RESUMEN INVESTIGADORES-2

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR RESULTS: A total of 959 patients were included in 81 ICUs. Tidal volume (vt) decreased significantly both in patients with acute respiratory distress syn- drome (ARDS) criteria (estimated 8.5ml/kg b.w. in 1998 to 6ml/kg in 2016; P<0.001) and in patients without ARDS (estimated 9ml/kg b.w. in 1998 to 6ml/kg in 2016; P<0.001). The ventilatory protective strategy (defined as vt < 6ml/kg or < 8ml/kg and a plateau pressure < 30cmH2O) was: 19% in 1998, 44% in 2004, 58% in 2010 and 75% in 2016 (P<0.001). The adjusted mor- tality rate in ICU over the 4 periods was: in 2004, odds ratio (OR) 1.05 (95% confidence interval, 95%CI: 0.73-1.72; P=0.764); in 2010, OR 1.68 (95%CI: 1.13-2.48; P=0.009); in 2016, OR 0.85 (95%CI: 0.60-1.20; P=0.368). CONCLUSIONS: The clinical practice of IMV in Mexican ICUs has been modified over a period of 18 years. The most significant change is the ven- tilatory strategy based on low vt. These changes have not been associated with significant changes in mortality. CITA: Med Intensiva (Engl Ed). Aug-Sep 2020;44(6):333-343 DOI: 10.1016/j.medin.2019.03.010 PMID: 31195778 TÍTULO: The fibrogenic process and the unleashing of acute-on-chronic liver failure AUTORES: López-Sánchez GN, Dóminguez-Pérez M, Uribe M, Nuño-Lámbarri N. SUMMARY: Acute-on-chronic liver failure (ACLF) is a life-threatening con- dition characterized by a rapid deterioration of previously well-compensat- ed chronic liver diseases. One of the main obstacles in ACLF is the lack of knowledge of the pathogenesis and specific broad-spectrum treatments. An excessive systemic inflammatory response has been proposed to explain the pathogenesis of ACLF; this hypothesis involves stellate cells, which are implicated in many liver homeostatic functions that include vitamin A storage, regulation of sinusoidal blood flow, local inflammation, maintenance of the hepatocyte phenotype and extracellular matrix remodeling. However, when there is damage to the liver, these cells are the main target of the inflam- matory stimulus, as a result, the secretion of the extracellular matrix is al- tered. Activated hepatic stellate cells raise the survival of neutrophils by the stimulation of granulocytes colonies and macrophages, which exacerbates liver inflammation and promotes damage to hepatocytes. Elevation of patho- gen-associated molecular patterns is related to liver damage by different pathophysiological mechanisms of decompensation, showing ballooning de- generation and cell death with a predominance of cholestatic infection. More- over, patients with ACLF present a marked elevation of C-reactive protein together with an elevation of the leukocyte count. Chronic liver disease is a complex pathological state with a heterogeneous pathophysiology in which genetic factors of the host and external triggers interact and culminate in hepatic insufficiency. The better understanding of such interactions should lead to a better comprehension of the disease and to the discovery of new treatment targets that will make acute decompensations preventable and even decrease mortality. CITA: Clin Mol Hepatol. 2020 Jan;26(1):7-15 DOI: 10.3350/cmh.2019.0011 351

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31492476 TÍTULO: Evidence-based clinical practice guidelines for the management of PMID: 31594758 sedoanalgesia and delirium in critically ill adult patients AUTORES: Celis-Rodríguez E, Díaz Cortés JC, Cárdenas Bolívar YR, Car- rizosa González JA, Pinilla DI, Ferrer Záccaro LE, Birchenall C, Caballero López J, Argüello BM, Castillo Abrego G, Castorena Arellano G, Dueñas Castell C, Jáuregui Solórzano JM, Leal R, Pardo Oviedo JM, Arroyo M, Raffán-Sanabria F, Raimondi N, Reina R, Rodríguez Lima DR, Silesky Jiménez JI, Ugarte Ubiergo S, Gómez Escobar LG, Díaz Aya DP, Fowler C, Nates JL. SUMMARY: Given the importance of the management of sedation, analge- sia and delirium in Intensive Care Units, and in order to update the previous- ly published guidelines, a new clinical practice guide is presented, address- ing the most relevant management and intervention aspects based on the recent literature. A group of 24intensivists from 9 countries of the Pan-Amer- ican and Iberian Federation of Societies of Critical Medicine and Intensive Therapy met to develop the guidelines. Assessment of evidence quality and recommendations was made according to the Grading of Recommendations Assessment, Development and Evaluation Working Group. A systematic search of the literature was carried out using MEDLINE, Cochrane Library databases such as the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials (CENTRAL), the Database of Abstracts of Reviews of Effects, the National Health Service Economic Evaluation Database and the database of Latin American and Caribbean Lit- erature in Health Sciences (LILACS). A total of 438 references were selected. After consensus, 47strong recommendations with high and moderate quality evidence, 14 conditional recommendations with moderate quality evidence, and 65 conditional recommendations with low quality evidence were estab- lished. Finally, the importance of initial and multimodal pain management was underscored. Emphasis was placed on decreasing sedation levels and the use of deep sedation only in specific cases. The evidence and recom- mendations for the use of drugs such as dexmedetomidine, remifentanil, ket- amine and others were incremented. CITA: Med Intensiva (Engl Ed). 2020 Apr;44(3):171-184 DOI: 10.1016/j.medin.2019.07.013 TÍTULO: Mechanisms of kidney dysfunction in the cirrhotic patient: Non-hepatorenal acute-on-chronic kidney damage considerations AUTORES: Muciño-Bermejo MJ. SUMMARY: Renal dysfunction is a common finding in cirrhotic patients and has a great physiologic, and therefore, prognostic relevance. The combina- tion of liver disease and renal dysfunction can occur as a result of systemic conditions that affect both the liver and the kidney, although primary disor- ders of the liver complicated by renal dysfunction are much more common. As most of the renal dysfunction scenarios in cirrhotic patients correspond to either prerenal azotemia or hepatorenal syndrome (HRS), physicians tend to conceive renal dysfunction in cirrhotic patients as mainly HRS. However, there are many systemic conditions that may cause both a \"baseline\" chron- ic kidney damage and a superimposed kidney dysfunction when this system- ic condition worsens. The main aim of this article is to review some of the most important non prerenal non-HRS considerations regarding acute on chronic kidney dysfunction in cirrhotic patients, including renal manifestation of related to non-alcoholic steatohepatitis (NASH) viral hepatitis, the effect 352

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31611091 of cardiorenal syndrome in cirrhotic and corticosteroid-deficiency associated renal dysfunction. CITA: Ann Hepatol. 2019 Sep 24. Pii: S1665-2681(19)32234-3 DOI: 10.1016/j.aohep.2019.06.022 TÍTULO: Outcomes following percutaneous coronary intervention in patients with cancer AUTORES: Quintana RA, Monlezun DJ, Davogustto G, Saenz HR, Loza- no-Ruiz F, Sueta D, Tsujita K, Landes U, Denktas AE, Alam M, Paniagua D, Addison D, Jneid H. BACKGROUND: Randomized clinical trials demonstrated the benefits of percutaneous coronary interventions (PCI) in diverse clinical settings. Pa- tients with cancer were not routinely included in these studies. METHODS/RESULTS: Literature search of PubMed, Cochrane, Medline, SCOPUS, EMBASE, and Clinical Trials was conducted to identify studies that assessed one-year all-cause, cardiovascular and non-cardiovascular mortality in patients with historical or active cancer. Using the random effects model, we computed risk ratios (RRs) and standardized mean differences and their 95% confidence intervals for the dichotomous and continuous mea- sures and outcomes, respectively. Of 171articles evaluated in total, 5 eligible studies were included in this meta-analysis. In total, 33,175 patients receiv- ing PCI were analyzed, of whom3323 patients had cancer and 29,852 no cancer history. Patients in the cancer group had greater all-cause mortality [RR 2.22 (1.51-3.26; p<0.001)], including cardiovascular mortality [RR 1.34 (1.1-1.65; p=0.005)] and non-cardiovascular mortality [RR 3.42 (1.74-6.74; p≤0.001], at one-year compared to non-cancer patients. Patients in the can- cer group had greater one-month all-cause mortality [RR 2.01 (1.24-3.27; p=0.005)] and greater non-cardiovascular mortality [RR 6.87 (3.10-15.21; p≤0.001)], but no difference in one-month cardiovascular mortality com- pared to non-cancer patients. Meta-regression analyses showed that the difference in one-year all-cause and cardiovascular mortality between both groups was not attributable to differences in baseline characteristics, index PCI characteristics, or medications prescribed at discharge. CONCLUSIONS: Patients with cancer undergoing PCI have worse mid-term outcomes compared to non-cancer patients. Cancer patients should be man- aged by a multi-specialist team, in an effort to close the mortality gap. CITA: Int J Cardiol. 2020 Feb 1; 300:106-112 DOI: 10.1016/j.ijcard.2019.09.016 PMID: 31627910 TÍTULO: Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations As- sessment, Development and Evaluation (GRADE) and real-world evidence AUTORES: Bousquet J, (…) Larenas-Linnemann D, Lau et al. ABSTRACT: The selection of pharmacotherapy for patients with allergic rhinitis aims to control the disease and depends on many factors. Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines have considerably improved the treatment of allergic rhinitis. 353

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31650184 However, there is an increasing trend toward use of real-world evidence PMID: 31715614 to inform clinical practice, especially because randomized controlled trials are often limited with regard to the applicability of results. The Contre les Maladies Chroniques pour un Vieillissement Actif (MACVIA) algorithm has proposed an allergic rhinitis treatment by a consensus group. This simple algorithm can be used to step up or step down allergic rhinitis treatment. Next-generation guidelines for the pharmacologic treatment of allergic rhi- nitis were developed by using existing GRADE-based guidelines for the disease, real-world evidence provided by mobile technology, and additive studies (allergen chamber studies) to refine the MACVIA algorithm. CITA: J Allergy Clin Immunol. 2020 Jan; 145(1):70-80.e3 DOI: 10.1016/j.jaci.2019.06.049 TÍTULO: Less is more, but are we doing enough? AUTORES: Ñamendys-Silva SA. SUMMARY: Letter to the editor CITA: Intensive Care Med. 2020 Jan; 46(1):113-115 DOI: 10.1007/s00134-019-05831-7 TÍTULO: Impact of the Type of Analgesic Therapy on Postsurgical Complica- tions of Patients with Kidney Cancer Undergoing Nephrectomy AUTORES: Varela-Santoyo E, Escamilla-López MI, Izquierdo-Tolosa CD, Arroyave-Ramírez AM, Buerba-Vieregge HH, Dorantes-Heredia R, Moto- la-Kuba D, Ruiz-Morales JM. BACKGROUND: The treatment of kidney cancer usually involves surgery, and in some cases systemic therapy. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to control postsurgical pain in patients under- going nephrectomy for renal cancer. Nevertheless, the association between these drugs and adverse postsurgical outcomes, including deterioration of renal function, is not fully established. METHODS: This retrospective cohort study included patients >18 years old with kidney cancer undergoing nephrectomy between January 2006 and January 2018. The primary endpoint was to determine the impact of postsur- gical analgesic therapy (NSAIDs vs. acetaminophen) on renal function and postsurgical complications. This study was approved by our scientific and bioethical committee. RESULTS: One hundred patients were included in the final analysis. Clear- cell renal-cell carcinoma was the most frequent histologic subtype. Adequate acute pain control was accomplished in 91% of the patients during hospital- ization. Twenty percent of the patients presented postsurgical complications. Bleeding-related complications were the most frequent (9%), followed by surgical-site infection (6%) and acute renal injury (6%). The administration of NSAIDs was not related to any postsurgical complication in comparison with the use of acetaminophen (21.3 vs. 17.9%, respectively). The length of hospital stay did not differ between patients treated with NSAIDs and those treated with acetaminophen (the average stay was 4 days for both groups, p = 0.32). 354

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR CONCLUSION: The use of NSAIDs was not related to acute kidney injury, postsurgical complications, or prolonged hospital stay in patients with renal cancer undergoing nephrectomy. CITA: Oncology. 2020; 98(2):117-122 DOI: 10.1159/000504258 PMID: 31734332 TÍTULO: Risk factors for wheezing in primary health care settings in the PMID: 31751163 tropics AUTORES: Larenas-Linnemann D, Romero-Tapia SJ, Virgen C, Mallol J, Baeza Bacab MA, García-Marcos L. Background: The International Study of Wheezing in Infants (EISL) is a cross-sectional, population-based study, based on ISAAC (http://www.isaac. auckland.ac.nz). It uses a validated questionnaire on early wheezing and risk/protective factors. Objective: To apply the EISL questionnaire regarding wheezing events in 0- to 12-month-old infants with or without atopic background searching for risk factors in the tropics. METHODS: The population was toddlers coming in for a checkup or 12-months' vaccination in primary health care clinics of a tropical city. Apart from child factors (eg, daycare attendance), we evaluated home factors (eg, air conditioning, bathroom, carpet, >6 persons, pollution) and mothers' factors (eg, education level, employment, cellphone). Data analysis was de- scriptive and case-control, with as cases atopic (AW) or non-atopic (NAW) wheezing children vs healthy controls. Wheezing-associated factors were evaluated using multivariate analysis, adjusted for the relation of AW/NAW with factors that were significant in prior univariate analysis. RESULTS: The study included 999 toddlers. Any wheeze: 31.3%, recurrent wheeze (≥3 episodes): 12.1%. Major risk factors for AW (OR; 95%CI) in- cluded smoking (11.39; 2.36-54.99), common cold before 3 months of life (3.72; 2.59-5.36), mold (3.48; 2.28-5.30), kitchen indoors (2.40; 1.27-4.54), and pets (1.69; 1.09-2.62); breastfeeding was almost protective. For NAW, common cold and pets were risk factors, but cesarean section (0.44; 0.23- 0.82), more than 1 sibling (0.33; 0.18-0.61), and breastfeeding for longer than 3 months (0.50; 0.28-0.91) were protective. Conclusion: Wheezing is a health care burden. We found potential new risk factors for AW, some possibly unique for tropical climates. We suggest testing several hypotheses: could early AW be reduced in the tropics by at- tacking mold growth? Enhancing cooking place ventilation? Keeping pets outside? Or by postponing daycare attendance until after 4 months of age and avoiding (passive) smoking during pregnancy? CITA: Ann Allergy Asthma Immunol. 2020 Feb;124(2):179-184.e1 DOI: 10.1016/j.anai.2019.11.008 TÍTULO: Health-Related Quality of Life With Carboplatin-Paclitaxel or nab-Paclitaxel With or Without Pembrolizumab in Patients With Metastatic Squamous Non-Small-Cell Lung Cancer 355

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31753060 AUTORES: Mazieres J, Kowalski D, Luft A, Vicente D, Tafreshi A, Gümüş M, Laktionov K, Hermes B, Cicin I, Rodríguez-Cid J, Wilson J, Kato T, Ramlau R, Novello S, Reddy S, Kopp HG, Piperdi B, Li X, Burke T, Paz-Ares L. PURPOSE: In the phase 3 KEYNOTE-407 study, the addition of pembroli- zumab to carboplatin-paclitaxel/nab-paclitaxel significantly improved overall survival, progression-free survival, and objective response rate in patients with previously untreated metastatic squamous non-small-cell lung cancer (NSCLC), with little impact on severe toxicity. We present patient-reported outcomes (PROs) from KEYNOTE-407. METHODS: Patients were randomly assigned to receive 4 cycles of pem- brolizumab 200mg or placebo once every 3 weeks plus carboplatin plus paclitaxel or nab-paclitaxel, followed by pembrolizumab or placebo for an additional 31 cycles.Health-related quality of life (HRQoL) was evaluated us- ing the European Organisation for Research and Treatment of Cancer Treat- ment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30) and Qual- ity of Life Questionnaire-Lung Cancer Module 13 (QLQ-LC13). Key PRO endpoints were change from baseline to weeks9 and 18 (during and after platinum therapy) in the QLQ-C30 global health status/quality of life (GHS/ QoL) score and time to deterioration in the composite endpoint of cough, chest pain, or dyspnea from the QLQ-C30 and QLQ-LC13. Two-sided, nom- inal P values are provided. RESULTS: A total of 554 and 553 patients completed ≥ 1 QLQ-C30 or ≥ 1 QLQ-LC13assessment, respectively. GHS/QoL score improved for the pem- brolizumab-combination group (least squares [LS] mean [95% CI] change from baseline: week 9, 1.8 [-0.9 to 4.4]; week 18, 4.3 [1.7 to 6.9]) and deteri- orated in the placebo-combination group (week 9, -1.8 [-4.4 to 0.7]; week 18, -0.57[-3.3 to 2.2]). Between-group differences were improved for the pem- brolizumab-combination group (difference in LS mean scores: week 9, 3.6 [95%CI, 0.3 to 6.9], nominal P = .0337; week 18, 4.9 [1.4 to 8.3], nominal P =.0060). Median time to deterioration in cough, chest pain, or dyspnea was not reached in either group (hazard ratio, 0.79; 95% CI, 0.58 to 1.06]; nominal P =.125). CONCLUSION: Addition of pembrolizumab to chemotherapy maintained or improved HRQoL measurements relative to baseline and improved HRQoL versus chemotherapy alone at weeks 9 and 18. These results support use of pembrolizumab plus chemotherapy as first-line therapy for metastatic squa- mous NSCLC. CITA: J Clin Oncol. 2020 Jan 20; 38(3):271-280 DOI: 10.1200/JCO.19.01348 TÍTULO: Characterisation and outcome of neuropsychiatric symptoms in pa- tients with anti-NMDAR encephalitis AUTORES: Restrepo-Martinez M, Ramirez-Bermudez J, Bayliss L, Espino- la-Nadurille M. BACKGROUND: Encephalitis due to anti-N-methyl-D-aspartate receptor an- tibodies (ANMDARE) is the most frequent immune-mediated encephalitis. It is distinguished by the subacute onset of neuropsychiatric symptoms. OBJECTIVE: To evaluate the characteristic neuropsychiatric symptoms and their outcome in patients diagnosed with ANMDARE. 356

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31753060 METHODS: This was a prospective, longitudinal study in patients with a di- agnostic suspicion of ANMDARE that presented to the National Institute of Neurology from March 2018 to February 2019. A comparative analysis of two groups (positive N-methyl-D-aspartate receptor [NMDAR] vs. negative NMDAR antibodies in cerebrospinal fluid [CSF]) was done on admission and at discharge. Neuropsychiatric systematic assessments included the Neu- ropsychiatric Inventory Questionnaire, the Bush Francis Catatonia Rating Scale, the Confusion Assessment Method Severity, the Montreal Cognitive Assessment, and the Overt Agitation Severity Scale. RESULTS: 24 individuals were analysed: 14 had positive NMDAR antibod- ies, and 10had negative NMDAR antibodies in CSF. On admission, agita- tion/aggression, euphoria/exaltation, and disinhibition were more common in patients with positive antibodies. Excited catatonia and delirium were diagnosed more frequently inpatients with positive antibodies. At discharge, there was an important decrease in neuropsychiatric symptoms, but sub- stantial cognitive impairment remained. The mean hospitalisation length was 41.71 (SD 39.33) days for patients with definitive ANMDARE (p 0.259). CONCLUSIONS: Neuropsychiatric symptoms profile in ANMDARE was as- sociated with the early onset of euphoria/exaltation and disinhibition, accom- panied by marked psychomotor agitation. When ANMDARE was suspected, the presence of excited-type catatonia and delirium showed a tendency to predict definitive ANMDARE. At discharged, most patients recovered from catatonia, delirium, and psychosis, but marked cognitive symptoms, anxiety, and depression persisted at discharge. CITA: Acta Neuropsychiatr. 2019 Nov 22:1-7 DOI: 10.1017/neu.2019.46 TÍTULO: Characterisation and outcome of neuropsychiatric symptoms in pa- tients with anti-NMDAR encephalitis AUTORES: Restrepo-Martinez M, Ramirez-Bermudez J, Bayliss L, Espino- la-Nadurille M. BACKGROUND: Encephalitis due to anti-N-methyl-D-aspartate receptor an- tibodies (ANMDARE) is the most frequent immune-mediated encephalitis. It is distinguished by the subacute onset of neuropsychiatric symptoms. OBJECTIVE: To evaluate the characteristic neuropsychiatric symptoms and their outcome in patients diagnosed with ANMDARE. METHODS: This was a prospective, longitudinal study in patients with a di- agnostic suspicion of ANMDARE that presented to the National Institute of Neurology from March 2018 to February 2019. A comparative analysis of two groups (positive N-methyl-D-aspartate receptor [NMDAR] vs. negative NMDAR antibodies in cerebrospinal fluid [CSF]) was done on admission and at discharge. Neuropsychiatric systematic assessments included the Neu- ropsychiatric Inventory Questionnaire, the Bush Francis Catatonia Rating Scale, the Confusion Assessment Method Severity, the Montreal Cognitive Assessment, and the Overt Agitation Severity Scale. RESULTS: 24 individuals were analysed: 14 had positive NMDAR antibod- ies, and 10had negative NMDAR antibodies in CSF. On admission, agita- tion/aggression, euphoria/exaltation, and disinhibition were more common in patients with positive antibodies. Excited catatonia and delirium were 357

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31754853 diagnosed more frequently inpatients with positive antibodies. At discharge, there was an important decrease in neuropsychiatric symptoms, but sub- stantial cognitive impairment remained. The mean hospitalisation length was 41.71 (SD 39.33) days for patients with definitive ANMDARE (p 0.259). CONCLUSIONS: Neuropsychiatric symptoms profile in ANMDARE was as- sociated with the early onset of euphoria/exaltation and disinhibition, accom- panied by marked psychomotor agitation. When ANMDARE was suspected, the presence of excited-type catatonia and delirium showed a tendency to predict definitive ANMDARE. At discharged, most patients recovered from catatonia, delirium, and psychosis, but marked cognitive symptoms, anxiety, and depression persisted at discharge. CITA: Acta Neuropsychiatr. 2019 Nov 22:1-7 DOI: 10.1017/neu.2019.46 TÍTULO: Performance of Indocyanine green for sentinel lymph node map- ping and lymph node metastasis in colorectal cancer: a diagnostic test accu- racy meta-analysis AUTORES: Villegas-Tovar E, Jimenez-Lillo J, Jimenez-Valerio V, Diaz-Gi- ron-Gidi A, Faes-Petersen R, Otero-Piñeiro A, De Lacy FB, Martinez-Portilla RJ, Lacy AM. BACKGROUND: Indocyanine green has been widely employed as a secure and easy technique for sentinel lymph node mapping in different types of cancer. Nonetheless, the usage of Indocyanine green has not been fully implemented due to the heterogeneous results found in published studies. Thus, the objective of this meta-analysis is to evaluate the overall perfor- mance of Indocyanine green for sentinel lymph node mapping and node me- tastasis in patients undergoing colorectal cancer surgery. METHODS: An extensive systematic search was performed to identify relevant studies in English and Spanish with no time limit restrictions. For the meta-analysis, a hierarchical summary receiver operating characteris- tic curve (HSROCs) was constructed, and quantitative data synthesis was performed using random effects models. Specificity, sensitivity, positive, and negative likelihood ratios were obtained from the corresponding HSROC. Between-study heterogeneity was visually evaluated using Galbraith plot, and publication bias was quantified using Deeks' method. RESULTS: A total of 11 studies were included for analysis. The pooled de- tection rate for sentinel lymph node mapping was 91% (80-98%). Covariates significantly influencing the pooled detection rate were having colon cancer (estimate: 1.3001; 1.114 to 1.486; p < 0.001) and the usage of a laparoscopic approach (estimate: 1.3495; 1.1029 to 1.5961; p < 0.001). The performance of Indocyanine green for the detection of metastatic lymph nodes yielded an area under the roc curve of66.5%, sensitivity of 64.3% (51-76%), and specificity of 65% (36-85%). CONCLUSIONS: Indocyanine green for the detection of sentinel lymph node mapping demonstrates better accuracy when used in colonic cancer and by a laparoscopic approach. Nevertheless, its overall performance for the detection of lymph node metastasis is poor. CITA: Surg Endosc . 2020 Mar;34(3):1035-1047 DOI: 10.1007/s00464-019-07274-z 358

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31836274 TÍTULO: Efficacy of rifaximin in the different clinical scenarios of hepatic en- PMID: 31908602 cephalopathy AUTORES: Coronel-Castillo CE, Contreras-Carmona J, Frati-Munari AC, Uribe M, Méndez-Sánchez N. SUMMARY: Hepatic encephalopathy is a frequent complication in patients with cirrhosis of the liver and is associated with a high mortality rate. Costs attributed to the management of patients with cirrhosis are especially high due to complications, such as hepatic encephalopathy, given that they increase the number of days of hospital stay. Different drugs are current- ly used to treat hepatic encephalopathy, and the main ones are lactulose, L-ornithine L-aspartate (LOLA), and certain antibiotics, especially rifaximin-α (RFX). Even though many of them have been shown to be effective to great- er or lesser degrees, it is important to understand the differences between them, so that every patient receives individualized treatment and the best option is chosen, in accordance with the different clinical scenarios. Thus, the aim of the present study was to analyze the evidence on the advantages and disadvantages of the individual or combined use of the 3 main treat- ments for hepatic encephalopathy, specifically taking into consideration their different degrees of efficacy, their impact on quality of life, prophylaxis, and cost reduction. CITA: Rev Gastroenterol Mex. 2020 Jan - Mar; 85(1):56-68 DOI: 10.1016/j.rgmx.2019.09.001 TÍTULO: Voluntary breath-hold reduces dose to organs at risk in radiothera- py of left-sided breast cancer AUTORES: Poitevin-Chacón MA, Ramos-Prudencio R, Rumoro- so-García JA, Rodríguez-Laguna A, Martínez-Robledo JC. AIM: To compare the dose to organs at risk with free breathing (FB) or voluntary breath-hold (VBH) during radiotherapy of patients with left sided breast cancer. BACKGROUND: Radiotherapy reduces the risk of breast-cancer-specific mortality but the effects on other organs increase non-cancer-specific mor- tality. Radiation exposure to the heart, in particular in patients with left sided breast cancer, can be reduced by breath hold methods that increase the distance between the heart and the radiation field. MATERIALS AND METHODS: Three-dimensional conformal radiotherapy (3D-CRT) dose plans for the left breast and organs at risk including the heart, left anterior descending coronary artery (LAD) and ipsilateral lung were com- pared with FB and VBH in ten patients with left sided breast cancer. RESULTS: The mean doses to the heart and LAD were reduced by 50.4 % (p < 0.001) and 58.8 % (p = 0.006), respectively, in VBH relative to FB. The mean dose to the ipsilateral lung was reduced by 13.8 % (p = 0.11) in VBH relative to FB. The planning target volume (PTV) coverage was at least 95 % in both FB and VBH (p = 0.78). CONCLUSION: The VBH technique significantly reduces the dose to organs at risk in3D-CRT treatment plans of left sided breast cancer. CITA: Rep Pract Oncol Radiother. 2020 Jan-Feb; 25(1):104-108 DOI: 10.1016/j.rpor.2019.12.016 359

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 31960692 TÍTULO: [Non-caloric sweeteners in women of reproductive age - A consen- sus document] AUTORES: Bailón Uriza R, Ayala Méndez JA, Cavagnari BM, Celis González C, Chapa Tellez R, Chávez Brambila J, Espinosa-Marrón A, Lira Plascencia J, López Alarcón MG, López García R, Maldonado Alvarado JD, Molina Segui F, Montoya Cossio J, Méndez Trujeque J, Nolasco Morán V, Sirahuén Neri Ruz E, Peralta Sánchez AE, Santa Rita Escamilla MT, Tena Alavez G, Riobó Serván P, Laviada Molina H. SUMMARY: Non-nutritive sweeteners (NNS) are food additives that have been used as a possible tool to reduce energy and sugar intake. There is a scientific debate around the real benefits of their use. NNS are substances widely evaluated in the scientific literature. Their safety is reviewed by in- ternational regulatory health agencies. Health professionals and consumers often lack education and objective information about food additives based on the best scientific evidence. NNS have been used as a substitute for sucrose, especially by people with diabetes mellitus and obesity. However, concerns related to their possible association with preterm birth have been raised, and also with their use during pregnancy and lactation because of the possibility of metabolic or other consequences in both the mother and offspring. This analysis of the evidence in gynecology and obstetrics pres- ents a review of the most commonly asked questions regarding this matter by health professionals and their patients. This document evaluates a di- versity of scientific publications under the sieve of evidence-based medicine and the regulatory framework for food additives to elucidate whether the use of NNS in women in these critical stages of pregnancy and breastfeeding represents a potential risk. CITA: Nutr Hosp. 2020 Feb 17;37(1):211-222 DOI: 10.20960/nh.02870 PMID: 31972295 TÍTULO: Acute emotional stress proposed as a risk factor for anaphylaxis in patients receiving allergen immunotherapy AUTORES: Larenas-Linnemann DE, Costa-Domínguez MDC, Creticos PS. RESUMEN: Case report CITA: Ann Allergy Asthma Immunol. 2020 Apr;124(4):314-317 DOI: 10.1016/j.anai.2020.01.006 PMID: 31995656 TÍTULO: Correlation between work impairment, scores of rhinitis severity and asthma using the MASK-air® App AUTORES: Bédard A, (…) Larenas-Linnemann D, et al. BACKGROUND: In allergic rhinitis, a relevant outcome providing informa- tion on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently. 360

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32006721 METHODS: All consecutive MASK-air users in 23 countries from June 1, 2016 to October 31, 2018 were included (14,189 users; 205,904 days). Geo- localized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 100) for overall symptoms (global), nose, eyes, asthma and work. Two symp- tom-medication scores were used: the modified EAACI CSMS score, and the MASK control score for rhinitis. To assess data quality, the intra-individual response variability (IRV) index was calculated. RESULTS: A strong correlation was observed between VAS work and oth- er VAS. The highest levels for correlation with VAS work and variance ex- plained in VAS work were found with VAS global, followed by VAS nose, eye and asthma. In comparison to VAS global, the mCSMS and MASK control score showed a lower correlation with VAS work. Results are unlikely to be explained by a low quality of data arising from repeated VAS measures. CONCLUSIONS: VAS work correlates with other outcomes (VAS global, nose, eye and asthma) but less well with a symptom-medication score. VAS work should be considered as a potentially useful AR outcome in interven- tion studies. CITA: Allergy. 2020 Jul;75(7):1672-1688 DOI: 10.1111/all.14204 TÍTULO: Nebulized Inhaled Corticosteroids in Asthma Treatment in Children ≤5 Years or Younger: A Systematic Review and Global Expert Analysis AUTORES: Murphy KR, Hong JG, Wandalsen G, Larenas-Linnemann D, El Beleidy A, Zaytseva OV, Pedersen SE. BACKGROUND: Although nebulized corticosteroids (NebCS) are a key treatment option for young children with asthma or viral-induced wheezing (VIW), there are no uniform recommendations on their best use. METHODS: This systematic review aims to clarify the role of NebCS in children aged ≤5 years for the management of acute asthma exacerbations, asthma maintenance therapy and for the treatment of VIW. Electronic data- bases were used to identify relevant English language articles with no date restrictions. Studies reporting efficacy data in children aged ≤5years, with a double-blind, placebo- or open-controlled, randomized design, and inclu- sion of ≥40 participants (no lower patient limit for VIW) were included. Ten articles on asthma exacerbation, 9 on asthma maintenance, and 7 on VIW were identified. RESULTS: Results showed NebCS to be at least as efficacious as oral corti- costeroids in the emergency room (ER) for the management of mild-to-mod- erate asthma exacerbations. In asthma maintenance, nebulized budesonide, the agent of focus in all trials analyzed, significantly reduced the risk of fur- ther asthma exacerbations compared with placebo, cromolyn sodium, and montelukast. CONCLUSIONS: Intermittent NebCS treatment of VIW was as effective as continuous daily treatment. In summary, NebCS are effective and well tolerat- ed in patients aged ≤5years for the management of acute and chronic asthma. CITA: J Allergy Clin Immunol Pract. 2020 Jan 29. Pii: S2213-2198(20)30100-8 DOI: 10.1016/j.jaip.2020.01.042 361

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32008155 TÍTULO: The role of socioeconomic status in the susceptibility to develop PMID: 32033394 systemic lupus erythematosus in Mexican patients AUTORES: Salgado-Galicia NA, Hernández-Doño S, Ruiz-Gómez D, Jakez-Ocampo J, Zúñiga J, Vargas-Alarcón G, Acuña V, Hernández MT, Márquez-García JE, García-Lechuga M, Llorente L, Lima G, Pineda C, Yu N, Yunis E, Granados J. INTRODUCTION: Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disorder for which Major Histocompatibility Complex (MHC) genes are well-identified as risk factors. SLE patients have different pheno- types or clinical presentations, which vary among Mexicans. This variation could be explained by ethnicity and admixture. Since socioeconomic status probably limits and change the patterns of migration, this factor could fa- vor inbreeding and homogamy in some geographic areas. Consequently, it could alter or restrict the possibilities of admixture too. Therefore, the so- cioeconomic status may also have implications in the susceptibility and the clinical heterogeneity of SLE in Mexican patients. METHODS: One hundred twenty-three SLE patients and 234 healthy individu- als with Mexican admixed ancestry were recruited. HLA alleles were analyzed using the HLA typing method based on Sequence-based typing (SBT). RESULTS: As expected, it was found an increased frequency of the HLA-DRB1*03:01allele in all socioeconomic groups when compared with healthy individuals. The susceptibility allele found in the low-income SLE patients was HLA-DRB1*04:05whereas, the susceptibility alleles for the high-income SLE patients wereHLA-DRB1*07:01 (pC = 0.03, OR = 2.0) and HLA-DRB1*11:04 (pC = 0.0004, OR = 5.1). Additionally, the frequen- cies of two protective alleles HLA-DRB1*14:06(pC = 0.01, OR = 0.28) and HLA-DRB1*16:02 (pC = 0.04, OR = 0.22) were found diminished. These findings correlate with the admixture differences between low-income and high-income SLE patients. The clinical manifestations showed a different distribution between both groups. Arthritis and neurological disorder were prevalent in low-income SLE patients, while the hematological disorder was prevalent in high-income SLE patients. CONCLUSIONS: These findings suggest that HLA class II DRB1 genes con- tribute to the susceptibility and protection to develop SLE differently depend- ing on socioeconomic status. Due to this, the clinical manifestations vary among patients and it could be related to different admixture charge. Key Point• HLA class II DRB1 genes contribute to the susceptibility and protec- tion to develop SLE differently depending on socioeconomic status. CITA: Clin Rheumatol. 2020 Jul;39(7):2151-2161 DOI: 10.1007/s10067-020-04928-5 TÍTULO: In Vitro Susceptibility to Ceftazidime/Avibactam and Comparators in Clinical Isolates of Enterobacterales from Five Latin American Countries AUTORES: Appel TM, Mojica MF, De La Cadena E, Pallares CJ, Radice MA, Castañeda-Méndez P, Jaime-Villalón DA, Gales AC, Munita JM, Ville- gas MV. SUMMARY: High rates of resistance to third-generation cephalosporins and carbapenems in Enterobacterales have been reported in Latin America. Cef- 362

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR tazidime/avibactam (CZA) is the combination of a third-generation cephalo- sporin and a non-β-lactam β-lactamase inhibitor, which has shown activity against isolates producing class A, C and D β-lactamases. Herein, we eval- uated the activity of CZA and comparators against clinical isolates of Entero- bacteralesin Latin America. Methods: The activity of CZA and comparators was evaluated against clinical isolates of Enterobacterales from Argentina, Brazil, Chile, Colombia and Mexico that were collected between January 2016 and October 2017. One specific phenotypic subset was evaluated. A carbapenem non-susceptible (CNS) phenotype was defined as any isolate displaying a minimum inhibitory concentration (MIC) ≥1 mg/L for ertapenem. Results: CZA was active against 95.8% of all isolates and 77.5% of CNS iso- lates. Fosfomycin (FOS) and tigecycline (TGC) were the second most active antibiotics with 93.4% of Enterobacterales being susceptible. Conclusions: The results of this study underline the potential therapeutic role of CZA in Latin America. CITA: Antibiotics (Basel). 2020 Feb 5; 9(2). Pii: E62 DOI: 10.3390/antibiotics9020062 PMID: 32065881 TÍTULO: Manipulation of microbiota with probiotics as an alternative for PMID: 32111488 treatment of hepatic encephalopathy AUTORES: Rivera-Flores R, Morán-Villota S, Cervantes-Barragán L, Lópe- z-Macias C, Uribe M. SUMMARY: Hepatic encephalopathy is a cerebral alteration mainly caused by hepatic insufficiency or portosystemic shunt. It ranges from minimal neu- rologic manifestations to coma in its overt stage. The multifactorial patho- physiology of hepatic encephalopathy has rendered numerous treatment al- ternatives, among which the modification of dysbiosis and hyperammonemia are currently considered to be effective, not only clinically, but also regarding cost. Recent work has developed knowledge of probiotics in different clinical settings including the relationship of the gut microenvironment to liver cirrho- sis. The aim of this review was to analyze the results of clinical trials on the effect of different probiotics on hepatic encephalopathy. CITA: Nutrition. 2020 May;73:110693 DOI: 10.1016/j.nut.2019.110693 TÍTULO: Polycystic ovary syndrome with feasible equivalence to overweight as a risk factor for non-alcoholic fatty liver disease development and severity in Mexican population AUTORES: Salva-Pastor N, López-Sánchez GN, Chávez-Tapia NC, Audifred-Salomón JR, Niebla-Cárdenas D, Topete-Estrada R, Pereznuñe- z-Zamora H, Vidaltamayo-Ramírez R, Báez-Arellano ME, Uribe M, Nuño- -Lámbarri N. INTRODUCTION AND OBJECTIVES: Polycystic ovary syndrome (PCOS) is the most common endocrinology disorder in women of reproductive age; these patients have a higher risk of suffering from non-alcoholic fatty liver disease (NAFLD). We determine the frequency of NAFLD in Mexican pa- tients with PCOS and matched-controls. PATIENTS AND METHODS: Cross-sectional study, with 98 women of 18-44 years old. Rotterdam 2003 criteria integrated PCOS diagnosis. Those with 363

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32113828 significant alcohol consumption, chronic liver disease, use of steatogenic PMID: 32142637 drugs, and pharmacological PCOS treatment or fertility protocol were ex- cluded. Controls were matched in a 1:1 ratio by age and body mass index (BMI). The presence of NAFLD was determined by transient elastography performed by a single experienced operator. RESULTS: A total of 98 female volunteers at reproductive age were recruit- ed. NAFLD denoted markedly higher in patients with than without PCOS at 69.3% vs. 34.6%, respectively. Compared to controls, PCOS patients had a significantly higher risk of NAFLD (OR=4.26, 95% CI 1.83-9.93). Severe ste- atosis was the most frequent NAFLD stage between women with PCOS and NAFLD. Patients with hyperandrogenism have a significantly higher mean CAP 277.83dB/m than controls without hyperandrogenism 191.57dB/m. NA- FLD prevalence was 84.3% in PCOS patients with phenotype A, while in another phenotype, it was 41.1%. CONCLUSIONS: PCOS is an independent risk factor for NAFLD develop- ment. NAFLD screening needs to be considered in all PCOS patients inde- pendently of BMI, except in PCOS patients without hyperandrogenism and BMI<25. CITA: Ann Hepatol. May-Jun 2020;19(3):251-257 DOI: 10.1016/j.aohep.2020.01.004 TÍTULO: Current use and abuse of anabolic steroids AUTORES: Reyes-Vallejo L. SUMMARY: Common abuse of anabolic androgenic steroids (AAS) is no lon- ger confined to high performance athletes, as it has spread among the general population. Epidemiological data about the abuse of these substances show that it is a common practice in young populations. Its use is based on the desire to increase muscle mass and strength, as well as improving physical performance. The ease of acquisition of this type of substances has developed a \"sophisticated\" knowledge of steroid pharmacology based on subjective and anecdotal analysis with no adverse event information, which translates into a public health crisis. Unfortunately, athletes seem to be more influenced by these experiences than by their physician's advice. The abuse of AAS by the athlete and non-athlete population and its adverse events ought to be evaluat- ed in order to improve routine clinical practice on this regard. CITA: Actas Urol Esp (Engl Ed). 2020 Jun;44(5):309-313 DOI: 10.1016/j.acuro.2019.10.011 TÍTULO: Increasing Volume of Bone Marrow Biopsies by Radiology Providers: Evaluation of Trends by Physician Specialty and Practice Setting AUTORES: Ahmed O, Wadhwa V, Patel MV, Patel K, Lionberg A, Klejch W, Lizardo A, Ginsburg M. PURPOSE: The aim of this study was to evaluate trends in bone marrow biop- sies performed in the United States by physician specialty and practice setting. METHODS: The CMS Medicare Physician Supplier Procedure Summary da- tabase was queried from 2005 to 2016 for bone marrow biopsies and aspi- 364

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32145829 rations (BMBs). Data were categorized according to the largest subspecialty PMID: 32173593 groups (medicine, surgery, radiology, pathology, and other) and encounter setting (office, inpatient hospital, and outpatient hospital). Trends in proce- dure volume by specialty and practice setting were evaluated. RESULTS: Between 2005 and 2016, an annual average of 11,417 BMBs were performed (range, 10,380-14,204), with no significant year-over-year change in volume. Medicine was the largest provider of BMBs by specialty, although their market share over this time period declined from 60.2% to 36.6%. Radiology saw the greatest growth in BMB market share from 4.1% to 16.2%. The compound annual growth rate (CAGR) of BMBs performed by medicine subspecialists demonstrated a decrease in year-over-year proce- dural volume at -5.16% (P < .001). Both surgery and radiology demonstrated positive trends in the number of BMBs performed, with CAGRs of 6.20% (P < .001) and 12.43% (P < .001), respectively. Independent of physician spe- cialty, there was a decrease in the number of biopsies performed in the office setting, decreasing by a CAGR of -5.59% (P < .001). CONCLUSIONS: From 2005 to 2016, medicine has remained the primary provider of BMBs, although their market share has declined. Radiology has experienced the greatest rate of growth in this time period and now rep- resents the third largest individual specialty providing this service. CITA: J Am Coll Radiol. 2020 Jul;17(7):933-937 DOI: 10.1016/j.jacr.2020.02.004 TÍTULO: Respiratory support for patients with COVID-19 infection AUTORES: Ñamendys-Silva SA. SUMMARY: Letter to the editor CITA: Lancet Respir Med. 2020 Apr;8(4):e18 DOI: 10.1016/S2213-2600(20)30110-7 TÍTULO: Liver Recovery and Transplantation From Deceased Donors in the Metropolitan Area of the Valley of Mexico AUTORES: Zamora-Valdés D, Leal-Leyte P, Díaz-Muñoz I, Méndez-Sán- chez N. BACKGROUND: Evaluation of donation and transplantation activity allows for strategic planning. Liver donation and transplantation activity in the Met- ropolitan Area of the Valley of Mexico (MAVM) has never been published. The aim of this study was to analyze deceased liver donation and transplan- tation, liver use, and observed-to-expected (O:E) ratio in the MAVM. METHODS: Information from 2014 to 2018 was obtained from the National Center of Transplantation and adjusted per million persons. O:E ratio was analyzed and compared between regions. RESULTS: From all Mexican states, Mexico City (CDMX) had the highest liver donation and transplantation per million persons rates in the country. In contrast, when the MAVM was considered, the region was sixth in liver donation and first in transplantation, although the latter was not statistically 365

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR different to Nuevo Leon (5.4 vs 4.3; P = .52). Liver use in Mexico State within the MAVM (37.8%) was not different from that of CDMX (15th in the nation, 35.2%, P = .78), while deceased donor liver use in the rest of the state was statistically higher (52.4%, P = .01; third in the nation). O:E ratio was higher in Mexico states outside the MAVM (CDMX 10.1, 2.1 vs 29.4, 26.5; P = .009). CONCLUSIONS: Analysis of deceased donation and transplantation of Mexican states without considering the metropolitan areas is insufficient. To consider CDMX as a region without acknowledging the MAVM leads to an inappropriately small denominator during efficiency analysis. CITA: Transplant Proc. 2020 May;52(4):1062-1065 DOI: 10.1016/j.transproceed.2020.02.009 PMID: 32182491 TÍTULO: Delirious mania as a frequent and recognizable neuropsychiatric syndrome in patients with anti-NMDAR encephalitis AUTORES: Restrepo-Martinez M, Ramirez-Bermudez J, Bayliss L, Espino- la-Nadurille M. BACKGROUND: Previous case reports showed that delirious mania could be one of the many neuropsychiatric presentations of Anti-N-methyl-d-aspar- tate receptor encephalitis (ANMDARE). OBJECTIVE: To evaluate the frequency of delirious mania and its associat- ed factors in ANMDARE. METHOD: A prospective study, including all patients with ANMDARE admit- ted to the National Institute of Neurology and Neurosurgery of Mexico, from January 2014 to April 2019. The diagnosis of delirious mania was established when diagnostic criteria for mania and delirium were fulfilled simultaneously. RESULTS: 79 patients with definitive ANMDARE were included. Delirious mania was identified in 20 (25.3%) of these patients. Catatonia, psychomo- tor agitation, disinhibition, impulsivity, and grandiose delusions were signifi- cantly associated with delirious mania. Also, a lower frequency of EEG ab- normalities, absence of extreme delta brush, and a shorter hospital stay was observed in these patients. CONCLUSION: Delirious mania proved to be a frequent neuropsychiatric presentation of ANMDARE, and its presence should warn the physician about the possibility of this diagnosis. It was mainly associated with higher rates of catatonia, psychomotor agitation, disinhibition, and psychotic symp- toms. The lack of recognition of delirious mania as a neuropsychiatric pre- sentation in ANMDARE may be a source of diagnostic and therapeutic errors, as most physicians associate this with bipolar disorder. CITA: Gen Hosp Psychiatry. May-Jun 2020;64:50-55 DOI: 10.1016/j.genhosppsych.2020.03.003 PMID: 32196388 TÍTULO: Real-World Evidence: Multicenter Efficacy and Toxicity Analysis of Nintedanib With Docetaxel as Second-Line Treatment in Mexican Patients With Advanced Lung Adenocarcinoma 366

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32204726 AUTORES: Rodríguez-Cid JR, Campos-Gomez S, García-Montes V, Ma- PMID: 32223988 gallanes-Maciel M, Flores-Mariñelarena RR, Fernández-Garibay VM, González-Espinoza IR, Ceja-García JP, Cázarez-Price JC, Martínez-Barre- ra L, Barriguete-Parra L, Zuloaga-Fernandez CJ, Kuri-Exsome R, Suárez- García D, Gonzalez-Villanueva JI, Flores-Anaya N, Acevedo-Delgado JA, Astorga-Ramos AM, Gerson-Cwilich R, Villalobos-Prieto A, Rodríguez-Silva C, Noriega-Iriondo MF, Vázquez-Cortés L, Perales-Rodríguez E, Acosta-Es- pinoza A, Perez-Lozano Y, Capdeville-García D, Alatorre-Alexander JA. PURPOSE: The LUME-Lung 1 study has brought consistent evidence of the effective use of nintedanib in lung adenocarcinoma as a second line of treatment; however, differences among ethnicities have been found in some studies. METHODS: This was a retrospective review among 21 medical centers of 150 patients with a confirmed diagnosis of lung adenocarcinoma, included in a compassionate use program of nintedanib from March 2014 to Sep- tember 2015. The current study aimed to analyze the effectiveness of nin- tedanib in combination with docetaxel in the Mexican population, using pro- gression-free survival rate and the best objective response to treatment by RECIST 1.1 as a surrogate of effectiveness. In addition, we examined the toxicity profile of our study population as a secondary end point. RESULTS: After exclusion criteria, only 99 patients met the criteria for en- rollment in the current study. From the total study population, 53 patients (53.5%) were male and 46 (46.5%) were female, with an average age of 60 years and stage IV as the most prevalent clinical stage at the beginning of the compassionate use program. A total of 48 patients (48.5%) had partial response; 26 (26.3%), stable disease; 4 (4%), complete response; and 16 (16.2%), progression; and 5 (5%) were nonevaluable. We found a median progression-free survival of 5 months (95% CI, 4.3 to 5.7 months). The most common grade 3 or 4 adverse reactions were fatigue (14%) and diarrhea (13%). CONCLUSION: Nintedanib, as part of a chemotherapy regimen, is an effec- tive option with an acceptable toxicity profile for advanced lung adenocarci- noma after first-line treatment progression. CITA: JCO Glob Oncol. 2020 Mar;6:462-470 DOI: 10.1200/JGO.19.00330 TÍTULO: Prone positioning combined with high-flow nasal cannula in severe noninfectious ARDS AUTORES: Pérez-Nieto OR, Guerrero-Gutiérrez MA, Deloya-Tomas E, Ñamendys-Silva SA. SUMMARY: Letter to the editor CITA: Crit Care. 2020 Mar 23;24(1):114 DOI: 10.1186/s13054-020-2821-y TÍTULO: ECMO for ARDS due to COVID-19 AUTORES: Ñamendys-Silva SA. 367

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR SUMMARY: Letter to the editor CITA: Heart Lung. Jul-Aug 2020;49(4):348-349 DOI: 10.1016/j.hrtlng.2020.03.012 PMID: 32224621 TÍTULO: Urticaria: Collegium Internationale Allergologicum (CIA) Update PMID: 32229039 2020 AUTORES: Maurer M, Eyerich K, Eyerich S, Ferrer M, Gutermuth J, Hart- mann K, Jakob T, Kapp A, Kolkhir P, Larenas-Linnemann D, Park HS, Pejler G, Sánchez-Borges M, Schäkel K, Simon D, Simon HU, Weller K, Zuberbier T, Metz M. SUMMARY: This update on chronic urticaria (CU) focuses on the prevalence and pathogenesis of chronic spontaneous urticaria (CSU), the expanding spectrum of patient-reported outcome measures (PROMs) for assessing CU disease activity, impact, and control, as well as future treatment options for CU. This update is needed, as several recently reported findings have led to significant advances in these areas. Some of these key discoveries were first presented at past meetings of the Collegium Internationale Aller- gologicum (CIA). New evidence shows that the prevalence of CSU is geo- graphically heterogeneous, high in all age groups, and increasing. Several recent reports have helped to better characterize two endotypes of CSU: type I autoimmune (or autoallergic) CSU, driven by IgE to autoallergens, and type IIb autoimmune CSU, which is due to mast cell (MC)-targeted autoanti- bodies. The aim of treatment in CU is complete disease control with absence of signs and symptoms as well as normalization of quality of life (QoL). This is best monitored by the use of an expanding set of PROMs, to which the Angioedema Control Test, the Cholinergic Urticaria Quality of Life Question- naire, and the Cholinergic Urticaria Activity Score have recently been add- ed. Current treatment approaches for CU under development include drugs that inhibit the effects of signals that drive MC activation and accumulation, drugs that inhibit intracellular pathways of MC activation and degranulation, and drugs that silence MCs by binding to inhibitory receptors. The under- standing, knowledge, and management of CU are rapidly increasing. The aim of this review is to provide physicians who treat CU patients with an update on where we stand and where we will go. Many questions and unmet needs remain to be addressed, such as the development of routine diagnos- tic tests for type I and type IIb autoimmune CSU, the global dissemination and consistent use of PROMs to assess disease activity, impact, and control, and the development of more effective and well-tolerated long-term treat- ments for all forms of CU. CITA: Int Arch Allergy Immunol. 2020;181(5):321-333 DOI: 10.1159/000507218 TÍTULO: Caveats for the implementation of global strategies against non-al- coholic fatty liver disease AUTORES: Méndez-Sánchez N, Valencia-Rodríguez A. SUMMARY: Letter to the editor CITA: J Hepatol. 2020 Jul;73(1):220 DOI: 10.1016/j.jhep.2020.02.013 368

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32233040 TÍTULO: Intranasal corticosteroids in allergic rhinitis in COVID-19 infected PMID: 32253047 patients: An ARIA-EAACI statement AUTORES: Bousquet J, (…) Larenas-Linnemann D, et al. PMID: 32278004 SUMMARY: Position paper CITA: Allergy. 2020 Oct;75(10):2440-2444 DOI: 10.1111/all.14302 TÍTULO: Clinical Spectrum and Long-term Outcome of 183 Cases of Eb- stein's Anomaly, Experience of Mexican Population AUTORES: Herrera-Bello H, Ávila-Vanzzini N, Fritche-Salazar JF, Kuri-Al- faro J, Gaxiola-Macias MBA, Cossio-Aranda JE. BACKGROUND: Ebstein's anomaly (EA) is a myopathy of the right ventricle that causes a variable spectrum of tricuspid valve delamination failure with diverse clinical and anatomical presentation. We reviewed our data of EA to establish an association between clinical and echocardiographic findings with mortality. METHODS: We divided patients in infants, Children/adolescents (Ch/A), and adults, according to age of presentation. Clinical and echocardiographic pa- rameters were compared among groups. Multivariate analysis was performed for mortality. Survival analysis was plotted using Kaplan Meier curves. RESULTS: Cyanosis, severe forms of AE and heart failure were more fre- quent among infants, arrhythmias in Ch/A and stroke among adults. Surgery was performed in 71 patients; infants had higher mortality and early compli- cations. We found that the predicted mortality at 40 years of age in the three groups was significantly different (log rank test, p <0.0001): Infants: 38%, Ch/A 16 and 4% in adults. Multivariate model in surgical group showed that progressive drop of right ventricular fractional shortening (RVFS) predicts a higher mortality risk. In the non-surgical group, low RVFS and cyanosis were significantly associated with mortality. CONCLUSION: EA in infants is linked to higher morbidity and mortali- ty, while arrhythmias predominate in Ch/A and stroke in adults. In general, stroke is frequent in patients with EA, some prevention alternative must be implemented. Right ventricular dysfunction is very important in EA and is as- sociated with high mortality. It must be subject of discussion the planning of the type of surgery or even in the decision of to preclude surgical treatment. CITA: Arch Med Res. 2020 May;51(4):336-342 DOI: 10.1016/j.arcmed.2020.03.008 TÍTULO: A new definition for metabolic dysfunction-associated fatty liver dis- ease: An international expert consensus statement AUTORES: Eslam M, Newsome PN, Sarin SK, Anstee QM, Targher G, Romero-Gomez M, Zelber-Sagi S, Wai-Sun Wong V, Dufour JF, Schatten- berg JM, Kawaguchi T, Arrese M, Valenti L, Shiha G, Tiribelli C, Yki-Järvinen H, Fan JG, Grønbæk H, Yilmaz Y, Cortez-Pinto H, Oliveira CP, Bedossa P, Adams LA, Zheng MH, Fouad Y, Chan WK, Mendez-Sanchez N, Ahn SH, Castera L, Bugianesi E, Ratziu V, George J. 369

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR SUMMARY: The exclusion of other chronic liver diseases including \"excess\" alcohol intake has until now been necessary to establish a diagnosis of met- abolic dysfunction-associated fatty liver disease (MAFLD). However, given our current understanding of the pathogenesis of MAFLD and its rising prev- alence, \"positive criteria\" to diagnose the disease are required. In this work, a panel of international experts from 22 countries propose a new definition for the diagnosis of MAFLD that is both comprehensive and simple, and is independent of other liver diseases. The criteria are based on evidence of hepatic steatosis, in addition to one of the following three criteria, namely overweight/obesity, presence of type 2 diabetes mellitus, or evidence of met- abolic dysregulation. We propose that disease assessment and stratification of severity should extend beyond a simple dichotomous classification to ste- atohepatitis vs. non-steatohepatitis. The group also suggests a set of criteria to define MAFLD-associated cirrhosis and proposes a conceptual framework to consider other causes of fatty liver disease. Finally, we bring clarity to the distinction between diagnostic criteria and inclusion criteria for research studies and clinical trials. Reaching consensus on the criteria for MAFLD will help unify the terminology (e.g. for ICD-coding), enhance the legitimacy of clinical practice and clinical trials, improve clinical care and move the clinical and scientific field of liver research forward. CITA: J Hepatol. 2020 Jul;73(1):202-209 DOI: 10.1016/j.jhep.2020.03.039 PMID: 32299261 TÍTULO: Sarcopenia in chronic liver diseases: a translational overview AUTORES: Barbero-Becerra VJ, López-Méndez I, Romo-Araiza A, Visag- -Castillo V, Chávez-Tapia NC, Uribe M, Juárez-Hernandez E. INTRODUCTION: Sarcopenia refers to a progressive and generalized mus- cle mass and strength loss. In liver diseases, it has been related to worse outcomes and high risk of decompensations. AREAS COVERED: Sarcopenia is caused by a set of cellular processes in the muscle such as denervation, mitochondrial dysfunction, endotoxemia and inflammation; which are manifested through the alteration of several proteolytic pathways such as lysosomal, proteasomal and caspase systems. In autophagy, myostatin and oxidative stress; such as hyperammonemia, contributes importantly to liver sarcopenia through loss of muscle mass al- ready demonstrated in in vitro and in vivo models. In addition, hormones and the regulation of the intestinal microbiota, influence in a not less im- portant magnitude. In the clinical setting, early identification of sarcopenia has been established as a mandatory item to prevent progression of muscle mass loss; however, diagnostic methods have extreme variation according to methodology, population, etiology and severity of liver disease. Reversing sarcopenia should be an integral therapeutic strategy. EXPERT OPINION: Clinical and nutritional interventions should be adapted to liver injury etiology and stage of disease, each of them shares a similar sarcopenia development pathway. There are specific biomarkers that condi- tion or exacerbate loss of skeletal muscle. CITA: Expert Rev Gastroenterol Hepatol. 2020 May;14(5):355-366 DOI: 10.1080/17474124.2020.1757427 370

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32309152 TÍTULO: What Has the COVID-19 Pandemic Taught Us so Far? Addressing PMID: 32329930 the Problem from a Hepatologist's Perspective PMID: 32355844 AUTORES: Méndez-Sánchez N, Valencia-Rodríguez A, Qi X, Yoshida EM, Romero-Gómez M, George J, Eslam M, Abenavoli L, Xie W, Teschke R, Car- rion AF, Keaveny AP. SUMMARY: Editorial CITA: J Clin Transl Hepatol. 2020 Jun 28;8(2):0024 DOI: 10.14218/JCTH.2020.00024 TÍTULO: Handling of allergen immunotherapy in the COVID-19 pandemic: An ARIA-EAACI statement AUTORES: Klimek L, (...) Larenas-Linnemann D, et al SUMMARY: The current COVID-19 pandemic influences many areas of so- cial life, medical treatments and the way allergy is performed. Allergen‐spe- cific immunotherapy (AIT) is one of the most important treatment options for IgE‐mediated allergies and is based on immunological effects on the dis- eased patient CITA: Allergy. 2020 Jul;75(7):1546-1554 DOI: 10.1111/all.14336 TÍTULO: The cellular pathways of liver fibrosis in non-alcoholic steatohepati- tis AUTORES: Méndez-Sánchez N, Valencia-Rodríguez A, Coronel-Castillo C, Vera-Barajas A, Contreras-Carmona J, Ponciano-Rodríguez G, Zamo- ra-Valdés D. SUMMARY: Non-alcoholic steatohepatitis (NASH) is considered the ad- vanced stage of non-alcoholic fatty liver disease (NAFLD). It is characterized by liver steatosis, inflammation and different degrees of fibrosis. Although the exact mechanisms by which fatty liver progresses to NASH are still not well understood, innate and adaptive immune responses seem to be essen- tial key regulators in the establishment, progression, and chronicity of these disease. Diet-induced lipid overload of parenchymal and non-parenchymal liver cells is considered the first step for the development of fatty liver with the consequent organelle dysfunction, cellular stress and liver injury. These will generate the production of pro-inflammatory cytokines, chemokines and damage-associated molecular patterns (DAMPs) that will upregulate the ac- tivation of Kupffer cells (KCs) and monocyte-derived macrophages (MMs) favoring the polarization of the tolerogenic environment of the liver to an immunogenic phenotype with the resulting transdifferentiation of hepatic stellate cells (HSCs) into myofibroblasts developing fibrosis. In the long run, dendritic cells (DCs) will activate CD4+ T cells polarizing into the pro-inflam- matory lymphocytes Th1 and Th17 worsening the liver damage and inflam- mation. Therefore, the objective of this review is to discuss in a systematic way the mechanisms known so far of the immune and non-proper immune liver cells in the development and progression of NASH. CITA: Ann Transl Med. 2020 Mar;8(6):400 DOI: 10.21037/atm.2020.02.184 371

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32359519 TÍTULO: Looking into a new era for the approach of metabolic (dysfunction) PMID: 32413341 associated fatty liver disease PMID: 32415019 AUTORES: Valencia-Rodríguez A, Vera-Barajas A, Chávez-Tapia NC, Uribe M, Méndez-Sánchez N. SUMMARY: Letter to the editor CITA: Ann Hepatol. May-Jun 2020;19(3):227-229 DOI: 10.1016/j.aohep.2020.04.001 TÍTULO: Non-alcoholic fatty liver disease in non-obese individuals: the im- pact of metabolic health AUTORES: Eslam M, Fan JG, Mendez-Sanchez N. SUMMARY: Letter to the editor CITA: Lancet Gastroenterol Hepatol. 2020 Aug;5(8):713-715 DOI: 10.1016/S2468-1253(20)30090-X TÍTULO: Radial diffusivity is the best global biomarker able to discriminate healthy elders, mild cognitive impairment, and Alzheimer's disease: A diag- nostic study of DTI-derived data AUTORES: Becerra-Laparra I, Cortez-Conradis D, Garcia-Lazaro HG, Martinez-Lopez M, Roldan-Valadez E. INTRODUCTION: For the past two decades, diffusion tensor imaging (DTI)-derived metrics allowed the characterization of Alzheimer's disease (AzD). Previous studies reported only a few parameters (most commonly fractional anisotropy, mean diffusivity, and axial and radial diffusivities mea- sured at selected regions). We aimed to assess the diagnostic performance of 11 DTI-derived tensor metrics by using a global approach. MATERIALS AND METHODS: A prospective study performed in 34 sub- jects: 12 healthy elders, 11 mild cognitive impairment (MCI) patients, and 11 patients with AzD. Postprocessing of DTI magnetic resonance imaging allowed the calculation of 11 tensor metrics. Anisotropies included fractional (FA), and relative (RA). Diffusivities considered simple isotropic diffusion (p), simple anisotropic diffusion (q), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD). Tensors included the diffusion tensor total magni- tude (L); and the linear (Cl), planar (Cp), and spherical tensors (Cs). We per- formed a multivariate discriminant analysis and diagnostic tests assessment. RESULTS: RD was the only variable selected to assemble a predictive mod- el: Wilks' λ = 0.581, χ2 (2) = 14.673, P = 0.001. The model's overall accuracy was 64.5%, with areas under the curve of 0.81, 0.73 and 0.66 to diagnose AzD, MCI, and healthy brains, respectively. CONCLUSIONS: Global DTI-derived RD alone can discriminate between healthy elders, MCI, and AzD patients. Although this study proves evidence of a potential biomarker, it does not provide clinical guidance yet. Additional studies comparing DTI metrics might determine their usefulness to monitor disease progression, measure outcome in drug trials, and even perform the screening of pre-AzD subjects. 372

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR CITA: Neurol India. Mar-Apr 2020;68(2):427-434 DOI: 10.4103/0028-3886.284376 PMID: 32437567 TÍTULO: Synergistic Effect of Biejia-Ruangan on Fibrosis Regression in Pa- PMID: 32444115 tients with Chronic Hepatitis B Treated with Entecavir: A Multicenter, Ran- domized, Double-Blinded, Placebo-Controlled Trial AUTORES: Rong G, Chen Y, Yu Z, Li Q, Bi J, Tan L, Xiang D, Shang Q, Lei C, Chen L, Hu X, Wang J, Liu H, Lu W, Chen Y, Dong Z, Bai W, Yoshida EM, Mendez-Sanchez N, Hu KQ, Qi X, Yang Y. BACKGROUND AND AIMS: Long-term nucleos(t)ide analogues (NAs) treat- ment can reverse liver fibrosis in chronic hepatitis B (CHB), but its effect on fibrosis regression remains limited. Biejia-Ruangan (BR) has been approved in China as an anti-fibrotic traditional Chinese medicine drug in patients with chronic liver diseases. A multicenter randomized controlled trial aims to eval- uate the effect of BR on fibrosis regression in CHB patients treated with NAs. METHODS: CHB patients with histologically confirmed advanced fibrosis or cirrhosis were randomly assigned to receive entecavir (ETV) (0.5mg per day) plus BR (2g three times a day) or placebo for 72 weeks. Liver fibro- sis regression was defined as a reduction of ≥1 point by the Ishak Fibrosis Stage (IFS). RESULTS: Overall, 500 patients were enrolled in each group as the in- tention-to-treat population. The rate of fibrosis regression after 72 week treatment was significantly higher in ETV+BR group (40% versus 31.8%, P=0.0069). Among 388 patients with cirrhosis (i.e., IFS ≥5) at baseline, the rate of cirrhosis reversal (i.e., IFS ≤4) was significantly higher in ETV+BR group (41.5% versus 30.7%, P=0.0103). CONCLUSIONS: Addition of BR to the current standard treatment with NAs in CHB patients with advanced fibrosis or cirrhosis can improve liver fibrosis regression. CITA: J Infect Dis. 2020 May 21;jiaa266 DOI: 10.1093/infdis/jiaa266 TÍTULO: Food allergen sensitization patterns in a large allergic population in Mexico AUTORES: Ruiz Segura LT, Figueroa Pérez E, Nowak-Wegrzyn A, Sie- pmann T, Larenas-Linnemann D. INTRODUCTION AND OBJECTIVES: Although food allergy is recognized as a growing worldwide public health problem, there continues to be limited data on prevalence rates in developing and emerging countries. Most preva- lence estimates are based on self-reports, with only few studies using objec- tive assessments. The aim was to analyze the frequency of sensitization to food allergens by serum specific IgE in a large group of unselected allergic patients in Mexico. MATERIALS AND METHODS: We analyzed data registries from patients of all ages with suspected food allergy referred to a specialized laboratory in Mexico City from January 2016 to April 2018. A descriptive analysis, and an age/food-group comparison were made. 373

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR RESULTS: A total of 2633 subjects tested for food allergy were identified during the study period; 1795 subjects fulfilled the inclusion criteria. The overall positivity (sIgE≥0.35kUA/L) to at least one food was 24%. The most frequently positive foods were hazelnut, apple, shrimp, peanut, egg white, egg yolk, peach, almond, tomato, bean, milk, strawberry, kiwi, maize and wheat. Positivity for some foods was more frequent across different age groups, in young children (≤5 years) milk; in older children (6-17 years): pea- nut, almond, wheat, soy and maize; in adults: apple. We also found other foods with high positivity but less than 50 samples: rye 60%, mango 42.9%, carrot 37.5%, cashew 27.3%, banana 21.1% and oat 20.6%. CONCLUSION: Our study reported the presence of a differential regional IgE sensitization pattern as compared with the internationally reported one, highlighting the importance of local staple foods. CITA: Allergol Immunopathol (Madr). Nov-Dec 2020;48(6):553-559 DOI: 10.1016/j.aller.2020.02.004 PMID: 32494227 TÍTULO: Pelvic radiation therapy with volumetric modulated arc therapy and intensity-modulated radiotherapy after renal transplant: A report of 3 cases AUTORES: Ileana PÁS, Rubi RP, Javier LRF, Sagrario MGMD, Haydeé FBC. AIM: Describe characteristics and outcomes of three patients treated with pelvic radiation therapy after kidney transplant. BACKGROUND: The incidence of pelvic cancers in kidney transplant (KT) recipients is rising. Currently it is the leading cause of death. Moreover, treatment is challenging because anatomical variants, comorbidities, and as- sociated treatments, which raises the concern of using radiotherapy (RT). RT has been discouraged due to the increased risk of urethral/ureteral stricture and KT dysfunction. MATERIALS AND METHODS: We reviewed the electronic health records and digital planning system of patients treated with pelvic RT between De- cember 2013 and December 2018 to identify patients with previous KT. CASES DESCRIPTION: We describe three successful cases of KT patients in which modern techniques allowed full standard RT for pelvic malignances (2 prostate and 1 vaginal cancer) with or without elective pelvic nodal RT, without allograft toxicity at short and long follow-up (up to 60 months). CONCLUSION: When needed, RT modern techniques remain a valid option with excellent oncologic results and acceptable toxicity. Physicians should give special considerations to accomplish all OAR dose constraints in the patient's specific setting. Recent publications recommend KT mean dose <4 Gy, but graft proximity to CTV makes this unfeasible. We present 2 cas- es where dose constraint was not achieved, and to a short follow-up of 20 months renal toxicity has not been documented. We recommend the lowest possible mean dose to the KT, but never compromising the CTV coverage, since morbimortality from recurrent or progressive cancer disease outweighs the risk of graft injury. CITA: Rep Pract Oncol Radiother. Jul-Aug 2020;25(4):548-555 DOI: 10.1016/j.rpor.2020.04.003 374

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32499909 TÍTULO: Is diet partly responsible for differences in COVID-19 death rates between and within countries? AUTORES: Bousquet J, Anto JM, Iaccarino G, Czarlewski W, Haahtela T, Anto A, Akdis CA, Blain H, Canonica GW, Cardona V, Cruz AA, Illario M, Ivancevich JC, Jutel M, Klimek L, Kuna P, Laune D, Larenas-Linnemann D, Mullol J, Papadopoulos NG, Pfaar O, Samolinski B, Valiulis A, Yorgancioglu A, Zuberbier T SUMMARY: Reported COVID-19 deaths in Germany are relatively low as compared to many European countries. Among the several explanations proposed, an early and large testing of the population was put forward. Most current debates on COVID-19 focus on the differences among coun- tries, but little attention has been given to regional differences and diet. The low-death rate European countries (e.g. Austria, Baltic States, Czech Republic, Finland, Norway, Poland, Slovakia) have used different quar- antine and/or confinement times and methods and none have performed as many early tests as Germany. Among other factors that may be sig- nificant are the dietary habits. It seems that some foods largely used in these countries may reduce angiotensin-converting enzyme activity or are anti-oxidants. Among the many possible areas of research, it might be im- portant to understand diet and angiotensin-converting enzyme-2 (ACE2) levels in populations with different COVID-19 death rates since dietary in- terventions may be of great benefit. CITA: Clin Transl Allergy. 2020 May 27;10:16 DOI: 10.1186/s13601-020-00323-0 PMID: 32523137 TÍTULO: The SARS-CoV-2 (COVID-19) coronavirus pandemic: current situ- ation and implications for Mexico AUTORES: Escudero X, Guarner J, Galindo-Fraga A, Escudero-Salaman- ca M, Alcocer-Gamba MA, Del-Río C. SUMMARY: The Coronavirus pandemic (COVID-19) is one of the most dev- astating in this century. It originated in China in December 2019 caused by the SARS-Cov-2 virus, and in less than a month it had been classified as an \"International Public Health Emergency\". To date there are nearly 3 million people infected and more than 250,000 deaths caused by the disease world- wide. Initially it affects the respiratory tract with atypical pneumonia and in severe cases it produces systemic inflammation with cytokine storm that can cause rapid deterioration with circulatory and respiratory failure, coagulop- athy and a lethality rate of approximately 7%. In Mexico, the first case was detected in February 2020, and to date there are 26,616 confirmed cases and 2,961 deaths throughout the country. The low number of diagnostic tests conducted in our country clearly underestimates the real incidence and im- pact of the disease. The most affected groups are those with risk factors such as age over 60, presence of hypertension, diabetes or cardiovascular disease. Of the confirmed cases, 15% are healthcare workers. There is no specific treatment or vaccine yet, so it is important to have hygiene, social isolation and personal protection measures. Health, social and economic consequences could have great impact in the near future. CITA: Arch Cardiol Mex. 2020;90(Supl):7-14 DOI: 10.24875/ACM.M20000064 375

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32523146 TÍTULO: Cardiac imaging studies in the COVID-19 pandemic PMID: 32534022 AUTORES: Pérez-Soriano P, Herrera-Gomar M, Lozoya-Del Rosal JJ, Fa- jardo-Juárez AI, Olmos-Temois SG, Carbajal-Juárez I. SUMMARY: COVID-19 is an acute respiratory syndrome caused by corona- virus-2 (SARS COV2). The different cardiac imaging methods have issued specific recommendations for the different imaging methods in this pan- demic, so it is essential to emphasize the recommendations for carrying out these studies. CITA: Arch Cardiol Mex. 2020;90(Supl):41-44 DOI: 10.24875/ACM.M20000059 TÍTULO: Coronavirus disease 2019 and allergen immunotherapy: Theoreti- cal benefits invite to adjustments in practice recommendations AUTORES: Larenas-Linnemann D, Rodríguez-Pérez N, Ortega-Martell JA, Blandon-Vijil V, Luna-Pech JA SUMMARY: Letter to the editor CITA: Ann Allergy Asthma Immunol. 2020 Sep;125(3):247-249 DOI: 10.1016/j.anai.2020.06.009 PMID: 32542548 TÍTULO: Vitamin D deficiency in Mexicans have a high prevalence: a cross-sectional analysis of the patients from the Centro Médico Nacional 20 de Noviembre AUTORES: Martínez-Zavala N, López-Sánchez GN, Vergara-Lopez A, Chávez-Tapia NC, Uribe M, Nuño-Lámbarri N. SUMMARY: Disorders of vitamin D concentration (deficiency or insufficien- cy) are a global health problem, which are associated with various chronic diseases. In Latin America, alterations in vitamin D prevalence are different from those shown in previous studies and may be due to differences in geo- graphic location, skin color, and diet type. PURPOSE: To know the prevalence of vitamin D insufficiency (21-29 ng/mL) and deficiency (< 20 ng/mL) in Mexican patients; although it is a risk factor for developing multiple complex diseases, its prevalence in the population is still unknown. METHODS: Cross-sectional study carried out at the endocrinology service of the highly specialized national center November 20. Data on cardiovas- cular risk factors were obtained and 25-hydroxy vitamin D was measured by chemiluminescence. Prevalence was calculated, and the results were ana- lyzed to categorize the patients according to 25-hydroxy vitamin D deficient or insufficient levels. RESULTS: The mean value of the serum vitamin D concentration was 18.37 ng/mL. Of the 117 patients, 93.2% (n = 109) have decreased vitamin D val- ues; 62.4% (n = 73) of the patients had vitamin D deficiency and 30.8% (n = 36) vitamin D insufficiency. The prevalence of vitamin D deficiency was 62.4% and 30.8% for vitamin D insufficiency. The total prevalence of alter- ations in vitamin D levels in this population was 93.2%. 376

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32552211 CONCLUSIONS: This study reports a prevalence of vitamin D deficiency and insufficiency much higher than those described by previous studies, which is of utmost importance for the population due to the morbidities asso- ciated with these alterations. CITA: Arch Osteoporos. 2020 Jun 16;15(1):88 DOI: 10.1007/s11657-020-00765-w TÍTULO: Genetics and epigenetics purpose in nonalcoholic fatty liver dis- ease AUTORES: Botello-Manilla AE, Chávez-Tapia NC, Uribe M, Nuño-Lám- barri N. INTRODUCTION: nonalcoholic fatty liver disease (NAFLD) comprises a broad spectrum of diseases, which can progress from benign steatosis to nonalcoholic steatohepatitis, liver cirrhosis and hepatocellular carcinoma. NAFLD is the most common chronic liver disease in developed countries, affecting approximately 25% of the general population. Insulin resistance, adipose tissue dysfunction, mitochondrial and endoplasmic reticulum stress, chronic inflammation, genetic and epigenetic factors are NAFLD triggers that control the disease susceptibility and progression. AREAS COVERED: In recent years a large number of investigations have been carried out to elucidate genetic and epigenetic factors in the disease pathogenesis, as well as the search for diagnostic markers and therapeutic targets. This paper objective is to report the most studied genetic and epi- genetic variants around NAFLD. EXPERT OPINION: NAFLD lead to various comorbidities, which have a considerable impact on the patient wellness and life quality, as well as on the costs they generate for the country's health services. It is essential to continue with molecular research, since it could be used as a clinical tool for prognosis and disease severity. Specifically, in the field of hepatology, plasma miRNAs could provide a novel tool in liver diseases diagnosis and monitoring, representing an alternative to invasive diagnostic procedures. CITA: Expert Rev Gastroenterol Hepatol. 2020 Aug;14(8):733-748 DOI: 10.1080/17474124.2020.1780915 PMID: 32563732 TÍTULO: Comorbidity burden in terms of disability in patients with osteoar- thritis in Mexico. The IMPACTAR registry AUTORES: Vega-Morales D, Esquivel-Valerio JA, Vázquez-Fuentes BR, Díaz-Borjón A, Arce-Salinas CA, Álvarez-Hernández E, Torres-Roldán JF, Aguilera-Zepeda JM, Toledo-Infanson V, Alcántar-Luna E, Aldrete-Velasco JA, Martínez Hernández JL, Gutiérrez-Gómez JJ, Espinosa-Morales R OBJECTIVE: To determine the comorbidities associated with disability in pa- tients with OA in Mexico (2013-2015). MATERIAL AND METHODS: A cross-sectional, retrospective and multi- centre IMPACTAR study (n=7703) in Mexican patients (2013-2015). Comor- bidities associated with disability were identified in 4971 patients diagnosed with OA from the IMPACTAR registry (n=7073). An adjusted logistic regres- sion analysis was carried out by demographic, economic, clinical and med- ical variables. 377

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32564927 RESULTS: Mean age was 63 years; and 75% of the patients were women. PMID: 32577283 Subjects with OA and presence of comorbidities are 42% more likely to de- velop disabilities than patients without associated comorbidity, considering age, sex, family income, OA diagnosis duration, and education level. The highest rate of people with disability (28.9%) was concentrated in Region 7, which corresponds to Mexico City. There are also significant differences between median family incomes, when the income of persons with disability is under $13 000 (IQR: 9000-16 000) Mexican pesos, compared to patients without disability. Almost half of the subjects (49.6%) reported having at least one comorbidity. Arterial hypertension was the risk factor with a sta- tistically significant difference (32.8%) among those with disability (34.7%). CONCLUSIONS: Programs and interventions for OA patients should take into consideration comorbidity factors, being female, family income, and the region of residence as variables that may increase the possibility of develop- ing an OA-associated disability. CITA: Reumatol Clin (Engl Ed). 2020 Jun 17;S1699-258X(20)30080-2 DOI: 10.1016/j.reuma.2020.03.005 TÍTULO: Author response AUTORES: Larenas-Linnemann D, Romero-Tapia S, Virgen C, Mallol J, Baeza Bacab MA, García-Marcos L. SUMMARY: Letter to the editor CITA: Ann Allergy Asthma Immunol. 2020 Jul;125(1):116 DOI: 10.1016/j.anai.2020.05.010 TÍTULO: Early detection of and intervention for two newborns with critical congenital heart disease using a specialized device as part of a screening system AUTORES: Gómez-Gutiérrez R, Cruz-Camino H, Cantú-Reyna C, Martínez-Cer- vantes A, Vazquez-Cantu DL, Rivas-Soriano V, Vargas-Betancourt E, Brit- ton-Robles C. SUMMARY: Screening for critical congenital heart disease is a clinical method used for their early detection using pulse oximetry technology. This, followed by a diagnostic confirmatory protocol, allows timely therapeutic in- terventions that improve the newborn's outcome. According to Mexican birth statistics, approximately 18,000-21,000 neonates are born with a form of congenital heart disease each year, of which 25% are estimated to be critical congenital heart disease. We report two cases with an early critical congen- ital heart disease detection and intervention through an innovative critical congenital heart disease screening program implemented in two Mexican hospitals. They integrated a new automated pulse oximetry data analysis method and a comprehensive follow-up system (Cárdi-k®). Both cases were confirmed by echocardiogram, which served for an intervention in the first week of life, and the patients were discharged in good clinical condition. In addition, to the routine physical assessments, the critical congenital heart disease screening program (which includes echocardiogram for presumptive positive cases) should be implemented in a timely manner. CITA: SAGE Open Med Case Rep. 2020 Jun 10;8:2050313X20926041 DOI: 10.1177/2050313X20926041 378

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32582865 TÍTULO: The mechanism of dysbiosis in alcoholic liver disease leading to PMID: 32595949 liver cancer AUTORES: Méndez-Sánchez N, Valencia-Rodriguez A, Vera-Barajas A, Abenavoli L, Scarpellini E, Ponciano-Rodriguez G, Wang DQ. SUMMARY: Currently, alcoholic liver disease (ALD) is one of the most preva- lent chronic liver diseases worldwide, representing one of the main etiologies of cirrhosis and hepatocellular carcinoma (HCC). Although we do not know the exact mechanisms by which only a selected group of patients with ALD progress to the final stage of HCC, the role of the gut microbiota within the progression to HCC has been intensively studied in recent years. To date, we know that alcohol-induced gut dysbiosis is an important feature of ALD with im- portant repercussions on the severity of this disease. In essence, an increased metabolism of ethanol in the gut induced by an excessive alcohol consump- tion promotes gut dysfunction and bacterial overgrowth, setting a leaky gut. This causes the translocation of bacteria, endotoxins, and ethanol metabolites across the enterohepatic circulation reaching the liver, where the recognition of the pathogen-associated molecular patterns via specific Toll-like receptors of liver cells will induce the activation of the nuclear factor kappa-B pathway, which releases pro-inflammatory cytokines and chemokines. In addition, the mitogenic activity of hepatocytes will be promoted and cellular apoptosis will be inhibited, resulting in the development of HCC. In this context, it is not sur- prising that microbiota-regulating drugs have proven effectiveness in prolong- ing the overall survival of patients with HCC, making attractive the implementa- tion of these drugs as co-adjuvant for HCC treatment. CITA: Hepatoma Res. 2020;6:5 DOI: 10.20517/2394-5079.2019.29 TÍTULO: Dyslipidemia as a risk factor for liver fibrosis progression in a multi- centric population with non-alcoholic steatohepatitis AUTORES: Méndez-Sánchez N, Cerda-Reyes E, Higuera-de-la-Tijera F, Salas-García AK, Cabrera-Palma S, Cabrera-Álvarez G, Cortez-Hernández C, Pérez-Arredondo LA, Purón-González E, Coronado-Alejandro E, Pan- duro A, Rodríguez-Hernández H, Cruz-Ramón VC, Valencia-Rodríguez A, Qi X, Hamdan-Pérez N, Aguilar-Olivos NE, Barranco-Fragoso B, Ramírez- Pérez O, Vera-Barajas A. BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is a serious worldwide health problem, with an estimated global prevalence of 24%; it has a notable relationship with other metabolic disorders, like obesity and type 2 diabetes mellitus (T2DM). Nonalcoholic steatohepatitis (NASH) is one of the most important clinical entities of NAFLD, which is associated with an increased risk of progression to liver cirrhosis and hepatocellular carcinoma (HCC). Mexico is one of the countries with the highest prevalence of meta- bolic diseases; therefore, we sought to investigate the impact that these clin- ical entities have in the progression to advanced fibrosis in Mexican patients with NASH. METHODS: We performed a multicenter retrospective cross-sectional study, from January 2012 to December 2017. A total of 215 patients with biop- sy-proven NASH and fibrosis were enrolled. NASH was diagnosed accord- ing NAS score and liver fibrosis was staged by the Kleiner scoring system. For comparing the risk of liver fibrosis progression, we divided our sample into two groups. Those patients with stage F0-F2 liver fibrosis were included 379

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32599071 in the group with non-significant liver fibrosis (n=178) and those individuals with F3-F4 fibrosis were included in the significant fibrosis group (n=37). We carried out a multivariate analysis to find risk factors associated with liver fibrosis progression. RESULTS: From the 215 patients included, 37 had significant liver fibrosis (F3-4). After logistic regression analysis T2DM (p=0.044), systemic arterial hypertension (p=0.014), cholesterol (p=0.041) and triglycerides (p=0.015) were the main predictor of advanced liver fibrosis. CONCLUSIONS: In a Mexican population, dyslipidemia was the most im- portant risk factor associated with advanced liver fibrosis and cirrhosis CITA: F1000Res. 2020 Jan 28;9:56 DOI: 10.12688/f1000research.21918.1 TÍTULO: A Randomized, Placebo-Controlled Trial of Pembrolizumab Plus Chemotherapy in Patients With Metastatic Squamous NSCLC: Proto- col-Specified Final Analysis of KEYNOTE-407 AUTORES: Paz-Ares L, Vicente D, Tafreshi A, Robinson A, Soto Parra H, Mazières J, Hermes B, Cicin I, Medgyasszay B, Rodríguez-Cid J, Okamoto I, Lee S, Ramlau R, Vladimirov V, Cheng Y, Deng X, Zhang Y, Bas T, Piperdi B, Halmos B. INTRODUCTION: In the randomized KEYNOTE-407 study (ClinicalTrials. gov, NCT02775435), pembrolizumab plus carboplatin and paclitaxel/nab-pa- clitaxel (chemotherapy) significantly improved overall survival (OS) and pro- gression-free survival (PFS) compared with placebo plus chemotherapy in patients with previously untreated metastatic squamous NSCLC. We report updated efficacy outcomes from the protocol-specified final analysis and, for the first time, progression on next line of treatment. METHODS: Eligible patients were randomized to chemotherapy plus either pembrolizumab (n = 278) or placebo (n = 281). After positive results from the second interim analysis, patients still receiving placebo could cross over to pembrolizumab monotherapy at the time of confirmed progressive disease. The primary end points were OS and PFS. PFS-2 (time from randomization to progression on next-line treatment/death, whichever occurred first) was an exploratory end point. RESULTS: After median (range) follow-up of 14.3 (0.1-31.3) months, pem- brolizumab plus chemotherapy continued to exhibit a clinically meaningful improvement over placebo plus chemotherapy in OS (median, 17.1 mo [95% confidence interval (CI): 14.4‒19.9] versus 11.6 mo [95% CI: 10.1‒13.7]; haz- ard ratio [HR], 0.71 [95% CI: 0.58‒0.88]) and PFS (median, 8.0 mo [95% CI: 6.3‒8.4] versus 5.1 mo [95% CI: 4.3‒6.0]; HR, 0.57 [95% CI: 0.47‒0.69]). PFS-2 was longer for patients randomized to first-line pembrolizumab plus chemotherapy (HR, 0.59 [95% CI: 0.49‒0.72]). Grade 3 to 5 adverse events occurred in 74.1% and 69.6% of patients receiving pembrolizumab plus che- motherapy and placebo plus chemotherapy, respectively. CONCLUSIONS: Pembrolizumab plus chemotherapy continued to ex- hibit substantially improved OS and PFS in patients with metastatic squamous NSCLC. The PFS-2 outcomes support pembrolizumab plus chemotherapy as a standard first-line treatment in patients with meta- static squamous NSCLC. 380

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR CITA: J Thorac Oncol. 2020 Oct;15(10):1657-1669 DOI: 10.1016/j.jtho.2020.06.015 PMID: 32620214 TÍTULO: Sexual Medicine. Ibero-American Issue. A Global Project AUTORES: García EL, Carvajal A, Reyes L, Tomada N. SUMMARY: Editorial CITA: Actas Urol Esp (Engl Ed). 2020 Jun;44(5):261 DOI: 10.1016/j.acuro.2020.05.001 PMID: 32642023 TÍTULO: Prevalence and triggers of self-reported nasal hyperreactivity in adults with asthma AUTORES: Feijen J, Seys SF, Steelant B, Bullens DMA, Dupont LJ, García- Cruz M, Jimenez-Chobillón A, Larenas-Linnemann D, Van Gerven L, Fok- kens WJ, Agache I, Hellings PW. BACKGROUND: Nasal hyperreactivity (NHR) is a common feature of vari- ous rhinitis subtypes and represents a novel phenotype of rhinitis. It is being reported in two-thirds of adult rhinitis patients irrespective of the atopic sta- tus. Data on the prevalence of NHR in patients with asthma are lacking, as well as the nature of evoking triggers. METHODS: Postal questionnaires were distributed to an unselected group of asthmatic patients in Leuven (Belgium, n = 190) and completed by 114 patients. In Mexico City (Mexico) and Brasov (Romania), respectively, 97 out of 110 and 80 out of 100 asthmatic patients attending the outpatient clin- ic completed the questionnaire. Non-asthmatic volunteers were recruited amongst university and hospital co-workers in Leuven (n = 53). The pres- ence of self-reported NHR, the type of triggers evoking nasal and bronchial symptoms, medication use, self-reported allergy, and environmental factors were evaluated. RESULTS: Overall, 69% of asthma patients reported NHR, with 32% having more than 4 triggers evoking NHR. These triggers included mainly exposure to temperature and humidity changes, cigarette smoke, and strong odours. A higher prevalence of NHR was detected in allergic compared to non-allergic asthma patients (73% vs. 53% p < 0.01). The prevalence of NHR correlated with asthma severity, ranging from 63% (VAS ≤3) to 81% (VAS ≥7). BHR was found more frequently in patients with NHR compared to without NHR (89% vs. 53%, p < 0.0001). CONCLUSION: NHR represents a clinical phenotype of upper airway dis- ease affecting over two-thirds of asthma patients and correlates with asth- ma severity. Targeting NHR in patients with asthma is often overlooked and should be reinforced in the future to achieve better symptom control. CITA: World Allergy Organ J. 2020 Jul 1;13(6):100132 DOI: 10.1016/j.waojou.2020.100132 381

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32671667 TÍTULO: Survival and renal recovery after acute kidney injury requiring dial- ysis outside of intensive care units AUTORES: González Sanchidrián S, Deira Lorenzo JL, Muciño Bermejo MJ, Labrador Gómez PJ, Gómez-Martino Arroyo JR, Aresu S, Tonini E, Ar- mignacco P, Ronco C. BACKGROUND: The incidence of acute kidney injury requiring dialysis (AKI-D) is increasing globally and it is usually associated to chronic kidney disease (CKD) and high mortality. Literature is lacking in short- and interme- diate-term data on recovery of renal function after acute kidney injury (AKI). OBJECTIVES: The objective was to evaluate the overall survival and re- nal recovery after an episode of AKI requiring dialysis out of intensive care units (ICUs). MATERIALS AND METHODS: Retrospective study including patients admit- ted in two nephrology units along a period of 2 years. Patients admitted to ICUs and renal transplant patients were excluded. Baseline renal function, mortality and glomerular filtration rate (GFR) improvement were evaluated. RESULTS: 151 consecutive adult patients with AKI requiring renal replace- ment therapy (RRT) were included. Mean age was 70.5 ± 15.2 years, 60.3% were males. Median baseline creatinine (bCr) and baseline GFR (bGFR) were 1.4 mg/dL and 46 mL/min/1.73 m2, respectively. After 1 year of fol- low-up, we completed the monitoring of 94 patients: 64.9% had died, 10.6% were alive on dialysis and 24.5% were alive without need for RRT. Patients with bGFR > 60 mL/min/1.73 m2 prior to AKI episode had a slower but sus- tained GFR improvement through the follow-up in comparison with patients with bGFR < 60 mL/min/1.73 m2 whose recovery was incomplete. CONCLUSIONS: Patients with AKI requiring RRT have high short- and inter- mediate-term mortality and some require maintenance dialysis. Patients with GFR > 60 mL/min/1.73 m2 prior to AKI had a renal recovery closer to the basal renal function than in patients with a previously diminished GFR. CITA: Int Urol Nephrol. 2020 Dec;52(12):2367-2377 DOI: 10.1007/s11255-020-02555-2 PMID: 32676484 TÍTULO: Role of Terlipressin in Cirrhotic Patients with Ascites and without Hepatorenal Syndrome: A Systematic Review of Current Evidence AUTORES: Bai Z, An Y, Guo X, Teschke R, Méndez-Sánchez N, Li H, Qi X. SUMMARY: Ascites, a common complication in cirrhosis, is prone to the development of acute kidney injury or hepatorenal syndrome and can be complicated by circulatory dysfunction after paracentesis. Terlipressin has not been considered as the mainstay treatment option for ascites in cirrhosis yet. The present work aimed to systematically review the current evidence regarding the use of terlipressin in cirrhosis with ascites and without hepato- renal syndrome. PubMed, EMBASE, and Cochrane Library databases were searched for relevant studies. Twelve studies were eligible. In 3 studies (1 randomized controlled trial and 2 single-arm studies without controls) in- volving 32 patients who received terlipressin for nonrefractory ascites, ter- lipressin improved hemodynamics by decreasing the heart rate and cardiac output and increasing the mean arterial pressure and systemic vascular re- sistance. In 5 studies (1 randomized controlled trial, 2 single-arm studies 382

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32683094 without controls, and 2 comparative studies with controls) involving 67 pa- tients who received terlipressin for refractory ascites, terlipressin improved renal function by increasing the glomerular filtration rate, renal blood flow, urinary sodium, and urine output and decreasing serum creatinine. In 4 studies (4 randomized controlled trials) involving 71 patients who received terlipressin for preventing from paracentesis-induced circulatory dysfunction, terlipressin prevented from paracentesis-induced circulatory dysfunction by increasing the mean arterial pressure and systemic vascular resistance and decreasing plasma renin. Terlipressin may improve hemodynamics, severity of ascites, and renal function and prevent from paracentesis-induced circula- tory dysfunction in cirrhosis with ascites and without hepatorenal syndrome. However, no study has evaluated the effect of terlipressin for prevention of acute kidney injury. CITA: Can J Gastroenterol Hepatol. 2020 Jun 22;2020:5106958 DOI: 10.1155/2020/5106958 TÍTULO: Cerebral hemodynamics in the non-alcoholic fatty liver AUTORES: Vidal-González D, López-Sánchez GN, Concha-Rebollar LA, Rodríguez-Herrera A, Morales-Ramirez F, Chávez-Tapia N, Uribe M, Na- der-Kawachi JA, Nuño-Lámbarri N. INTRODUCTION AND OBJECTIVES: The association between non-alco- holic fatty liver disease and cerebral hemodynamics arises from cardiovas- cular damage mechanisms such as endothelial dysfunction, arterial wall in- creased stiffness, high thickness of the intimate index of the internal carotid artery, left ventricular hypertrophy, left diastolic dysfunction, calcification cor- onary arteries and increased epicardial fat. The multidirectional relationship between systemic inflammation and lipid metabolism constitutes a common and simultaneous mechanism that causes vascular damage. This study aims to provide insight into the relationship between non-alcoholic fatty liver disease and the function of systemic circulation and cerebral circulation us- ing Doppler ultrasound. PATIENTS AND METHODS: Is an observational, cross-sectional, prospec- tive, comparative study conducted at Medica Sur Hospital. Thirty-five pa- tients were selected consecutively. The patients consulted neurological ser- vice for various symptoms without severity criteria, such as vertigo, primary headache and balance disturbances. RESULTS: There is a difference in the variables mean of the right MCA PI (p = 0.023), left MCA PI\" (p = 0.004), and left VA PI (p = 0.036) between the control and NAFLD groups. The correlation analysis between these vari- ables and the CAP showed a positive correlation of the three variables with the CAP, \"right MCA PI\" (r = 0.384), left MCA PI \"(r = 0.509) and\" left VA PI \" (r = 0.551). CONCLUSIONS: This study demonstrates a subclinical process of the mid- dle cerebral artery in subjects with NAFLD, which suggests it may be in- volved in the disease development and points the need to make decisions for this liver manifestation prevention and treatment. CITA: Ann Hepatol. Nov-Dec 2020;19(6):668-673 DOI: 10.1016/j.aohep.2020.06.006 383

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32693206 TÍTULO: Gaps in allergen immunotherapy administration and subcutane- ous allergen immunotherapy dose adjustment schedules: Need for pro- spective data AUTORES: Larenas-Linnemann DE, Epstein T, Ponda P, Bernstein D, Wil- liams P, Creticos P. SUMMARY: Letter to the editor CITA: Ann Allergy Asthma Immunol. 2020 Nov;125(5):505-506.e2 DOI: 10.1016/j.anai.2020.07.015 PMID: 32707227 TÍTULO: Rhinitis 2020: A practice parameter update AUTORES: Dykewicz MS, (…) Larenas-Linnemann DES, et al. SUMMARY: This comprehensive practice parameter for allergic rhinitis (AR) and nonallergic rhinitis (NAR) provides updated guidance on diagnosis, assessment, selection of monotherapy and combination pharmacologic op- tions, and allergen immunotherapy for AR. Newer information about local AR is reviewed. Cough is emphasized as a common symptom in both AR and NAR. Food allergy testing is not recommended in the routine evaluation of rhinitis. Intranasal corticosteroids (INCS) remain the preferred monotherapy for persistent AR, but additional studies support the additive benefit of com- bination treatment with INCS and intranasal antihistamines in both AR and NAR. Either intranasal antihistamines or INCS may be offered as first-line monotherapy for NAR. Montelukast should only be used for AR if there has been an inadequate response or intolerance to alternative therapies. Depot parenteral corticosteroids are not recommended for treatment of AR due to potential risks. While intranasal decongestants generally should be limited to short-term use to prevent rebound congestion, in limited circumstances, patients receiving regimens that include an INCS may be offered, in addi- tion, an intranasal decongestant for up to 4 weeks. Neither acupuncture nor herbal products have adequate studies to support their use for AR. Oral decongestants should be avoided during the first trimester of pregnancy. Recommendations for use of subcutaneous and sublingual tablet allergen immunotherapy in AR are provided. Algorithms based on a combination of evidence and expert opinion are provided to guide in the selection of phar- macologic options for intermittent and persistent AR and NAR. CITA: J Allergy Clin Immunol. 2020 Oct;146(4):721-767 DOI: 10.1016/j.jaci.2020.07.007 PMID: 32710250 TÍTULO: Incidence, risk factors, and prognosis of abnormal liver biochem- ical tests in COVID-19 patients: a systematic review and meta-analysis AUTORES: Wu Y, Li H, Guo X, Yoshida EM, Mendez-Sanchez N, Levi San- dri GB, Teschke R, Romeiro FG, Shukla A, Qi X. BACKGROUND AND AIMS: Coronavirus disease 2019 (COVID-19) pan- demic is ongoing. Except for lung injury, it is possible that COVID-19 patients develop liver injury. Thus, we conducted a systematic review and meta-anal- ysis to explore the incidence, risk factors, and prognosis of abnormal liver biochemical tests in COVID-19 patients. 384

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32717363 METHODS: PubMed, Embase, Cochrane Library, China National Knowl- edge Infrastructure (CNKI), VIP, and Wanfang databases were searched. The incidence of abnormal liver biochemical tests, including aspartate ami- notransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), total bilirubin (TBIL), and albumin (ALB), was pooled. Risk ratio (RR) was calculated to explore the association of abnormal liver biochemical tests with severity and prognosis of COVID-19 patients. RESULTS: Forty-five studies were included. The pooled incidence of any abnormal liver biochemical indicator at admission and during hospitalization was 27.2% and 36%, respectively. Among the abnormal liver biochemical indicators observed at admission, abnormal ALB was the most common, followed by GGT, AST, ALT, TBIL, and ALP (39.8%, 35.8%, 21.8%, 20.4%, 8.8%, and 4.7%). Among the abnormal liver biochemical indicators observed during hospitalization, abnormal ALT was more common than AST and TBIL (38.4%, 28.1%, and 23.2%). Severe and/or critical patients had a significant- ly higher pooled incidence of abnormal liver biochemical indicators at admis- sion than mild and/or moderate patients. Non-survivors had a significantly higher incidence of abnormal liver biochemical indicators than survivors (RR = 1.34, p = 0.04). CONCLUSIONS: Abnormal liver biochemical tests are common in COVID-19 patients. Liver biochemical indicators are closely related to the severity and prognosis of COVID-19 patients. CITA: Hepatol Int. 2020 Sep;14(5):621-637 DOI: 10.1007/s12072-020-10074-6 TÍTULO: Dietary consumption and serum pattern of bioactive fatty acids in NAFLD patients AUTORES: López-Bautista F, Barbero-Becerra VJ, Ríos MY, Ramírez- Cisneros MÁ, Sánchez-Pérez CA, Ramos-Ostos MH, Uribe M, Chávez- Tapia NC, Juárez-Hernández E. INTRODUCTION AND OBJECTIVES: Nonalcoholic fatty liver disease (NA- FLD) is the hepatic manifestation of metabolic syndrome. Some dietary fatty acids have showed different bioactive functions in metabolic syndrome. The aim of this study is to determine the dietary consumption patterns and serum percentage of bioactive fatty acids in NAFLD patients. PATIENTS AND METHODS: Cross-sectional study with NAFLD patients and non-NAFLD patients. Dietary consumption of bioactive fatty acids was assessed by a food frequency questionnaire. NAFLD and liver fibrosis were diagnosed by transient elastography. The identification of serum bioactive fatty acids was achieved by gas chromatography-mass spectrometry (%). Bioactive fatty acids consumption was correlated with NAFLD clinical char- acteristics with the Spearman correlation analysis. RESULTS: A total of 299 patients were included, whose mean of age and body mass index were 44.2±9.9 years and 25.9±3.8kg/m2, respectively. The consumption of bioactive fatty acids was no different regarding the pres- ence of NAFLD; however, the consumption of stearic and linoleic fatty acids was higher in relation with NAFLD severity (p≤0.05). The consumption of myristic acid was higher in patients with fibrosis (p=0.02). Serum percentage and dietary consumption did not show correlations. 385

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32718403 CONCLUSION: Dietary consumption of bioactive fatty acids is different ac- PMID: 32735062 cording to NAFLD severity. Individualized diets according to NAFLD severity could be successful in order to prevent liver injury-related outcomes. CITA: Ann Hepatol. Sep-Oct 2020;19(5):482-488 DOI: 10.1016/j.aohep.2020.06.008 TÍTULO: Functional impact of sequelae in drug-susceptible and multi- drug-resistant tuberculosis AUTORES: Muñoz-Torrico M, Cid-Juárez S, Gochicoa-Rangel L, Torre- -Bouscolet L, Salazar-Lezama MA, Villarreal-Velarde H, Pérez-Padilla R, Vis- ca D, Centis R, D'Ambrosio L, Spanevello A, Saderi L, Sotgiu G, Migliori GB. BACKGROUND: Evidence on the impact of tuberculosis (TB) treatment on lung function is scarce. The aim of this study was to evaluate post-treatment sequelae in drug-susceptible and drug-resistant-TB (DR-TB) cases in Mexico and Italy. METHODS: At the end of TB treatment the patients underwent complete clinical assessment, functional evaluation of respiratory mechanics, gas ex- change and a 6-minute walking test. Treatment regimens (and definitions) recommended by the World Health Organization were used throughout. RESULTS: Of 61 patients, 65.6% had functional impairment, with obstruc- tion in 24/61 patients (39.4%), and 78% with no bronchodilator response. These effects were more prevalent among DR-TB cases (forced expirato- ry volume in 1 s/forced vital capacity [FEV1/FVC] < lower limit of normali- ty, 14/24 vs. 10/34; P = 0.075). DR-TB patients showed moderately severe (FEV1 < 60%) and severe obstruction (FEV1 < 50%) (P = 0.008). Pre- and post-bronchodilator FEV1 and FEV1/FVC (% of predicted) were significantly lower among DR-TB cases. Plethysmography abnormalities (restriction, hy- perinflation and/or air trapping) were more frequent among DR-TB cases (P = 0.001), along with abnormal carbon monoxide diffusing capacity (DLCO) (P = 0.003). CONCLUSION: The majority of TB patients suffer the consequences of post-treatment sequelae (of differing levels), which compromise quality of life, exercise tolerance and long-term prognosis. It is therefore important that lung function is comprehensively evaluated post-treatment to identify patient needs for future medication and pulmonary rehabilitation. CITA: Int J Tuberc Lung Dis. 2020 Jul 1;24(7):700-705 DOI: 10.5588/ijtld.19.0809 TÍTULO: International registry of otolaryngologist-head and neck surgeons with COVID-19 AUTORES: Sowerby LJ, (…) Reynoso DD, et al. BACKGROUND: It has become clear that healthcare workers are at high risk, and otolaryngology has been theorized to be among the highest risk specialties for coronavirus disease 2019 (COVID-19). The purpose of this study was to detail the international impact of COVID-19 among otolaryngol- ogists, and to identify instructional cases. 386

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR METHODS: Country representatives of the Young Otolaryngologists-Interna- tional Federation of Otolaryngologic Societies (YO-IFOS) surveyed otolaryn- gologists through various channels. Nationwide surveys were distributed in 19 countries. The gray literature and social media channels were searched to identify reported deaths of otolaryngologists from COVID-19. RESULTS: A total of 361 otolaryngologists were identified to have had COVID-19, and data for 325 surgeons was available for analysis. The age range was 25 to 84 years, with one-half under the age of 44 years. There were 24 deaths in the study period, with 83% over age 55 years. Source of infection was likely clinical activity in 175 (54%) cases. Prolonged exposure to a colleague was the source for 37 (11%) surgeons. Six instructional cases were identified where infections occurred during the performance of aero- sol-generating operations (tracheostomy, mastoidectomy, epistaxis control, dacryocystorhinostomy, and translabyrinthine resection). In 3 of these cases, multiple operating room attendees were infected, and in 2, the surgeon suc- cumbed to complications of COVID-19. CONCLUSION: The etiology of reported cases within the otolaryngolo- gy community appear to stem equally from clinical activity and communi- ty spread. Multiple procedures performed by otolaryngologists are aero- sol-generating procedures (AGPs) and great care should be taken to protect the surgical team before, during, and after these operations. CITA: Int Forum Allergy Rhinol. 2020 Nov;10(11):1201-1208 DOI: 10.1002/alr.22677 PMID: 32772434 TÍTULO: Cross-continental comparison of safety and protection measures amongst urologists during COVID-19 AUTORES: de la Rosette J, Laguna P, Álvarez-Maestro M, Eto M, Mochtar CA, Albayrak S, Mendoza-Valdes A, Ong TA, Khadgi S, Al-Terki A, Bolton D, Gomez R, Klotz L, Kulkarni S, Tanguay S, Gravas S OBJECTIVES: To determine the well-being of urologists worldwide during the coronavirus disease 2019 pandemic, and whether they have adequate personal protective equipment knowledge and supplies appropriate to their clinical setting. METHODS: Urologists worldwide completed a Société Internationale d'Urol- ogie online survey from 16 April 2020 until 1 May 2020. Analysis was carried out to evaluate their knowledge about protecting themselves and others in the workplace, including their confidence in their ability to remain safe at work, and any regional differences. RESULTS: There were 3488 respondents from 109 countries. Urologists who stated they were moderately comfortable that their work environment of- fers good protection against coronavirus disease 2019 showed a total mean satisfaction level of 5.99 (on a \"0 = not at all\" to \"10 = very\" scale). A large majority (86.33%) were confident about protecting themselves from coro- navirus disease 2019 at work. However, only about one-third reported their institution provided the required personal protective equipment (35.78%), and nearly half indicated their hospital has or had limited personal protective equipment availability (48.08%). Worldwide, a large majority of respondents answered affirmatively for testing the healthcare team (83.09%). Approxi- mately half of the respondents (52.85%) across all regions indicated that 387

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR all surgical team members face an equal risk of contracting coronavirus dis- ease 2019 (52.85%). Nearly one-third of respondents reported that they had experienced social avoidance (28.97%). CONCLUSIONS: Our results show that urologists lack up-to-date knowl- edge of preferred protocols for personal protective equipment selection and use, social distancing, and coronavirus disease 2019 testing. These data can provide insights into functional domains from which other specialties could also benefit. CITA: Int J Urol. 2020 Nov;27(11):981-989 DOI: 10.1111/iju.14340 PMID: 32773176 TÍTULO: Cholecystectomy as a risk factor for non-alcoholic fatty liver dis- ease development AUTORES: Rodríguez-Antonio I, López-Sánchez GN, Garrido-Camacho VY, Uribe M, Chávez-Tapia NC, Nuño-Lámbarri N. BACKGROUND: Hepatic steatosis and gallstone disease are highly prev- alent in the general population; the shared risk factors are age, ethnicity, obesity, insulin resistance, metabolic syndrome, atherosclerosis, risk of cardiovascular disease, and mortality. The presence of insulin resistance is the critical element in this association because it represents a crucial link between metabolic syndrome and non-alcoholic fatty liver disease, as well as a higher susceptibility to gallstone formation. METHODS: An exhaustive search engine investigation of gallstone disease, cholecystectomy, and liver steatosis latest literature was made. RESULTS: Clinical studies and systematic reviews suggest an association between gallstone disease, cholecystectomy, and hepatic steatosis. CONCLUSION: The bidirectional relationship between liver steatosis and gallstone disease and cholecystectomy is summarized in the role of insu- lin resistance, lipid metabolism, bile acids signaling pathways regulated by transcription factors expression, and to the gallbladder physiological role; however, more epidemiological and experimental studies should be comple- mented. CITA: HPB (Oxford). 2020 Nov;22(11):1513-152 DOI: 10.1016/j.hpb.2020.07.011 PMID: 32787707 TÍTULO: Characteristics and Outcomes in Patients With COVID-19 and Acute Ischemic Stroke: The Global COVID-19 Stroke Registry AUTORES: Ntaios G, (…) Soriano-Navarro E, Soto-Ramírez LE, Castañe- da-Méndez PF, Bay-Sansores D, et al. SUMMARY: Recent case-series of small size implied a pathophysiological association between coronavirus disease 2019 (COVID-19) and severe large-vessel acute ischemic stroke. Given that severe strokes are typically associated with poor prognosis and can be very efficiently treated with re- canalization techniques, confirmation of this putative association is urgently 388

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR warranted in a large representative patient cohort to alert stroke clinicians, and inform pre- and in-hospital acute stroke patient pathways. We pooled all consecutive patients hospitalized with laboratory-confirmed COVID-19 and acute ischemic stroke in 28 sites from 16 countries. To assess whether stroke severity and outcomes (assessed at discharge or at the latest as- sessment for those patients still hospitalized) in patients with acute ischemic stroke are different between patients with COVID-19 and non-COVID-19, we performed 1:1 propensity score matching analyses of our COVID-19 patients with non-COVID-19 patients registered in the Acute Stroke Regis- try and Analysis of Lausanne Registry between 2003 and 2019. Between January 27, 2020, and May 19, 2020, 174 patients (median age 71.2 years; 37.9% females) with COVID-19 and acute ischemic stroke were hospitalized (median of 12 patients per site). The median National Institutes of Health Stroke Scale was 10 (interquartile range [IQR], 4-18). In the 1:1 matched sample of 336 patients with COVID-19 and non-COVID-19, the median Na- tional Institutes of Health Stroke Scale was higher in patients with COVID-19 (10 [IQR, 4-18] versus 6 [IQR, 3-14]), P=0.03; (odds ratio, 1.69 [95% CI, 1.08-2.65] for higher National Institutes of Health Stroke Scale score). There were 48 (27.6%) deaths, of which 22 were attributed to COVID-19 and 26 to stroke. Among 96 survivors with available information about disability sta- tus, 49 (51%) had severe disability at discharge. In the propensity score- matched population (n=330), patients with COVID-19 had higher risk for se- vere disability (median mRS 4 [IQR, 2-6] versus 2 [IQR, 1-4], P<0.001) and death (odds ratio, 4.3 [95% CI, 2.22-8.30]) compared with patients without COVID-19. Our findings suggest that COVID-19 associated ischemic strokes are more severe with worse functional outcome and higher mortality than non-COVID-19 ischemic strokes. CITA: Stroke. 2020 Sep;51(9):e254-e258 DOI: 0.1161/STROKEAHA.120.031208 PMID: 32796935 TÍTULO: Genomic characterization of malignant progression in neoplastic pancreatic cysts AUTORES: Noë M, (…) Albores-Saavedra J, et al. SUMMARY: Intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs) are non-invasive neoplasms that are often observed in association with invasive pancreatic cancers, but their origins and evolution- ary relationships are poorly understood. In this study, we analyze 148 samples from IPMNs, MCNs, and small associated invasive carcinomas from 18 pa- tients using whole exome or targeted sequencing. Using evolutionary analyses, we establish that both IPMNs and MCNs are direct precursors to pancreatic cancer. Mutations in SMAD4 and TGFBR2 are frequently restricted to inva- sive carcinoma, while RNF43 alterations are largely in non-invasive lesions. Genomic analyses suggest an average window of over three years between the development of high-grade dysplasia and pancreatic cancer. Taken togeth- er, these data establish non-invasive IPMNs and MCNs as origins of invasive pancreatic cancer, identifying potential drivers of invasion, highlighting the complex clonal dynamics prior to malignant transformation, and providing op- portunities for early detection and intervention. CITA: Nat Commun. 2020 Aug 14;11(1):4085 DOI: 10.1038/s41467-020-17917-8 389

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32814782 TÍTULO: Feasibility of a new free mobility procedure to evaluate the function PMID: 32845424 of the autonomic nervous system in patients with syncope AUTORES: Nader-Kawachi J, Manrique-Mirón PC, Pino-Peña YC, An- drade-Magdaleno ML, López-Estrada J. SUMMARY: To propose a new test to evaluate the autonomic nervous sys- tem in patients with syncope: Multimodal Monitoring for Diagnosis of Dysau- tonomia (MMDD). We included 21 patients with syncope (16 female, 6 male, mean age 43.5 years) and 21 with no-syncope subjects (15 female, 7 male, mean age 45.1 years) to perform a test of nine 2-min stages: four while resting and four during active testing of autonomic response. Transcrani- al-Doppler, electrocardiogram, and photoplethysmography blood pressure pulse-to-pulse monitoring, allow registering six variables from the Middle Cerebral Artery and four from the Cardiovascular System. We analyze each variable's mean differences in each stage and its change when they pass from one stage to another with the T and Z tests. To understand the sig- nificance of the change, we use a logistic regression model for a certain subgroup of variables. Since we have a small dataset, we use the bootstrap technique to infer the general behavior that characterizes a syncope. Our data confirm differences between syncope and non-syncope patients during MMDD stress stages 2, 4, 6 and 8. Bootstrap and multivariate logistic re- gression allow us to identify which sets of variables in each of these stages of the MMDD are sufficiently sensitive to recognizing syncope. MMDD pro- tocol can recognize a syncope patient with some confidence by detecting subtle changes in the autonomic nervous system. This protocol encourages us to continue to study the effectiveness of MMDD protocol allowing a new approach to future research. CITA: Sci Rep. 2020 Aug 19;10(1):1399 DOI: 10.1038/s41598-020-70701-y TÍTULO: Two-stage bone and meniscus allograft and autologous chondro- cytes implant for unicompartmental osteoarthritis: midterm results AUTORES: Álvarez-Lozano E, Luna-Pizarro D, Meraz-Lares G, Quintanil- la-Loredo R, Cerdá-García MV, Forriol F. BACKGROUND: We analyzed the clinical and radiographic evolution of patients with knee unicompartmental osteoarthritis and axis alteration and osteochondral lesions in the femoral condyle, treated with tibial plateau and meniscus allograft and cultured autologous chondrocyte implantation in the femur in two steps. PURPOSE: To analyze the clinical results with the first patients treated with this two-stage technique to avoid knee prosthesis in patients with unicom- partmental osteoarthritis. MATERIAL AND METHODOLOGY: Sixteen patients, average age 56 years, were included in a cohort study. We performed an osteotomy with tibia pla- teau allograft, including the meniscus. In a second surgery, the chondrocyte fibrin scaffold was placed in the femur. Clinical symptoms and function were measured using KSSR and KOOS scores. Wilcoxon's test was performed to compare the results over the 2-year follow-up period. RESULTS: Mean KSSR before surgery was 35.69 (SD: 3.75) points, rising to 67 (SD: 15.42) at 3 months, 95.88 at 12 months (SD: 2.68) and 96.31 at 24 months (SD: 2.24). The KOOS before surgery was 65.14 (SD: 16.34), 390

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32847726 rising to 72.68 after 3 months (SD: 19.15), 76.68 at 12 months (SD: 18.92) and 64.28 at 24 months (SD: 11.79). Four of 5 patients returned to engaging in the activity that they had stopped practicing. Three patients experienced collapse of the tibia allograft, and they needed later a prosthesis. CONCLUSIONS: Simultaneous tibia plateau allograft and autologous chon- drocyte implantation in the femur, after correction of the angular deformity, were performed, restoring the anatomy of the medial compartment and knee function in 82% of the patients 2 years after the operation. CITA: Musculoskelet Surg. 2020 Aug 26 DOI: 10.1007/s12306-020-00680-w TÍTULO: Abdominal compartment syndrome: Current concepts and man- agement AUTORES: Montalvo-Jave EE, Espejel-Deloiza M, Chernitzky-Camaño J, Peña-Pérez CA, Rivero-Sigarroa E, Ortega-León LH. SUMMARY: Abdominal compartment syndrome occurs when 2 or more an- atomic compartments have a sustained intra-abdominal pressure >20mmHg, associated with organ failure. Incidence is 2% and prevalence varies from 0% to 36.4%. A literature search was conducted utilizing different databases. Articles published from 1970 to 2018 were included, in English or Spanish, to provide the concepts, classifications, and comprehensive management in the approach to abdominal compartment syndrome, for its treatment and the prevention of severe complications associated with the entity. Intravesi- cal pressure measurement is the standard diagnostic method. Treatment is based on evacuation of the intraluminal content, identification and treatment of intra-abdominal lesions, improvement of abdominal wall compliance, and optimum administration of fluids and tissue perfusion. Laparotomy is gener- ally followed by temporary abdominal wall closure 5 to 7 days after surgery. Reconstruction is performed 6 to 12 months after the last operation. Abdomi- nal compartment syndrome should be diagnosed and operated on before or- ganic damage from the illness occurs. Kidney injury can frequently progress and is a parameter for considering abdominal decompression. Having a bio- marker for early damage would be ideal. Surgical treatment is successful in the majority of cases. A multidisciplinary focus is necessary for the intensive care and reconstructive needs of the patient. Thus, efforts must be made to define and implement strategies for patient quality of life optimization. CITA: Rev Gastroenterol Mex (Engl Ed). Oct-Dec 2020;85(4):443-451 DOI: 10.1016/j.rgmx.2020.03.003 PMID: 32861251 TÍTULO: Legends in Urology PMID: 32862273 AUTORES: Mendoza-Valdés A. SUMMARY: Letter to the editor CITA: Can J Urol. 2020 Aug;27(4):10275-10277 TÍTULO: Supplemental oxygen in surgical patients with COVID-19 AUTORES: Mejía-Terrazas GE, López-Muñoz E. 391

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR SUMMARY: Letter to the editor CITA: J Anesth. 2020 Dec;34(6):958 DOI: 10.1007/s00540-020-02850- PMID: 32884611 TÍTULO: Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines AUTORES: Larenas-Linnemann D, (…) Onuma-Takane E, (...) Azamar- Jácome AA, et al. BACKGROUND: Allergen immunotherapy (AIT) has a longstanding histo- ry and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strat- egies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexi- co. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. METHODS: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asth- ma and Immunology (EAACI) guideines, the S2k guideline of various Ger- man-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with lo- cal possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, Supplementary data) concluded the following. RESULTS: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro test- ing and molecular such as species-specific allergens) might be useful in se- lected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous in- jections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50-200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissem- ination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. CONCLUSIONS: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed. CITA: World Allergy Organ J. 2020 Aug 21;13(8):100444 DOI: 10.1016/j.waojou.2020.100444 392

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32891255 TÍTULO: Hepatology and the \"new reality\" ushered in by the COVID-19 pan- PMID: 32892535 demic AUTORES: Uribe M, Aquino-Matus J. PMID: 32943651 SUMMARY: Editorial CITA: Ann Hepatol. Sep-Oct 2020;19(5):449-450 DOI: 10.1016/j.aohep.2020.08.060 TÍTULO: [Logistic precautions in preparation and administration of allergen immunotherapy during the COVID-19 pandemic in Mexico] AUTORES: Larenas-Linnemann D, et al. SUMMARY: La pandemia actual de COVID-19 ha representado un reto mayúsculo para la sociedad y la comunidad médica, no solo por su alta contagiosidad sino por la variabilidad de las manifestaciones clínicas y su comportamiento impredecible bajo diferentes contextos sanitarios. Ante ello, las medidas preventivas específicas son relevantes para evitar o disminuir contagios entre pacientes y personal de las unidades de salud, consideran- do que el periodo presintomático durante el cual el individuo contagiado ya puede transmitir el virus varía entre cinco y seis o hasta 14 días, según datos de la Organización Mundial de la Salud. Además, un paciente infect- ado puede estar asintomático, incluso, algunas personas después de haber padecido COVID-19 pueden continuar expulsando virus por algunos días más después de recuperarse. CITA: Rev Alerg Mex. Apr-Jun 2020;67(2):199-201 DOI: 10.29262/ram.v67i2.752 TÍTULO: Punica granatum L.-derived omega-5 nanoemulsion improves he- patic steatosis in mice fed a high fat diet by increasing fatty acid utilization in hepatocytes AUTORES: Zamora-López K, Noriega LG, Estanes-Hernández A, Escalo- na-Nández I, Tobón-Cornejo S, Tovar AR, Barbero-Becerra V, Pérez-Monter C. SUMMARY: Pomegranate seed oil (PSO) is mainly composed of punicic acid (PA), a polyunsaturated fatty acid also known as omega-5 (ω-5), a po- tent antioxidant associated with a variety of metabolic and cellular benefi- cial effects. However, the potential benefits of a nanoemulsified version of ω-5 (PSOn) have not been evaluated in a pathological liver condition. Here, we examined whether PSOn had beneficial effects on C57BL/6N mice fed a high-fat diet (HFD), specifically on hepatic steatosis. We observed that PSOn supplementation decreased body weight and body fat mass in control mice, whereas glucose intolerance, insulin resistance, energy expenditure, and hepatic steatosis were improved in both control mice and in mice fed a HFD. Interestingly, PSOn increased fatty acid oxidation in primary hepato- cytes and antioxidant gene expression. Altogether, our data indicate that PSOn effectively reduces some of the HFD-derived metabolic syndrome in- dicators by means of an increase in fatty acid oxidation within hepatocytes. CITA: Sci Rep. 2020 Sep 17;10(1):15229 DOI: 10.1038/s41598-020-71878-y 393

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32952156 TÍTULO: Comparative study of cardiac function between two populations in Latin America using the transthoracic echocardiogram: Atahualpa, Ecuador, and Mexico City, Mexico AUTORES: García-Graullera JM, Nader-Kawachi JA, Crespo-Serge L, Del Brutto ÓH. OBJECTIVE: To compare morphological and functional differences of the heart in two Latin American populations with different ethnicity and living conditions. METHODS: Using transthoracic echocardiogram we obtained data on 206 individuals: 103 from Atahualpa, Ecuador (living at sea level, mean age: 75 ± 4.2 years, 53 women) and 103 inhabitants from Mexico City (living at 2300 m above sea level, mean age: 75 ± 4.2 years, 52 women). RESULTS: Significant differences between Atahualpa and Mexico were: Heart rate 66 versus 80 x’, left ventricular diastolic diameter 40.8 versus 42.7, septum thickness 9.8 versus 11.6, posterior wall 10.2 versus 11.8, stroke volume cc 53.0 versus 46.6, left atrial volume 25. 8 versus 33.6, sys- tolic pressure of the pulmonary artery 27.1 versus 42.0, cardiac output 3.1 versus 4.8, E/Ea ratio 6.4 versus 9.2, and mitral area 3.4 versus 3.0. Com- parison of diastolic function between Atahualpa and Mexico was: Type 0; 2 versus 1. Type 1; 96 versus 81. Type 2; 5 versus 20 and Type 3; 0 versus 1. CONCLUSION: Echocardiographic characteristics that identify adaptive changes of the heart in Atahualpa are coincident with people living at sea level and with good physical activity, and Mexico City, with inhabitants liv- ing at high altitudes and exposed to environmental pollution. The systolic function of the left ventricle was similar in both populations, indicating that adaptive changes allow the heart to be effective in different circumstances of the ecosystem. CITA: Arch Cardiol Mex. 2020;90(3):274-283 DOI: 10.24875/ACM.20000355 PMID: 32990651 TÍTULO: Correlations between DTI-derived metrics and MRS metabolites in tumour regions of glioblastoma: a pilot study AUTORES: Flores-Alvarez E, Anselmo Rios Piedra E, Cruz-Priego GA, Du- rand-Muñoz C, Moreno-Jimenez S, Roldan-Valadez E. INTRODUCTION: Specific correlations among diffusion tensor imaging (DTI)-derived metrics and magnetic resonance spectroscopy (MRS) metab- olite ratios in brains with glioblastoma are still not completely understood. PATIENTS AND METHODS: We made retrospective cohort study. MRS ra- tios (choline-to-N-acetyl aspartate [Cho/NAA], lipids and lactate to creatine [LL/Cr], and myo-inositol/creatine [mI/Cr]) were correlated with eleven DTI biomarkers: mean diffusivity (MD), fractional anisotropy (FA), pure isotropic diffusion (p), pure anisotropic diffusion (q), the total magnitude of the diffu- sion tensor (L), linear tensor (Cl), planar tensor (Cp), spherical tensor (Cs), relative anisotropy (RA), axial diffusivity (AD) and radial diffusivity (RD) at the same regions: enhanced rim, peritumoral oedema and normal-appearing white matter. Correlational analyses of 546 MRS and DTI measurements used Spearman coefficient. 394

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32999634 RESULTS: At the enhancing rim we found four significant correlations: FA ⇔ LL/Cr, Rs = -.364, p = .034; Cp ⇔ LL/Cr, Rs = .362, p = .035; q ⇔ LL/Cr, Rs = -.349, p = .035; RA ⇔ LL/Cr, Rs = -.357, p = .038. Another ten pairs of signifi- cant correlations were found in the peritumoral edema: AD ⇔ LL/Cr, AD ⇔ mI/ Cr, MD ⇔ LL/Cr, MD ⇔ mI/Cr, p ⇔ LL/Cr, p ⇔ mI/ Cr, RD ⇔ mI/Cr, RD ⇔ mI/Cr, L ⇔ LL/Cr, L ⇔ mI/Cr. CONCLUSIONS: DTI and MRS biomarkers answer different questions; peri- tumoral oedema represents the biggest challenge with at least ten significant correlations between DTI and MRS that need additional studies. The fact that DTI and MRS measures are not specific of one histologic type of tumour broadens their application to a wider variety of intracranial pathologies. CITA: Radiol Oncol. 2020 Sep 29;54(4):394-408 DOI: 10.2478/raon-2020-0055 TÍTULO: Radiation oncology in Mexico: Current status according to Mexico's Radiation Oncology Certification Board AUTORES: Maldonado Magos F, Lozano Ruíz FJ, Pérez Álvarez SI, Garay Villar O, Cárdenas Pérez C, Bautista Hernández MY, Núñez Guardado G. AIM: Describe the results of the first national census of radiotherapy in Mex- ico in order to make a situational diagnosis of radiotherapy availability, offer more accurate information to radiation oncologists, and promote an ade- quate scientific based investment for the country. BACKGROUND: According to the Organisation for Economic Co-operation and Development (OECD), the density of radiotherapy (RT) machines per million habitants in Mexico is approximately 1.7-1.8. Other international or- ganizations such as DIRAC-IAEA report 1.15 per million habitants. National organizations collect data indirectly and previous surveys had a low accrual rate (32.5%). Therefore, a precise census is required. MATERIAL AND METHODS: The Mexican Radiation Oncology Certification Board (CMRO for its acronym in Spanish) conducted a nationwide census from January through November 2019. Gathered information was combined with CMRO database for sociodemographic information and human resources. RESULTS: The study included 103 RT centers [95.1% answered the sur- vey], with a median of 2 centers by state (ranging from 0 in Tlaxcala to 20 in Mexico City) and with a report of only 1 center in 11 states (34.4%). Fifty-six (54.3%) of the centers are public. Fourteen centers (13.6%) have residency-training programs. The total number of RT machines is 162 [141 clinical and linear accelerators (87%) and 21 radionuclide units (13%)] with a median of 3 machines by state (0 in Tlaxcala to 46 in Mexico City) and with ≤3 machines in 18 states (56.25%). The overall calculated density of RT machines per million habitants is 1.32, varying from 0 in Tlaxcala to 5.16 in Mexico City. The density of linear and clinical accelerators per million popu- lation is 1.19. The total number of brachytherapy units is 66, with a median of 1 center with brachytherapy unit per state and 29 states with ≤3 centers with a brachytherapy unit (90.6%). Thirty-seven brachytherapy units (56.1%) have automated afterload high-dose rate. The overall rate of brachythera- py units per million inhabitants is 0.55, varying from 0 in 5 states (15.6%), 0.1-0.49 in 8 states (25%), 0.5-0.99 in 13 states (40.6%), 1-1.49 in 5 states (15.6%) and 1.5-1.99 in Mexico City (3.1%). The Mexican CMRO has 368 radiation oncologists certified (99 women and 269 men), of whom only 346 remain as an active part of Mexico's workforce. 395

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32999635 CONCLUSIONS: This is the first time the CMRO conducts a national cen- PMID: 33000290 sus for a radiotherapy diagnostic situation in Mexico. The country currently holds a density of clinical and linear accelerators of 1.19 per million habi- tants. Brachytherapy density is 0.55 devices per million habitants, and 57% of radiotherapy centers have brachytherapy units. CITA: Rep Pract Oncol Radiother. Sep-Oct 2020;25(5):840-845 DOI: 10.1016/j.rpor.2020.06.002 TÍTULO: Medical physics graduate education in Mexico and its relation to the advances in radiation oncology AUTORES: Brandan ME, Rodríguez-Laguna A. AIM: To evaluate the state of graduate education in medical physics and progress in radiation oncology (RO) equipment in Mexico since 2000, when conferring degrees from two master's-degree programs in Medical Physics began. BACKGROUND: Medical physics is a Health Profession and there are in- ternational recommendations for education, training, and certification. Both programs follow these education guidelines. The most common clinical oc- cupation of graduates is in RO services. Techniques in Mexican RO include traditional and high-precision procedures. METHODS: Academic and occupational information about the programs and their graduates were obtained from official websites. Graduates were invited to respond to a survey that requested information about their present job. We obtained data on RO equipment and human resources from public databases and estimated staffing requirements of medical physicists (MPs). RESULTS: Medical physics programs have graduated a total of 225 MPs. Half of them work in a clinical environment and, of these, about 90 work in RO services. MPs with M.Sc. degrees constitute 36% of the current MP workforce in RO, estimated to be 250 individuals. Survey responses pointed out the main merits and limitations of the programs. The number of MPs in RO has increased fivefold and the number of linacs sixfold in 15 years. The present number of MPs is insufficient, according to published guidelines. CONCLUSION: All MPs in RO services with advanced modalities must be trained following international recommendations for graduate education and post-graduation clinical training. Education and health institutions must find incentives to create more graduate programs and clinical residencies. CITA: Rep Pract Oncol Radiother. Sep-Oct 2020;25(5):846-850 DOI: 10.1016/j.rpor.2020.06.012 TÍTULO: Hospital mortality in mechanically ventilated COVID-19 patients in Mexico AUTORES: Ñamendys-Silva SA, Gutiérrez-Villaseñor A, Rome- ro-González JP. SUMMARY: Letter to the editor CITA: Intensive Care Med. 2020 Nov;46(11):2086-2088 DOI: 10.1007/s00134-020-06256-3 396

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33005386 TÍTULO: Impact of Herbal and Dietary Supplements Causing Drug-Induced PMID: 33015988 Liver Injury in Latin America AUTORES: Nunes V, Mendez-Sanchez N. PMID: 33017878 SUMMARY: Review article CITA: Clin Liver Dis (Hoboken). 2020 Sep 22;16(3):83-86 DOI: 10.1002/cld.905 TÍTULO: Human skin biomarkers relationship to response to treatment with tyrosine kinase inhibitors in advanced EGFR-mutated lung adenocarcinoma AUTORES: Castañeda-Zárraga A, Rodríguez-Cid JR, Flores-Mariñelar- ena RR, Trinidad-Bibiano H, Martínez-Herrera JF, Sánchez-Ríos CP, Fernández-Garibay VM, Alatorre-Alexander JA, Martínez-Barrera L, Santil- lán-Doherty PJ, Vega-Memije ME. BACKGROUND: A relationship between the EGFR signaling pathway ex- pression in skin and the use of targeted cancer therapies has been previous- ly demonstrated. Consistent evidence to support the use of skin biopsies as a surrogate for therapeutic evaluation is needed. The purpose of this study was to establish the relationship between the expression of EGFR signaling pathway markers in skin samples from EGFR-mutated metastatic lung ade- nocarcinoma patients and their response to tyrosine kinase inhibitors. METHODS: This was a prospective single blind analysis of 35 skin biopsies from 31 patients with confirmed advanced EGFR-mutated lung adenocarci- noma. Immunohistochemistry was performed: EGFR, p27, Ki67, STAT3 and MAPK, as well as H&E histopathological analysis, in order to determine their treatment response to tyrosine kinase inhibitors. RESULTS: EGFR, Ki67, STAT3, stratum corneum thickness (number of lay- ers and millimeters) from skin samples had a statistical correlation with an adequate treatment response (P = 0.025, 0.015, 0.017, 0.041, 0.039 respec- tively). EGFR, p27 and number of layers of the stratum corneum were relat- ed to a better median progression-free survival (P = 0.025 and P = 0.030). CONCLUSIONS: The relationship between EGFR pathway inhibition in the skin and oncological outcomes obtained explains the parallel biological effects of tyrosine kinase inhibitors. We hope that our work incites future research to help validate and assess the use of these markers as potential prognostic and predictive factors. CITA: Thorac Cancer. 2020 Nov;11(11):3243-3251 DOI: 10.1111/1759-7714.13657 TÍTULO: [Mexican consensus on fractional exhaled nitric oxide (FeNO) in asthma 2020] AUTORES: Larenas-Linnemann D, Gochicoa-Rangel L, Macías-Wein- mann A, Soto-Ramos M, Luna-Pech JA, Elizondo-Ríos A, Del Río-Navarro BE, Hernández-Colín DD, García-Maldonado S, Zepeda B, Martínez-Infante EA, Vázquez JC. SUMMARY: The fractional exhaled nitric oxide (FeNO) is related to the level of eosinophilic inflammation in the airways and the levels of interleukin-13, 397

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR as such it could be a diagnostic and monitoring tool in asthma. A working group was convened between pulmonologists, respiratory physiology ex- perts, and allergists to establish criteria for the use of FeNO in asthma in Mexico. Through a simplified Delphi method and group discussion, seven key points regarding the use of FeNO were agreed upon. We agree that the measurement of FeNO serves for the diagnosis of asthma in specialized clinics, both in children and adults, as well as to determine the level of corti- costeroid treatment. In severe asthma, we recommend FeNO for endotyping, for detecting poor therapeutic adherence, undertreatment, and the risk of crisis. We suggest FeNO can be used to determine the level of corticosteroid treatment and to identify patients at risk of loss of lung function. We also recommend it in adults to improve the selection of biological therapy and, in this context, we only suggest it in selected cases for children. CITA: Rev Alerg Mex. 2020;67 Suppl 2:S1-S25 DOI: 10.29262/ram.v67i0.760 PMID: 33031970 TÍTULO: Latin American Association for the study of the liver (ALEH) practice guidance for the diagnosis and treatment of non-alcoholic fatty liver disease AUTORES: Arab JP, Dirchwolf M, Álvares-da-Silva MR, Barrera F, Benítez C, Castellanos-Fernandez M, Castro-Narro G, Chavez-Tapia N, Chiodi D, Cotrim H, Cusi K, de Oliveira CPMS, Díaz J, Fassio E, Gerona S, Girala M, Hernandez N, Marciano S, Masson W, Méndez-Sánchez N, Leite N, Lozano A, Padilla M, Panduro A, Paraná R, Parise E, Perez M, Poniachik J, Restre- po JC, Ruf A, Silva M, Tagle M, Tapias M, Torres K, Vilar-Gomez E, Costa Gil JE, Gadano A, Arrese M. SUMMARY: Non-alcoholic fatty liver disease (NAFLD) currently represents an epidemic worldwide. NAFLD is the most frequently diagnosed chronic liver disease, affecting 20-30% of the general population. Furthermore, its prevalence is predicted to increase exponentially in the next decades, concomitantly with the global epidemic of obesity, type 2 diabetes mellitus (T2DM), and sedentary lifestyle. NAFLD is a clinical syndrome that encom- passes a wide spectrum of associated diseases and hepatic complications such as hepatocellular carcinoma (HCC). Moreover, this disease is believed to become the main indication for liver transplantation in the near future. Since NAFLD management represents a growing challenge for primary care physicians, the Asociación Latinoamericana para el Estudio del Hígado (ALEH) has decided to organize this Practice Guidance for the Diagnosis and Treatment of Non-Alcoholic Fatty Liver Disease, written by Latin-Amer- ican specialists in different clinical areas, and destined to general practi- tioners, internal medicine specialists, endocrinologists, diabetologists, gas- troenterologists, and hepatologists. The main purpose of this document is to improve patient care and awareness of NAFLD. The information provided in this guidance may also be useful in assisting stakeholders in the deci- sion-making process related to NAFLD. Since new evidence is constantly emerging on different aspects of the disease, updates to this guideline will be required in future. CITA: Ann Hepatol. Nov-Dec 2020;19(6):674-690 DOI: 10.1016/j.aohep.2020.09.006 398

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33064694 TÍTULO: Experience in the management of severe COVID-19 patients in an intensive care unit AUTORES: Sosa-García JO, Gutiérrez-Villaseñor AO, García-Briones A, Romero-González JP, Juárez-Hernández E, González-Chon O. OBJECTIVE: To describe the clinical characteristics and management of se- vere COVID-19 patients. METHOD: Observational, descriptive, longitudinal, and retrospective study. RESULTS: 56 patients were admitted, of whom 80.3% (n = 45) were males with a mean age of 58 years [46-67]. The main comorbidities were obesity, high blood pressure, and diabetes. Symptoms onset time at admittance to the ICU was 9 [7-14] days, of which the most frequent were dyspnea, fever, and dry cough. Laboratory data were lymphopenia; elevation of LDH, fibrin- ogen, D-dimer, ferritin and CRP. 100% of the patients required mechanical ventilation, the median mechanical ventilation time was 12 [6-17] days, and 66% (n= 37) required a prone position. The pharmacological treatment was mainly based on azithromycin, hydroxychloroquine, tocilizumab and steroids. The most frequent complications were acute kidney injury, venous thrombo- embolism and acute myocardial infarction. Mortality rate was 17.8% (n = 10). CONCLUSION: The characteristics of the critically ill patients in our hospital were mostly elderly and obese, with the variables of higher SOFA score and acute kidney injury associated with higher mortality. CITA: Cir Cir. 2020;88(5):569-575 DOI: 10.24875/CIRU.20000675 PMID: 33072240 TÍTULO: Enhancing innate immunity against virus in times of COVID-19: Trying to untangle facts from fictions AUTORES: Larenas-Linnemann D, Rodríguez-Pérez N, Arias-Cruz A, Blandón-Vijil MV, Del Río-Navarro BE, Estrada-Cardona A, Gereda JE, Lu- na-Pech JA, Navarrete-Rodríguez EM, Onuma-Takane E, Pozo-Beltrán CF, Rojo-Gutiérrez MI. INTRODUCTION: In light of the current COVID-19 pandemic, during which the world is confronted with a new, highly contagious virus that suppresses innate immunity as one of its initial virulence mechanisms, thus escaping from first-line human defense mechanisms, enhancing innate immunity seems a good preventive strategy. METHODS: Without the intention to write an official systematic review, but more to give an overview of possible strategies, in this review article we dis- cuss several interventions that might stimulate innate immunity and thus our defense against (viral) respiratory tract infections. Some of these interven- tions can also stimulate the adaptive T- and B-cell responses, but our main focus is on the innate part of immunity. We divide the reviewed interventions into: 1) lifestyle related (exercise, >7 h sleep, forest walking, meditation/ mindfulness, vitamin supplementation); 2) Non-specific immune stimulants (letting fever advance, bacterial vaccines, probiotics, dialyzable leukocyte extract, pidotimod), and 3) specific vaccines with heterologous effect (BCG vaccine, mumps-measles-rubeola vaccine, etc). 399

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33102050 RESULTS: For each of these interventions we briefly comment on their defi- nition, possible mechanisms and evidence of clinical efficacy or lack of it, es- pecially focusing on respiratory tract infections, viral infections, and eventu- ally a reduced mortality in severe respiratory infections in the intensive care unit. At the end, a summary table demonstrates the best trials supporting (or not) clinical evidence. CONCLUSION: Several interventions have some degree of evidence for en- hancing the innate immune response and thus conveying possible benefit, but specific trials in COVID-19 should be conducted to support solid recom- mendations. CITA: World Allergy Organ J. 2020 Nov;13(11):100476 DOI: 10.1016/j.waojou.2020.100476 TÍTULO: Phimosis: A rare complication of immunotherapy with durvalumab AUTORES: Vázquez-Lavista LG, Llorente L, Alatorre-Alexander J, Ramírez-Muciño JA. SUMMARY: We present a case of a 69 year old man with phimosis asso- ciated with immunotherapy with durvalumab for metastatic non-small-cell lung cancer. The patient developed vitiligo like dermatosis after the induc- tion dose of durvalumab, subsequent administration of the immunotherapy the patient developed a fibrous ring of the foreskin. Immune-mediated ad- verse reactions have been described after the use of durvalumab, but, to our knowledge, there are no reports of phimosis and vitiligo like reactions. CITA: Urol Case Rep. 2020 Jul 16;33:101350 DOI: 10.1016/j.eucr.2020.101350 PMID: 33110492 TÍTULO: Correction to: Is diet partly responsible for differences in COVID-19 PMID: 33194858 death rates between and within countries? AUTORES: Bousquet J, (…) Larenas-Linnemann D, et al. SUMMARY: Erratum CITA: Clin Transl Allergy. 2020 Oct 26;10:44 DOI: 10.1186/s13601-020-00351-w TÍTULO: Reversible Cerebral Vasoconstriction Syndrome Associated with Infundibular Dilation AUTORES: Montenegro-Rosales H, González-Alonso B, Cárdenas- Sáenz O, Gutierrez-Romero A. BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) is defined as a clinical and radiological syndrome that comprises a group of disorders characterized by sudden-onset severe headache and segmental vasoconstriction of the cerebral arteries with resolution within 3 months. CASE PRESENTATION: A 51-year-old female patient with a 2-week histo- ry of sudden-onset severe headache, visual disturbances and cerebellum; 400