay in progression to acquired immune deficiency syndrome (AIDS), making it so that patients live in a chronic inflammatory state which, com- bined with other mechanisms such infectious ones, cause metabolic diseas- es. Areas covered: Considering a high prevalence of metabolic alterations, the relationship between metabolic syndrome (MetS) with nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), and liver diseases as a major cause of death in the HIV-infected population, this pa- per aims to overview the mechanisms and prevalence of NAFLD and NASH 322

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 30911372 as they relate to the developed metabolic diseases of HIV patients. Expert PMID: 30915161 opinion: The pathways underlying MetS include the effects of HIV and ART on the liver, adipose tissue, and muscle. These mechanisms result in liver damage, consequently leading to NAFLD and its more severe form NASH. These conditions have increased in HIV-infected population in recent years and since their life expectancy is improving it is important to be ready to attend their new emerging diseases. CITA: Expert Rev Gastroenterol Hepatol. 2019 Jun;13(6):531-540 DOI: 10.1080/17474124.2019.1599284 TÍTULO: Guidance to 2018 good practice: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma AUTORES: Bousquet J, (…) Larenas-Linnemann D, et al. AIMS: Mobile Airways Sentinel NetworK (MASK) belongs to the Fondation Partenariale MACVIA-LR of Montpellier, France and aims to provide an ac- tive and healthy life to rhinitis sufferers and to those with asthma multimor- bidity across the life cycle, whatever their gender or socio-economic status, in order to reduce health and social inequities incurred by the disease and to improve the digital transformation of health and care. The ultimate goal is to change the management strategy in chronic diseases. METHODS: MASK implements ICT technologies for individualized and predictive medicine to develop novel care pathways by a multi-disciplinary group centred around the patients. Stakeholders: Include patients, health care professionals (pharmacists and physicians), authorities, patient's associations, private and public sectors. RESULTS: MASK is deployed in 23 countries and 17 languages. 26,000 users have registered. EU grants 2018: MASK is participating in EU projects (POLLAR: impact of air POLLution in Asthma and Rhinitis, EIT Health, Digital Health Europe, Eu- riphi and Vigour). LESSONS LEARNT: (i) Adherence to treatment is the major problem of allergic disease, (ii) Self-management strategies should be considerably expanded (behavioural), (iii) Change management is essential in allergic dis- eases, (iv)Education strategies should be reconsidered using a patient-cen- tred approach and (v) Lessons learnt for allergic diseases can be expanded to chronic diseases. CITA: Clin Transl Allergy. 2019 Mar 11;9:16 DOI: 10.1186/s13601-019-0252-0 TÍTULO: Plasma neutrophil gelatinase-associated lipocalin and factors relat- ed to acute kidney injury and mortality in critically ill cancer patients AUTORES: Córdova-Sánchez BM, Ruiz-García EB, López-Yañez A, Barra- gan-Dessavre M, Bautista-Ocampo AR, Meneses-García A, Herrera-Gómez A, Ñamendys-Silva SA. RATIONALE: Acute kidney injury (AKI) is a frequent complication in critically ill cancer patients. 323

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 30937131 OBJECTIVES: To assess plasma neutrophil gelatinase-associated lipocalin (NGAL) levels and risks factors associated with AKI and mortality. METHODS: We recruited 96 critically ill cancer patients and followed them prospectively. Plasma NGAL levels were determined at intensive care unit (ICU)admission and at 48 hours. We generated receiver operating charac- teristic curves to assess the ability of NGAL to predict AKI. Logistic regres- sion analysis was performed to determine risks factors associated with AKI. Cox-regression analysis was performed to evaluate 6-month mortality. MEASUREMENTS AND MAIN RESULTS: From 96 patients, 60 (63%) de- veloped AKI and 33(55%) were classified as stages 2 and 3. In patients with- out AKI at admission, plasma NGAL levels revealed an area under the curve (AUC) = 0.522 for all AKI stages and an AUC = 0.573 for stages 2 and 3 AKI (85% sensitivity and 67%specificity for a 50.66 ng/mL cutoff). We identified sequential organ failure assessment (SOFA) score (without renal parame- ters) at admission as an independent factor for developing stages 2 and 3 AKI, and hemoglobin as a protective factor. We observed that metastatic dis- ease, dobutamine use and stage 3 AKI were independent factors associated with 6-month mortality. CONCLUSIONS: In our cohort of critically ill cancer patients, NGAL did not predict AKI. SOFA score was a risk factor for developing AKI, and hemoglo- bin level was a protective factor for developing AKI. The independent factors associated with 6-month mortality included metastatic disease, dobutamine use, lactate and stage 3 AKI. CITA: E cancer medical science. 2019 Feb 14;13:903 DOI: 10.3332/ecancer.2019.903 TÍTULO: Edible insects: Cross-recognition of IgE from crustacean- and house dust mite allergic patients, and reduction of allergenicity by food pro- cessing AUTORES: Pali-Schöll I, Meinlschmidt P, Larenas-Linnemann D, Purschke B, Hofstetter G, Rodríguez-Monroy FA, Einhorn L, Mothes-Luksch N, Jen- sen-Jarolim E, Jäger H. BACKGROUND: Insects have become increasingly interesting as alterna- tive nutrient sources for feeding humans and animals, most reasonably in processed form. Initially, some safety aspects - among them allergenicity - need to be ad- dressed. OBJECTIVE: To reveal the cross-reactivity of shrimp-, mite- and flies-aller- gic patients to different edible insects, and further to assess the efficacy of food processing in reducing the recognition of insect proteins by patients' IgE and in skin prick testing of shrimp-allergic patients. METHODS: IgE from patients allergic to crustaceans, house dust mite or flies was evaluated for cross-recognition of proteins in house cricket Acheta domesticus (AD), desert locust Schistocerca gregaria (SG) and Yellow meal- worm Tenebriomolitor (TM). Changes in IgE-binding and SPT-reactivity to processed insect extracts were determined for migratory locust (Locusta mi- gratoria, LM), after different extraction methods, enzymatic hydrolysis, and thermal processing were applied. 324

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR RESULTS: IgE from patients with crustacean-allergy shows cross-recogni- tion of AD, SG and stable flies; house dust mite allergics' IgE binds to AD and SG; and the flies-allergic patient recognized cricket, desert locust and migratory locust. Cross-reactivity and allergenicity in SPT to LM can be deleted by conventional processing steps, such as hydrolysis with different enzymes or heat treatment, during the preparation of protein concentrates. CONCLUSION: The results show that crustacean-, HDM- and stable flies-al- lergic patients cross-recognize desert locust and house cricket proteins, and crustacean-allergic patients also flies proteins. Furthermore, this study shows that appropriate food processing methods can reduce the risk of cross-reactivity and allergenicity of edible insects. CITA: World Allergy Organ J. 2019 Jan 26;12(1):100006 DOI: 10.1016/j.waojou.2018.10.001 PMID: 30951790 TÍTULO: Mobile technology offers novel insights into the control and treat- ment of allergic rhinitis: The MASK study AUTORES: Bédard A, (…) Larenas-Linnemann D, et al. BACKGROUND: Mobile health can be used to generate innovative insights into optimizing treatment to improve allergic rhinitis (AR) control. OBJECTIVES: A cross-sectional real-world observational study was under- taken in 22 countries to complement a pilot study and provide novel informa- tion on medication use, disease control, and work productivity in the every- day life of patients with AR. METHODS: A mobile phone app (Allergy Diary, which is freely available on GooglePlay and Apple stores) was used to collect the data of daily visual analogue scale (VAS) scores for (1) overall allergic symptoms; (2) nasal, oc- ular, and asthma symptoms; (3) work; and (4) medication use by using a treatment scroll list including all allergy medications (prescribed and over- the-counter) customized for 22 countries. The 4 most common intranasal medications containing intranasal corticosteroids and 8 oral H1-antihista- mines were studied. RESULTS: Nine thousand one hundred twenty-two users filled in 112,054 days of VASs in 2016 and 2017. Assessment of days was informative. Con- trol of days with rhinitis differed between no (best control), single (good control for intranasal corticosteroid-treated days), or multiple (worst control) treatments. Users with the worst control increased the range of treatments being used. The same trend was found for asthma, eye symptoms, and work productivity. Differences between oral H1-antihistamines were found. CONCLUSIONS: This study confirms the usefulness of the Allergy Diary in accessing and assessing behavior in patients with AR. This observational study using a very simple assessment tool (VAS) on a mobile phone had the potential to answer questions previously thought infeasible. CITA: J Allergy Clin Immunol. 2019 Jul;144(1):135-143.e6 DOI: 10.1016/j.jaci.2019.01.053 325

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 30955224 TÍTULO: 2019 ARIA Care pathways for allergen immunotherapy PMID: 30963004 AUTORES: Bousquet J, (…) Larenas-Linemann D, et al. ABSTRACT: Allergen immunotherapy (AIT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many guidelines or na- tional practice guidelines have been produced but the evidence-based method varies, many are complex and none propose care pathways. This paper reviews care pathways for AIT using strict criteria and provides simple recommendations that can be used by all stakeholders including healthcare professionals. The decision to prescribe AIT for the patient should be indi- vidualized and based on the relevance of the allergens, the persistence of symptoms despite appropriate medications according to guidelines as well as the availability of good-quality and efficacious extracts. Allergen extracts cannot be regarded as generics. Immunotherapy is selected by specialists for stratified patients. There are no currently available validated biomarkers that can predict AIT success. In adolescents and adults, AIT should be re- served for patients with moderate/severe rhinitis or for those with moderate asthma who, despite appropriate pharmacotherapy and adherence, continue to exhibit exacerbations that appear to be related to allergen exposure, ex- cept in some specific cases. Immunotherapy may be even more advanta- geous in patients with multimorbidity. In children, AIT may prevent asthma onset in patients with rhinitis. mHealth tools are promising for the stratifica- tion and follow-up of patients. CITA: Allergy. 2019 Nov;74(11):2087-2102 DOI: 10.1111/all.13805 TÍTULO: Radical aggressive treatment among non-small cell lung cancer patients with malignant pleural effusion without extra-thoracic disease AUTORES: Arrieta O, Escamilla-López I, Lyra-González I, Bar- rón F, Ramírez-Tirado LA, Vergara E, Corona-Cruz JF, Maldonado F, Jiménez-Fuentes E. SUMMARY: Malignant pleural effusion (MPE) is an indicator of advanced disease (stage M1a) in patients with non-small cell lung cancer (NSCLC). Typically, these patients are candidates for palliative treatment. There is a lack of evidence about the radical surgical treatment in carcinomatous pleu- ritis with massive effusion. Here, we present data from a specific subset of patients with MPE treated with systemic therapy and aggressive surgi- cal therapy. M1a NSCLC adenocarcinoma patients with MPE and without extra-thoracic disease were included. After receiving systemic therapy, all patients underwent surgical treatment, which included pneumonectomy or lobectomy, plus mediastinal dissection. Following surgery, patients received radiotherapy to thoracic wall and mediastinum. A total of six patients were analyzed. All patients had an Eastern Cooperative Oncology Group (ECOG) performance status ≤1, two patients harbored EGFR mutation and were treated with tyrosine kinase inhibitors (TKIs), the other four patients were treated with pemetrexed and platin as first-line treatment. Following system- ic therapy, two patients had a pneumonectomy, four patients had a lobec- tomy plus pleurectomy performed. All patients continued with maintenance systemic therapy, and achieved complete responses, according to RECIST 1.1 criteria. The media progression-free survival (PFS) time was 15.9 months (95% CI: 15.6-55.5 months). At the last follow-up, all patients were still alive, with 4 of them without signs of macroscopic tumoral activity. The median overall survival (OS) was not reached. NSCLC patients with MPE without 326

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR extra-thoracic disease could benefit from an aggressive surgical approach following standard of care systemic therapy. However, considering the low sample size of this study and the relatively low incidence of MPE without ex- tra-thoracic disease, further prospective multi-center studies are necessary to evaluate aggressive surgery as a therapeutic option. CITA: J Thorac Dis. 2019 Feb;11(2):595-601 DOI: 10.21037/jtd.2019.01.36 PMID: 31013416 TÍTULO: [MASK (Mobile Airways Sentinel Network). ARIA's comprehensive PMID: 31014749 solution for mobile app for the multimorbidity of allergic rhinitis and asth- ma] AUTORES: Larenas-Linnemann D, Mullol J, Ivancevich JC, Antó JM, Car- dona V, Dedeu T, Rodríguez-González M, Huerta Y, et al. ABSTRACT: The vast majority of patients with allergic rhinitis (AR) do not receive the proper management which is recommended by the guidelines, but they frequently self-medicate. MASK (Mobile Airways Sentinel Network) is an integral part of a project that is supported by the European Union against chronic diseases and focused on active and healthy aging. MASK represents the third phase of ARIA (Allergic Rhinitis and its Impact on Asth- ma), in which, by using a mobile application in a smart device, the objective is to guide the patient in the control of his/her multi-morbidity, AR and/or allergic conjunctivitis (AC) and/or asthma. The mobile app Allergy Diary by MACVIA-ARIA is free and it is available for both Android and iOS platforms. After it is downloaded to the patient's cell phone, it first requests some in- formation about the patient's profile, allergic pathologies and medication; afterwards, through a visual analog scale, the patient is invited to determine the degree of affectation in the nose, eyes, and bronchi, and its influence on their productivity at work / school. After analyzing the data generated by filling the Allergy Diary, it became clear there is a new clinical entity: aller- gic rhinitis+ allergic conjunctivitis +asthma, with greater effect; in addition to a high level of self-medication: in general, the patient takes medication on days when symptoms are present. The app has already been deployed in 23 countries, including several Spanish-speaking countries. CITA: Rev Alerg Mex. 2019 Jan-Mar;66(1):140-146 DOI: 10.29262/ram.v66i1.578 TÍTULO: The Mexican consensus on the diagnosis and treatment of divertic- ular disease of the colon AUTORES: Raña-Garibay R, Salgado-Nesme N, Carmona-Sánchez R, Remes-Troche JM, Aguilera-Carrera J, Alonso-Sánchez L, Arnaud-Carreño C, Charúa-Guindic L, Coss-Adame E, de la Torre-Bravo A, Espinosa-Medina D, Esquivel-Ayanegui F, Roesch-Dietlen F, López-Colombo A, Muñoz-Torres JI, Noble-Lugo A, Rojas-Mendoza F, Suazo-Barahona J, Stoopen-Rometti M, Torres-Flores E, Vallejo-Soto M, Vergara-Fernández O. SUMMARY: Since the publication of the 2008 guidelines on the diagnosis and treatment of diverticular disease of the colon by the Asociación Mex- icana de Gastroenterología, significant advances have been made in the knowledge of that disease. A systematic review of articles published in the medical literature from January 2008 to July 2018 was carried out to revise and update the 2008guidelines and provide new evidence-based recom- mendations. All high-quality articles in Spanish and English published within 327

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31036083 that time frame were included. The final versions of the 43 statements ac- PMID: 31043948 cepted in the three rounds of voting, utilizing the Delphi method, were writ- ten, and the quality of evidence and strength of the recommendations were established for each statement, utilizing the GRADE system. The present consensus contains new data on the definition, classification, epidemiology, pathophysiology, and risk factors of diverticular disease of the colon. Special emphasis is given to the usefulness of computed tomography and colonos- copy, as well as to the endoscopic methods for controlling bleeding. Outpa- tient treatment of uncomplicated diverticulitis is discussed, as well as the role of rifaximin and mesalazine in the management of complicated acute diverticulitis. Both its minimally invasive alternatives and surgical options are described, stressing their indications, limitations, and contraindications. The new statements provide guidelines based on updated scientific evidence. Each statement is discussed, and its quality of evidence and the strength of the recommendation are presented. CITA: Rev Gastroenterol Mex. 2019 Apr - Jun;84(2):220-240 DOI: 10.1016/j.rgmx.2019.01.002 TÍTULO: Successive complications after anterior cervical fixation: pharyn- goesophageal diverticulum, fistulization, and cervical spondylitis by Strepto- coccus milleri - case report and literature review AUTORES: Volkow-Fernández P, Islas-Muñoz B, Santillán-Doherty P, Es- trada-Lobato E, Alva-López L, Ávila-Ramírez J. INTRODUCTION: Pharyngoesophageal diverticulum is an uncommon com- plication after anterior cervical discectomy and fusion surgery. CASE PRESENTATION: Our patient was a 48-year-old woman with two pre- vious cervical surgeries with fixation of C4-C5 and C5-C6, the last one in 2003. Two years after surgery, she presented with arthralgia, arthritis, chills, and fluctuating rash. In 2007, she presented with dysphagia, halitosis, and sputum production. She was diagnosed with a pharyngoesophageal divertic- ulum with a fistula to C6 vertebra and secondary spondylitis. She was taken for open surgery with removal of screws and plates, cricopharyngeal myot- omy, and esophageal repair. Streptococcus milleri grew in tissue and osteo- synthetic material. She received 4 months of amoxicillin and probenecid and had a complete recovery. Since 1991, 19 similar cases have been reported with one fatality. To our knowledge, this is the first reported case of diverticu- lum complicated with fistula and secondary spondylitis. CONCLUSIONS: In patients with a history of anterior cervical discectomy and fusion complaining of dysphagia, even years after surgery, it is manda- tory to perform an esophagogram. This symptom was referred to in 88% of the cases reported in the literature. CITA: J Med Case Rep. 2019 Apr 30;13(1):129 DOI: 10.1186/s13256-019-2037-4 TÍTULO: Epidemiological Profile of Patients of Aged 65 Years and Over in a University Private Hospital AUTORES: Conde-Flores E, Dorantes-Heredia R, Motola-Kuba D, Grimal- do-Roque HJ, Martínez-Sámano JE, Ruiz-Morales JM. 328

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR OBJECTIVES: An increase in life expectancy is predicted for the general population and, by 2050, about one billion people will be older than 65 years. The Global Cancer Incidence, Mortality and Prevalence database estimates that 1.2million people of this age will have cancer; this number represents 58% of new cases in the American population. This represents a challenge for diagnosis and treatment, given that some older people have multiple co- morbidities and disabilities. MATERIALS AND METHODS: This was a retrospective descriptive study of 204 patients aged 65 years and over. All had a solid tumor that was diag- nosed in a private hospital from January 2015 to December 2017. RESULTS: The median age was 72.2 years; the most frequent age group (48.5% of patients) was 65-75 years, and only a small percentage (4.4%) were aged > 85years. The most common type of cancer was lung cancer (22.5%), followed by colorectal and urinary cancer. Most patients received cancer treatment after the disease diagnosis. CONCLUSION: There are no epidemiological studies of the older oncology population in Mexico. We believe it is necessary to perform larger studies to understand this population and to undertake actions to facilitate greater attention to patient diagnosis, treatment, and alleviation. CITA: Case Rep Oncol. 2019 Jan 24;12(1):113-118 DOI: 10.1159/000496812 PMID: 31053546 TÍTULO: Alcohol-related liver disease: Clinical practice guidelines by the Latin American Association for the Study of the Liver (ALEH) AUTORES: Arab JP, Roblero JP, Altamirano J, Bessone F, Chaves Araujo R, Higuera-De la Tijera F, Restrepo JC, Torre A, Urzua A, Simonetto DA, Abraldes JG, Méndez-Sánchez N, Contreras F, Lucey MR, Shah VH, Cor- tez-Pinto H, Bataller R. SUMMARY: Alcohol-related liver disease (ALD) is a major cause of ad- vanced chronic liver disease in Latin-America, although data on prevalence is limited. Public health policies aimed at reducing the alarming prevalence of alcohol use disorder in Latin-America should be implemented. ALD com- prises a clinical-pathological spectrum that ranges from steatosis, steato- hepatitis to advanced forms such as alcoholic hepatitis (AH), cirrhosis and hepatocellular carcinoma. Besides genetic factors, the amount of alcohol consumption is the most important risk factor for the development of ALD. Continuous consumption of more than 3 standard drinks per day in men and more than 2 drinks per day in women increases the risk of developing liver disease. The pathogenesis of ALD is only partially understood and recent translational studies have identified novel therapeutic targets. Early forms of ALD are often missed and most clinical attention is focused on AH, which is defined as an abrupt onset of jaundice and liver-related complications. In- patients with potential confounding factors, a transjugular biopsy is recom- mended. The standard therapy for AH (i.e. prednisolone) has not evolved in the last decades yet promising new therapies (i.e. G-CSF, N-acetylcysteine) have been recently proposed. In both patients with early and severe ALD, prolonged abstinence is the most efficient therapeutic measure to decrease long-term morbidity and mortality. A multidisciplinary team including alcohol addiction specialists is recommended to manage patients with ALD. Liver transplantation should be considered in the management of patients with 329

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31061854 end-stage ALD that do not recover despite abstinence. In selected cases, PMID: 31083272 increasing number of centers are proposing early transplantation for patients with severe AH not responding to medical therapy. CITA: Ann Hepatol. 2019 May - Jun;18(3):518-535 DOI: 10.1016/j.aohep.2019.04.005 TÍTULO: Data on genotype frequency for SNPs associated to age of smok- ing onset and successful smoking cessation treatment AUTORES: Pérez-Rubio G, López-Flores LA, Ramírez-Venegas A, San- sores RH, Falfán-Valencia R. SUMMARY: This article contains data on the allele and genotype frequency for single nucleotide polymorphisms (SNPs) in candidate genes CHRNA5 (rs16969968, rs17408276, rs680244) CHRNA3 (rs6495307, rs12914385) NRXN1 (rs10865246, rs1882296, rs985919) and HTR2A (rs6311, rs6313) previously evaluated as genetic risk variants for cigarette smoking at an ear- ly age and relapse to smoking cessation treatment Pérez-Rubio et al., 2018. These SNPs were selected due to previous associations in other populations, including Mexican Mestizos. Smokers were classified according to the age at onset, cigarettes per day, nicotine dependence, COPD status and therapy received. CITA: Data Brief. 2019 Apr 17;24:103893 DOI: 10.1016/j.dib.2019.103893 TÍTULO: Chemotherapy-induced posterior reversible encephalopathy syn- drome: Three case reports AUTORES: Cacho-Díaz B, Lorenzana-Mendoza NA, Salmerón-Moreno K, Reyes-Soto G, Castillo-Rangel C, Corona-Cedillo R, Escobar-Ceballos S, Garza-Salazar JG. RATIONALE: Posterior reversible encephalopathy syndrome (PRES) has been associated with the use of several medications, including chemother- apeutic agents. PATIENT CONCERNS: A 65-year-old woman was diagnosed with adeno- carcinoma of the ovary, after sixth-line treatment with topotecan, at the be- ginning of the fourth cycle, she was admitted to the emergency room for presenting tonic-clonic seizures, visual disturbance, and hypertension. A 66-year-old woman was diagnosed with bilateral breast cancer; due to dis- ease progression, treatment with paclitaxel and gemcitabine was started, 1 month after the last dose of chemotherapy, she was admitted to the emer- gency room for suffering severe headache, altered mental status, tonic-clon- ic seizures, and hypertension. A60-year-old patient diagnosed with breast cancer on the left side, underwent second-line chemotherapy with gemcit- abine, carboplatin, and bevacizumab, and 1month after the last dose of che- motherapy, she was also admitted to the emergency room due to altered mental status, vomiting, tonic-clonic seizures, and hypertension. DIAGNOSIS: They were diagnosed as PRES based on physical examina- tion, laboratory findings, and imaging techniques that revealed diffuse le- sions and edema within the parieto-occipital regions. 330

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR INTERVENTIONS: They received support treatment with blood pressure (BP) control, seizures were controlled with a single anti-epileptic agent, and chemotherapeutic agents from the onset of PRES to its resolution were dis- continued. OUTCOMES: All these patients improved after medical treatment was started. LESSONS: Medical personnel and therapeutic establishments need to be made aware about this chemotherapy-induced neurologic complication. CITA: Medicine (Baltimore). 2019 May;98(19):e15691 DOI: 10.1097/MD.0000000000015691 PMID: 31108462 TÍTULO: Cholesterol enrichment in liver mitochondria impairs oxidative PMID: 31115962 phosphorylation and disrupts the assembly of respiratory supercomplexes AUTORES: Solsona-Vilarrasa E, Fucho R, Torres S, Nuñez S, Nuño-Lám- barri N, Enrich C, García-Ruiz C, Fernández-Checa JC. SUMMARY: Mitochondrial cholesterol accumulation is a hallmark of alcohol- ic and non-alcoholic fatty liver diseases and impairs the function of specific solute carriers through changes in membrane physical properties. However, its impact on mitochondrial respiration and organization of respiratory super complexes has not been determined so far. Here we fed mice a cholester- ol-enriched diet (HC)supplemented with sodium cholate to examine the ef- fect of cholesterol in mitochondrial function. HC feeding increased liver cho- lesterol content, which downregulated Srebp2 and Hmgcr expression, while sodium cholate administration decreased Cyp7a1 and Cyp8b1 mRNA lev- els, suggesting the downregulation of bile acid synthesis through the clas- sical pathway. HC-fed mice exhibited increase dexpression of Stard1 and Mln64 and enhanced mitochondrial free cholesterol levels(2-3 fold), leading to decreased membrane fluidity. Mitochondria from HC-fed mice displayed increased cholesterol loading in both outer and inner mitochondrial mem- branes. Cholesterol loading decreased complex I and complex II-driven state 3 respiration and mitochondrial membrane potential. Decreased respiratory and uncoupling control ratio from complex I was also observed after in situ enrichment of mouse liver mitochondria with cholesterol or enantiomer cho- lesterol, the mirror image of natural cholesterol. Moreover, in vivo cholesterol loading decreased the level of complex III2 and the assembly of respiratory super complexes I1+III2+IV and I1+III2. Moreover, HC feeding caused oxi- dative stress and mitochondrial GSH (mGSH) depletion, which translated in hepatic steatosis and liver injury, effects that were rescued by replenishing GSH with GSH ethyl ester. Overall, mitochondrial cholesterol accumulation disrupts mitochondrial functional performance and the organization of respi- ratory supercomplexes assembly, which can contribute to oxidative stress and liver injury. CITA: Redox Biol. 2019 Jun;24:101214 DOI: 10.1016/j.redox.2019.101214 TÍTULO: Catatonia in patients with anti-NMDA receptor encephalitis AUTORES: Espinola-Nadurille M, Flores-Rivera J, Rivas-Alonso V, Vargas-Cañas S, Fricchione GL, Bayliss L, Martinez-Juarez IE, Hernan- 331

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31139356 dez-Vanegas LE, Martinez-Hernandez R, Bautista-Gomez P, Solis-Viv- PMID: 31167744 anco R, Perez-Esparza R, Bustamante-Gomez PA, Restrepo-Martinez M, Ramirez-Bermudez J. AIM: There is a lack of studies related to the frequency, phenomenology, and associated features of catatonic syndrome in patients with anti-NMDA receptor encephalitis (ANMDARE). This study aimed to measure the fre- quency of catatonia in this condition and to delineate its particular symptoms. METHODS: A prospective study was done with all inpatients who fulfilled the criteria of definite ANMDARE admitted to the National Institute of Neurology and Neurosurgery of Mexico from January 2014 to September 2018. The Bush-Francis Catatonia Rating Scale and Braünig Catatonia Rating Scale were administered at admission. RESULTS: Fifty-eight patients were included and catatonia was diagnosed in 41 of these patients (70.6%). Immobility, staring, mutism, and posturing were the most frequent catatonic signs. Catatonia was associated with deliri- um, hallucinations, psychomotor agitation, generalized electroencephalogra- phy dysfunction, and previous use of antipsychotics. Mortality was present in 10% of the total sample; it was associated with status epilepticus, and was less frequent in the catatonia group. After immunotherapy, all cases showed a complete recovery from catatonic signs. CONCLUSION: This systematic assessment of catatonic syndrome shows that it is a frequent feature in patients with ANMDARE as part of a clini- cal pattern that includes delirium, psychomotor agitation, and hallucinations. The lack of recognition of this pattern may be a source of diagnostic and therapeutic errors, as most physicians associate catatonia with schizophre- nia and affective disorders. CITA: Psychiatry Clin Neurosci. 2019 Sep;73(9):574-580 DOI: 10.1111/pcn.12867 TÍTULO: When the Creation of a Consortium Provides Useful Answers: Ex- perience of The Latin American DILI Network (LATINDILIN) AUTORES: Bessone F, Hernandez N, Mendizabal M, Sanchez A, Paraná R, Arrese M, Tagle M, Girala M, Lizarzabal M, Carrera E, Brahm J, Contreras F, Mendez-Sanchez N, Santos G, Nunes V, Medina-Caliz I, Parra-Martinez C, Sanz-Villanueva L, Isabel Lucena M, Andrade RJ. SUMMARY: Review article CITA: Clin Liver Dis (Hoboken). 2019 Mar 4;13(2):51-57 DOI: 10.1002/cld.778 TÍTULO: Technical position on milk and its derivatives in adult health and disease from the Asociación Mexicana de Gastroenterología and the Asocia- ción Mexicana de Gerontología y Geriatría AUTORES: Uscanga-Domínguez LF, Orozco-García IJ, Vázquez-Frias R, Aceves-Tavares GR, Albrecht-Junnghans RE, Amieva-Balmori M, Bazaldua-Merino LA, Bernal-Reyes R, Camacho-de León ME, Campos-Guti- érrez JA, Carmona-Sánchez RI, Castro-Marín LV, Coss-Adame E, Cue- vas-Estrada AJ, Escobedo-Martínez JA, González-Franco LR, Huerta-Iga 332

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR FM, Lozano-Lozano R, Martínez-Vázquez SE, Milke García MP, Noguei- ra-de Rojas JR, Padilla-González M, Pérez Y López N, Silva-Campechano F, Treviño-Mejía MC, Velázquez-Alva MC. SUMMARY: Milk is a liquid food that possesses an important quantity of highly bioavailable macronutrients. In addition, it is readily accessible, as well as relatively inexpensive. Given that the knowledge of physicians about nutrition and food composition is deficient, in general, many of the dietary interventions recommended in diverse clinical settings lack a scientific basis. The aim of the present review was to produce a technical opinion that serves as a frame of reference to best sustain recommendations for consuming milk and dairy products as daily nutrition in the adult and older adult. The effects of milk and dairy products during the pediatric stage are not addressed in the present work. The Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Gerontología y Geriatría jointly discussed and ana- lyzed topics dealing with the legal designation of milk, the classification and nutritional profile of cow's milk, its nutritional characteristics, its consumption in the adult, intolerance to cow's milk, and associations of milk consumption with digestive tract alterations and other conditions. Finally, certain aspects of milk consumption in the older adult and its relation to overall health are briefly discussed. CITA: Rev Gastroenterol Mex (Engl Ed). Jul-Sep 2019;84(3):357-371 DOI: 10.1016/j.rgmx.2019.03.002 PMID: 31185999 TÍTULO: Discriminant analysis and machine learning approach for evaluat- ing and improving the performance of immunohistochemical algorithms for COO classification of DLBCL AUTORES: Perfecto-Avalos Y, Garcia-Gonzalez A, Hernandez-Reynoso A, Sánchez-Ante G, Ortiz-Hidalgo C, Scott SP, Fuentes-Aguilar RQ, Di- az-Dominguez R, León-Martínez G, Velasco-Vales V, Cárdenas-Escudero MA, Hernández-Hernández JA, Santos A, Borbolla-Escoboza JR, Villela L. BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) is classified into germinal center-like (GCB) and non-germinal center-like (non-GCB) cell-of-origin groups, entities driven by different oncogenic pathways with different clinical outcomes. DLBCL classification by immunohistochemistry (IHC)-based decision tree algorithms is a simpler reported technique than gene expression profiling (GEP). There is a significant discrepancy between IHC-decision tree algorithms when they are compared to GEP. METHODS: To address these inconsistencies, we applied the machine learning approach considering the same combinations of antibodies as in IHC-decision tree algorithms. Immunohistochemistry data from a public DLBCL database was used to perform comparisons among IHC-decision tree algorithms, and the machine learning structures based on Bayesian, Bayesian simple, Naïve Bayesian, artificial neural networks, and support vector machine to show the best diagnostic model. We implemented the linear discriminant analysis over the complete database, detecting a higher influence of BCL6 antibody for GCB classification and MUM1 for non-GCB classification. RESULTS: The classifier with the highest metrics was the four anti- body-based Perfecto-Villela (PV) algorithm with 0.94 accuracy, 0.93 spec- ificity, and 0.95sensitivity, with a perfect agreement with GEP (κ = 0.88, P < 0.001). After training, a sample of 49 Mexican-mestizo DLBCL patient data was classified by COO for the first time in a testing trial. 333

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR CONCLUSIONS: Harnessing all the available immunohistochemical data without reliance on the order of examination or cut-off value, we conclude that our PV machine learning algorithm outperforms Hans and other IHC-de- cision tree algorithms currently in use and represents an affordable and time-saving alternative for DLBCL cell-of-origin identification. CITA: J Transl Med. 2019 Jun 11;17(1):198 DOI: 10.1186/s12967-019-1951-y PMID: 31187034 TÍTULO: Usefulness of qSOFA and ECOG Scores for Predicting Hospital Mortality in Postsurgical Cancer Patients without Infection AUTORES: Ñamendys-Silva SA, Joachin-Sánchez E, Joffre-Torres A, Cór- dova-Sánchez BM, Ferrer-Burgos G, González-Chon O, Herrera-Gomez A. BACKGROUND: The quick sequential organ failure assessment (qSOFA) and the Eastern Cooperative Oncologic Group (ECOG) scale are simple and easy parameters to measure because they do not require laboratory tests. The objective of this study was to compare the discriminatory capacity of the qSOFA and ECOG to predict hospital mortality in postsurgical cancer patients without infection. METHODS: During the period 2013-2017, we prospectively collected data of all patients without infection who were admitted to the ICU during the postoperative period, except those who stayed in the ICU for <24 hours or patients under 18years. The ECOG score during the last month before hos- pitalization and the qSOFA performed during the first hour after admission to the intensive care unit (ICU) were collected. The primary outcome for this study was the in-hospital mortality rate. RESULTS: A total of 315 patients were included. The ICU and hospital mor- tality rates were 6% and 9.2%, respectively. No difference was observed be- tween the qSOFA [AUC=0.75 (95% CI = 0.69-0.79)] and the ECOG scores [AUC=0.68 (95%CI=0.62-0.73)] (p=0.221) for predicting in-hospital mortality. qSOFA greater than 1predicted in-hospital mortality with a high sensitivity (100%) but lows pecificity (38.8%); positive predictive value of 26.3% and negative predictive value of 93.1% compared to 74.4% of specificity, 55.1% of sensitivity%; positive predictive value of 18% and negative predictive val- ue of 94.2% for an ECOG score greater than 1. Multivariable Cox regression analysis identified two independent predicting factors of in-hospital mortality, which included ECOG score during thelast month before hospitalization (HR: 1.46; 95 % CI: 1.06-2.00); qSOFAcalculated in the first hours after ICU ad- mission (OR: 3.17; 95 % CI: 1.79-5.63). CONCLUSION: No difference was observed between the qSOFA and ECOG for predicting in-hospital mortality. The qSOFA score performed during the first hour after admission to the ICU and ECOG scale during the last month before hospitalization were associated with in-hospital mortality in postsur- gical cancer patients without infection. The qSOFA and ECOG score have a potential to be included as early warning tools for hospitalized postsurgical cancer patients without infection. CITA: Int J Chronic Dis. 2019 May 2;2019:9418971 DOI: 10.1155/2019/9418971 334

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31200425 TÍTULO: [MASK (Mobile Airways Sentinel Network), a mobile App with PMID: 31200597 ARIA's comprehensive solution in Spanish-speaking countries] AUTORES: Larenas-Linnemann D, Mullol J, Ivancevich JC, Anto JM, Car- dona V, Dedeu T, Rodríguez-González M, et al. ABSTRACT: Although there are high quality clinical guidelines about allergic rhinitis, many patients receive deficient treatment, partly due to the high lev- el of self-medication. MASK (Mobile Airways Sentinel Network) is an integral part of a project against chronic diseases which it is focused on active and healthy aging and is supported by the European Union. It forms the third phase of ARIA (Allergic Rhinitis and its Impact on Asthma) in which, through a mobile app on a smart device, the purpose is to guide patients in the con- trol of their multimorbidity, allergic rhinitis or conjunctivitis, or asthma. The \"Allergy Diary\" app by MACVIA-ARIA is free and it is available for Android and iOS; on it, patients indicate how unpleasant the symptoms are on a daily basis through five screens with an analogous visual scale; two more screens were recently added (sleep affectation). With the app, it is also possible to download the information of the \"Allergy Diary\" on the physician's computer through a QR code at the moment of the medical consultation. In this article, we review the first year of experience in Spain, Mexico and Argentina, where the Spanish version is used. CITA: Rev Alerg Mex. 2019 Apr-Jun;66(2):263-268 DOI: 10.29262/ram.v66i2.628 TÍTULO: [GUIMIT 2019, Mexican Guideline on Immunotherapy. Guideline on the diagnosis of IgE-mediated allergic disease and immunotherapy fol- lowing the ADAPTE approach] AUTORES: Larenas-Linnemann D, et al. BACKGROUND: In Mexico, allergen immunotherapy (AIT) and immuno- therapy with hymenoptera venom (VIT) is traditionally practiced combining aspects of the European and American school. In addition, both types of ex- tracts (European and American) are commercially available in Mexico. More- over, for an adequate AIT/VITa timely diagnosis is crucial. Therefore, there is a need for a widely accepted, up-to-date national immunotherapy guideline that covers diagnostic issues, indications, dosage, mechanisms, adverse ef- fects and future expectations of AIT(GUIMIT 2019). METHOD: With nationwide groups of allergists participating, including dele- gates from postgraduate training-programs in Allergy/Immunology-forming, the guideline document was developed according to the ADAPTE methodology: the immune therapy guidelines from European Academy of Allergy and Clini- cal Immunology, German Society for Allergology and Clinical Immunology, The American Academy of Allergy, Asthma and Immunology and American College of Allergy, Asthma, and Immunology were selected as mother guidelines, as they received the highest AGREE-II score among international guidelines available; their evidence conforms the scientific basis for this document. RESULTS: GUIMIT emanates strong or weak (suggestions) recommenda- tions about practical issues directly related to in vivo or in vitro diagnosis of IgE mediated allergic diseases and the preparation and application of AIT/ VIT and its adverse effects. GUIMIT finishes with a perspective on AIT mo- dalities for the future. All the statements were discussed and voted on until > 80 % consensus was reached. 335

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31213259 CONCLUSIONS: A wide and diverse group of AIT/VIT experts issued trans- culturized, evidence-based recommendations and reached consensus that might improve and standardize AIT practice in Mexico. CITA: Rev Alerg Mex. 2019;66 Suppl 1:1-105 DOI: 10.29262/ram.v66i5.631 TÍTULO: [The histological and immunohistochemical diagnosis of solid pseu- dopapillary neoplasm of the pancreas and its differential diagnosis] AUTORES: Erráez-Jaramillo PJ, Ortiz-Hidalgo C. SUMMARY: Solid pseudopapillary neoplasm of the pancreas is a rare tumor of uncertain histogenesis, described separately by Gruber and Frantz, that accounts for between approximately 1% and 3% of pancreatic neoplasms. It is characterized by a cystic and solid pattern of growth patterns with forma- tion of pseudo papillae. It occurs primarily in young women, although cases in children and older patients and men have been reported. The tumor is of low-grade malignant potential, as the majority of the cases are cured by sim- ple but complete surgical resection. Knowledge of the unique morphologic characteristics of this neoplasm is essential for the correct diagnosis. We review herein the pathologic and immunohistochemical features of this neo- plasm and its differential diagnosis with other pancreatic tumors. CITA: Rev Esp Patol. 2019 Jul - Sep; 52(3):178-189 DOI: 10.1016/j.patol.2019.03.001 PMID: 31213326 TÍTULO: The Mexican consensus on non-cardiac chest pain AUTORES: Gómez-Escudero O, Coss-Adame E, Amieva-Balmori M, Car- mona-Sánchez RI, Remes-Troche JM, Abreu Y Abreu AT, Cerda-Contre- ras E, Gómez-Castaños PC, González-Martínez MA, Huerta-Iga FM, Ibar- ra-Palomino J, Icaza-Chávez ME, López-Colombo A, Márquez-Murillo MF, Mejía-Rivas M, Morales-Arámbula M, Rodríguez-Chávez JL, Torres-Barrera G, Valdovinos-García LR, Valdovinos-Díaz MA, Vázquez-Elizondo G, Vil- lar-Chávez AS, Zavala-Solares M, Achem SR. INTRODUCTION: Non-cardiac chest pain is defined as a clinical syndrome characterized by retrosternal pain similar to that of angina pectoris, but of non-cardiac origin and produced by esophageal, musculoskeletal, pulmo- nary, or psychiatric diseases. AIM: To present a consensus review based on evidence regarding the defi- nition, epidemiology, pathophysiology, and diagnosis of non-cardiac chest pain, as well as the therapeutic options for those patients. METHODS: Three general coordinators carried out a literature review of all articles published in English and Spanish on the theme and formulated 38 initial statements, dividing them into 3 main categories: (i)definitions, epi- demiology, and pathophysiology; (ii)diagnosis, and (iii)treatment. The state- ments underwent 3rounds of voting, utilizing the Delphi system. The final statements were those that reached >75% agreement, and they were rated utilizing the GRADE system. 336

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31261501 RESULTS AND CONCLUSIONS: The final consensus included 29 state- PMID: 31276353 ments. All patients presenting with chest pain should initially be evaluated by a cardiologist. The most common cause of non-cardiac chest pain is gastroesophageal reflux disease. If there are no alarm symptoms, the ini- tial approach should be a therapeutic trial with a proton pump inhibitor for 2-4weeks. If dysphagia or alarm symptoms are present, endoscopy is rec- ommended. High-resolution manometry is the best method for ruling out spastic motor disorders and achalasia and pH monitoring aids in demon- strating abnormal esophageal acid exposure. Treatment should be directed at the pathophysiologic mechanism. It can include proton pump inhibitors, neuromodulators and/or smooth muscle relaxants, psychologic intervention and/or cognitive therapy, and occasionally surgery or endoscopic therapy. CITA: Rev Gastroenterol Mex. 2019 Jul - Sep; 84(3):372-397 DOI: 10.1016/j.rgmx.2019.05.002 TÍTULO: Analysis of circulating blood and tissue biopsy PDX1 and MSX2 gene expression in patients with pancreatic cancer: A case-control experi- mental study AUTORES: Duarte-Medrano G, Lopez-Méndez I, Ramírez-Luna MÁ, Val- dovinos-Andraca F, Cruz-Martínez R, Medina-Vera I, Pérez-Monter C, Télle- z-Ávila FI. SUMMARY: Early diagnosis of pancreatic cancer (PC) is based on endo- scopic ultrasound (EUS). However, EUS is invasive and requires a high level of technical skill. Recently, liquid biopsies have achieved the same sensi- tivity and specificity for the diagnosis of numerous pathologies, including cancer. Insulin-promoting factor1 (PDX1) and Msh-homeobox 2 (MSX2), 2 homeotic genes, have been confirmed to be related to pancreatic oncogen- esis. The aim of this study is to establish the diagnostic utility of circulating serum levels of MSX2 and PDX1 expression in patients with PC. A prospec- tive study was conducted from January 2014 to February 2017. Patients with a suspected diagnosis of PC who underwent fine needle aspiration biopsy guided by EUS (EUS-FNA) were included in the study, in addition to non- PC control subjects. Both tissue and blood serum samples were submitted to histopathological analysis and measurement of PDX1 and MSX2 gene expression by means of qRT-PCR. Patients were divided into non-PC, ma- lignant pathology (MP), or benign pathology (BP) groups. Significant differ- ences in both MSX2 [2.05(1.66-4.60) vs 0.83 (0.49-1.60), P = .006] and PDX1 [2.59 (1.28-10.12) vs 1.02(0.81-1.17), P = .036] gene expression were found in blood samples of PC compared with non-PC subjects. We also observed a significant increase in MSX2 transcripts in tissue biopsy samples of pa- tients diagnosed with MP compared with those with BP [1.98 (1.44-4.61) and 0.66 (0.45-1.54), respectively, P = .012]. The ROC curves indicate a sensi- tivity and specificity of 80% for PDX1 and 86% forMSX2.Gene expression of MSX2 in tissue samples obtained by EUS-FNA and serum expression of MSX2 and PDX1 were higher in patients with PC. CITA: Medicine (Baltimore). 2019 Jun; 98(26):e15954 DOI: 10.1097/MD.0000000000015954 TÍTULO: National Clinical Practice Guidelines for the management of non- small cell lung cancer in early, locally advanced and metastatic stages. Ex- tended version AUTORES: Barrón-Barrón F, (…) Lozano-Ruiz FJ, et a.. 337

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR OBJECTIVE: Lung cancer is one the leading causes of mortality world- wide. Symptomatic manifestations of the disease generally occur in the ad- vanced-stage setting, and therefore an important number of patients have advanced or metastatic disease by the time they are diagnosed. This situa- tion contributes to a poor prognosis in the treatment of lung cancer. Evidence based clinical recommendations are of great value to support decision-making for daily practice, and thus improving health care quality and patient outcomes. MATERIALS AND METHODS: This document was an initiative of the Mex- ican Society of Oncology (SMEO) in collaboration with Mexican Center of Clinical Excellence (Cenetec) according to Interna- tional Standards. Such standards included those described by the IOM, NICE, SIGN and GI-N. An interdisciplinary Guideline Development Group (GDG) was put together which included medical oncologists, surgical oncologists, radiation thera- pists, and methodologists with expertise in critical appraisal, systematic re- views and clinical practice guidelines development. RESULTS: 62 clinical questions were agreed among members of the GDG. With the evidence identified from systematic reviews, the GDG developed clinical recommendations using a Modified Delphi Panel technique. Patients' representatives validated them. CONCLUSIONS: These Clinical Practice Guideline aims to support the shared decision-making process for patients with different stages of non- small cell lung cancer. Our goal is to improve health-care quality on these patients. CITA: Salud Publica Mex. 2019 May-Jun;61(3):359-414 DOI: 10.21149/9916 PMID: 31318706 TÍTULO: Evaluating an Outpatient With an Elevated Bilirubin AUTORES: Méndez-Sánchez N, Qi X, Vitek L, Arrese M. SUMMARY: Review CITA: Am J Gastroenterol. 2019 Aug; 114(8):1185-1188 DOI: 10.14309/ajg.0000000000000336 PMID: 31324404 TÍTULO: Progressive supranuclear palsy as differential diagnosis of Parkin- son's disease in the elderly AUTORES: Fernández-Ferreira R, García-Santos RA, Rodríguez-Violante M, López-Martínez C, Becerra-Laparra IK, Torres-Pérez ME. INTRODUCTION: Progressive supranuclear palsy (PSP) is a syndrome characterized by progressive Parkinsonism with early falls due to postural in- stability, typically vertical gaze supranuclear ophthalmoplegia, pseudobulbar dysfunction, neck dystonia and upper trunk rigidity as well as mild cognitive dysfunction. Progressive supranuclear palsy must be differentiated from Par- kinson's disease taking into account several so-called red flags. MATERIALS AND METHODS: We report a case series hallmarked by gait abnormalities, falls and bradykinesia in which Parkinson's disease was the initial diagnosis. 338

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31333824 RESULTS: Due to a torpid clinical course, magnetic resonance imaging (MRI) was performed demonstrating midbrain atrophy, highly suggestive of progressive supranuclear palsy. CONCLUSION: The neuroradiological exams (magnetic resonance imaging, single photon emission computer tomography, and positron emission tomog- raphy) can be useful for diagnosis of PSP. Treatment with levodopa should be considered, especially in patients with a more parkinsonian phenotype. CITA: Rev Esp Geriatr Gerontol. 2019 Sep - Oct; 54(5):251-256 DOI: 10.1016/j.regg.2019.04.002 TÍTULO: Cuando la creación de un consorcio proporciona respuestas útiles: experiencia de la Latin American DILI network (LATINDILIN) AUTORES: Bessone F, Hernández N, Mendizábal M, Sánchez A, Paraná R, Arrese M, Tagle M, Girala M, Lizarzábal M, Carrera E, Brahm J, Contreras F, Méndez-Sánchez N, Santos G, Nunes V, Medina-Cáliz I, Parra-Martínez C, Sanz-Villanueva L, Isabel Lucena M, Andrade RJ. SUMMARY: Editorial CITA: Clin Liver Dis (Hoboken). 2019 May 29; 13(Suppl 1):S17-S23 DOI: 10.1002/cld.840 PMID: 31378319 TÍTULO: Erratum to: The Mexican consensus on the diagnosis and treat- ment of diverticular disease of the colon\" AUTORES: Raña-Garibay R, Salgado-Nesme N, Carmona-Sánchez R, Remes-Troche JM, Aguilera-Carrera J, Alonso-Sánchez L, Arnaud-Carreño C, Charúa-Guindic L, Coss-Adame E, de la Torre-Bravo A, Espinosa-Medina D, Esquivel-Ayanegui F, Jacobo-Karam JS, Roesch-Dietlen F, López-Colom- bo A, Muñoz-Torres JI, Noble-Lugo A, Rojas-Mendoza F, Suazo-Barahona J, Stoopen-Rometti M, Torres-Flores E, Vallejo-Soto M, Vergara-Fernández O. SUMMARY: Editorial CITA: Rev Gastroenterol Mex. 2019 Jul - Sep; 84(3):423-424 DOI: 10.1016/j.rgmx.2019.07.001 PMID: 31381969 TÍTULO: Understanding the association of polycystic ovary syndrome and non-alcoholic fatty liver disease AUTORES: Salva-Pastor N, Chávez-Tapia NC, Uribe M, Nuño-Lámbarri N. SUMMARY: Polycystic ovary syndrome (PCOS) is the most common endo- crine disorder among reproductive-age women. Patients with non-alcoholic fatty liver disease (NAFLD) often suffer from metabolic syndrome, athero- sclerosis, ischemic heart disease, and extrahepatic tumors, conferring a lower survival than the general population; therefore it is crucial to study the association between NAFLD and PCOS since it remains poorly understood. Insulin resistance (IR) plays a central role in the pathogenesis of NAFLD and PCOS; also, hyperandrogenism enhances IR in these patients. IR, present in the NAFLD-PCOS association could decrease the hepatic production of 339

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR sex hormone-binding globulin through a possible regulation mediated by hepatocyte nu- clear factor 4 alpha. On the other hand, apoptotic processes initiated by androgens actively contribute to the progression of NAFLD. Considering the association between the two conditions, the screening of women with PCOS for the presence of NAFLD appears reasonable. The pathophysiological mecha- nisms of PCOS-NAFLD association and the initial approach will be reviewed here. CITA: J Steroid Biochem Mol Biol. 2019 Nov; 194:105445 DOI: 10.1016/j.jsbmb.2019.105445 PMID: 31388920 TÍTULO:AcuteAbdomen in Kawasaki Disease AUTORES: Velez-Tirado N, Ridaura-Sanz C, Venegas-Montoya E, Scheffler-Mendoza S, Camacho-Moreno R, Otero-Mendoza F, Medina-Vega FA, Garrido-García LM, Rivas- -Larrauri F, Nakashimada MAY. SUMMARY: Letter to the editor CITA: Indian J Pediatr. 2019 Dec; 86(12):1151-1152 DOI: 10.1007/s12098-019-03048-6 PMID: 31416707 TÍTULO: The bidirectional relationship between viral hepatitis infections and work PMID: 31445223 AUTORES: Chavez-Tapia N. SUMMARY: Editorial CITA: Ann Hepatol. 2019 Sep - Oct; 18(5):655 DOI: 10.1016/j.aohep.2019.07.001 TÍTULO: Mobile Technology inAllergic Rhinitis: Evolution in Management or Revolution in Health and Care? AUTORES: Bousquet J, (…), Larenas-Linnemann D, et al. ABSTRACT: Smart devices and Internet-based applications (apps) are largely used in allergic rhinitis and may help to address some unmet needs. However, these new tools need to first of all be tested for privacy rules, acceptability, usability, and cost-effectiveness. Second, they should be evaluated in the frame of the digital transformation of health, their impact on health care delivery, and health outcomes. This review (1) summarizes some existing mobile health apps for allergic rhinitis and reviews those in which testing has been published, (2) discusses apps that include risk factors of allergic rhinitis, (3) examines the impact of mobile health apps in phenotype discovery, (4) provides real-world evidence for care pathways, and finally (5) discusses mobile health tools enabling the digital transforma- tion of health and care, empowering citizens, and building a healthier society. CITA: JAllergy Clin Immunol Pract. 2019 Nov - Dec;7(8):2511-2523 DOI: 10.1016/j.jaip.2019.07.044 340

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31447927 TÍTULO: Incidence of disseminated intravascular coagulation in critically ill cancer patients PMID: 31486793 PMID: 31486801 AUTORES: Hernández-Ramírez O, Sánchez-Hurtado LA, Ferrer-Burgos G, Gue- vara-García H, García-Guillen FJ, Ñamendys-Silva SA. SUMMARY: Letter to the editor CITA: J Intensive Care Soc. 2019Aug; 20(3):NP17-NP18 DOI: 10.1177/1751143719840262 TÍTULO: Discurso de ingreso de nuevos académicos numerarios a laAcademia Nacional de Medicina de México, 2019 AUTORES: Poitevin-Chacón MA. SUMMARY: Editorial CITA: Gac Med Mex. 2019; 155(4):448-449 TÍTULO: Consenso multidisciplinario de diagnóstico y tratamiento del dolor neuropático periférico y localizado en México AUTORES: Lara-Solares A, Mayoral-Rojals V, Guillén-Núñez MDR, Villafaña-Tello JJS, Cantú-Brito C, Genis-Rondero MÁ, Nader-Kawachi JA, Tito-Hernández H, Salado-Ávila MM, Paz-Lozano JA, Hernández-Ortiz A, Flores-Cantisani JA, Leyva-Rendón A, Hernán- dez-Santos JR. SUMMARY: Neuropathic pain is an entity that causes patient disability and its diagnosis and treatment is a challenge for physicians. In a significant percentage of patients with neu- ropathic pain, it is restricted to one dermatome or to a particular region of the body; in this case, it is referred to as localized neuropathic pain.There are no Mexican clinical guidelines proposing recommendations for the diagnosis and treatment of localized neuropathic pain in our population. This article presents the recommendations of a multidisciplinary consen- sus of specialists from different areas involved in the diagnosis and treatment of this type of patients. CITA: Gac Med Mex. 2019; 155(4):428-435 DOI: 10.24875/GMM.19005195 PMID: 31496674 TÍTULO: Bronchodilators for hyperinflation in COPD associated with bio- mass smoke: clinical trial AUTORES: Ramírez-Venegas A, Velázquez-Uncal M, Aranda-Chávez A, Guzmán-Bouilloud NE, Mayar-Maya ME, Pérez Lara-Albisua JL, Hernán- dez-Zenteno RJ, Flores-Trujillo F, Sansores RH. INTRODUCTION: The efficacy of long-acting bronchodilators for COPD as- sociated with biomass (BE-COPD) has not been properly evaluated. OBJECTIVE: To determine the acute effect of indacaterol (IND) 150 μg q.d and tiotropium (TIO) 18 μg q.d. on lung hyperinflation, walking distance (WD) and dyspnea during the six-minute walking test (6MWT) in moderate BE-COPD at 30, 60and 240 mins post-drug administration. 341

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31512638 DESIGN: Randomized, controlled, open-level, crossover noninferiority clini- cal trial. Forty-two women with BE-COPD were randomly assigned to a bron- cho dilator sequence: IND-TIO or vice versa. RESULTS: There were statistically significant changes over time in inspira- tory capacity (IC) (p<0.0001), FEV1 (p<0.0001) and FVC (p<0.0001) when IND was used.When TIO was administered, an increase over all time peri- ods was observed only for FEV1 (p<0.0001) and FVC (p<0.0001), whereas for IC an increase was observed only at 30 mins and 24 hrs after TIO admin- istration. We did not find clinically significant increases in WD and dyspnea after the administration of both bronchodilators. CONCLUSION: Both IND and TIO showed significant and fast onset im- provement in hyperinflation. Therefore, either of them may be recommended as a first line of treatment for COPD associated with BE-COPD. CITA: Int J Chron Obstruct Pulmon Dis. 2019 Aug 6; 14:1753-1762 DOI: 10.2147/COPD.S201314 TÍTULO: Clinical Significance of Fractional Anisotropy Measured in Peritu- moral Edema as a Biomarker of Overall Survival in Glioblastoma: Evidence Using Correspondence Analysis AUTORES: Flores-Alvarez E, Durand-Muñoz C, Cortes-Hernandez F, Muñoz-Hernandez O, Moreno-Jimenez S, Roldan-Valadez E. INTRODUCTION: Fractional anisotropy (FA), a diffusion tensor image (DTI) derived biomarker is related to invasion, infiltration, and extension of glio- blastoma (GB). We aimed to evaluate FA values and their association with intervals of overall survival (OS). MATERIALS AND METHODS: Retrospective study conducted in 36 patients with GB included 23 (63.9%) males, 46 ± 14 y; and 13 (36.1%) females, 53 ± 13; followed up for 36 months. We measured FA at edema, enhancing rim, and necrosis. We created two categorical variables using levels of FA and intervals of OS to evaluate their relationships. Kaplan-Meier method and correspondence analysis evaluated the association between OS (grouped in 7 six-month intervals) and FA measurements. RESULTS: Median FA values were higher in healthy brain regions (0.351), followed by peritumoral edema (0.190), enhancing ring (0.116), and necrosis (0.071). Pair-wise comparisons among tumor regions showed a significant difference, P <0.001. The median OS for all patients was 19.3 months; vari- ations in the OS curves among subgroups was significant χ2 (3) = 8.48, P = 0.037. Correspondence analysis showed a significant association between FA values in the edema region and the survival intervals χ2 (18) = 30.996, P = 0.029. CONCLUSIONS: Alternative multivariate assessment using correspondence analysis might supplement the traditional survival analysis in patients with GB. A close follow-up of the variability of FA in the peritumoral edema region is pre- dictive of the OS within specific six-month interval subgroup. Further studies should focus on predictive models combining surgical and DTI biomarkers. CITA: Neurol India. 2019 Jul-Aug; 67(4):1074-1081 DOI: 10.4103/0028-3886.266284 342

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31516692 TÍTULO: Next-generation ARIA care pathways for rhinitis and asthma: a PMID: 31559071 model for multimorbid chronic diseases AUTORES: Bousquet JJ, (…) Larenas-Linnemann D, et al. BACKGROUND: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organiza- tional health literacy. MAIN BODY: As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EITHealth), in collaboration with professional and patient organiza- tions in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor envi- ronmental exposure.Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted \"patient activation\", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. CONCLUSION: In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement. CITA: Clin Transl Allergy. 2019 Sep 9; 9:44 DOI: 10.1186/s13601-019-0279-2 TÍTULO: Next-generation care pathways for allergic rhinitis and asthma mul- timorbidity: a model for multimorbid non-communicable diseases-Meeting Report (Part 1) AUTORES: Bousquet J, (…) Larenas-Linneman D, et al. ABSTRACT: Review article CITA: J Thorac Dis. 2019 Aug; 11(8):3633-3642 DOI: 10.21037/jtd.2019.08.64 PMID: 31653319 TÍTULO: The Importance of Amerindian Ancestry on Nonalcoholic Fatty Liv- er Disease in the Hispanic/Latino American Population AUTORES: Cruz-Ramón VC, Méndez-Sánchez N. SUMMARY: Editorial CITA: Clin Gastroenterol Hepatol. 2019 Nov;17 (12):2623-2624 DOI: 10.1016/j.cgh.2019.05.021 343

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31656683 TÍTULO: Next-generation care pathways for allergic rhinitis and asthma mul- PMID: 31720429 timorbidity: a model for multimorbid non-communicable diseases-Meeting Report (Part 2) PMID: 31735347 AUTORES: Bousquet J, (…) Larenas-Linneman D, et al. PMID: 31749914 RESUMEN: Review article CITA: J Thorac Dis. 2019 Sep;11(9):4072-4084 DOI: 10.21037/jtd.2019.09.38 TÍTULO: A case of concomitant pulmonary tuberculosis and mucormycosis in an insulin-dependent diabetic patient AUTORES: O Jiménez-Zarazúa, Ln Vélez-Ramírez, M Alcocer-León, Jd Utrilla Álvarez, Ma Martínez-Rivera, Ga Flores-Saldaña Jd Mondragón. SUMMARY: Conditions, where the patient's immune system is compromised are the main risk factor for mucormycosis. Approximately 23% of the world's population is estimated to have a latent Mycobacterium tuberculosis infec- tion and more than 10 million new cases were estimated in 2017. Pulmonary mucormycosis and tuberculosis co-infections are very rare. We present the case of a 56-year-oldinsulin-dependent diabetic patient with a pulmonary mucormycosis and tuberculosis co-infection. While the patient did not suf- fer from ketoacidosis, she had poor glycemic control. A chest X-ray and a computed tomography showed nodular and cavitary lesions in both lungs. The patient was diagnosed through a biopsy of the bronchial mucosa and an RT-PCR for M. tuberculosis from bronchoalveolar lavage. The patient was treated with the recommended 4-drug regimen for TB (i.e.isoniazid, rifampin, pyrazinamide, and ethambutol); concurrently, amphotericin B deoxycholate was administered to treat the mucormycosis infection. Thirty days after initial hospital admission the patient underwent a lobectomy on the right lung. The case described here is only the sixth case reported in the literature of con- comitant pulmonary tuberculosis and mucormycosis and the third case as- sociated with a TB and mucormycosis co-infection involving an uncontrolled DM patient to survive. CITA: J Clin Tuberc Other Mycobact Dis. 2019 Apr 30; 16:100105 DOI: 10.1016/j.jctube.2019.100105 TÍTULO: The lack of guidelines and government policies for regulating non- prescription sale of antibiotics and its medical consequences AUTORES: Juárez-Hernández E, Uribe M. SUMMARY: Editorial CITA: Ann Hepatol. 2019 Nov - Dec;18(6):783-785 DOI: 10.1016/j.aohep.2019.10.001 TÍTULO: The diagnostic and initial approach of the patient with non-alcohol- ic fatty liver disease: role of the primary care provider AUTORES: Salva-Pastor N, Chávez-Tapia NC, Uribe M, Nuño-Lámbarri N. 344

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR SUMMARY: Non-alcoholic fatty liver disease (NAFLD) represents a broad spectrum of liver damage, ranging from simple steatosis to steatohepatitis and fibrosis; as well, there is a close association between NAFLD, obesity, metabolic syndrome and type 2 diabetes mellitus. There is a certain degree of uncertainty regarding the natural history and prognosis of NAFLD; howev- er, several methods are currently used for its diagnostic approach. In the first instance, non-invasive tests could be used to identify patients at low risk of developing fibrosis and to establish more easily the need for a liver biopsy, whose accuracy in the evaluation of fibrosis has been questioned, mainly due to errors of intra and interobserver sampling, technical problems and cost, which limits its use. Therefore, it is essential to determine the diagnos- tic strategy for patients with NAFLD. CITA: Gastroenterol Hepatol Bed Bench. 2019 Fall; 12(4):267-277 PMID: 31768217 TÍTULO: An online survey detected knowledge gaps and cost-saving oppor- tunities in asthma maintenance treatment among allergists, pulmonologists, ENTs and primary care AUTORES: Désirée LL, Margarita FV, Mónica RG, María Del Carmen CS, Jorge Agustín LP, José Antonio OM, Blanca DR, Erika Del Carmen LE, Jade RL, Juan Carlos VG, Jorge SP. BACKGROUND: In April 2017 the Mexican Asthma Guidelines (GUIMA) were published. Before the launch, physicians' knowledge was explored re- lated to key issues of the guideline. METHODS: A SurveyMonkey® survey was sent out to board-certified phy- sicians of 5 medical specialties treating asthma. Replies were analyzed per specialty against the GUIMA evidence-based recommendations. We present the treatment part here. RESULTS: A total of 364 allergists (ALLERG), 161 pulmonologists (PULM), 34 ENTs, 239 pediatricians (PED) and 62 general practitioners (GPs) replied to the survey and 247-83-14-135-37 respectively finished it. Spirometry is not routinely indicated when asthma is very probable by ALLERG 54%, PULM 47%, ENT 39%, PED 65%, GP 64%. A fictitious case proposed to the physicians with intermittent asthma was erroneously treated with ICS by ALLERG 9%, PULM 11%, ENT 28%, PED 10%, GP 11%. The mild persistent case received mistakenly ICS-LABA by ALLERG 25%, PULM 26%, ENT 33%, PED 27%, GP 23%. The first-line option for moderate persistent asthma was ICS(median dose) instead of ICS(low)+LABA for ALLERG 29%, PULM 25%, ENT 17%, PED 27%, GP 23% and in severe asthma maintenance treatment PULM20%, ALLERG-ENT-PED-GP 22-34% failed to indicate LABA. Con- cerning the guidelines' recommendation to use one inhaler for maintenance & rescue in moderate-to-severe asthma, PULM45%, ALLERG-ENT-PED-GP 56-80% (p < 0.00001), erroneously indicated ICS-salmeterol could be used, instead of ICS-formoterol. Oral β2 or theophylline are no longer recommend- ed, but PULM 37% and ALLERG-ENT-PED-GP 42-62% (p < 0.01) still in- dicate their use. In severe asthma 61-73% of physicians consider adding LTRA to the treatment; only PULM38%, OTHERS12-25% consider adding tiotropium (p < 0.001) and 3-17% consider adding omalizumab, both guide- line recommended add-ons. As for asthma in pregnancy, most surveyed are not aware budesonide is the 1st line option ICS. Finally, 81-97% of the group-members recognized allergen immunotherapy, as a viable add-on, in line with GINA/GEMA/GUIMA recommendations. 345

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR CONCLUSIONS: An online survey could detect knowledge-gaps related to asthma treatment. Interestingly, surveyed physicians tended to over-treat the milder asthma cases, thus clearly leaving room for cost-savings. Caution should be taken in the promotion of the SMART (single-maintenance-and-re- liever-treatment) approach, which can only be done with ICS-formoter- ol. Many physicians opt for other combinations not apt for this approach. Among all surveyed specialties there is ample room for improvement in mild and severe asthma management. CITA: World Allergy Organ J. 2019 Nov 19;12(12):100084 DOI: 10.1016/j.waojou.2019.100084 PMID: 31905892 TÍTULO: The VNTR 48 bp Polymorphism in the DRD4 Gene Is Associated with Higher Tobacco Smoking in Male Mexican Mestizo Smokers with and without COPD AUTORES: Pérez-Rubio G, García-Carmona S, García-Gómez L, Hernán- dez-Pérez A, Ramírez-Venegas A, López-Flores LA, Sansores R, Falfán-Va- lencia R. SUMMARY: Cigarette smoking is influenced by nicotine's effects on dopa- minergic activity, which appear to be moderated by genetic variation, partic- ularly a variable number tandem repeat (VNTR, 48 bp) polymorphism in the third exon of the dopamine receptor gene (DRD4). Smokers with the VNTR ≥7 repeats (long, L allele) report markedly increased participation in some smoking behaviors; hence, our aim was to evaluate the association of the L allele in Mexican Mestizo smokers with and without COPD. The DRD4 VNTR 48 bp was genotyped in 492 Mexican Mestizo smokers:164 COPD patients (≥20 cigarettes per day, cpd), 164 heavy smokers without COP- D(HS, ≥20 cpd) and 164 light smokers without COPD (LS, 1-10 cpd). In the dominant model analysis (SL + LL vs. SS), men in the COPD and HS groups showed a statistical difference compared to LS (p = 0.01, OR = 2.06, CI 95% 1.17-3.64 and p = 0.05, OR = 1.88, CI 95% 1.03-3.45, respectively). In addition, by clustering smokers >20 cpd (COPD + HS) and comparing with the LS group, we found an association with increased risk of higher tobacco smoking p = 0.01, OR = 1.99, CI95% 1.18-3.34. In conclusion, the long allele (L) in the VNTR of the DRD4 gene is associated with the risk of presenting higher tobacco smoking in male Mexican Mestizo smokers. CITA: Diagnostics (Basel). 2019 Dec 30; 10(1) DOI: 10.3390/diagnostics10010016 PMID: 31929992 TÍTULO: Probiotics supplementation in the management of hepatocellular carcinoma AUTORES: Abenavoli L, Luzza F, Mendez-Sanchez N. SUMMARY: Editorial CITA: Hepatobiliary Surg Nutr. 2019 Dec; 8(6):632-634 DOI: 10.21037/hbsn.2019.10.12 346

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31930096 TÍTULO: New therapeutic options for bile acid malabsorption diarrhea AUTORES: Valencia-Rodríguez A, Aquino-Matus J, Vera-Barajas A, Qi X, Méndez-Sánchez N. SUMMARY: Editorial CITA: Ann Transl Med. 2019 Nov; 7(22):695 DOI: 10.21037/atm.2019.09.112 PMID: 31961116 TÍTULO: Following the light in glioma surgery: a comparison of sodium fluo- rescein and 5-aminolevulinic acid as surgical adjuncts in glioma resection AUTORES: Navarro-Bonnet J, Suarez-Meade P, Brown DA, Chaichana KL, Quinones-Hinojosa A. SUMMARY: Gliomas are molecularly complex neoplasms and require a multidisciplinary approach to treatment. Maximal safe resection is often the initial goal of treatment and extent of resection (EOR) is an important prognostic factor correlating with both progression-free-survival (PFS) and overall survival (OS). Postoperative patient outcome is also a critical and independent prognosticator and high EOR must not be achieved at the ex- pense of good functional outcome. Several intraoperative adjuvant techniques have been developed to help the surgeon push the boundaries of EOR while maintaining safety. Fluores- cence-guided surgery for brain tumors is a contemporary adjuvant technique that allows for intraoperative delineation of diseased and normal brain thus improving maximal safe resection. The most extensively used fluorophores are 5-aminolevulinic acid (5-ALA) and sodium fluorescein (SFL). These flu- orophores have different spectrophotometric properties, mechanisms of ac- tion and considerations for use. Both have demonstrated utility in neurosur- gical oncology. They are safe and both are FDA approved for use as surgical adjuncts during resection of primary CNS neoplasms although they have been used with varying success for other tumor types. When combined with other surgical adjuvant strategies such as neuro navigation, intraoperative ultrasound, intraoperative MRI, awake resection and/or electrophysiological mapping/monitoring, fluorescence-guided resection appears to further im- prove resection quality in regard to EOR and safety. In this article, we review the current knowledge related to both fluorophores for brain tumor resection, their benefits, and pitfalls, as well as the major advantages associated with their use. We also briefly review additional fluorophores in early clinical de- velopment. Fluorescence-guided surgery is a novel surgical adjuvant which allows for real-time delineation of neoplastic tissues. The most widely used fluorophores are 5-ALA and SFL. They are safe compounds and there is a large body of evidence suggesting improvement in EOR when these are em- ployed. There are nuances to the use of each; the fluorescence intensity is dose-dependent in either case and the sensitivity and specificity for various tumors vary widely. Additional prospective studies will be necessary to parse the impact of this technique and these fluorophores on survival metrics. CITA: J Neurosurg Sci. 2019 Dec;63(6):633-647 DOI: 10.23736/S0390-5616.19.04745-3 347

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31992957 TÍTULO: Cancer immunotherapy experience in the Integral Oncology Centre \"Diana Laura Riojas de Colosio\", Médica Sur Hospital PMID: 32016019 AUTORES: Fernández-Ferreira R, Motola-Kuba D, Mackinney-Novelo I, PMID: 32246612 Ruiz-Morales JM, Torres-Pérez ME. INTRODUCTION: The use of immunotherapy in Mexico has been used since 2012 with ipilimumab and since 2015 with nivolumab and pembroli- zumab, so it is a matter of necessity to know the experience of these drugs. MATERIAL AND METHODS: An observational, descriptive, cross-sectional, and retrospective study was performed in Médica Sur Hospital, where with dossiers from 2012 to June 2018 patients with metastatic cancer who re- ceived immunotherapy with ipilimumab, nivolumab, and pembrolizumab for six months were evaluated, searching as principal outcomes the adverse ef- fects of those drugs and as secondary outcomes the response to treatment. RESULTS: Seventy subjects fulfilled the inclusion criteria for the study, and 42 (60%) were women with an average age of 60.73 ±13.64 years (16-82 years). The pathologies that received immunotherapy were the following: melanoma and lung cancer. The most frequent clinical and lab- oratory adverse effects were as follows: fatigue - 32 (45.71%), asthaenia - 30 (42%), nausea - 8 (11.4%), diarrhoea - 8 (11.4%), and rash - 7 (10%). The worst adverse effects wererespiratory and endocrinological: pneumo- nitis - 10 (14.28%), hypothyroidism - 4(5.71%), hyperglycaemia - 1 (1.4%), and hypophysitis - 2 (2.9%). With respect to treatment response: complete response - 8 (11.4%), partial response - 11(15.71%), stable disease - 33 (47.14%), and disease progression - 19 (27.14%). CONCLUSIONS: The most common adverse effects did not condition the suspension of treatment or increase in intra-hospital stay, but there were some adverse effects that actually had an impact on evolution, hospital stay, and mortality. CITA: Contemp Oncol (Pozn). 2019; 23(4):239-246 DOI: 10.5114/wo.2019.91534 TÍTULO: New insights into the association between non-alcoholic fatty liver disease and atherosclerosis AUTORES: Valencia-Rodríguez A, Vera-Barajas A, Barranco-Fragoso B, Kúsulas-Delint D, Qi X, Méndez-Sánchez N. SUMMARY: Editorial CITA: Ann Transl Med. 2019 Dec; 7(Suppl 8):S300 DOI: 10.21037/atm.2019.11.13 TÍTULO: [Biomechanics of the lumbar spine: a clinical approach] AUTORES: Lomelí-Rivas A, Larrinúa-Betancourt JE. SUMMARY: The study of Biomechanics of the lumbar spine with clinical approach allows the physician related to locomotive sciences, to have a better interpretation of the clinical and radiological findings in order to carry 348

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR 2020 out a treatment or a prediction of a medical problem with greater scientific foundation. The lumbar vertebral segment is studied from a biomechanical PMID: 28931367 point of view in an integrated way, correlating with other body regions. The structures analyzed are the vertebrae, the intervertebral disks, the ligament PMID: 31008860 and muscular system. The method of study goes from the static of the col- umn to the dynamic, which includes the kinetic and kinematic aspects. The contradiction in the study of the lumbar spine is that the disorders of this body region are of the most frequent in the general and specialized medical consultation and, however, is not enough provided to the financial funds to carry out research. CITA: Acta Ortop Mex. May-Jun 2019;33(3):185-191 TÍTULO: Changes in Radial Artery Pulse Pressure During a Fluid Challenge Cannot Assess Fluid Responsiveness in Patients With Septic Shock AUTORES: De la Puente-Diaz de Leon V, de Jesus Jaramillo-Rocha V, Te- boul JL, Garcia-Miranda S, Martinez-Guerra BA, Dominguez-Cherit G. BACKGROUND: Arterial blood pressure is the most common variable used to assess the response to a fluid challenge in routine clinical practice. The aim of this study was to evaluate the accuracy of the change in the radial artery pulse pressure (rPP) to detect the change in cardiac output after a fluid challenge in patients with septic shock. METHODS: Prospective observational study including 35 patients with septic shock in which rPP and cardiac output were measured before and after a fluid challenge with 400 mL of crystalloid solution. Cardiac output was measured with intermittent thermodilution technique using a pulmonary artery catheter. Patients were divided between responders (increase >15% of cardiac output after fluid challenge) and non responders. The area under the receiver operating characteristic curve (AUROC), Pearson correlation coefficient and paired Student t test were used in statistical analysis. RESULTS: Forty-three percent of the patients were fluid responders. The change in rPP could not neither discriminate between responders and non responders (AUROC = 0.52; [95% confidence interval: 0.31-0.72] P = .8) nor correlate (r = .21, P =.1) with the change in cardiac output after the fluid challenge. CONCLUSIONS: The change in rPP neither discriminated between fluid re- sponders and non responders nor correlated with the change in cardiac out- put after a fluid challenge. The change in rPP cannot serve as a surrogate of the change in cardiac output to assess the response to a fluid challenge in patients with septic shock.  CITA: J Intensive Care Med. 2020 Feb; 35(2):149-153 DOI: 10.1177/0885066617732291 TÍTULO: Diaphragmatic Ultrasonography, a Novel Approach in Critical Care: A Proposal for a New Weaning Index AUTORES: Garrido-Aguirre E, Ñamendys-Silva SA, Del Moral OR, Cortés- Soto CA, Romero-González JP. 349

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR SUMMARY: The evaluation of the diaphragm in critically ill patients is simple and noninvasive and has shown good repeatability. The aim of the study was to generate a predictive index for successful weaning (ULDIMex) from invasive mechanical ventilation (IMV) based on an ultrasonographic dia- phragmatic assessment before performing a spontaneous breathing test. We recruited patients who required IMV and who were candidates for weaning from ventilation. The measurement of diaphragmatic excursion and time during inspiration and expiration was obtained with a 3- to 5-MHz probe in the M mode. Using the formula (a +b)c/2, the value for the ULDIMex was obtained to evaluate its impact on predicting the successful weaning of IMV, where a is the time during the inspiratory phase, b is the time during ex- piration, and c is the diaphragmatic excursion during the inspiratory phase, which corresponds to the highest point of the curve from the baseline. We recruited 114 patients, of whom 86 (76%) were successfully weaned from IMV. The patients who were successfully weaned from the IMV had a cutoff value greater than 4.06 cm/s for the ULDIMex index, with a sensitivity of 92.8% (95% confidence interval, 76.5-99.1), specificity of 63.9%(95% confi- dence interval, 52.9-74.0), positive predictive value of 45.6%, and negative predictive value of 96.5%. The ULDIMex index demonstrated a good level of discrimination for successful weaning prediction. Considering the excellent negative likelihood ratio of the ULDIMex index of greater than 4.06, this in- dex may be considered before performing an spontaneous breathing test to identify critically ill adult patients who will extubate successfully. CITA: Ultrasound Q. 2020 Mar;36(1):54-58 DOI: 10.1097/RUQ.0000000000000442 PMID: 31130359 TÍTULO: Have there been changes in the application of mechanical venti- lation in relation to scientific evidence? A multicenter observational study in Mexico AUTORES: Marín MC, (...) Ñamendys-Silva AS, et al OBJECTIVE: The main study objectives were to describe the practice of me- chanical ventilation over an 18-year period in Mexico, and estimate changes in mortality among critical patients subjected to invasive mechanical ventila- tion (IMV). DESIGN: A retrospective subanalysis of a prospective observational study conducted in 1998, 2004, 2010 and 2016 was carried out. Setting: Intensive Care Units (ICUs) in Mexico. PARTICIPANTS: Adult patients consecutively enrolled in the ICU during one month and who underwent IMV for more than 12hours or noninvasive me- chanical ventilation for more than one hour. Follow-up was performed up to a maximum of 28 days after inclusion. INTERVENTIONS: None. PRINCIPAL VARIABLES OF INTEREST: Age, sex, severity upon admission as estimated by SAPS II, parameters of daily arterial blood gases, treatment and complication variables, date and status at discharge from the ICU and from hospital. 350