RESUMEN INVESTIGADORES-2

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR no relevant imaging findings, except for an infundibular dilation at the origin of the posterior communicating artery, and so, angiography was performed. When symptoms persisted, a new imaging study was carried out with find- ings of RCVS as the cause of the symptoms from the beginning. CONCLUSIONS: Findings of RCVS can be obtained in various vasculop- athies of the nervous system and vasculitis, being misdiagnosed, and so, clinical suspicion is essential; if vasoconstriction is not demonstrated on the initial image and other diagnoses have been excluded, the patient should be managed as having possible or probable RCVS. LEARNING POINTS: RCVS is a clinical and radiological syndrome that comprises a group of disorders characterized by sudden-onset severe head- ache and segmental vasoconstriction of the cerebral arteries. It can occur spontaneously or can be triggered by a specific \"trigger\" in 25 to 60% of cas- es. It commonly affects women between 20 and 50 years of age, but children and adolescents may also be affected. CITA: Eur J Case Rep Intern Med. 2020 Aug 31;7(11):001839 DOI: 10.12890/2020_001839 PMID: 33281937 TÍTULO: Lactobacillus acidophilus LB: a useful pharmabiotic for the treat- PMID: 33296911 ment of digestive disorders AUTORES: María Remes Troche J, Coss Adame E, Ángel Valdovinos Díaz M, Gómez Escudero O, Eugenia Icaza Chávez M, Antonio Chávez-Barrera J, Zárate Mondragón F, Antonio Ruíz Velarde Velasco J, Rafael Aceves Ta- vares G, Antonio Lira Pedrín M, Cerda Contreras E, Carmona Sánchez RI, Guerra López H, Solana Ortiz R. SUMMARY: Dysbiosis, a loss of balance between resident bacterial commu- nities and their host, is associated with multiple diseases, including inflam- matory bowel diseases (nonspecific chronic ulcerative colitis and Crohn's disease), and digestive functional disorders. Probiotics, prebiotics, synbiotic organisms and, more recently, pharmabiotics, have been shown to modulate the human microbiota. In this review, we provide an overview of the key con- cepts relating to probiotics, prebiotics, synbiotic organisms, and pharmabiot- ics, with a focus on available clinical evidence regarding the specific use of a unique pharmabiotic, the strain Lactobacillus acidophilus LB (Lactobacillus boucardii), for the management of gastrointestinal disorders. Since it does not contain living organisms, the administration of L. acidophilus LB is ef- fective and safe as an adjuvant in the treatment of acute diarrhea, chronic diarrhea, and antibiotic-associated diarrhea, even in the presence of immu- nosuppression. CITA: Therap Adv Gastroenterol. 2020 Nov 24;13:1756284820971201 DOI: 10.1177/1756284820971201 TÍTULO: [Correlación de variables ecocardiográficas y biomarcadores en pacientes graves con COVID-19] AUTORES: Calderón-Esquivel N, Vázquez-Flores AD, González-Chon O, García-Briones A, Gutiérrez-Villaseñor AO, Romero-González JP, Juárez-Hernández E, Sosa-García JO. 401

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR OBJETIVO: Describir las variables ecocardiográficas de los pacientes con COVID-19 y su correlación con biomarcadores y mortalidad. MÉTODO: Estudio observacional, descriptivo, longitudinal y retrospectivo. RESULTADOS: El 70% (n = 21) eran de sexo masculino, el promedio de edad fue de 59 (46-67) años y el índice de masa corporal fue de 30.1 (27.3- 32.4) kg/m2. En la evaluación de la función sistólica del ventrículo izquierdo se observó una adecuada correlación entre la excursión sistólica del plano del anillo mitral (MAPSE) y la fracción de eyección del ventrículo izquierdo (r2 = 0.508, p = 0.004). La evaluación de la función sistólica del ventrículo derecho indicó una óptima correlación entre la excursión sistólica del plano del anillo tricuspídeo (TAPSE) y la fracción de acortamiento del ventrículo derecho (r2 = 0.649, p = ≤ 0.0001). No hubo correlación de los biomarca- dores y las variables ecocardiográficas entre los pacientes sobrevivientes y no sobrevivientes, a excepción del MAPSE y las concentraciones séricas de deshidrogenasa láctica (r2 = -0.427, p = 0.019). La tasa de mortalidad fue del 16% (n = 5). CONCLUSIÓN: Existe una adecuada correlación entre las variables eco- cardiográficas de la función sistólica del ventrículo izquierdo y del ventrículo derecho, así como también entre la MAPSE y los valores séricos de DHL. CITA: Cir Cir. 2020 Dec 9 DOI: 10.24875/CIRU.20000900 PMID: 33298191 TÍTULO: Treatment of allergic rhinitis during and outside the pollen season using mobile technology. A MASK study AUTORES: Bédard A, (…) Larenas-Linnemann DE, et al. BACKGROUND: The analysis of mobile health (mHealth) data has gener- ated innovative insights into improving allergic rhinitis control, but additive information is needed. A cross-sectional real-world observational study was undertaken in 17 European countries during and outside the estimated pol- len season. The aim was to collect novel information including the phenotyp- ic characteristics of the users. METHODS: The Allergy Diary-MASK-air-mobile phone app, freely available via Google Play and App, was used to collect the data of daily visual ana- logue scales (VASs) for overall allergic symptoms and medication use. Flu- ticasone Furoate (FF), Mometasone Furoate (MF), Azelastine Fluticasone Proprionate combination (MPAzeFlu) and eight oral H1-antihistamines were studied. Phenotypic characteristics were recorded at entry. The ARIA sever- ity score was derived from entry data. This was an a priori planned analysis. RESULTS: 9037 users filled in 70,286 days of VAS in 2016, 2017 and 2018. The ARIA severity score was lower outside than during the pollen season. Severity was similar for all treatment groups during the pollen season, and lower in the MPAzeFlu group outside the pollen season. Days with MPAze- Flu had lower VAS levels and a higher frequency of monotherapy than the other treatments during the season. Outside the season, days with MPAzeF- lu also had a higher frequency of monotherapy. The number of reported days was significantly higher with MPAzeFlu during and outside the season than with MF, FF or oral H1-antihistamines. CONCLUSIONS: This study shows that the overall efficacy of treatments is similar during and outside the pollen season and indicates that medications are similarly effective during the year. 402

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR CITA: Clin Transl Allergy. 2020 Dec 9;10(1):62 DOI: 10.1186/s13601-020-00342-x PMID: 33364779 TÍTULO: Perceptions and Management of Allergic Rhinitis Among Ecuador- ian Otorhinolaryngologists: A Survey-Based Study AUTORES: Felix M, Vera Paz C, Mata VL, Vanegas E, Larenas-Linne- mann D, Rosario NA, Letort J, Cherrez-Ojeda I. OBJECTIVE: Allergic rhinitis (AR) represents a large burden to the health- care system due to its high prevalence and impact on patients' lives. Despite the existence of evidence-based guidelines, some studies have found that physicians do not always follow the latest recommendations. The aim of our study was to determine how Ecuadorian otorhinolaryngologists (ENTs) per- ceive some epidemiological aspects related to AR, as well as their preferenc- es for managing the disease. METHODS: We conducted an observational, survey-based cross-sectional study, among 116 Ecuadorian ENTs. The survey used was adapted from a previous publication and consisted of 30 multiple choice questions, concern- ing several topics of AR. Descriptive statistics (frequency, and standard devi- ation) were performed for clinical and demographic variables. RESULTS: A total of 116 Ecuadorian ENTs completed the survey. Of them, 62.9% were male, with an average age of 42 years (SD ± 11.58). Comput- ed tomography (CT) scan and nasal cytology were selected as the main di- agnostic tests for AR by 62/91 (68.1%) and 45/91 (49.5%) of participants, respectively. Moreover, only 12/116 (10.3%) of participants performed skin prick tests (SPT). Allergen immunotherapy (AIT) was performed by 37/107 (36.4%) of participants. CONCLUSION: In general, most participants agreed that the prevalence of AR appears to be increasing, with increased exposure to allergens, irri- tants, and pollutants as the main probable cause. Children and adolescents were accounted as the group most affected by AR, with sinusitis and asthma identified as the most frequent comorbidities. Finally, we found unmet needs in the diagnostic and management of AR that should be addressed among Ecuadorian ENTs, in particular the high use of CT scans as part of routine evaluations, as well as the low use of allergen immunotherapy. CITA: J Multidiscip Healthc. 2020 Dec 17;13:1975-1981 DOI: 10.2147/JMDH.S269531 PMID: 33372940 TÍTULO: Tomographic behavior of pneumonia caused by SARS-CoV-2 AUTORES: Concha-Rebollar LA, Izquierdo-Echávarri EA, Alva-López LF, Ayala-Ochoa FJ, Hernández-Melchor VS. BACKGROUND: From the first report of the respiratory disease caused by SARS-Cov-2 towards the end of 2019, in Wuhan, China, to June 8, 2020, 6,931,000 people had been affected in the world, and 113,619 in Mexico, where there is a lack of literature describing the tomographic behavior of this disease throughout its evolution and its correlation with patient clinical data. 403

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33373345 OBJECTIVE: To identify, describe and classify the manifestations detected on chest computed tomography images of patients with pneumonia caused by SARS-CoV-2. METHOD: Hospitalized patients with RT-PCR-confirmed SARS-CoV-2 infec- tion and who underwent a plain chest tomography were included. RESULTS: The most common tomographic patterns were ground glass opacity, consolidation, cobblestone pattern and mixed pattern, with periph- eral and subpleural distribution and bilateral involvement in up to 95 %. Sub- pleural bands that distorted the architecture were identified in up to 62 % of patients, with an average of seven days of evolution. The most common extrapulmonary finding was an increase in pulmonary artery transverse axis. CONCLUSION: Knowing the behavior of this type of pneumonia allows be- coming familiarized with the characteristic tomographic patterns, in order to aid timely detection and treatment. CITA: Gac Med Mex. 2020;156(5):390-396 DOI: 10.24875/GMM.M20000426 TÍTULO: Body mass index is associated with low postoperative cardiac out- put in patients undergoing aortic valve replacement AUTORES: Avila-Vanzzini N, Berrios-Barcenas E, Cossio-Aranda J, Herre- ra-Bello H, Rodriguez-Chavez LL, Briseño-Diaz NM, Gaspar-Hernandez J. BACKGROUND: Overweight and obesity (O/O) generate lipotoxicity of the cardiac fiber and increase the incidence and progression of aortic valve ste- nosis. The low cardiac output syndrome (LCOS) is a timing complication af- ter to aortic valve replacement (AVR) surgery. OBJECTIVE: The objective of the study was to investigate if body mass index (BMI) kg/m2 is a risk factor associated with LCOS and mortality in the post-operative period of AVR. METHODS: A historic cohort study was designed, including patients with severe aortic stenosis (SAS), who were subjected to AVR. RESULTS: 152 patients were included, 45 (29.6%), with normal weight (NW), 60 were overweight (39.5%), and 47 obese (30.9%). The prevalence of systemic hypertension (HT) was higher in O/O (p < 0.0001). Incidence of LCOS was 44.7%, being more frequent in the O/O groups compared to the NW group, 43.3%, 68.1%, and 22.2%, respectively, (p < 0.05 in overweight and p < 0.0001 in the obese). Assessing the presence or absence of LCOS associated with BMI as a numerical variable, we found that women, HT, BMI, left ventricular mass, and valve size, were associated with LCOS (p < 0.02, p < 0.02, p < 0.001, p < 0.032, and p < 0.045, respectively). Mortality was higher in patients who had LCOS (p < 0.02). Multivariate model showed that BMI was an independent risk factor for LCOS (odds ratio [OR] 1.21 [95% CI 1.08-1.35], p < 0.001). CONCLUSION: BMI is a risk factor associated to LCOS in the post-opera- tive period of AVR in patients with SAS. CITA: Arch Cardiol Mex. 2020;90(4):490-497 DOI: 10.24875/ACM.20000129 404

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33442371 TÍTULO: Intergluteal Cleft Eccrine Porocarcinoma with Metastasis to Ingui- PMID: 33877116 nal Region and Lung: Case Report and Review of the Literature PMID: 34020518 AUTORES: Fernández-Ferreira R, Alvarado-Luna G, Motola-Kuba D, Mackinney-Novelo I, Cervera-Ceballos EE, Segura-Rivera R. SUMMARY: Eccrine porocarcinoma (EPC) is an infrequent cutaneous neo- plasm, and was described in 1963 by Pinkus and Mehregan. It is a rare type of skin tumor (0.005-0.01% of all skin tumors). Less than 300 cases have been described in the entire world medical literature. To our knowledge, no case of intergluteal cleft EPC has been reported in the literature in English and Spanish to date, so this would be the first reported case of such patholo- gy. Metastatic EPC is less frequent, since only <10% of metastatic type have been reported and the rest as localized disease. The primary treatment of choice is surgical wide local excision of the tumor with histological confirma- tion of tumor-free margins. Prognosis is difficult to determine because of the rarity of EPC and the variations in natural history. There are no data to sup- port the use of adjuvant chemotherapy or radiotherapy, and there are cur- rently no agreed criteria to define patients at high risk of relapse. We present a 67-year-old man with intergluteal cleft eccrine tumor by biopsy. Metastasis to left inguinal region and lung was reported by contrasted abdominal and chest computed tomography. He started chemotherapy based on etoposide, vincristine, carboplatin. A review of pertinent literature is provided. CITA: Case Rep Oncol. 2020 Dec 10;13(3):1463-1473 DOI: 10.1159/000510311 TÍTULO: Carl von Rokitansky, the Linné of pathological anatomy AUTORES: Ortiz-Hidalgo C. SUMMARY: Carl von Rokitansky was one of the most important figures in pathological anatomy, and was largely responsible for the resurgence of Vi- enna as the great medical center of the world in the mid-19th century. He was born in current Hradec Králové, studied medicine in Prague and Vien- na and was graduated in 1828. He was greatly influenced by the anatomy, embryology and pathology studies of Andral, Lobstein and Meckel. At the Vienna School, he was Johann Wagner pathological anatomy assistant and became a pathology professor, where he remained until four years before his death. Rokitansky emphasized the importance of correlating patient symptoms with postmortem changes. It is possible that he had access to between 1,500 and 1,800 cadavers annually to be able to perform 30,000 necropsies; in addition, he reviewed several thousand more autopsies. In Handbuch der pathologischen Anatomie, published between 1842 and 1846, he made numerous descriptions: lobar and lobular pneumonia, endocarditis, diseases of the arteries, cysts in several viscera, various neoplasms and acute yellow atrophy of the liver. With his brilliant work on gross pathology, Rokitansky established the nosological classification of diseases, for which Virchow named him \"the Lineé of pathological anatomy\". CITA: Gac Med Mex. 2020;156(6):584-591 DOI: 10.24875/GMM.M21000462 TÍTULO: [Anterior ankle impingement: follow-up in 52 cases] AUTORES: Cuellar-Avaroma A, Doger-Echegaray P, King-Martínez AC. 405

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR INTRODUCTION: The anterior ankle impingement is a common pathology. It is mostly seen in athletes. Pain in the anterior portion of the ankle and limitation in the ankle's dorsiflexion are the most common symptoms. These lesions are commonly preceded by an inversion movement most commonly during soccer. MATERIAL AND METHODS: This is a observational, descriptive, prospec- tive and longitudinal study of 52 consecutive patients with anterior ankle im- pingement in whom an anterior ankle arthroscopy was perform. The objec- tive is to know the clinical follow-up at least one year. We evaluated numeric pain scale, functional outcomes and personal satisfaction. RESULTS: Of the 52 patients, we had 36 males, and 16 females. Pain scale moved from 5.75 to 0.98 points. The AOFAS scale moved from 73.65 preop- erative to 92.98 postoperatively the SFMCP scale went form 72.44 preopera- tive to 94.48 postop. 23 patients (44.23%) returned to there previous level of sport with in four to seven months form the intervention. CONCLUSIONS: Arthroscopic treatment of the anterior ankle impingement showed significant improvement to 12 months of follow-up. The return to sports activity at the same level prior to the injury was four to seven months. CITA: Acta Ortop Mex. Nov-Dec 2020;34(6):382-387 DOI: 10.35366/99136 2021 PMID: 32079989 TÍTULO: Use of Infliximab in the Treatment of Macrophage Activation Syn- PMID: 32127230 drome Complicating Kawasaki Disease AUTORES: Rivera-Rodriguez L, Pardo-Díaz E, Moreno-Espinosa S, Scheffler-Mendoza S, Ruiz-Ontiveros MA, Garrido-García LM, Iglesias- -Amaya A, Yamazaki-Nakashimada MA. SUMMARY: Kawasaki disease (KD) is an acute systemic vasculitis of un- known etiology. KD can be complicated with macrophage activation syn- drome. The optimal treatment for this KD complication has not been estab- lished, and a variety of treatments have been used. Infliximab, a chimeric monoclonal antibody that binds tumor necrosis factor, has proved to be efficacious in IV gammaglobulin resistant KD. We present 2 cases of KD complicated with macrophage activation syndrome, including 1 patient with DiGeorge syndrome successfully treated with a combined treatment of IV gammaglobulin, corticosteroids, cyclosporine, and infliximab. CITA: J Pediatr Hematol Oncol. 2021 Apr 1;43(3):e448-e451 DOI: 10.1097/MPH.0000000000001756 TÍTULO: Comparing Spirometric Reference Values From Childhood to Old Age Estimated by LMS and Linear Regression Models AUTORES: Martínez-Briseño D, Gochicoa-Rangel L, Torre-Bouscoulet L, Cid-Juárez S, Fernández-Plata R, Martínez-Valdeavellano L, Chapela-Lara S, Del Río-Hidalgo R, Pérez-Padilla R. 406

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32141983 BACKGROUND: Proper reference values for lung function testing are es- sential for achieving adequate interpretations. The LMS procedure (lambda, mu, sigma) permits continuous analyses of entire populations avoiding gaps in the transition between childhood and adulthood. It also allows more pre- cise calculations of average values, dispersion, and 5th percentiles, which are usually considered the lower limit of normality. The objective of this study was to compare our results fitted with the LMS method with standard multi- ple linear regression, and with those from international Global Lung Function Initiative (GLI) equations. METHODS: Data from 9835 healthy residents of the metropolitan area of Mexico City aged 8-80 years were compiled from several studies: EMPECE, PLATINO, adult Mexican workers and two unpublished studies. The LMS procedure and multiple linear regression models were fit to obtain reference equations using R software. RESULTS: Residuals from the LMS models had a median closer to zero, and smaller dispersion than those from the linear model, but differences al- though statistically significant were very small and of questionable practical relevance. For example, for females and ln(FEV1), median residual was -0.001 with p25 of -0.08 and p75 of 0.08 for LMS, compared with 0.004 (-0.08, 0.09) [p<0.05] for the linear model. Average spirometric values for a given height for our population, were higher than those predicted by the GLI study. CONCLUSION: Continuous reference equations for the Mexican population calculated using the LMS technique showed slightly better fit than linear re- gression models. CITA: Arch Bronconeumol (Engl Ed). 2021 Mar;57(3):172-178 DOI: 10.1016/j.arbres.2019.12.033 TÍTULO: Neurophysiological Intraoperative Monitoring in the Elderly AUTORES: De la Maza Krzeptowsky LC, San-Juan D, Ximénez Camilli C, Alvarez Perera LÁ, Valdez Ruvalcaba H, Morales Báez JA, Anschel DJ. INTRODUCTION: Intraoperative neurophysiological monitoring (IONM) is widely used to prevent nervous system injury during surgeries in elderly pa- tients. However, there are no studies that describe the characteristics and changes in neurophysiological tests during the IONM of patients aged 60 years and older. The study aims to describe and compare IONM changes during surgeries in adult patients aged 18 to 59 years with those aged 60 years and older. METHODS: We performed a comparative retrospective study of patients aged 18 to 59 years versus those 60 aged years and older who underwent IONM during 2013 to 2018 in Mexico City. Sociodemographic characteristics were recorded and compared. Intraoperative neurophysiological monitoring techniques, their changes, and surgical procedures for both groups were an- alyzed and compared using descriptive statistics, Mann-Whitney U, Fisher, and χ2 tests. The sensitivity, specificity, and positive and negative predictive values were calculated. RESULTS: In total, 195 patients were analyzed: 104 patients, 68.63 ± 6.54 years old (elderly group) and 91 patients, 42.3 ± 10.5 years old (younger group). No differences were found in the rates of signal change during IONM between the group of elderly patients and the younger group. The sensitivity, 407

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32312136 specificity, and positive and negative predictive values were 80%, 99%, 80%, PMID: 32482104 and 99%, respectively. CONCLUSIONS: Elderly patients have a similar rate of changes in IONM signals compared with younger patients during heterogeneous surgeries guided by IONM. CITA: J Clin Neurophysiol. 2021 May 1;38(3):231-236 DOI: 10.1097/WNP.0000000000000689 TÍTULO: Anxiety and depression in adult patients with asthma: the role of asthma control, obesity and allergic sensitization AUTORES: Bedolla-Barajas M, Morales-Romero J, Fonseca-López JC, Pu- lido-Guillén NA, Larenas-Linnemann D, Hernández-Colín DD. OBJECTIVE: To determine the frequency of anxiety and depression in adult patients with asthma and to identify factors associated with them. METHODS: This cross-sectional study included 164 consecutively recruited patients with asthma aged ≥ 18 years. Participants were clinically assessed and the mental state was analyzed through of the Beck Anxiety Inventory (BAI), the Beck Depression Inventory II (BDI-II); the Asthma Control Test (ACT) was measured, and allergic sensitization and respiratory function were also evaluated. Binary logistic regression models to identify the factors related to anxiety or depression were carried out. Complementary, 95% con- fidence intervals (CI) were estimated. RESULTS: Anxiety was present in 54.3% of patients (95% CI: 46.6%-61.7%) while depression was found in 50.6% (95% CI: 43.0%-58.2%). Depres- sion increased the odds of anxiety in patients with asthma (OR: 26.00, p < 0.0001), whereas an ACT score ≥ 20 points and allergic asthma were asso- ciated with a lower odds than the reference group (OR: 0.29; p = 0.007 and OR: 0.29; p = 0.024, respectively). Depression was associated with anxiety and obesity (OR: 25.33, p < 0.0001 and OR: 3.66; p = 0.014, respectively). CONCLUSIONS: Overall, more than half of all asthmatic patients suffer from anxiety and depression. Well-controlled asthma and allergic sensitization de- creased the likelihood of anxiety, while depression was associated with both obesity and anxiety. CITA: J Asthma. 2021 Aug;58(8):1058-1066 DOI: 10.1080/02770903.2020.1759087 TÍTULO: The Role of a Cachexia Grading System in Patients with Non-Small Cell Lung Cancer Treated with Immunotherapy: Implications for Survival AUTORES: Turcott JG, Martinez-Samano JE, Cardona AF, Bassarmal SS, Ramírez-Tirado LA, Zatarain-Barrón ZL, Barrón F, Corrales L, Martín C, Bar- ragán-Castillo PA, Ruiz-Patiño A, Flores-Estrada D, Arrieta O. OBJECTIVE: The association between cancer-induced weight-loss (CIWL) and poor clinical outcomes in patients treated with immunotherapy is scarcely understood. We evaluated the use of a cachexia-grading system in IO-treated non-small cell lung cancer (NSCLC) patients in order to predict clinical outcomes. 408

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32501878 MATERIALS: 300 patients with NSCLC, who received immunotherapy PMID: 32512619 during any line of therapy, were included. All patients were graded accord- ing to a previously validated cachexia scale, which takes into consideration body mass index (BMI) and weight loss, stratifying patients into five risk cat- egories (0 [pre-cachexia] - 4 [refractory cachexia]). Primary endpoint was overall survival (OS). RESULTS: Ninety-one (30.3%) patients were classified in the low risk cat- egory, 176 (58.6%) were classified in the intermediate risk category and 33 (11%) were in the high risk category. Patients classified as low-risk had a significantly longer OS compared with those with intermediate or high risk (22.4 mo, [95%CI: 16.6-NR] vs. 17.1 [95%CI: 13.5-22.4] vs. 8.0 [3.9-18.4]; p < 0.001). In the multivariate analysis, after adjusting for age, hemoglobin and ORR, hazard of death increased as per the cachexia risk scale (Hazard ratio: 1.62 [1.22-2.16]; p = 0.001). CONCLUSION: Cachexia is independently associated with worse OS in NS- CLC patients who receive immunotherapy, highlighting the role for nutritional assessment. CITA: Nutr Cancer. 2021;73(5):794-801 DOI: 10.1080/01635581.2020.1769691 TÍTULO: Association of portal venous system thrombosis with endoscopic variceal treatment: a systematic review and meta-analysis AUTORES: Wang L, Guo X, Xu X, Philips CA, Primignani M, Mendez-San- chez N, Li Q, Zheng K, Qi X. SUMMARY: The association of endoscopic variceal treatment (EVT) with the development of portal venous system thrombosis (PVST) in liver cir- rhosis remains uncertain. A systematic review and meta-analysis aimed to investigate the incidence of PVST after EVT and to explore the association of EVT with the development of PVST in liver cirrhosis. All relevant studies were searched via the PubMed, EMBASE, and Cochrane Library databases. The incidence of PVST in patients treated with and without EVT was pooled. Risk ratios with 95% confidence intervals (CIs) were calculated. Heteroge- neity among studies was calculated. Meta-regression, sensitivity, and sub- group analyses were used to analyze the source of heterogeneity. Thirteen studies involving a total of 833 patients were included. The pooled incidence of PVST after EVT was 10.4% (95% CI, 4.9-17.7%). There was a statisti- cally significant heterogeneity (I2 = 83.3%, P < 0.0001). Meta-regression, sensitivity, and subgroup analyses did not find the source of heterogeneity. Four studies compared the incidence of PVST between patients treated with and without EVT. The incidence of PVST was significantly higher in the EVT group than that in the no-EVT group (risk ratio: 2.23; 95% CI, 1.11-4.49; P = 0.02). The heterogeneity was not statistically significant (I2 = 0%, P = 0.43). In conclusion, PVST after EVT may not be scare, and EVT may increase the risk of PVST in liver cirrhosis. CITA: Eur J Gastroenterol Hepatol. 2021 Feb 1;32(2):125-131 DOI: 10.1097/MEG.0000000000001774 TÍTULO: ARIA digital anamorphosis: Digital transformation of health and care in airway diseases from research to practice 409

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32531110 AUTORES: Bousquet J, (…) Larenas-Linnemann DE, et al. PMID: 32533953 SUMMARY: Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strate- gies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Us- ing the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed. CITA: Allergy. 2021 Jan;76(1):168-190 DOI: 10.1111/all.14422 TÍTULO: COVID-19 pandemic: Practical considerations on the organization of an allergy clinic-An EAACI/ARIA Position Paper AUTORES: Pfaar O, (…) Larenas-Linnemann DE, et al. BACKGROUND: The coronavirus disease 2019 (COVID-19) has evolved into a pandemic infectious disease transmitted by the severe acute respiratory syndrome coronavirus (SARS-CoV-2). Allergists and other healthcare provid- ers (HCPs) in the field of allergies and associated airway diseases are on the front line, taking care of patients potentially infected with SARS-CoV-2. Hence, strategies and practices to minimize risks of infection for both HCPs and treat- ed patients have to be developed and followed by allergy clinics. METHOD: The scientific information on COVID-19 was analysed by a litera- ture search in MEDLINE, PubMed, the National and International Guidelines from the European Academy of Allergy and Clinical Immunology (EAACI), the Cochrane Library, and the internet. RESULTS: Based on the diagnostic and treatment standards developed by EAACI, on international information regarding COVID-19, on guidelines of the World Health Organization (WHO) and other international organizations, and on previous experience, a panel of experts including clinicians, psychol- ogists, IT experts, and basic scientists along with EAACI and the \"Allergic Rhinitis and its Impact on Asthma (ARIA)\" initiative have developed recom- mendations for the optimal management of allergy clinics during the current COVID-19 pandemic. These recommendations are grouped into nine sec- tions on different relevant aspects for the care of patients with allergies. CONCLUSIONS: This international Position Paper provides recommenda- tions on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients while ensuring the necessary safety measures in the current COVID-19 pandemic. CITA: Allergy. 2021 Mar;76(3):648-676 DOI: 10.1111/all.14453 TÍTULO: Non-alcoholic fatty liver disease and microRNAs expression, how it affects the development and progression of the disease AUTORES: López-Sánchez GN, Dóminguez-Pérez M, Uribe M, Chávez- Tapia NC, Nuño-Lámbarri N. 410

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR SUMMARY: The obesity pandemic that affects the global population gener- ates one of the most unfavorable microenvironmental conditions in the he- patocyte, which triggers the metabolic hepatopathy known as non-alcoholic fatty liver; its annual rates increase in its prevalence and does not seem to improve in the future. The international consortia, LITMUS by the European Union and NIMBLE by the United States of America, have started a race for the development of hepatic steatosis and steatohepatitis reliable biomarkers to have an adequate diagnosis. MicroRNAs have been proposed as diag- nostic and prognostic biomarkers involved in adaptation to changes in the liver microenvironment, which could improve clinical intervention strategies in patients with hepatic steatosis. CITA: Ann Hepatol. Mar-Apr 2021;21:100212 DOI: 10.1016/j.aohep.2020.04.012 PMID: 32588922 TÍTULO: ARIA-EAACI statement on asthma and COVID-19 (June 2, 2020) AUTORES: Bousquet J, (…) Larenas-Linnemann D, et al. SUMMARY: Letter to the editor CITA: Allergy. 2021 Mar;76(3):689-697. doi: 10.1111/all.14471 DOI: 10.1111/all.14471 PMID: 32684153 TÍTULO: Free Area of the Spinal Canal and Torg's Ratio in Acute Cervical Trauma and Degenerative Disease: MANCOVA and Correlational Analyses AUTORES: Martinez-Martinez L, Perez-Perez JD, Soto-Hernandez JL, Corona-Cedillo R, Roldan-Valadez E. BACKGROUND: The two of the most common indications for magnetic res- onance (MR) imaging of the cervical spine include acute spine trauma and degenerative disease. OBJECTIVE: We aimed to correlate the measurements of the free area of the spinal canal (FASC), a new approach to the cervical spinal canal com- promise, with the Torg´s ratio quantification of the cervical spine. METHODS: A cross-sectional study including 50 cervical-spine MR evalua- tions of patients with acute cervical trauma or degenerative disease was per- formed. We used multivariate analysis of covariance (MANCOVA) to identify the type of lesion, intervertebral level and gender differences between FASC and Torg´s ratio quantification of the cervical spine; age was the controlled covariate. Correlates between FASC and Torg´s ratio were obtained at each intervertebral level. RESULTS: There was a non-significant interaction between the type of le- sion, gender and intervertebral levels between FASC and Torg´s ratio mea- surements, F (8, 456) 0.260, p = .978; Wilks' Lambda 0.991; with a small effect size (partial η2 = .005). Among the main effects, only the gender was statistically significant: F (2, 228) = 3.682, p = .027. The age (controlled co- variate) was non-significantly related to FASC and Torg´s ratio quantification: F (2, 228) = .098, p = .907. The Pearson´s correlation coefficient depicted a poor, non-significant agreement between FASC and Torg´s ratio. 411

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32873572 CONCLUSION: FASC provides an integrative evaluation of the cervical spi- nal canal compromise in acute, cervical spine trauma and degenerative dis- ease. Further observations and correlation with specific neurological symp- toms, surgical findings and clinical outcomes are necessary to assess the usefulness of FASC in clinical settings. CITA: Curr Med Imaging. 2021;17(3):366-373 DOI: 10.2174/1573405616666200720002059. TÍTULO: Efficacy and Safety of Nivolumab Plus Ipilimumab versus Sunitinib in First-line Treatment of Patients with Advanced Sarcomatoid Renal Cell Carcinoma AUTORES: Tannir NM, Signoretti S, Choueiri TK, McDermott DF, Motzer RJ, Flaifel A, Pignon JC, Ficial M, Frontera OA, George S, Powles T, Donskov F, Harrison MR, Barthélémy P, Tykodi SS, Kocsis J, Ravaud A, Rodriguez-Cid JR, Pal SK, Murad AM, Ishii Y, Saggi SS, McHenry MB, Rini BI. PURPOSE: Patients with advanced renal cell carcinoma with sarcomatoid features (sRCC) have poor prognoses and suboptimal outcomes with target- ed therapy. This post hoc analysis of the phase III CheckMate 214 trial ana- lyzed the efficacy of nivolumab plus ipilimumab (NIVO+IPI) versus sunitinib in patients with sRCC. PATIENTS AND METHODS: Patients with sRCC were identified via inde- pendent central pathology review of archival tumor tissue or histologic clas- sification per local pathology report. Patients were randomized 1:1 to receive nivolumab (3 mg/kg) plus ipilimumab (1 mg/kg) every 3 weeks (four dos- es) then nivolumab 3 mg/kg every 2 weeks, or sunitinib 50 mg orally every day (4 weeks; 6-week cycles). Outcomes in patients with sRCC were not prespecified. Endpoints in patients with sRCC and International Metastatic Renal Cell Carcinoma Database Consortium intermediate/poor-risk disease included overall survival (OS), progression-free survival (PFS) per indepen- dent radiology review, and objective response rate (ORR) per RECIST v1.1. Safety outcomes used descriptive statistics. RESULTS: Of 1,096 randomized patients in CheckMate 214, 139 patients with sRCC and intermediate/poor-risk disease and six with favorable-risk disease were identified. With 42 months' minimum follow-up in patients with sRCC and intermediate/poor-risk disease, median OS [95% confidence in- terval (CI)] favored NIVO+IPI [not reached (NR) (25.2-not estimable [NE]); n = 74] versus sunitinib [14.2 months (9.3-22.9); n = 65; HR, 0.45 (95% CI, 0.3-0.7; P = 0.0004)]; PFS benefits with NIVO+IPI were similarly observed [median 26.5 vs. 5.1 months; HR, 0.54 (95% CI, 0.33-0.86; P = 0.0093)]. Confirmed ORR was 60.8% with NIVO+IPI versus 23.1% with sunitinib, with complete response rates of 18.9% versus 3.1%, respectively. No new safety signals emerged. CONCLUSIONS: NIVO+IPI showed unprecedented long-term survival, re- sponse, and complete response benefits versus sunitinib in previously un- treated patients with sRCC and intermediate/poor-risk disease, supporting the use of first-line NIVO+IPI for this population. See related commentary by Hwang et al., p. 5. CITA: Clin Cancer Res. 2021 Jan 1;27(1):78-86 DOI: 10.1158/1078-0432.CCR-20-2063 412

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 32878736 TÍTULO: Voice Therapy in the Context of the COVID-19 Pandemic: Guide- lines for Clinical Practice PMID: 32894782 AUTORES: Castillo-Allendes A, Contreras-Ruston F, Cantor-Cutiva LC, PMID: Codino J, Guzman M, Malebran C, Manzano C, Pavez A, Vaiano T, Wilder F, Behlau M. INTRODUCTION: Since the beginning of the new pandemic, COVID-19 health services have had to face a new scenario. Voice therapy faces a dou- ble challenge, interventions using telepractice, and delivering rehabilitation services to a growing population of patients at risk of functional impairment related to the COVID-19 disease. Moreover, as COVID-19 is transmitted through droplets, it is critical to understand how to mitigate these risks during assessment and treatment. OBJECTIVE: To promote safety, and effective clinical practice to voice assessment and rehabilitation in the pandemic COVID-19 context for speech-language pathologists. METHODS: A group of 11 experts in voice and swallowing disorders from five different countries conducted a consensus recommendation following the American Academy of Otolaryngology-Head and Neck Surgery rules building a clinical guide for speech-language pathologists during this pan- demic context. RESULTS: The clinical guide provides 65 recommendations for clinicians in the management of voice disorders during the pandemic and includes advice from assessment, direct treatment, telepractice, and teamwork. The consensus was reached 95% for all topics. CONCLUSION: This guideline should be taken only as recommendation; each clinician must attempt to mitigate the risk of infection and achieve the best therapeutic results taking into account the patient's particular reality. CITA: J Voice. 2021 Sep;35(5):717-727 DOI: 10.1016/j.jvoice.2020.08.001 TÍTULO: Thirty-six COVID-19 cases preventively vaccinated with mumps-measles-rubella vaccine: All mild course AUTORES: Larenas-Linnemann DE, Rodríguez-Monroy F. SUMMARY: Letter to the editor CITA: Allergy. 2021 Mar;76(3):910-914 DOI: 10.1111/all.14584 32917457 TÍTULO: Terapia Vocal No Contexto Da Pandemia Do Covid-19 AUTORES: Castillo-Allendes A, Contreras-Ruston F, Cantor L, Codino J, Guz- man M, Malebran C, Manzano C, Pavez A, Vaiano T, Wilder F, Behlau M. INTRODUCTION: Since the beginning of the new pandemic, Corona Virus Disease 2019 (COVID-19) health services have had to face a new scenar- 413

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR io. Voice therapy faces a double challenge, interventions using telepractice, and delivering rehabilitation services to a growing population of patients at risk of functional impairment related to the COVID-19 disease. Moreover, as COVID-19 is transmitted through droplets, it is critical to understand how to mitigate these risks during assessment and treatment. OBJECTIVE: To promote safety, and effective clinical practice to voice assessment and rehabilitation in the pandemic COVID-19 context for speech-language pathologists. METHODS: A group of 11 experts in voice and swallowing disorders from five different countries conducted a consensus recommendation following the American Academy of Otolaryngology-Head and Neck Surgery rules building a clinical guide for speech-language pathologists during this pan- demic context. RESULT: The clinical guide provides 79 recommendations for clinicians in the management of voice disorders during the pandemic and includes ad- vice from assessment, direct treatment, telepractice, and teamwork. The consensus was reached 95% for all topics. CONCLUSION: This guideline should be taken only as recommendation; each clinician must attempt to mitigate the risk of infection and achieve the best therapeutic results taking into account the patient's particular reality. CITA: J Voice. 2021 Sep;35(5):808.e1-808.e12 DOI: 10.1016/j.jvoice.2020.08.018 PMID: 32917460 TÍTULO: Terapia Vocal No Contexto Da Pandemia Do Covid-19 AUTORES: Castillo-Allendes A, Contreras-Ruston F, Cantor L, Codino J, Guz- man M, Malebran C, Manzano C, Pavez A, Vaiano T, Wilder F, Behlau M. INTRODUCTION: Since the beginning of the new pandemic, Corona Virus Disease 2019 (COVID-19) health services have had to face a new scenar- io. Voice therapy faces a double challenge, interventions using telepractice, and delivering rehabilitation services to a growing population of patients at risk of functional impairment related to the COVID-19 disease. Moreover, as COVID-19 is transmitted through droplets, it is critical to understand how to mitigate these risks during assessment and treatment. OBJECTIVE: To promote safety, and effective clinical practice to voice assessment and rehabilitation in the pandemic COVID-19 context for speech-language pathologists. METHODS: A group of 11 experts in voice and swallowing disorders from five different countries conducted a consensus recommendation following the American Academy of Otolaryngology-Head and Neck Surgery rules building a clinical guide for speech-language pathologists during this pan- demic context. RESULT: The clinical guide provides 79 recommendations for clinicians in the management of voice disorders during the pandemic and includes ad- vice from assessment, direct treatment, telepractice, and teamwork. The consensus was reached 95% for all topics. CONCLUSION: This guideline should be taken only as recommendation; each clinician must attempt to mitigate the risk of infection and achieve the best therapeutic results taking into account the patient's particular reality. 414

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR CITA: J Voice. 2021 Sep;35(5):808.e13-808.e24 DOI: 10.1016/j.jvoice.2020.08.019 PMID: 33099028 TÍTULO: Association of liver steatosis and fibrosis with clinical outcomes in PMID: 33138974 patients with SARS-CoV-2 infection (COVID-19) AUTORES: Lopez-Mendez I, Aquino-Matus J, Gall SM, Prieto-Nava JD, Juarez-Hernandez E, Uribe M, Castro-Narro G. INTRODUCTION AND OBJECTIVES: Liver function tests (LFT) abnormal- ities are reported in up to 50% of COVID-19 patients, and metabolic co- morbidities are associated with poorer outcomes. The aim of the study was to determine the prevalence of liver steatosis and fibrosis in patients with COVID-19 and their association with clinical outcomes. MATERIAL AND METHODS: Retrospective study in hospitalized COVID-19 patients was conducted. The risk for liver steatosis was estimated by HSI > 36, and risk for advanced liver fibrosis with APRI > 1.0, NAFLD FS > 0.675 and/or FIB-4 > 3.25. Clinical outcomes were admission to Intensive Care Unit (ICU) and mortality. RESULTS: Of 155 patients, 71.6% were male (n = 111), and 28.4% (n = 44) were obese. Abnormal LFT were present in 96.8% (n = 150), prevalence of steatosis was 42.6% (n = 66) and of significative liver fibrosis was 44.5% (n = 69). Liver fibrosis by FIB-4 was associated with risk of ICU admission (OR 1.74 [95%CI 1.74-2.68; p = 0.023]) and mortality (OR 6.45 [95%CI 2.01- 20.83, p = 0.002]); no independent associations were found. CONCLUSIONS: The prevalence of steatosis and significant liver fibrosis was high in COVID-19 patients but was not associated with clinical outcomes. CITA: Ann Hepatol. Jan-Feb 2021;20:100271 DOI: 10.1016/j.aohep.2020.09.015 TÍTULO: Outcomes of patients with COVID-19 in the intensive care unit in Mexico: A multicenter observational study AUTORES: Ñamendys-Silva SA, Alvarado-Ávila PE, Domínguez-Cherit G, Rivero-Sigarroa E, Sánchez-Hurtado LA, Gutiérrez-Villaseñor A, Rome- ro-González JP, Rodríguez-Bautista H, García-Briones A, Garnica-Cama- cho CE, Cruz-Ruiz NG, González-Herrera MO, García-Guillén FJ, Guerre- ro-Gutiérrez MA, Salmerón-González JD, Romero-Gutiérrez L, Canto-Castro JL, Cervantes VH BACKGROUND: As of June 15, 2020, a cumulative total of 7,823,289 con- firmed cases of COVID-19 have been reported across 216 countries and territories worldwide. However, there is little information on the clinical char- acteristics and outcomes of critically ill patients with severe COVID-19 who were admitted to intensive care units (ICUs) in Latin America. The present study evaluated the clinical characteristics and outcomes of critically ill pa- tients with severe COVID-19 who were admitted to ICUs in Mexico. METHODS: This was a multicenter observational study that included 164 critically ill patients with laboratory-confirmed COVID-19 who were admitted to 10 ICUs in Mexico, from April 1 to April 30, 2020. Demographic data, co- morbid conditions, clinical presentation, treatment, and outcomes were col- lected and analyzed. The date of final follow-up was June 4, 2020. 415

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33181118 RESULTS: A total of 164 patients with severe COVID-19 were included in this study. The mean age of patients was 57.3 years (SD 13.7), 114 (69.5%) were men, and 6.0% were healthcare workers. Comorbid conditions were common in patients with critical COVID-19: 38.4% of patients had hyper- tension and 32.3% had diabetes. Compared to survivors, nonsurvivors were older and more likely to have diabetes, hypertension or other condi- tions. Patients presented to the hospital a median of 7 days (IQR 4.5-9) after symptom onset. The most common presenting symptoms were shortness of breath, fever, dry cough, and myalgias. One hundred percent of patients received invasive mechanical ventilation for a median time of 11 days (IQR 6-14). A total of 139 of 164 patients (89.4%) received vasopressors, and 24 patients (14.6%) received renal replacement therapy during hospitalization. Eighty-five (51.8%) patients died at or before 30 days, with a median surviv- al of 25 days. Age (OR, 1.05; 95% CI, 1.02-1.08; p<0.001) and C-reactive protein levels upon ICU admission (1.008; 95% CI, 1.003-1.012; p<0.001) were associated with a higher risk of in-hospital death. ICU length of stay was associated with reduced in-hospital mortality risk (OR, 0.89; 95% CI, 0.84-0.94; p<0.001). CONCLUSIONS: This observational study of critically ill patients with laborato- ry-confirmed COVID-19 who were admitted to the ICU in Mexico demonstrated that age and C-reactive protein level upon ICU admission were associated with in-hospital mortality, and the overall hospital mortality rate was high. CITA: Heart Lung. Jan-Feb 2021;50(1):28-32 DOI: 10.1016/j.hrtlng.2020.10.013 TÍTULO: The Latin American Association for the Study of the Liver (ALEH) position statement on the redefinition of fatty liver disease AUTORES: Mendez-Sanchez N, Arrese M, Gadano A, Oliveira CP, Fassio E, Arab JP, Chávez-Tapia NC, Dirchwolf M, Torre A, Ridruejo E, Pinchemel-Cotrim H, Castellanos Fernández MI, Uribe M, Girala M, Diaz-Ferrer J, Restrepo JC, Padilla-Machaca M, Dagher L, Gatica M, Olaechea B, Pessôa MG, Silva M. SUMMARY: The Latin American Association for the Study of the Liver (Aso- ciación Latinoamericana para el Estudio del Hígado; ALEH) represents liver professionals in Latin America with the mission of promoting liver health and quality patient care by advancing the science and practice of hepatology and contributing to the development of a regional health policy framework. Fatty liver disease associated with metabolic dysfunction is of specific concern in the ALEH region, where its prevalence is one of the highest globally, second only to the Middle East. A recent consensus from an international panel rec- ommended a new definition of fatty liver disease associated with metabolic dysfunction, including a shift in name from non-alcoholic fatty liver disease (NAFLD) to metabolic-associated fatty liver disease (MAFLD), and adoption of a set of positive criteria to diagnose the disease, independent of alcohol intake or other liver diseases. Given, the importance of this proposal, ALEH invited leading members of regional nations to come to a consensus on it from a local perspective. We reached a consensus to endorse the proposal that the disease should be renamed as MAFLD and that the disease should be diagnosed by the proposed simple and easily applicable criteria. We expect that this change in nosology will result in improvements in disease awareness and in advances in scientific, economic, public health, political, and regulatory aspects of the disease. CITA: Lancet Gastroenterol Hepatol. 2021 Jan;6(1):65-72 DOI: 10.1016/S2468-1253(20)30340-X 416

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33212528 TÍTULO: Inflammatory bowel disease in developing tropical countries: ab- PMID: 33275310 dominal pain caused by Ascaris lumbricoides diagnosed with single-balloon PMID: 33352565 enteroscopy AUTORES: Tepox-Padrón A, Figueroa M, Sánchez-Fernández N, Tellez-A- PMID: 33405959 vila FI. SUMMARY: Case report CITA: Endoscopy. 2021 Oct;53(10):E359-E360 DOI: 10.1055/a-1294-9555 TÍTULO: Primary cutaneous blastic plasmacytoid dendritic cell neoplasm in a child: A challenging diagnosis and management AUTORES: Rivas-Calderón MK, Cheirif-Wolosky O, Rosas-Romero ME, Toussaint-Caire S, Duran-Mckinster C, González-Pedroza ML, López-San- tiago NC, García-Romero MT. SUMMARY: Case report CITA: Pediatr Dermatol. 2021 Jan;38(1):260-262 DOI: 10.1111/pde.14473 TÍTULO: Spices to Control COVID-19 Symptoms: Yes, but Not Only… AUTORES: Bousquet J, (…) Larenas-Linnemann DE, et al. SUMMARY: There are large country variations in COVID-19 death rates that may be partly explained by diet. Many countries with low COVID-19 death rates have a common feature of eating large quantities of fermented vege- tables such as cabbage and, in some continents, various spices. Fermented vegetables and spices are agonists of the antioxidant transcription factor nuclear factor (erythroid-derived 2)-like 2 (Nrf2), and spices are transient re- ceptor potential ankyrin 1 and vanillin 1 (TRPA1/V1) agonists. These mech- anisms may explain many COVID-19 symptoms and severity. It appears that there is a synergy between Nrf2 and TRPA1/V1 foods that may explain the role of diet in COVID-19. One of the mechanisms of COVID-19 appears to be an oxygen species (ROS)-mediated process in synergy with TRP chan- nels, modulated by Nrf2 pathways. Spicy foods are likely to desensitize TRP channels and act in synergy with exogenous antioxidants that activate the Nrf2 pathway. CITA: Int Arch Allergy Immunol. 2021;182(6):489-495 DOI: 10.1159/000513538 TÍTULO: Cross-Sectional International Survey to Determine the Educational Interests of Spanish-Speaking Latin American Radiation Oncologists AUTORES: Mailhot Vega RB, De La Mata D, Amendola B, Li B, Poitevin A, Sarria G, Sole S, Sher DJ, Hardenbergh P. PURPOSE: With the existing oncology disparities in Latin America, physi- cian expertise has been cited as a possible contributor to inferior oncologic outcomes in some cancers. As two-dimensional radiotherapy rapidly evolved 417

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR to intensity-modulated radiation therapy in Latin America, adequate contour- ing education is an actionable target to improving physician knowledge and clinical outcomes. Yet, topics of interest to Latin American radiation oncol- ogists are underreported. We assessed Latin American interest in a virtual platform for case discussion and identified the educational topics of most interest to them. MATERIALS AND METHODS: A Spanish-language online survey was de- signed by a team of Latin American educators. The questions assessed professional nationality, desire for an online educational platform for case presentation, career length, and topics of interest. Educational topics in- cluded head and neck (H&N), CNS, GI, lung, gynecologic, breast, and pe- diatric cancers, lymphoma, sarcoma, stereotactic body radiotherapy (SBRT), brachytherapy, and medical physics. RESULTS: One hundred thirty-three surveys were included for analysis. Overall, 127 respondents (98%) affirmed interest in participating in a virtual platform for case discussion and treatment advances. The most popular ed- ucational themes were H&N cancers (24%), SBRT (14%), and CNS cancers (13%). Of countries with > 10 respondents, the most popular educational topic remained H&N cancers for Argentina, Chile, and Mexico, but the most popular topic among Peruvian respondents was CNS cancer (27%). CONCLUSION: With international collaboration and a large sample size, we present the first survey results describing Latin American radiation oncology educational interests. Participants were overwhelmingly interested in a virtu- al platform, and most were specifically interested in H&N cancer education. These results can be used for focused didactic preparation in Latin Ameri- ca. Future efforts should expand on improving representation and outreach among Central American radiation oncologists. CITA: JCO Glob Oncol. 2021 Jan;7:29-34 DOI: 10.1200/GO.20.00330 PMID: 33472577 TÍTULO: Hiccups and psychosis: two atypical presentations of COVID-19 AUTORES: Alvarez-Cisneros T, Lara-Reyes A, Sansón-Tinoco S. SUMMARY: The WHO defines a possible case of COVID-19 as a person ex- periencing fever, cough, shortness of breath, and neurological signs includ- ing anosmia, ageusia, or dysgeusia. However, experiences from hospitals all over the world have shown that presentations vary widely. Some atypical presentations include cardiac, gastrointestinal, neurological, and cutaneous and while some are driven by the inflammatory response, others are a con- sequence of the hypercoagulable state. In our emergency department in a private hospital in Mexico City, we received two patients with very different symptoms on the same shift. Two previously healthy men in their 40s pre- sented to the ER with very atypical manifestations of COVID-19. Neither of them complained of fever, cough, or shortness of breath. The first referred a 3-day history of hiccups that had not resolved with metoclopramide. The sec- ond presented with an acute episode of altered mental status. While the first case revealed lung involvement of the disease, the second case had a clean chest CT scan. These cases are relevant as manifestations of COVID-19 vary widely, especially in previously healthy young adults. CITA: Int J Emerg Med. 2021 Jan 20;14(1):8 DOI: 10.1186/s12245-021-00333-0 418

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33485464 TÍTULO: First-line nivolumab plus ipilimumab in unresectable malignant pleural mesothelioma (CheckMate 743): a multicentre, randomised, open-la- bel, phase 3 trial AUTORES: Baas P, Scherpereel A, Nowak AK, Fujimoto N, Peters S, Tsao AS, Mansfield AS, Popat S, Jahan T, Antonia S, Oulkhouir Y, Bautista Y, Cornelissen R, Greillier L, Grossi F, Kowalski D, Rodríguez-Cid J, Aanur P, Oukessou A, Baudelet C, Zalcman G. BACKGROUND: Approved systemic treatments for malignant pleural me- sothelioma (MPM) have been limited to chemotherapy regimens that have moderate survival benefit with poor outcomes. Nivolumab plus ipilimumab has shown clinical benefit in other tumour types, including first-line non- small-cell lung cancer. We hypothesised that this regimen would improve overall survival in MPM. METHODS: This open-label, randomised, phase 3 study (CheckMate 743) was run at 103 hospitals across 21 countries. Eligible individuals were aged 18 years and older, with previously untreated, histologically confirmed unresectable MPM, and an Eastern Cooperative Oncology Group perfor- mance status of 0 or 1. Eligible participants were randomly assigned (1:1) to nivolumab (3 mg/kg intravenously once every 2 weeks) plus ipilimumab (1 mg/kg intravenously once every 6 weeks) for up to 2 years, or platinum plus pemetrexed chemotherapy (pemetrexed [500 mg/m2 intravenously] plus cisplatin [75 mg/m2 intravenously] or carboplatin [area under the con- centration-time curve 5 mg/mL per min intravenously]) once every 3 weeks for up to six cycles. The primary endpoint was overall survival among all participants randomly assigned to treatment, and safety was assessed in all participants who received at least one dose of study treatment. This study is registered with ClinicalTrials.gov, NCT02899299, and is closed to accrual. FINDINGS: Between Nov 29, 2016, and April 28, 2018, 713 patients were enrolled, of whom 605 were randomly assigned to either nivolumab plus ip- ilimumab (n=303) or chemotherapy (n=302). 467 (77%) of 605 participants were male and median age was 69 years (IQR 64-75). At the prespecified interim analysis (database lock April 3, 2020; median follow-up of 29·7 months [IQR 26·7-32·9]), nivolumab plus ipilimumab significantly extended overall survival versus chemotherapy (median overall survival 18·1 months [95% CI 16·8-21·4] vs 14·1 months [12·4-16·2]; hazard ratio 0·74 [96·6% CI 0·60-0·91]; p=0·0020). 2-year overall survival rates were 41% (95% CI 35·1-46·5) in the nivolumab plus ipilimumab group and 27% (21·9-32·4) in the chemotherapy group. Grade 3-4 treatment-related adverse events were reported in 91 (30%) of 300 patients treated with nivolumab plus ipilimumab and 91 (32%) of 284 treated with chemotherapy. Three (1%) treatment-re- lated deaths occurred in the nivolumab plus ipilimumab group (pneumonitis, encephalitis, and heart failure) and one (<1%) in the chemotherapy group (myelosuppression). INTERPRETATION: Nivolumab plus ipilimumab provided significant and clinically meaningful improvements in overall survival versus standard-of- care chemotherapy, supporting the use of this first-in-class regimen that has been approved in the USA as of October, 2020, for previously untreated un- resectable MPM. CITA: Lancet. 2021 Jan 30;397(10272):375 DOI: 10.1016/S0140-6736(20)32714-8 419

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33490350 TÍTULO: An unusual pattern in serum protein electrophoresis to take in PMID: 33515138 mind: A case report AUTORES: Gastélum-Cano JM, Fragoso-Flores J, Noffal-Nuño VM, Def- fis-Court M. SUMMARY: Here we described a case of an asymptomatic 73 years-old female patient in geriatric routine consultation, whose laboratory testing showed hyperproteinemia with accompanying hyperglobulinemia. A diagno- sis of BGUS was made only after a correlation among SPEP, densitometry tracing and IFE results was established, evidencing a second peak, that was less evident and not reported at first. These biclonal conditions are of very low incidence in the clinical laboratory, requiring the laboratory professional to have particular skills for their identification. As far as is known, clinical findings in BGUS are similar to those found in MGUS. However, they remain not well understood. Therefore, for an accurate diagnosis of BGUS, the clin- ical laboratory technician must be trained and sensitized to detect a second M - protein as a band or peak; taking in mind the possible different scenarios in heavy and light chain typing. CITA: Pract Lab Med. 2021 Jan 1;24:e00200 DOI: 10.1016/j.plabm.2020.e00200 TÍTULO: Performance of Indocyanine-Green Imaging for Sentinel Lymph Node Mapping and Lymph Node Metastasis in Esophageal Cancer: System- atic Review and Meta-Analysis AUTORES: Jimenez-Lillo J, Villegas-Tovar E, Momblan-Garcia D, Turra- do-Rodriguez V, Ibarzabal-Olano A, De Lacy B, Diaz-Giron-Gidi A, Faes-Pe- tersen R, Martinez-Portilla RJ, Lacy A. BACKGROUND AND OBJECTIVES: Lymphatic mapping with indocy- anine-green (ICG) and near-infrared light fluorescent imaging is widely used for sentinel lymph node staging in different types of cancer but is not fully accepted for all procedures because studies have reported heterogeneous results. This study aimed to assess the detection rate (DR) of ICG imag- ing for sentinel lymph node mapping (SLNM) and lymph node metastases (LNMs) in esophageal cancer. METHODS: A systematic search was performed to identify relevant studies examining the use of ICG imaging for SLNM in patients with esophageal cancer. Extracted results were pooled in a single-proportion meta-analysis, with a random-effects model, presented as forest plots. RESULTS: Six studies were included in the analysis. The ICG DR for SLNM was 89% [95% confidence interval (CI) 71%-96%]. The pooled sensitivity and specificity values for the detection of LNMs were 84% (95% CI 64%- 94%) and 15% (95% CI 3%-45%), respectively. A trend towards a lower DR was found with increasing mean latency time between ICG injection and SLNM. CONCLUSIONS: ICG imaging is a technique that potentially could improve lymph node yield excision and, as a consequence, improve the detection of lymph node metastases. CITA: Ann Surg Oncol. 2021 Sep;28(9):4869-4877 DOI: 10.1245/s10434-021-09617-4 420

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33528934 TÍTULO: CME suggestions for pediatricians, allergists, and dermatologists, directed by an online survey on urticaria knowledge PMID: 33531166 AUTORES: Pozo-Beltrán CF, Larenas-Linnemann D, Arteche JDC. PMID: 33549735 BACKGROUND: The Mexican Guidelines for the diagnosis and treatment of urticaria have been published. Just before their launch, physicians' knowl- edge was explored relating to key issues of the guidelines. OBJECTIVE: The aim of this study was to investigate the opinion of medical specialists concerning urticaria management. METHODS: A SurveyMonkey® survey was sent out to board-certified phy- sicians of three medical specialties treating urticaria. Replies were analyzed per specialty against the evidence-based recommendations. RESULTS: Sixty-five allergists (ALLERG), 24 dermatologists (DERM), and 120 pediatricians (PED) sent their replies. As for diagnosis: ALERG 42% and PED 76% believe cutaneous mastocytosis, urticarial vasculitis, and hereditary angioedema are forms of urticaria, versus DERM 29% (P < 0.005). Most of the specialties find that the clinical history and physical examination are enough to diagnose acute urticaria, except DERM 45% (P < 0.01). DERM 45% believe laboratory-tests are necessary, as opposed to <15% ALLERG-PED (P < 0.005). However, PED 69% did not know that the most frequent cause of acute urticaria in children is infections, versus AL- LERG-DERM 30% (P < 0.005). Many erroneously do laboratory testing in physical urticaria and ALLERG 51%, DERM 59%, and PED 37% do exten- sive laboratory testing in chronic spontaneous urticaria (CSU); many more PED 59% take Immunoglobulin G (IgG) against foods (P < 0.005). More than half of non-allergists do not know about autologous serum testing nor auto- immunity (P < 0.05). As for treatment, there were a few major gaps: when CSU was controlled, >75% prescribed antihistamines pro re nata, and >85% gave first-generation antiH1 for insomnia. Finally, >40% of DERM did not know that cyclosporine A, omalizumab, or other immunosuppressants could be used in recalcitrant cases. CONCLUSION: Specialty-specific continuous medical education might en- hance urticaria management. CITA: Allergol Immunopathol (Madr). 2021 Jan 2;49(1):87-94 DOI: 10.15586/aei.v49i1.26 TÍTULO: Acute heart failure following transjugular intrahepatic portal-sys- temic shunting corrected through transient balloon occlusion AUTORES: Valdivia-Correa B, Reynier-Garza V, Chávez-Tapia N, Alanis- -Estrada G, Araiza-Garaygordobil D. SUMMARY: Case report CITA: Rev Gastroenterol Mex (Engl Ed). Apr-Jun 2021;86(2):195-197 DOI: 10.1016/j.rgmx.2020.04.009 TÍTULO: Hepatic steatosis and respiratory diseases: a new panorama AUTORES: Botello-Manilla AE, López-Sánchez GN, Chávez-Tapia NC, Uribe M, Nuño-Lámbarri N. 421

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33558263 SUMMARY: Non-alcoholic fatty liver disease is defined as hepatic fat ac- cumulation in more than 5% of hepatocytes, without other liver steatosis causes. It comprises a broad spectrum that can range from benign steatosis and progress to non-alcoholic steatohepatitis, fibrosis, and ultimately hepa- tocellular carcinoma. Non-alcoholic fatty liver is considered a multisystemic disease since it is related to multiple disorders, such as type 2 diabetes mel- litus, polycystic ovary syndrome, chronic kidney disease, psoriasis, osteopo- rosis, hypothyroidism, cardiovascular diseases, and obstructive sleep apnea syndrome; it is becoming increasingly clear that it is also a risk factor for developing certain respiratory diseases. This article aims to understand the liver and chronic obstructive pulmonary disease mechanisms, obstructive sleep apnea syndrome, asthma, and lung cancer. Given that non-alcoholic fatty liver disease has a considerable impact on the patient's well-being and life quality, as well as on the costs they generate for the country's health services, it is essential to continue research, especially in areas such as the respiratory tract, as there is much misinformation about it. CITA: Ann Hepatol. Sep-Oct 2021;24:100320 DOI: 10.1016/j.aohep.2021.100320 TÍTULO: Can topical epinephrine application to the papilla prevent pancre- atitis after endoscopic retrograde cholangiopancreatography? Results from a double blind, multicentre, placebo controlled, randomised clinical trial AUTORES: Romano-Munive AF, García-Correa JJ, García-Contreras LF, Ramírez-García J, Uscanga L, Barbero-Becerra VJ, Moctezuma-Velázquez C, Ochoa-Rubí JA, Toledo-Cuque J, Vázquez-Anaya G, Keil-Ríos D, Graja- les-Figueroa G, Ramírez-Luna MÁ, Valdovinos-Andraca F, Zamora-Nava LE, Tellez-Avila F. BACKGROUND AND STUDY AIMS: Post-endoscopic retrograde cholan- giopancreatography (ERCP) pancreatitis (PEP) is a complication associat- ed with important morbidity, occasional mortality and high costs. Preventive strategies are suboptimal as PEP continues to affect 4% to 9% of patients. Spraying epinephrine on the papilla may decrease oedema and prevent PEP. This study aimed to compare rectal indomethacin plus epinephrine (EI) ver- sus rectal indomethacin plus sterile water (WI) for the prevention of PEP. PATIENTS AND METHODS: This multicentre randomised controlled trial included patients aged >18 years with an indication for ERCP and naive major papilla. All patients received 100 mg of rectal indomethacin and 10 mL of sterile water or a 1:10 000 epinephrine dilution. Patients were asked about PEP symptoms via telephone 24 hours and 7 days after the procedure. The trial was stopped half way through after a new publication reported an increased incidence of PEP among patients receiving epinephrine. RESULTS: Of the 3602 patients deemed eligible, 3054 were excluded after screening. The remaining 548 patients were randomised to EI group (n=275) or WI group (n=273). The EI and WI groups had similar baseline character- istics. Patients in the EI group had a similar incidence of PEP to those in the WI group (3.6% (10/275) vs 5.12% (14/273), p=0.41). Pancreatic duct guidewire insertion was identified as a risk factor for PEP (OR 4.38, 95% CI (1.44 to 13.29), p=0.009). CONCLUSION: Spraying epinephrine on the papilla was no more effective than rectal indomethacin alone for the prevention of PEP. CITA: BMJ Open Gastroenterol. 2021 Feb;8(1):e000562 DOI: 10.1136/bmjgast-2020-000562 422

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33567446 TÍTULO: Potential Interplay between Nrf2, TRPA1, and TRPV1 in Nutrients for the Control of COVID-19 PMID: 33582320 AUTORES: Bousquet J, (…) Larenas-Linnemann DE, et al. PMID: 33588427 SUMMARY: In this article, we propose that differences in COVID-19 mor- PMID: 33593404 bidity may be associated with transient receptor potential ankyrin 1 (TRPA1) and/or transient receptor potential vanilloid 1 (TRPV1) activation as well as desensitization. TRPA1 and TRPV1 induce inflammation and play a key role in the physiology of almost all organs. They may augment sensory or vagal nerve discharges to evoke pain and several symptoms of COVID-19, including cough, nasal obstruction, vomiting, diarrhea, and, at least partly, sudden and severe loss of smell and taste. TRPA1 can be activated by reactive oxygen species and may therefore be up-regulated in COVID-19. TRPA1 and TRPV1 channels can be activated by pungent compounds including many nuclear factor (erythroid-derived 2) (Nrf2)-interacting foods leading to channel desen- sitization. Interactions between Nrf2-associated nutrients and TRPA1/TRPV1 may be partly responsible for the severity of some of the COVID-19 symptoms. The regulation by Nrf2 of TRPA1/TRPV1 is still unclear, but suggested from very limited clinical evidence. In COVID-19, it is proposed that rapid desensiti- zation of TRAP1/TRPV1 by some ingredients in foods could reduce symptom severity and provide new therapeutic strategies. CITA: Int Arch Allergy Immunol. 2021;182(4):324-338 DOI: 10.1159/000514204 TÍTULO: Reply to: Association of liver steatosis and fibrosis with clinical out- comes in patients with SARS-CoV-2 infection (COVID-19) AUTORES: López-Mendez I, Castro-Narro G. SUMMARY: Letter to the editor CITA: Ann Hepatol. May-Jun 2021;22:100326 DOI: 10.1016/j.aohep.2021.100326 TÍTULO: Consensus on hemophilia in Mexico AUTORES: López-Arroyo JL, (…) Varela-Constantino A, et al. SUMMARY: Review article CITA: Gac Med Mex. 2021;157(Supl 1):S1-S37 DOI: 10.24875/GMM.M20000451 TÍTULO: Case fatality ratio of COVID-19 patients requiring invasive mechan- ical ventilation in Mexico: an analysis of nationwide data AUTORES: Ñamendys-Silva SA. SUMMARY: Research letter CITA: Crit Care. 2021 Feb 16;25(1):68 DOI: 10.1186/s13054-021-03485-w 423

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33601216 TÍTULO: G protein-coupled receptors: Key molecules in metabolic associat- ed fatty liver disease development AUTORES: López-Méndez I, Méndez-Maldonado K, Manzo-Francisco LA, Juárez-Hernández E, Uribe M, Barbero-Becerra VJ. SUMMARY: Metabolic associated fatty liver disease (MAFLD) is a range of hepatic disorders with progression to steatohepatitis with risk of develop- ment of fibrosis, cirrhosis, and hepatocellular carcinoma. MAFLD is strongly related to metabolic disorders of active fatty acids, which seem to be selec- tive according to their specific ligand of G protein-coupled receptors (GPRs) located in immune response cells. An approach to study the pathophysiolog- ical mechanisms of MAFLD could be through the expression of active fatty acids ligands. The expression of GPRs is associated with obesity, microbiota environment, and dietary characteristics in patients with MAFLD. More spe- cifically, GPR41, GPR43, GPR20, and GPR120 have been associated with alteration of lipid metabolism in hepatic and intestinal cells, and consequent- ly they have a key role in metabolic diseases. We observed that GPR120 is not expressed in nonoverweight/obese patients, regardless of the presence of MAFLD; meanwhile the expression of GPR41 is increased in patients with lean MAFLD. GPRs role in liver disease is intriguing and a field of research opportunity. More studies are necessary to define the role of active fatty ac- ids in the development of metabolic diseases. CITA: Nutr Res. 2021 Mar;87:70-79 DOI: 10.1016/j.nutres.2020.12.019 PMID: 33609753 TÍTULO: Drug-induced liver injury: A management position paper from the Latin American Association for Study of the liver AUTORES: Bessone F, Hernandez N, Tagle M, Arrese M, Parana R, Mén- dez-Sánchez N, Ridruejo E, Mendizabal M, Dagher L, Contreras F, Fassio E, Pessoa M, Brahm J, Silva M. SUMMARY: Idiosyncratic drug-induced liver injury (DILI) caused by xenobi- otics (drugs, herbals and dietary supplements) is an uncommon cause of liv- er disease presenting with a wide range of phenotypes and disease severity, acute hepatitis mimicking viral hepatitis to autoimmune hepatitis, steatosis, fibrosis or rare chronic vascular syndromes. Disease severity ranges from asymptomatic liver test abnormalities to acute liver failure. DILI has been traditionally classified in predictable or intrinsic (dose-related) or unpredict- able (not dose-related) mechanisms. Few prospective studies are assessing the real prevalence and incidence of hepatotoxicity in the general population. DILI registries represent useful networks used for the study of liver toxicity, aimed at improving the understanding of causes, phenotypes, natural history, and standardized definitions of hepatotoxicity. Although most of the regis- tries do not carry out population-based studies, they may provide important data related to the prevalence of DILI, and also may be useful to compare features from different countries. With the support of the Spanish Registry of Hepatotoxicity, our Latin American Registry (LATINDILI) was created in 2011, and more than 350 DILI patients have been recruited to date. This position paper describes the more frequent drugs and herbs-induced DILI in Latin America, mainly focusing on several features of responsible medicaments. Also, we highlighted the most critical points on the management of hepa- totoxicity in general and those based on findings from our Latin American experience in particular. 424

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR CITA: Ann Hepatol. Sep-Oct 2021;24:100321 DOI: 10.1016/j.aohep.2021.100321 PMID: 33611315 TÍTULO: Subcutaneous Allergen-Specific Immunotherapy Is Safe in Pediat- PMID: 33623424 ric Patients with Allergic Rhinitis AUTORES: Pavon-Romero GF, Larenas-Linnemann DE, Xochipa Ruiz KE, Ramirez-Jimenez F, Teran LM. INTRODUCTION: Subcutaneous allergen-specific immunotherapy (SCIT) is one of the main cornerstones in the treatment of allergic rhinitis in pediatric patients. It has demonstrated symptoms and quality of life improvement, but it is not exempt from adverse reactions (ADVrs). Nevertheless, there are a few reports that have evaluated their safety. Our objective was to evaluate the ADVr to SCIT in pediatric patients. METHODS: We reviewed 786 clinical records with SCIT from 2005 to 2018, comparing the clinical characteristics of patients with ADVrs with SCIT ver- sus a group of a similar number of patients who completed SCIT (control group, CG). The analysis of ADVrs was according to the World Allergy Orga- nization (WAO) 2010 grading system by frequency analysis, survival curve, and log rank. RESULTS: Of 786 patients, 106 (13.4%) presented ADVrs, and the patients with ADVr had sensitivity and immunotherapy with at least 2 allergens versus CG p < 0.001, containing a combination of standardized and nonstandard- ized allergens (p = 0.003). The ADVrs were in the buildup phase (p < 0.001). The survival curve showed that 50% had some reaction at 12 weeks of SCIT. The most frequent ADVr was grade 1 in 73/106 patients (68.8%) and grade 2 in 33/106 (31.1%). The log-rank analysis between the grades of the WAO grading system showed a statistically significant difference (p = 0.02). CONCLUSIONS: The SCIT is safe in pediatric patients. The ADVrs are infre- quent, grade 1 being the most reported; however, at >12 weeks, the risk of ADVrs that involve 2 organs systems increases. CITA: Int Arch Allergy Immunol. 2021;182(6):553-561 DOI: 10.1159/000513158 TÍTULO: Towards Better Perioperative Pain Management in Mexico: A Study in a Network of Hospitals Using Quality Improvement Methods from PAIN OUT AUTORES: Garduño-López AL, Acosta Nava VM, Castro Garcés L, Ras- cón-Martínez DM, Cuellar-Guzmán LF, Flores-Villanueva ME, Villegas-Sotelo E, Carrillo-Torres O, Vilchis-Sámano H, Calderón-Vidal M, Islas-Lagunas G, Richard Chapman C, Komann M, Meissner W, Baumbach P, Zaslansky R. OBJECTIVE: This was a pre-post study in a network of hospitals in Mexi- co-City, Mexico. Participants developed and implemented Quality Improve- ment (QI) interventions addressing perioperative pain management. METHODS: PAIN OUT, an international QI and research network, provid- ed tools for web-based auditing and feedback of pain management and patient-reported outcomes (PROs) in the clinical routine. Ward- and pa- tient-level factors were evaluated with multi-level models. Change in pro- 425

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR portion of patients reporting worst pain ≥6/10 between project phases was the primary outcome. RESULTS: Participants created locally adapted resources for teaching and pain management, available to providers in the form of a website and a special issue of a national anesthesia journal. They offered teaching to anesthesiologists, surgeons, including residents, and nurses. Information was offered to patients and families. A total of 2658 patients were audited in 9 hospitals, between July 2016 and December 2018. Participants report- ed that the project made them aware of the importance of: training in pain management; auditing one's own patients to learn about PROs and that QI requires collaboration between multi-disciplinary teams. Participants report- ed being unaware that their patients experienced severe pain and lacked information about pain treatment options. Worst pain decreased significant- ly between the two project phases, as did PROs related to pain interfering with movement, taking a deep breath/coughing or sleep. The opportunity of patients receiving information about their pain treatment options increased from 44% to 77%. CONCLUSIONS: Patients benefited from improved care and pain-related PROs. Clinicians appreciated gaining increased expertise in perioperative pain management and methods of QI. CITA: J Pain Res. 2021 Feb 15;14:415-430 DOI: 10.2147/JPR.S282850 PMID: 33627784 TÍTULO: H2A.Z over- expression suppresses senescence and chemosensitivity in pancreatic duc- tal adenocarcinoma AUTORES: Ávila-López PA, Guerrero G, Nuñez-Martínez HN, Peralta-Alva- rez CA, Hernández-Montes G, Álvarez-Hilario LG, Herrera-Goepfert R, Al- bores-Saavedra J, Villegas-Sepúlveda N, Cedillo-Barrón L, Montes-Gómez AE, Vargas M, Schnoor M, Recillas-Targa F, Hernández-Rivas R. SUMMARY: Pancreatic ductal adenocarcinoma (PDAC) is one of the most intractable and devastating malignant tumors. Epigenetic modifications such as DNA methylation and histone modification regulate tumor initiation and progression. However, the contribution of histone variants in PDAC is un- known. Here, we demonstrated that the histone variant H2A.Z is highly ex- pressed in PDAC cell lines and PDAC patients and that its overexpression correlates with poor prognosis. Moreover, all three H2A.Z isoforms (H2A.Z.1, H2A.Z.2.1, and H2A.Z.2.2) are highly expressed in PDAC cell lines and PDAC patients. Knockdown of these H2A.Z isoforms in PDAC cell lines in- duces a senescent phenotype, cell cycle arrest in phase G2/M, increased expression of cyclin-dependent kinase inhibitor CDKN2A/p16, SA-β-galac- tosidase activity and interleukin 8 production. Transcriptome analysis of H2A.Z-depleted PDAC cells showed altered gene expression in fatty acid biosynthesis pathways and those that regulate cell cycle and DNA damage repair. Importantly, depletion of H2A.Z isoforms reduces the tumor size in a mouse xenograft model in vivo and sensitizes PDAC cells to gemcitabine. Overexpression of H2A.Z.1 and H2A.Z.2.1 more than H2A.Z.2.2 partially restores the oncogenic phenotype. Therefore, our data suggest that over- expression of H2A.Z isoforms enables cells to overcome the oncoprotective barrier associated with senescence, favoring PDAC tumor grow and chemo- resistance. These results make H2A.Z a potential candidate as a diagnostic biomarker and therapeutic target for PDAC. 426

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR CITA: Oncogene. 2021 Mar;40(11):2065-2080 DOI: 10.1038/s41388-021-01664-1 PMID: 33628159 TÍTULO: All-cause mortality among patients treated with repurposed antivi- rals and antibiotics for COVID-19 in Mexico City: A real-world observational study AUTORES: Mancilla-Galindo J, García-Méndez JÓ, Márquez-Sánchez J, Reyes-Casarrubias RE, Aguirre-Aguilar E, Rocha-González HI, Kam- mar-García A. SUMMARY: The aim of our study was to evaluate all-cause mortality risk in patients with laboratory-confirmed COVID-19 in Mexico City treated with repurposed antivirals and antibiotics. This real-world retrospective cohort study contemplated 395,343 patients evaluated for suspected COVID-19 be- tween February 24 and September 14, 2020 in 688 primary-to-tertiary med- ical units in Mexico City. Patients were included with a positive RT-PCR for SARS-CoV-2; those receiving unspecified antivirals, excluded; and groups of antivirals prescribed in < 30 patients, eliminated. Survival and mortality risks were determined for patients receiving antivirals, antibiotics, both, or none. We assessed the effect of early (<2 days) versus late (>2 days) use of antivirals on mortality in a sub-cohort of patients. Multivariable adjustment, propensity score matching, generalized estimating equations, and calcu- lation of E-values were performed to limit confounding. 136,855 patients were analyzed; mean age 44.2 (SD:16.8) years; 51.3 % were men. 16.6 % received antivirals (3 %), antibiotics (10 %), or both (3.6 %). Antivirals studied were Oseltamivir (n=8414), Amantadine (n=319), Lopinavir-Ritonavir (n=100), Rimantadine (n=61), Zanamivir (n=39), and Acyclovir (n=36). Sur- vival with antivirals (73.7 %, p<0.0001) and antibiotics (85.8 %, p<0.0001) was lower than no antiviral/antibiotic (93.6 %). After multivariable adjustment, increased risk of death occurred with antivirals (HR=1.72, 95 % CI: 1.61- 1.84) in ambulatory (HR=4.7, 95 % CI: 3.94-5.62) and non-critical (HR=2.03, 95 % CI: 1.86-2.21) patients. Oseltamivir increased mortality risk in the gen- eral population (HR=1.72, 95 % CI: 1.61-1.84), ambulatory (HR=4.79, 95 % CI: 4.01-5.75), non-critical (HR=2.05, 95 % CI: 1.88-2.23), and pregnancy (HR=8.35, 95 % CI: 1.77-39.30); as well as hospitalized (HR=1.13, 95 % CI: 1.01-1.26) and critical patients (HR=1.22, 95 % CI: 1.05-1.43) after pro- pensity score-matching. Early versus late oseltamivir did not modify the risk. Antibiotics were a risk factor in general population (HR=1.13, 95 % CI: 1.08- 1.19) and pediatrics (HR=4.22, 95 % CI: 2.01-8.86), but a protective factor in hospitalized (HR=0.81, 95 % CI: 0.77-0.86) and critical patients (HR=0.67, 95 % CI: 0.63-0.72). No significant benefit for repurposed antivirals was ob- served; oseltamivir was associated with increased mortality. Antibiotics in- creased mortality risk in the general population but may increase survival in hospitalized and critical patients. CITA: EXCLI J. 2021 Feb 4;20:199-222 DOI: 10.17179/excli2021 PMID: 33630167 TÍTULO: Cutaneous Manifestations Related to COVID-19 Immune Dysregu- lation in the Pediatric Age Group AUTORES: Larenas-Linnemann D, Luna-Pech J, Navarrete-Rodríguez EM, Rodríguez-Pérez N, Arias-Cruz A, Blandón-Vijil MV, Del Rio-Navarro BE, Estrada-Cardona A, Onuma-Takane E, Pozo-Beltrán CF, Valencia-Her- rera AM, Ortiz-Aldana FI, Toledo-Bahena ME. 427

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PURPOSE OF REVIEW: At the juncture of the COVID-19 pandemic, the world is currently in an early phase of collecting clinical data and reports of its skin manifestations, and its pathophysiology is still highly conjectural. We reviewed cutaneous manifestations associated with COVID-19 in the pediat- ric age group. RECENT FINDINGS: Children infected by SARS-CoV-2 usually develop milder respiratory symptoms, but cutaneous manifestations seem a little more prevalent than in adults. These skin features of infection by the coro- navirus can be similar to those produced by other common viruses, but there are also reports of cases with more heterogeneous clinical pictures, which have made their classification difficult. To date, the more frequently report- ed skin variants featured in pediatric cases are purpuric (pseudo-chilblain, necrotic-acral ischemia, hemorrhagic macules, and/or cutaneous necrosis), morbilliform/maculopapular, erythema multiforme, urticarial, vesicular, Kawa- saki-like, and miscellaneous (highly variable in both frequency and severity). Their pathophysiological mechanism is still elusive and is likely to be the result of the complex involvement of one or more mechanisms, like direct virus-induced skin damage, vasculitis-like reactions, and/or indirect injury as a consequence of a systemic inflammatory reaction. In this review, we presented and discussed clinical cases as examples of different cutaneous responses reported in some children with SARS-CoV-2 infection, differential diagnosis considerations, and a preliminary conceptual approach to some of their probable associated pathologic mechanisms. CITA: Curr Allergy Asthma Rep. 2021 Feb 25;21(2):13 DOI: 10.1007/s11882-020-00986-6 PMID: 33647501 TÍTULO: Lactate-dehydrogenase associated with mortality in hospitalized patients with COVID-19 in Mexico: a multi-centre retrospective cohort study AUTORES: Vidal-Cevallos P, Higuera-De-La-Tijera F, Chávez-Tapia NC, Sanchez-Giron F, Cerda-Reyes E, Rosales-Salyano VH, Servin-Caamaño A, Vázquez-Medina MU, Méndez-Sánchez N. INTRODUCTION AND OBJECTIVES: As of January 2021, over 88 million people have been infected with COVID-19. Almost two million people have died of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A high SOFA score and a D-Dimer >1 µg/mL identifies patients with high risk of mortality. High lactate dehydrogenase (LDH) levels on admission are as- sociated with severity and mortality. Different degrees of alanine aminotrans- ferase (ALT) and/or aspartate aminotransferase (AST) abnormalities have been reported in these patients, its association with a mortality risk remains controversial. The aim of this study was to explore the correlation between LDH and in-hospital mortality in Mexican patients admitted with COVID-19. MATERIALS & METHODS: We performed a retrospective multi-centre cohort study with 377 hospitalized patients with confirmed SARS-CoV-2 in three centres in Mexico City, Mexico, who were ≥18 years old and died or were discharged between April 1 and May 31, 2020. RESULTS: A total of 377 patients were evaluated, 298 (79.1%) patients were discharged, and 79 (20.9%) patients died during hospitalization. Non-survivors were older, with a median age of 46.7 ± 25.7 years old, most patients were male. An ALT > 61 U/l (OR 3.45, 95% CI 1.27-9.37; p = 0.015), C-reactive protein (CRP) > 231 mg/l (OR 4.71, 95% CI 2.35-9.46; p = 0.000), LDH > 561 U/l (OR 3.03, 95% CI 1.40-6.55; p = 0.005) were associated with higher odds for in-hospital death. 428

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33662672 CONCLUSIONS: Our results indicate that higher levels of LDH, CRP, and ALT are associated with higher in-hospital mortality risk in Mexican patients admitted with COVID-19. CITA: Ann Hepatol. Sep-Oct 2021;24:100338 DOI: 10.1016/j.aohep.2021.100338 TÍTULO: The Role of Mobile Health Technologies in Stratifying Patients for AIT and Its Cessation: The ARIA-EAACI Perspective AUTORES: Bousquet J, Jutel M, Pfaar O, Fonseca JA, Agache I, Czarlews- ki W, Bachert C, Bergmann KC, Cruz AA, Klimek L, Kvedariene V, Lare- nas-Linnemann DE, Papadopoulos NG, Patella V, Regateiro FS, Scichilone N, Shamji MH, Sheikh A, Valovirta E, Ventura MT, Zuberbier T. SUMMARY: Allergen immunotherapy (AIT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many international or nation- al practice guidelines have been produced, but the evidence-based method varies and they do not usually propose care pathways. The present article considers the possible role of mobile health in AIT for allergic rhinitis/asthma. There are no currently available validated biologic biomarkers that can pre- dict AIT success, and mobile health biomarkers have some relevance. In the current article, the following aspects will be discussed: patient stratification for AIT, symptom-medication scores for the follow-up of patients, clinical tri- als, as well as the approach of the European Academy of Allergy and Clinical Immunology. CITA: J Allergy Clin Immunol Pract. 2021 May;9(5):1805-1812 DOI: 10.1016/j.jaip.2021.02.035 PMID: 33683919 TÍTULO: Nivolumab and Ipilimumab as Maintenance Therapy in Exten- sive-Disease Small-Cell Lung Cancer: CheckMate 451 AUTORES: Owonikoko TK, Park K, Govindan R, Ready N, Reck M, Peters S, Dakhil SR, Navarro A, Rodríguez-Cid J, Schenker M, Lee JS, Gutierrez V, Percent I, Morgensztern D, Barrios CH, Greillier L, Baka S, Patel M, Lin WH, Selvaggi G, Baudelet C, Baden J, Pandya D, Doshi P, Kim HR. PURPOSE: In extensive-disease small-cell lung cancer (ED-SCLC), re- sponse rates to first-line platinum-based chemotherapy are robust, but responses lack durability. CheckMate 451, a double-blind phase III trial, evaluated nivolumab plus ipilimumab and nivolumab monotherapy as main- tenance therapy following first-line chemotherapy for ED-SCLC. METHODS: Patients with ED-SCLC, Eastern Cooperative Oncology Group performance status 0-1, and no progression after ≤ 4 cycles of first-line che- motherapy were randomly assigned (1:1:1) to nivolumab 1 mg/kg plus ipilim- umab 3 mg/kg once every 3 weeks for 12 weeks followed by nivolumab 240 mg once every 2 weeks, nivolumab 240 mg once every 2 weeks, or placebo for ≤ 2 years or until progression or unacceptable toxicity. Primary end point was overall survival (OS) with nivolumab plus ipilimumab versus placebo. Secondary end points were hierarchically tested. RESULTS: Overall, 834 patients were randomly assigned. The minimum fol- low-up was 8.9 months. OS was not significantly prolonged with nivolumab 429

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33730365 plus ipilimumab versus placebo (hazard ratio [HR], 0.92; 95% CI, 0.75 to PMID: 33776692 1.12; P = .37; median, 9.2 v 9.6 months). The HR for OS with nivolumab ver- sus placebo was 0.84 (95% CI, 0.69 to 1.02); the median OS for nivolumab was 10.4 months. Progression-free survival HRs versus placebo were 0.72 for nivolumab plus ipilimumab (95% CI, 0.60 to 0.87) and 0.67 for nivolumab (95% CI, 0.56 to 0.81). A trend toward OS benefit with nivolumab plus ipilim- umab was observed in patients with tumor mutational burden ≥ 13 mutations per megabase. Rates of grade 3-4 treatment-related adverse events were nivolumab plus ipilimumab (52.2%), nivolumab (11.5%), and placebo (8.4%). CONCLUSION: Maintenance therapy with nivolumab plus ipilimumab did not prolong OS for patients with ED-SCLC who did not progress on first-line chemotherapy. There were no new safety signals. CITA: J Clin Oncol. 2021 Apr 20;39(12):1349-1359 DOI: 10.1200/JCO.20.02212 TÍTULO: Differentiation of COVID-19 signs and symptoms from allergic rhini- tis and common cold: An ARIA-EAACI-GA(2) LEN consensus AUTORES: Hagemann J, (…) Larenas-Linnemann DE, et al. BACKGROUND: Although there are many asymptomatic patients, one of the problems of COVID-19 is early recognition of the disease. COVID-19 symptoms are polymorphic and may include upper respiratory symptoms. However, COVID-19 symptoms may be mistaken with the common cold or allergic rhinitis. An ARIA-EAACI study group attempted to differentiate upper respiratory symptoms between the three diseases. METHODS: A modified Delphi process was used. The ARIA members who were seeing COVID-19 patients were asked to fill in a questionnaire on the upper airway symptoms of COVID-19, common cold and allergic rhinitis. RESULTS: Among the 192 ARIA members who were invited to respond to the questionnaire, 89 responded and 87 questionnaires were analysed. The consensus was then reported. A two-way ANOVA revealed significant differ- ences in the symptom intensity between the three diseases (p < .001). CONCLUSIONS: This modified Delphi approach enabled the differentiation of upper respiratory symptoms between COVID-19, the common cold and aller- gic rhinitis. An electronic algorithm will be devised using the questionnaire. CITA: Allergy. 2021 Aug;76(8):2354-2366 DOI: 10.1111/all.14815 TÍTULO: Calcitonin-Negative Neuroendocrine Carcinoma of the Thyroid Gland: Case Report and Literature Review AUTORES: Fernández-Ferreira R, De la Peña-López IR, Zamudio-Coro- nado KW, Delgado-Soler LA, Torres-Pérez ME, Bourlón-de Los Ríos C, Cortés-González R. SUMMARY: Calcitonin-negative neuroendocrine tumor (CNNET) of the thy- roid is an extremely rare entity. In some of the previously reported cases within the literature, the terms \"atypical medullary thyroid carcinoma,\" \"calci- 430

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33776693 tonin-free oat cell carcinoma,\" and \"a distinct clinical entity\" were applied to PMID: 33776699 NETs without definitive evidence of calcitonin production. In the English-lan- guage literature, not only are there only few reported cases of CNNET, but the criteria for diagnosis in these cases are also controversial. Most of the current published cases were also treated surgically for local disease. We describe a case of NET of the thyroid with calcitonin, chromogranin A and thyroglobulin negativity, synaptophysin and TTF-1 positivity, and a high Ki-67 proliferation index with metastases in the cervical region as well as medias- tinal adenopathies. This case was considered an unresectable thyroid carci- noma, and chemotherapy including cisplatin and etoposide was started as neoadjuvant treatment at the department of medical oncology. Total thyroid- ectomy plus bilateral and central cervical dissection was performed, and the patient underwent 2 cycles of adjuvant radiotherapy. Currently, the patient's 18F-FDG-PET/CT findings show a complete response 17 months after diag- nosis. In conclusion, CNNET of the thyroid is very rare and there is limited evidence regarding treatment in patients with metastases. Chemotherapy in- cluding cisplatin and etoposide as well as early aggressive surgical resection appears to positively impact patients' survival. CITA: Case Rep Oncol. 2021 Mar 1;14(1):112-122 DOI: 10.1159/000510807 TÍTULO: Giant Benign Mammary Phyllodes Tumor: Report of a Case and Review of the Literature AUTORES: Fernández-Ferreira R, Arroyave-Ramírez A, Motola-Kuba D, Alvarado-Luna G, Mackinney-Novelo I, Segura-Rivera R. SUMMARY: Phyllodes tumor of the breast is an infrequently encountered fibroepithelial neoplasm, which accounts for 0.3-1% of all tumors. Few case reports have described the occurrence of giant phyllodes tumor. To our knowledge, about 20% of phyllodes tumors would be considered giant benign. Complete surgical excision is the standard of care for giant benign phyllodes tumors; axillary lymph node metastasis is rare, and dissection should be limited to patients with pathologic evidence of tumor in the lymph nodes. We report the case of a 40-year-old Mexican woman with giant mam- mary tumor who underwent a right total mastectomy. The pathology results showed a benign phyllodes tumor 4,857 g in weight and 40.2 × 36.3 × 15 cm in size. We do not suggest adjuvant radiation therapy for patients with benign phyllodes tumors that are widely excised. A review of the pertinent literature was performed. CITA: Case Rep Oncol. 2021 Mar 1;14(1):123-133 DOI: 10.1159/000510741 TÍTULO: Breast Metastasis of Gastric Signet Ring Cell Carcinoma: A Case Report and Literature Review AUTORES: Buerba-Vieregge HH, Fernández-Ferreira R, Soberanis-Piña PD, De la Peña-López IR, Navarro-García LM, Macari-Jorge A. SUMMARY: Breast metastasis from gastric signet ring cell carcinoma is ex- tremely rare in clinical practice. The estimated incidence is 0.5-1.3%. There are few cases reported in the literature (approx. less than 60) of breast me- tastasis from gastric signet ring cell carcinoma, and due to the rare asso- 431

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33776700 ciation between gastric cancer and its extension to the breast, it is difficult PMID: 33819260 to establish the diagnosis. Clinical history, histological findings, and immu- nohistochemical markers are helpful in distinguishing primary breast cancer from breast metastasis of gastric cancer. The treatment for breast metasta- sis from gastric carcinoma remains controversial. The prognosis of breast metastasis from gastric carcinoma is generally poor. We report a case of breast metastasis of gastric signet ring cell carcinoma in a 38-year-old wom- an. She started chemotherapy with ramucirumab, paclitaxel, and irinotecan. Three months later, a combined 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography showed a complete response. This is the first reported case of breast metastasis from gastric signet ring cell carcinoma with a complete response. CITA: Case Rep Oncol. 2021 Mar 1;14(1):165-172 DOI: 10.1159/000510938 TÍTULO: Myoepithelial Carcinoma Arising in a Plasmacytoid Myoepithelioma of the Parotid Gland Synchronized with Melanoma: A Case Report and Re- view of the Literature AUTORES: Soberanis-Piña PD, Fernández-Ferreira R, Buerba-Vieregge HH, Varela-Santoyo E, Rodriguez-Cid JR, Macari-Jorge A, Dorantes-He- redia R. SUMMARY: Myoepithelial carcinoma, also known as malignant myoepithelio- ma, is considered an extremely rare (0.45-1%) malignant salivary gland neo- plasm. Approximately 100 cases have been reported in the English-language literature on myoepithelial carcinoma. The majority of the myoepitheliomas described in the literature have been benign, and the malignant counterpart is considered rare (<1%). Such a tumor may appear de novo or rarely devel- op from a preexisting pleomorphic adenoma (<20%), and in exceedingly rare cases (<0.5%), it has arisen from a benign myoepithelioma (i.e., plasmacytoid myoepithelioma). To our knowledge, no case of myoepithelial carcinoma of the parotid gland arising in a plasmacytoid myoepithelioma synchronized with melanoma has been reported to date. The treatment of myoepithelial carci- noma has been mainly surgical, including wide excision with free margins, with or without nodal dissection. The roles of chemotherapy and radiotherapy have not yet been established. We report a case of myoepithelial carcinoma of the parotid gland arising in a plasmacytoid myoepithelioma synchronized with melanoma in a 40-year-old woman. In our case, a complete response was achieved with surgery followed by adjuvant chemotherapy based on car- boplatin and paclitaxel concurrent with radiotherapy. CITA: Case Rep Oncol. 2021 Mar 1;14(1):173-183 DOI: 10.1159/000510937 TÍTULO: Consensus on hemophilia in Mexico AUTORES: López-Arroyo JL, (…) Varela-Constantino A, et al. SUMMARY: Hemophilia is a hemorrhagic disorder with a sex-linked inher- ited pattern, characterized by an inability to amplify coagulation due to a deficiency in coagulation factor VIII (hemophilia A or classic) or factor IX (he- mophilia B). Sequencing of the genes involved in hemophilia has provided a description and record of the main mutations, as well as a correlation with the various degrees of severity. Hemorrhagic manifestations are related to 432

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33833761 levels of circulating factor, mainly affecting the musculoskeletal system and PMID: 33864948 specifically the large joints (knees, ankles, and elbows). This document is a review and consensus of the main genetic aspects of hemophilia, from the inheritance pattern to the concept of women carriers, physiopathology and classification of the disorder, the basic and confirmation studies when hemophilia is suspected, the various treatment regimens based on infusion of the deficient coagulation factor as well as innovative factor-free therapies and recommendations for the management of complications associated with treatment (development of inhibitors and/or transfusion-transmitted in- fections), or secondary to articular hemorrhagic events (hemophilic arthrop- athy). Finally, relevant reviews of clinical and treatment aspects of hemor- rhagic pathology characterized by acquired deficiency of FVIII secondary to neutralized antibodies named acquired hemophilia. CITA: Gac Med Mex. 2021;157(Suppl 1):S1-S35 DOI: 10.24875/GMM.M21000463 TÍTULO: Hepatic Dendritic Cells in the Development and Progression of Metabolic Steatohepatitis AUTORES: Méndez-Sánchez N, Córdova-Gallardo J, Barranco-Fragoso B, Eslam M. SUMMARY: Metabolic Associated Fatty liver disease (MAFLD) is a global health problem and represents the most common cause of chronic liver dis- ease in the world. MAFLD spectrum goes from simple steatosis to cirrhosis, in between metabolic steatohepatitis with progressive fibrosis, which patho- genesis is not completely understood. Hence, the role of the immune system has become an important fact in the trigger of inflammatory cascades in met- abolic steatohepatitis and in the activation of hepatic stellate cells (HSCs). Among, the more studied immune cells in the pathogenesis of MAFLD are macrophages, T cells, natural killer and dendritic cells. In particular, hepatic dendritic cells had recently attracted a special attention, with a dual role in the pathogenesis of MAFLD. These cells have the capacity to switch from a tolerant state to active state inducing an inflammatory cascade. Further- more, these cells play a role in the lipid storage within the liver, having, thus providing a crucial nexus between inflammation and lipid metabolism. In this review, we will discuss the current knowledge on the dual role of dendritic cells in lipid accumulation, as wells as in the triggering of hepatic inflamma- tion and hepatocytes cell death in metabolic steatohepatitis. CITA: Front Immunol. 2021 Mar 23;12:641240 DOI: 10.3389/fimmu.2021.641240. TÍTULO: Comparison of different prognostic scores for patients with cirrho- sis hospitalized with SARS-CoV-2 infection AUTORES: Mendizabal M, (…) Chavez-Tapia N, (...) Castro-Narro G, Ru- binstein F, Silva MO. INTRODUCTION AND OBJECTIVES: Viral infections have been described to increase the risk of decompensation in patients with cirrhosis. We aimed to determine the effect of SARS-CoV-2 infection on outcome of hospitalized patients with cirrhosis and to compare the performance of different prognos- tic models for predicting mortality. 433

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33875250 PATIENTS: We performed a prospective cohort study including 2211 hos- pitalized patients with confirmed SARS-CoV-2 infection from April 15, 2020 through October 1, 2020 in 38 Hospitals from 11 Latin American countries. We registered clinical and laboratory parameters of patients with and without cirrhosis. All patients were followed until discharge or death. We evaluated the prognostic performance of different scoring systems to predict mortality in patients with cirrhosis using ROC curves. RESULTS: Overall, 4.6% (CI 3.7-5.6) subjects had cirrhosis (n = 96). Base- line Child-Turcotte-Pugh (CTP) class was assessed: CTP-A (23%), CTP-B (45%) and CTP-C (32%); median MELD-Na score was 19 (IQR 14-25). Mor- tality was 47% in patients with cirrhosis and 16% in patients without cirrhosis (P < .0001). Cirrhosis was independently associated with death [OR 3.1 (CI 1.9-4.8); P < .0001], adjusted by age, gender, and body mass index >30. The areas under the ROC curves for performance evaluation in predicting 28- days mortality for Chronic Liver Failure Consortium (CLIF-C), North Ameri- can Consortium for the Study of End-Stage Liver Disease (NACSELD), CTP score and MELD-Na were 0.85, 0.75, 0.69, 0.67; respectively (P < .0001). CONCLUSIONS: SARS-CoV-2 infection is associated with elevated mortal- ity in patients with cirrhosis. CLIF-C had better performance in predicting mortality than NACSELD, CTP and MELD-Na in patients with cirrhosis and SARS-CoV-2 infection. CITA: Ann Hepatol. Nov-Dec 2021;25:100350 DOI: 10.1016/j.aohep.2021.100350 TÍTULO: Portal venous system thrombosis after bariatric surgery: A system- atic review and meta-analysis AUTORES: Luo L, Li H, Wu Y, Bai Z, Xu X, Wang L, Mendez-Sanchez N, Qi X. BACKGROUND: Portal venous system thrombosis can develop after bariat- ric surgery. A systematic review and meta-analysis was conducted to evalu- ate the incidence of portal venous system thrombosis after bariatric surgery and clarify the role of anticoagulation for the prevention of portal venous system thrombosis after bariatric surgery. METHODS: PubMed, EMBASE, and Cochrane Library databases were searched. The incidence of portal venous system thrombosis after bariatric surgery was pooled by a random-effect model. Subgroup analyses were per- formed to explore the incidence of portal venous system thrombosis accord- ing to the average duration of prophylactic anticoagulation (extended versus short-term). Meta-regression and sensitivity analyses were performed to ex- plore the source of heterogeneity. RESULTS: Among 2,714 papers initially screened, 68 studies were included. Among 100,964 patients undergoing bariatric surgery, 300 developed portal venous system thrombosis. The pooled overall incidence of portal venous system thrombosis after bariatric surgery was 0.419% (95% confidence interval: 0.341%-0.505%). The pooled incidence of portal venous system thrombosis after bariatric surgery was numerically lower in patients who re- ceived extended prophylactic anticoagulation protocol after bariatric surgery than those who received short-term prophylactic anticoagulation protocol (0.184% vs 0.459%). Meta-regression analyses demonstrated that sample size (P = .006), type of surgery (P < .001), and average duration of prophy- 434

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33892008 lactic anticoagulation (P = .024) might be sources of heterogeneity, but not PMID: 33901638 region, publication year, history of bariatric surgery, follow-up duration, or PMID: 33924379 use of prophylactic anticoagulation. Sensitivity analyses could not identify any source of heterogeneity. The estimated mortality of portal venous sys- tem thrombosis after bariatric surgery was 1.33%. CONCLUSION: Portal venous system thrombosis after bariatric surgery is rare, but potentially lethal. Extended prophylactic anticoagulation protocol may be considered in patients at a high risk of developing portal venous system thrombosis after bariatric surgery. CITA: Surgery. 2021 Aug;170(2):363-372. DOI: 10.1016/j.surg.2021.03.005 TÍTULO: Redefinition of fatty liver disease from NAFLD to MAFLD raised disease awareness: Mexican experience AUTORES: Méndez-Sánchez N, Díaz-Orozco L, Córdova-Gallardo J. SUMMARY: Letter to the editor CITA: J Hepatol. 2021 Jul;75(1):221-222 DOI: 10.1016/j.jhep.2021.04.021 TÍTULO: Reply to: Lactate-dehydrogenase associated with mortality in hos- pitalized patients with COVID-19 in Mexico AUTORES: Vidal-Cevallos P, Higuera-De-La-Tijera F, Chávez-Tapia NC, Sánchez-Girón F, Reyes EC, Rosales-Salyano VH, Servin-Caamaño A, Vázquez-Medina MU, Méndez-Sánchez N. SUMMARY: Letter to the editor CITA: Ann Hepatol. Sep-Oct 2021;24:100354 DOI: 10.1016/j.aohep.2021.100354 TÍTULO: Lung Damage Caused by Heated Tobacco Products and Electronic Nicotine Delivery Systems: A Systematic Review AUTORES: Bravo-Gutiérrez OA, Falfán-Valencia R, Ramírez-Venegas A, Sansores RH, Ponciano-Rodríguez G, Pérez-Rubio G. SUMMARY: The tobacco industry promotes electronic nicotine delivery sys- tems (ENDS) and heated tobacco products (HTP) as a safer alternative to conventional cigarettes with misleading marketing sustained by studies with conflict of interest. As a result, these devices sell without regulations and warnings about their adverse effects on health, with a growing user base tar- geting young people. This systematic review aimed to describe the adverse effects on the respiratory system in consumers of these devices. We con- ducted a systematic review and bibliometric analysis of 79 studies without conflict of interest evaluating ENDS and HTP effects in the respiratory sys- tem in experimental models, retrieved from the PubMed database. We found that the damage produced by using these devices is involved in pathways related to pulmonary diseases, involving mechanisms previously reported in 435

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33940219 conventional cigarettes as well as new mechanisms particular to these de- PMID: 33947631 vices, which challenges that the tobacco industry's claims. The present study provides significant evidence to suggest that these devices are an emerging public health problem and that they should be regulated or avoided. CITA: Int J Environ Res Public Health. 2021 Apr 13;18(8):4079 DOI: 10.3390/ijerph18084079 TÍTULO: COVID-19 vaccine-induced immune thrombotic thrombocytopenia: An emerging cause of splanchnic vein thrombosis AUTORES: Porres-Aguilar M, Lazo-Langner A, Panduro A, Uribe M. SUMMARY: Editorial CITA: Ann Hepatol. Jul-Aug 2021;23:100356 DOI: 10.1016/j.aohep.2021.100356 TÍTULO: Association of Carcinoembryonic Antigen Reduction With Progres- sion-free and Overall Survival Improvement in Advanced Non-small-cell Lung Cancer AUTORES: Arrieta O, Varela-Santoyo E, Cardona AF, Sánchez-Reyes R, Lara-Mejía L, Bassarmal SS, Valle-Bautista D, Corrales-Rodríguez L, Moto- la-Kuba D, Cabrera-Miranda L, Martín C. BACKGROUND: Non-small cell lung cancer elevates serum carcinoembry- onic antigen (CEA). CEA determinations are not recommended currently. This study aims to identify the correlation between reducing serum CEA lev- els with progression-free survival (PFS) and overall survival. METHODS: This study assessed at baseline and in every scheduled visit serum CEA levels throughout first-line therapy. A sensitivity and specific- ity analysis identified the best cut-off point and correlated it with progres- sion-free survival and overall survival. Multivariate Cox proportional hazard models were conducted. RESULTS: We assessed 748 patients with elevated serum CEA levels at diagnosis. A ≥20% decrease from baseline was associated with a 2-fold me- dian survival compared with patients with lower decreases (20.5 months vs 9.1 months; hazard ratio, 0.53; 95% confidence interval, 0.44 to -0.64; P < .001). CEA sensitivity and specificity to predict survival was 79.8% and 59.8%, respectively. A ≥10% decrease in CEA concentrations was associat- ed with longer progression-free survival (7.7 months vs 5.9 months; hazard ratio, 0.71; 95% confidence interval, 0.57 to -0.88; P = .001) in those treat- ed with chemotherapy, and in patients under tyrosine kinase inhibitors (11.9 months vs 7.3 months; hazard ratio, 0.63; 95% confidence interval, 0.47 to -0.83; P = .0001) and a ≥20% decrease. CONCLUSION: In patients with metastatic non-small cell lung cancer with an elevated baseline CEA level, the percentage decrease of CEA concen- trations above the threshold during the first-line therapy was associated with more prolonged survival and progression-free intervals. Serum CEA determi- nations are a feasible, noninvasive option for monitoring and prognosis. CITA: Clin Lung Cancer. 2021 Nov;22(6):510-522 DOI: 10.1016/j.cllc.2021.03.014 436

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 33978392 TÍTULO: Nutraceuticals & microbiota: review PMID: 33980331 AUTORES: Díaz-Orozco LE, Méndez-Sánchez N. SUMMARY: Nutraceuticals are defined as products isolated or purified from foods that are generally sold in medicinal or dosage forms not usually associ- ated with food which is demonstrated to have a physiological benefit or provide protection against chronic disease. In this context, the products offered should be rigorously evaluated by international regulatory agencies. More recently, nutraceuticals have been proposed as a potential preventive and therapeutic option in the assessment of chronic diseases, mainly by altering the microbi- ome composition. However, the current lack of conclusive evidence supporting the \"healthy\" or \"normal\" microbiome, along with the dysbiosis concept para- digm, could be both contributing to the lack of homogeneous results. These is- sues may be solved in the next years with the use of emergent technologies in the individual's microbiome assessment and its fluctuations in time or related to many factors, such as nutraceuticals. Additionally, future research assess- ing the independent association between the dysbiosis modification and any \"potential\" nutraceutical product (including bioactive ingredient or chemical compound in food) is going to enlarge the currently reduced \"established nu- traceuticals\" group. In this work we have assessed the nutraceutical's poten- tial role as a microbiome-targeted manipulation therapy, and the gut-liver axis involved in the digestive diseases' pathogenesis and progression, including the chronic liver diseases. Moreover, microbiome targeted nutraceuticals that show consistent results might be further included in clinical research and trials in the therapeutic assessment of chronic diseases. Finally, the indication of these quality microbiome-targeted nutraceuticals will undoubtedly carry health benefits for individuals. CITA: Minerva Gastroenterol (Torino). 2021 Dec;67(4):326-338 DOI: 10.23736/S2724-5985.21.02914-4 TÍTULO: Coronavirus disease 2019, allergic diseases, and allergen immu- notherapy: Possible favorable mechanisms of interaction AUTORES: Larenas-Linnemann DE, Ortega-Martell JA, Blandón-Vijil MV, Rodríguez-Pérez N, Luna-Pech JA, Estrada-Cardona A, Arias-Cruz A, Del Rio-Navarro BE, Rodríguez EMN, Pozo-Beltrán CF, Takane EO, Rojo-Guti- érrez MI, Espinosa-Rosales FJ, Martínez-Infante EA. BACKGROUND: Both, allergen immunotherapy (AIT) and SARS-COV-2 in- fection cause a set of immunologic changes that respectively vary during the course of the treatment or the disease. OBJECTIVE: To review immune changes brought along by each of these entities and how they might interrelate. METHODS: We start presenting a brief review of the structure of the new coro- navirus and how it alters the functioning of the human immune system. Sub- sequently, we describe the immune changes induced by AIT and how these changes could be favorable or unfavorable in the allergic patient infected with SARS-CoV-2 at a particular point of time during the evolving infection. RESULTS: We describe how a healthy immune response against SARS- CoV-2 develops, versus an immune response that is initially suppressed by the virus, but ultimately overactivated, leading to an excessive production of cytokines (cytokine-storm-like). These changes are then linked to the clinical 437

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34004366 manifestations and outcomes of the patient. Reviewing the immune changes PMID: 34007794 secondary to AIT, it becomes clear how AIT is capable of restoring a healthy innate immunity. Investigators have previously shown that the frequency of respiratory infections is reduced in allergic patients treated with AIT. On the other hand it also increases immunoregulation. CONCLUSION: As there are many variables involved, it is hard to predict how AIT could influence the allergic patient's reaction to a SARS-CoV-2 in- fection. In any case, AIT is likely to be beneficial for the patient with allergic rhinitis and/or allergic asthma in the context of the SARS-CoV-2 pandem- ic as controlling allergic diseases leads to a reduced need for contact with healthcare professionals. The authors remind the reader that everything in this article is still theoretical, since at the moment, there are no published clinical trials on the outcome of COVID-19 in allergic patients under AIT. CITA: Allergy Asthma Proc. 2021 May 1;42(3):187-197 DOI: 10.2500/aap.2021.42.210013 TÍTULO: NAFLD: Challenges and opportunities to address the public health problem in Latin America AUTORES: Arab JP, Díaz LA, Dirchwolf M, Mark HE, Lazarus JV, Vaughan E, Méndez-Sánchez N, Oliveira CP, Gadano A, Arrese M. SUMMARY: Non-alcoholic fatty liver disease (NAFLD) is reaching epidemic proportions worldwide. Collectively, Latin American countries have some of the highest obesity rates in the world and the fastest-growing prevalence of type 2 diabetes mellitus (T2DM). Since obesity and T2DM are intrinsically linked with NAFLD, epidemiological projections are worrisome. In addition to this adverse epidemiological setting, the region of Latin America faces unique challenges and obstacles to addressing the growing burden of NA- FLD. In this article, on the occasion of the International NASH Day on June 10, 2021, we describe the main challenges and opportunities to improve care of people living with NAFLD in Latin America. Among the major challenges to be tackled are: lack of disease awareness, limited educational opportunities for healthcare personnel and general public, health system fragmentation, and lack of effective strategies for the prevention and effective treatment of NAFLD and common comorbidities, namely obesity and T2DM. Wide dissemination of current concepts on NAFLD, and extensive collaboration between scientific societies, governments, non-governmental organizations, pharmaceutical industry, and other stakeholders is urgently needed to ad- vance the NAFLD public health policies agenda that allows us to address this disease with a whole of society approach. CITA: Ann Hepatol. Sep-Oct 2021;24:100359 DOI: 10.1016/j.aohep.2021.100359 TÍTULO: Very-early-stage Hepatocellular Carcinoma, Are We at Long Last on Route for Achieving Better Patient Outcomes? AUTORES: Vidal-Cevallos P, Chavez-Tapia N. SUMMARY: Editorial CITA: J Clin Transl Hepatol. 2021 Apr 28;9(2):141-142 DOI: 10.14218/JCTH.2021.00137 438

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34007805 TÍTULO: Gut Microbiota in Metabolic-associated Fatty Liver Disease and in PMID: 34050551 Other Chronic Metabolic Diseases PMID: 34079860 AUTORES: Hernández-Ceballos W, Cordova-Gallardo J, Mendez-Sanchez N. SUMMARY: The gut microbiome plays a key role in the health-disease bal- ance in the human body. Although its composition is unique for each per- son and tends to remain stable throughout lifetime, it has been shown that certain bacterial patterns may be determining factors in the onset of cer- tain chronic metabolic diseases, such as type 2 diabetes mellitus (T2DM), obesity, metabolic-associated fatty liver disease (MAFLD), and metabolic syndrome. The gut-liver axis embodies the close relationship between the gut and the liver; disturbance of the normal gut microbiota, also known as dysbiosis, may lead to a cascade of mechanisms that modify the epithelial properties and facilitate bacterial translocation. Regulation of gut microbiota is fundamental to maintaining gut integrity, as well as the bile acids compo- sition. In the present review, we summarize the current knowledge regarding the microbiota, bile acids composition and their association with MAFLD, obesity, T2DM and metabolic syndrome. CITA: J Clin Transl Hepatol. 2021 Apr 28;9(2):227-238 DOI: 10.14218/JCTH.2020.00131 TÍTULO: Role of the inflammasome, gasdermin D, and pyroptosis in non-al- coholic fatty liver disease AUTORES: Rodríguez-Antonio I, López-Sánchez GN, Uribe M, Chávez- Tapia NC, Nuño-Lámbarri N. SUMMARY: Pyroptosis is a type of programmed cell death mediated by a multiprotein complex called the inflammasome through the pro-inflammatory activity of gasdermin D. This study aimed to recognize the final biological product that leads to pore formation in the cell membrane, lysis, pro-inflam- matory cytokines release, and the establishment of an immune response. An exhaustive search engine investigation of an elevated immune response can induce a sustained inflammation that directly links this mechanism to non-al- coholic fatty liver disease and its progression to non-alcoholic steatohepatitis. Clinical studies and systematic reviews suggest that gasdermin D is a criti- cal molecule between the immune response and the disease manifestation, which could be considered a therapeutic target for highly prevalent diseases characterized by presenting perpetuated inflammatory processes. Both ba- sic and clinical research show evidence on the expression and regulation of the inflammasome-gasdermin D-pyroptosis trinomial for the progression of non-alcoholic fatty liver disease to non-alcoholic steatohepatitis. CITA: J Gastroenterol Hepatol. 2021 Oct;36(10):2720-2727 DOI: 10.1111/jgh.15561 TÍTULO: Assessment of quality benchmarks in adenoma detection in Mexi- co AUTORES: Aguilar-Olivos NE, Balanzá R, Rojas-Mendoza F, Soto-Solis R, Ballesteros-Amozurrutia MA, González-Uribe N, Fernández-Rivero JA. BACKGROUND AND STUDY AIMS: Several Latin American countries, in- cluding Mexico, have reported an increase in colorectal cancer (CRC) mor- 439

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR tality. The effectiveness of a colonoscopy in preventing CRC depends on the quality of the procedure, for which the adenoma detection rate (ADR) is one of the most trusted indicators. Awareness of ADR can improve the quality of colonoscopies through proper feedback and training of the specialists. The goal of this study was to estimate the ADR among Mexican endoscopists with experience in CRC screening and to compare it with previously reported data from this country. METHODS: We carried out a retrospective study to analyze ADR data in Mexico. The information was obtained from a group of certified endoscopists and compared with the former published data from Mexico. RESULTS; We found a current ADR of 24.6 % (95 %CI, 22.4 %-26.8 %) from 1,478 colonoscopies performed by eight endoscopists in two third-level private hospitals. The average ADR reported in previous publications was 15.2 % (95 %CI, 13.3 %-17.1 %). Statistical analysis showed differences between our re- sults and those from previous studies (24.6 % vs. 15.2 %, P < 0.001). CONCLUSIONS: The actual ADR in Mexico is higher than previously report- ed. Previous low ADR values could be explained by poorly performed colo- noscopies rather than by low adenoma and CRC incidence in our country. CITA: Endosc Int Open. 2021 Jun;9(6):E796-E80 DOI: 10.1055/a-1396-3718 PMID: 34103552 TÍTULO: Cross-sectional pilot study to assess primary healthcare workers' knowledge of nonalcoholic fatty liver disease in a marginalized community in Mexico AUTORES: Vidal-Cevallos P, Ordóñez-Vázquez AL, Procopio-Mosso O, Cardoso-Arias R, Uribe M, Chávez-Tapia NC. SUMMARY: The registered incidence of nonalcoholic fatty liver disease (NA- FLD) in primary healthcare centers is lower than expected, suggesting a lack of awareness by primary care healthcare professionals. The implementation of educational tools for healthcare workers has been found to increase timely referral and treatment of patients. We aimed to determine healthcare workers' knowledge of NAFLD to identify their educational needs in one marginalized region. We performed a cross-sectional survey of 261 healthcare profession- als in Tlapa de Comonfort, Guerrero, Mexico from October 2019 to December 2019. We created a questionnaire that assessed domains most relevant to NAFLD knowledge. Two hundred and forty-six questionnaires were complet- ed. Of the respondents, 38.3% were nurses and 63.4% were women. Most nurses identified NAFLD as a prevalent (89%) and preventable (93%) disease. Hypertension (33%) and obesity (84%) were recognized as risk factors. The associations between NAFLD and cancer, cirrhosis and cardiovascular dis- ease were identified by 53%, 67% and 72% of respondents, respectively. The largest gaps were found in diagnostic workup, therapeutic approach and the current treatments. We identify modifiable knowledge gaps in NAFLD. Educa- tional strategies for primary care workers could enhance the identification of patients with NAFLD and prevent complications. CITA: Sci Rep. 2021 Jun 8;11(1):12100 DOI: 10.1038/s41598-021-91199-y 440

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34112475 TÍTULO: Comparing Antihistamines in Chronic Spontaneous Urticaria: Pos- PMID: 34136127 sible Future Directions PMID: 34147309 AUTORES: Larenas-Linnemann D. SUMMARY: Editorial CITA: J Allergy Clin Immunol Pract. 2021 Jun;9(6):2272-2273 DOI: 10.1016/j.jaip.2021.02.024 TÍTULO: ARIA-EAACI care pathways for allergen immunotherapy in respira- tory allergy AUTORES: Bousquet J, (…) Larenas-Linnemann DE, et al. SUMMARY: Review article CITA: Clin Transl Allergy. 2021 Jun 9;11(4):e12014 DOI: 10.1002/clt2.12014 TÍTULO: Real-world experience with MMX mesalazine use in Mexican pa- tients with ulcerative colitis at two tertiary care centers AUTORES: Yamamoto-Furusho JK, Parra-Holguín NN. INTRODUCTION AND AIMS: The 5-aminosalicylates, especially mesal- azine, are the first option in the treatment of mild-to-moderate ulcerative colitis (UC). High rates of remission induction and maintenance have been observed with the new multimatrix (MMX) mesalazine formulation, mainly in patients with distal disease. Our aim was to describe the real-world experi- ence with MMX mesalazine in patients with UC at two tertiary care centers. MATERIALS AND METHODS: A retrospective cohort study was conducted that included 142 patients with confirmed UC diagnosis, analyzed in three study groups: 1) oral MMX mesalazine as monotherapy for remission induc- tion, 2) oral MMX mesalazine as monotherapy for remission maintenance, and 3) oral MMX mesalazine plus topical therapy for remission induction. RESULTS: The frequency of clinical remission induction in group 1 was 80.3%, with biochemical remission of 74.2%. Group 2 had 100% clinical and biochemical remission maintenance. The frequency of clinical remission in- duction in group 3 was 88.6%, biochemical remission was 85.7%, and top- ical therapy was suspended in 87.3% at the end of follow-up. No adverse events were documented. CONCLUSIONS: There were high percentages of clinical and biochemical remission in the two corresponding study groups and topical therapy was suspended in the majority of patients in a short follow-up period. CITA: Rev Gastroenterol Mex (Engl Ed). 2021 Jun 16; S0375-0906(21)00058-6 DOI: 10.1016/j.rgmx.2021.01.010 441

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34155351 TÍTULO: Breast implant-associated anaplastic large cell lymphoma: clinical PMID: 34168283 follow-up and analysis of sequential pathologic specimens of untreated pa- tients shows persistent or progressive disease AUTORES: Evans MG, Medeiros LJ, Marques-Piubelli ML, Wang HY, Or- tiz-Hidalgo C, Pina-Oviedo S, Morine A, Clemens MW, Hunt KK, Iyer S, Hu Q, Recavarren C, Demichelis R, Romero M, Sohani AR, Misialek M, Amin MB, Bueso-Ramos CE, Carballo-Zarate AA, Lee HJ, Ok CY, Xu J, Miranda RN. SUMMARY: Breast implant-associated anaplastic large cell lymphoma (ALCL) is a distinctive type of T-cell lymphoma that arises around tex- tured-surface breast implants. In a subset of patients, this disease can in- volve surrounding tissues, spread to regional lymph nodes, and rarely me- tastasize to distant sites. The aim of this study was to assess sequential pathologic specimens from patients with breast implant-associated ALCL to better understand the natural history of early-stage disease. To achieve this goal, we searched our files for patients who had breast implant-associated ALCL and who had undergone earlier surgical intervention with assessment of biopsy or cytologic specimens. We then focused on the patient subset in whom a definitive diagnosis was not established, and patients did not re- ceive current standard-of-care therapy at that time. We identified a study group of ten patients with breast implant-associated ALCL in whom patho- logic specimens were collected 0.5 to 4 years before a definitive diagnosis was established. A comparison of these serial biopsy specimens showed persistent disease without change in pathologic stage in three patients, pro- gression in five patients, and persistence versus progression in two patients. Eventually, six patients underwent implant removal with complete capsulec- tomy and four underwent partial capsulectomy. Seven patients also received chemotherapy because of invasive disease, three of whom also received radiation therapy, two brentuximab vedotin after chemotherapy failure, and one allogeneic stem cell transplant. Eight patients achieved complete remis- sion and two had partial remission after definitive therapy. At time of last fol- low-up, six patients were alive without disease, one had evidence of disease, one died of disease, and two patients died of unrelated cancers. In summary, this analysis of sequential specimens from patients with breast implant-as- sociated ALCL suggests these neoplasms persist or progress over time if not treated with standard-of-care therapy. CITA: Mod Pathol. 2021 Dec;34(12):2148-2153 DOI: 10.1038/s41379-021-00842-6 TÍTULO: Measurable residual disease in chronic lymphocytic leukemia: ex- pert review and consensus recommendations AUTORES: Wierda WG, Rawstron A, Cymbalista F, Badoux X, Rossi D, Brown JR, Egle A, Abello V, Cervera Ceballos E, Herishanu Y, Mulligan SP, Niemann CU, Diong CP, Soysal T, Suzuki R, Tran HTT, Wu SJ, Owen C, Stilgenbauer S, Ghia P, Hillmen P. SUMMARY: Assessment of measurable residual disease (often referred to as \"minimal residual disease\") has emerged as a highly sensitive indi- cator of disease burden during and at the end of treatment and has been correlated with time-to-event outcomes in chronic lymphocytic leukemia. Undetectable-measurable residual disease status at the end of treatment demonstrated independent prognostic significance in chronic lymphocytic leukemia, correlating with favorable progression-free and overall survival with chemoimmunotherapy. Given its utility in evaluating depth of response, 442

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34172076 determining measurable residual disease status is now a focus of outcomes PMID: 34221578 in chronic lymphocytic leukemia clinical trials. Increased adoption of measur- able residual disease assessment calls for standards for nomenclature and outcomes data reporting. In addition, many basic questions have not been systematically addressed. Here, we present the work of an international, multidisciplinary, 174-member panel convened to identify critical questions on key issues pertaining to measurable residual disease in chronic lympho- cytic leukemia, review evaluable data, develop unified answers in conjunc- tion with local expert input, and provide recommendations for future studies. Recommendations are presented regarding methodology for measurable residual disease determination, assay requirements and in which tissue to assess measurable residual disease, timing and frequency of assessment, use of measurable residual disease in clinical practice versus clinical trials, and the future usefulness of measurable residual disease assessment. No- menclature is also proposed. Adoption of these recommendations will work toward standardizing data acquisition and interpretation in future studies with new treatments with the ultimate objective of improving outcomes and curing chronic lymphocytic leukemia. CITA: Leukemia. 2021 Nov;35(11):3059-3072 DOI: 10.1038/s41375-021-01241-1 TÍTULO: Correction to: Superior silybin bioavailability of silybin-phospha- tidylcholine complex in oily-medium soft-gel capsules versus conventional silymarin tablets in healthy volunteers AUTORES: Méndez-Sánchez N, Dibildox-Martinez M, Sosa-Noguera J, Sánchez-Medal R, Flores-Murrieta FJ. SUMMARY: Erratum CITA: BMC Pharmacol Toxicol. 2021 Jun 25;22(1):37 DOI: 10.1186/s40360-021-00500-2 TÍTULO: C-methionine-PET-guided Gamma Knife radiosurgery boost as ad- juvant treatment for newly diagnosed glioblastomas AUTORES: Jacobo JA, Buentello M, Del Valle R. BACKGROUND: The most common glial tumor is the glioblastoma, and the prognosis remains dismal despite a multimodal therapeutic approach. The role of radiosurgery for the treatment of glioblastomas has been evaluated in several studies with some benefit at the recurrent stage. We evaluate the results of the protocol administered at the Gamma Knife unit administering radiosurgery as a boost to metabolic active parts of the tumor after the pa- tient had completed traditional external beam radiotherapy (XBRT) as part of the Stupp protocol for high-grade gliomas. METHODS: This is a retrospective analysis of seven patients with newly diagnosed glioblastomas who were treated with Gamma Knife radiosur- gery as a boost after receiving XBRT as part of the Stupp protocol. The target of radiation was determined according to the findings of the C-me- thionine PET scan in relation to magnetic resonance images. The prima- ry end point of this study was to determine the progression-free survival (PFS) from the time of diagnosis. 443

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34224458 RESULTS: The median age of patients was 48.8 years and the mean Karn- ofsky performance score was 92.8%. The median PFS was 12.4 months. No radiation adverse effects were documented. CONCLUSION: Stereotactic radiosurgery is safe to use in the upfront treat- ment for these patients and appears to have a beneficial role in improving the PFS. This beneficial role seems to be conditioned not only by the time the treatment is administered but also where the radiation dose is targeted to. CITA: Surg Neurol Int. 2021 May 31;12:247 DOI: 10.25259/SNI_706_2020 TÍTULO: Endonasal Endoscopic and Hybrid Surgery Techniques for Blunt Trauma Fractures of the Skull Base With Cerebrospinal Fluid Leaks AUTORES: Palma Díaz M, Martínez Anda JJ, Guerrero Suarez PD, de la Llata Segura C, Galván Hernández E, Avendaño Pradel R, Pineda Martínez D, Munguía López JC, Díaz Espinoza JL, Guerrero López DA, Pane Pi- anese C, Gómez Amador JL. SUMMARY: Cerebrospinal fluid (CSF) leakage caused by skull base frac- ture represents high risks of bacterial meningitis, and a rate of mortality of 8.9%. Endoscopic endonasal repair of CSF leaks is quite safe and effective procedure with high rates of success. The aim of this study is to describe our technique for management of skull base CSF leaks secondary to cra- niofacial trauma based on the anatomic location of the leak. This is a ret- rospective case series of 17 patients with diagnosis of craniofacial trauma, surgically treated with sole endonasal endoscopic and combined endonasal/ transcranial approaches with diagnosis of CSF leak secondary to skull base fractures. Seventeen patients met inclusion criteria for this study. Mean age was 46 years old. Most common etiology was motor vehicle. Early surgery was performed in 8 patients, and late surgery in 9 patients. The most com- mon site of CSF leak was at ethmoid cells or at the fronto-ethmoid junction in 9 patients. Thirteen patients (76.4%) were treated only with endonasal endo- scopic technique, and 4 (23.5%) with hybrid surgery, combining endonasal endoscopic and cranial bicoronal approaches with nasal and pericranial vas- cularized flaps, and nasal mucosal free flaps. Mean hospital stay was 23.7 days.The mean follow-up time was 25.6 months. When surgical reconstruc- tion is indicated for CSF leaks secondary to skull base fractures, endonasal endoscopic techniques should be part of the surgical management either as a sole procedure, or in combination with classical transcranial approaches with high rates of success and low morbidity. CITA: J Craniofac Surg. 2021 Oct 1;32(7):2500-2507 DOI: 10.1097/SCS.0000000000007932 PMID: 34229038 TÍTULO: A Global Survey of Physicians Knowledge About Nonalcoholic Fat- ty Liver Disease AUTORES: Younossi ZM, Ong JP, Takahashi H, Yilmaz Y, Eguc Hi Y, El Kassas M, Buti M, Diago M, Zheng MH, Fan JG, Yu ML, Wai-Sun Wong V, Alswat K, Chan WK, Mendez-Sanchez N, Burra P, Bugianesi E, Duseja AK, George J, Papatheodoridis GV, Saeed H, Castera L, Arrese M, Kugelmas M, Romero-Gomez M, Alqahtani S, Ziayee M, Lam B, Younossi I, Racila A, Henry L, Stepanova M 444

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR BACKGROUND & AIMS: Despite rapidly increasing nonalcoholic fatty liv- er disease (NAFLD) prevalence, providers' knowledge may be limited. We assessed NAFLD knowledge and associated factors among physicians of different specialties globally. METHODS: NAFLD knowledge surveys containing 54 and 59 questions cov- ering 3 domains (epidemiology/pathogenesis, diagnostics, and treatment) were completed electronically by hepatologists, gastroenterologists (GEs), endocrinologists (ENDOs), and primary care physicians (PCPs) from 40 countries comprising 5 Global Burden of Disease super-regions. Over 24 months, 2202 surveys were completed (488 hepatologists, 758 GEs, 148 ENDOs, and 808 PCPs; 50% high-income Global Burden of Disease su- per-region, 27% from North Africa and Middle East, 12% Southeast Asia, and 5% South Asian and Latin America). RESULTS: Hepatologists saw the greatest number of NAFLD patients an- nually: median 150 (interquartile range, 60-300) vs 100 (interquartile range, 35-200) for GEs, 100 (interquartile range, 30-200) for ENDOs, and 10 (inter- quartile range, 4-50) for PCPs (all P < .0001). The primary sources of NA- FLD knowledge acquisition for hepatologists were international conferences (33% vs 8%-26%) and practice guidelines for others (39%-44%). The Inter- net was the second most common source of NAFLD knowledge for PCPs (28%). NAFLD knowledge scores were higher for hepatologists than GEs: epidemiology, 62% vs 53%; diagnostics, 80% vs 73%; and treatment, 61% vs 58% (P < .0001), and ENDOs scores were higher than PCPs: epidemiolo- gy, 70% vs 60%; diagnostics, 71% vs 64%; and treatment, 79% vs 68% (P < .0001). Being a hepatologist or ENDO was associated with higher knowledge scores than a GE or PCP, respectively (P < .05). Higher NAFLD knowledge scores were associated independently with a greater number of NAFLD pa- tients seen (P < .05). CONCLUSIONS: Despite the growing burden of NAFLD, a significant knowl- edge gap remains for the identification, diagnosis, and management of NAFLD. CITA: Clin Gastroenterol Hepatol. 2021 Jul 3;S1542 3565(21)00719-9 DOI: 10.1016/j.cgh.2021.06.048 PMID: 34245425 TÍTULO: Impact of Cadmium Mediated by Tobacco Use in Musculoskeletal Diseases AUTORES: Fernández-Torres J, Zamudio-Cuevas Y, Martínez-Nava GA, Aztatzi-Aguilar OG, Sierra-Vargas MP, Lozada-Pérez CA, Suárez-Ahedo C, Landa-Solís C, Olivos-Meza A, Del Razo LM, Camacho-Rea MC, Martínez- Flores K. SUMMARY: Tobacco use has a negative impact on health due to its relation- ship with the development of high-mortality diseases, such as pulmonary can- cer. However, the effect of cadmium (Cd), present in tobacco smoke, on the development of joint diseases has been scarcely studied. The objective of this review is to discuss the evidence regarding the mechanisms by which Cd ex- posure, through tobacco smoke, may lead to the development of osteoarthritis (OA), osteoporosis (OP), and rheumatoid arthritis (RA). There's evidence sug- gesting a string association between moderate to severe OA development and tobacco use, and that a higher blood concentration of Cd can trigger oxidative stress (OS) and inflammation, favoring cartilage loss. At the bone level, the Cd that is inhaled through tobacco smoke affects bone mineral density, resulting 445

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34248137 in OP mediated by a decrease in the antioxidant enzymes, which favors the PMID: 34265431 bone resorption process. In RA, tobacco use promotes the citrullination pro- cess through Cd exposure and increases OS and inflammation. Understand- ing how tobacco use can increase the damage at the articular level mediated by a toxic metal, i.e., Cd, is important. Finally, we propose prevention, control, and treatment strategies for frequently disabling diseases, such as OA, OP, and RA to reduce its prevalence in the population. CITA: Biol Trace Elem Res. 2021 Jul 10 DOI: 10.1007/s12011-021-02814-y TÍTULO: Editorial: International Consensus Recommendations to Replace the Terminology of Non-Alcoholic Fatty Liver Disease (NAFLD) with Metabol- ic-Associated Fatty Liver Disease (MAFLD) AUTORES: Méndez-Sánchez N, Díaz-Orozco LE. SUMMARY: In 2020, international consensus guidelines recommended the renaming of non-alcoholic fatty liver disease (NAFLD) to metabolic-associ- ated fatty liver disease (MAFLD), supported by diagnostic criteria. MAFLD affects up to 25% of the global population. However, the rates of MAFLD are likely to be underestimated due to the increasing prevalence of type 2 diabetes mellitus (T2DM) and obesity. Within the next decade, MAFLD has been projected to become a major cause of cirrhosis and hepatocellular car- cinoma (HCC) worldwide, as well as the most common indication for liver transplantation in the US. This transition in terminology and clinical criteria may increase momentum and clinical evidence at multiple levels, including patient diagnosis, management, and care, and provide the basis for new research areas and clinical development for therapeutics. The diagnostic criteria for MAFLD are practical, simple, and superior to the existing NAFLD criteria for identifying patients at increased risk of developing progressive liver disease. This Editorial aims to present the historical evolution of the terminology for fatty liver disease and the advantages of diagnosis, patient management, and future research on MAFLD. CITA: Med Sci Monit. 2021 Jul 12;27:e933860 DOI: 10.12659/MSM.933860 TÍTULO: Outcomes With Pembrolizumab Plus Platinum-Based Chemother- apy for Patients With NSCLC and Stable Brain Metastases: Pooled Analysis of KEYNOTE-021, -189, and -407 AUTORES: Powell SF, Rodríguez-Abreu D, Langer CJ, Tafreshi A, Paz- Ares L, Kopp HG, Rodríguez-Cid J, Kowalski DM, Cheng Y, Kurata T, Awad MM, Lin J, Zhao B, Pietanza MC, Piperdi B, Garassino MC. INTRODUCTION: This exploratory analysis retrospectively evaluated out- comes in patients with advanced NSCLC to determine whether baseline brain metastases influenced the efficacy of first-line pembrolizumab plus chemotherapy versus chemotherapy alone. METHODS: We pooled data for patients with advanced NSCLC in KEY- NOTE-021 cohort G (nonsquamous), KEYNOTE-189 (nonsquamous), and KEYNOTE-407 (squamous). Patients were assigned to platinum-doublet chemotherapy with or without the addition of 35 cycles of pembrolizumab 200 mg every 3 weeks. All studies permitted enrollment of patients with pre- 446

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR viously treated or untreated (KEYNOTE-189 and KEYNOTE-407 only) stable brain metastases. Patients with previously treated brain metastases were clinically stable for 2 or more weeks (≥4 wk in KEYNOTE-021 cohort G), had no evidence of new or enlarging brain metastases, and had no steroid use at least 3 days before dosing. Patients with known untreated asymptomatic brain metastases required regular imaging of the brain. RESULTS: A total of 1298 patients were included, 171 with and 1127 without baseline brain metastases. Median (range) durations of follow-up at data cutoff were 10.9 (0.1‒35.1) and 11.0 (0.1‒34.9) months, respectively. Haz- ard ratios (pembrolizumab + chemotherapy/chemotherapy) were similar for patients with and without brain metastases for overall survival (0.48 [95% confidence interval (CI): 0.32‒0.70] and 0.63 [95% CI: 0.53‒0.75], respective- ly) and progression-free survival (0.44 [95% CI: 0.31‒0.62] and 0.55 [95% CI: 0.48‒0.63], respectively). In patients with brain metastases, median overall survival was 18.8 months with pembrolizumab plus chemotherapy and 7.6 months with chemotherapy, and median progression-free survival was 6.9 months and 4.1 months, respectively. Objective response rates were high- er and duration of response longer with pembrolizumab plus chemotherapy versus chemotherapy regardless of brain metastasis status. Incidences of treatment-related adverse events with pembrolizumab plus chemotherapy versus chemotherapy were 88.2% versus 82.8% among patients with brain metastases and 94.5% versus 90.6% in those without. CONCLUSIONS: With or without brain metastasis, pembrolizumab plus platinum-based histology-specific chemotherapy improved clinical outcomes versus chemotherapy alone across all programmed death ligand 1 sub- groups, including patients with programmed death ligand 1 tumor proportion score less than 1% and had a manageable safety profile in patients with advanced NSCLC. This regimen is a standard-of-care treatment option for treatment-naive patients with advanced NSCLC, including patients with sta- ble brain metastases. CITA: J Thorac Oncol. 2021 Nov;16(11):1883-1892 DOI: 10.1016/j.jtho.2021.06.020 PMID: 34275472 TÍTULO: Kinetics of HE4 and CA125 as prognosis biomarkers during neoad- juvant chemotherapy in advanced epithelial ovarian cancer AUTORES: Alegría-Baños JA, Jiménez-López JC, Vergara-Castañeda A, de León DFC, Mohar-Betancourt A, Pérez-Montiel D, Sánchez-Domín- guez G, García-Villarejo M, Olivares-Pérez C, Hernández-Constantino Á, González-Santiago A, Clara-Altamirano M, Arela-Quispe L, Prada-Ortega D. BACKGROUND: Ovarian cancer (OC) is considered the most lethal gyne- cological cancer, of which more than 65% cases are diagnosed in advanced stages, requiring platinum-based neoadjuvant chemotherapy (NACT). METHODS: A prospective-longitudinal study was conducted among wom- en with advanced epithelial ovarian cancer (AEOC), III and IV stages, and treated with NACT, at the National Cancer Institute - Mexico, from July 2017 to July 2018. Serum samples were obtained for quantification of CA125 and HE4 using ELISA at the first and in each of the three NACT cycles. The therapeutic response was evaluated through standard tomography. We de- termined whether CA125 and HE4, alone or in combination, were associated with TR to NACT during follow up. 447

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR RESULTS: 53 patients aged 38 to 79 years were included, 92.4% present- ed papillary serous subtype OC. Higher serum HE4 levels were observed in patients with non-tomographic response (6.89 vs 5.19 pmol/mL; p = 0.031), specially during the second (p = 0.039) and third cycle of NACT (p = 0.031). Multivariate-adjusted models showed an association between HE4 levels and TR, from the second treatment cycle (p = 0.042) to the third cycle (p = 0.033). Changes from baseline HE4 levels during the first cycle was negative associat- ed with TR. No associations were found between CA125 and TR. CONCLUSIONS: Serum HE4 levels were independently associated with TR among patients with AOEC treated with NACT, also a reduction between baseline HE4 and first chemotherapy levels was also independently asso- ciated with the TR. These findings might be relevant for predicting a lack of response to treatment. CITA: J Ovarian Res. 2021 Jul 19;14(1):96 DOI: 10.1186/s13048-021-00845-6 PMID: 34307427 TÍTULO: The \"Slow Horse Racing Effect\" on Lung Function in Adult Life in Chronic Obstructive Pulmonary Disease Associated to Biomass Exposure AUTORES: Ramírez-Venegas A, Montiel-Lopez F, Falfan-Valencia R, Pérez-Rubio G, Sansores RH. SUMMARY: Although different trajectories in lung function decline have been identified in patients with COPD associated to tobacco exposure (TE- COPD), genetic, environmental, and infectious factors affecting lung function throughout life have not been fully elucidated in patients with COPD associ- ated to biomass (BE-COPD). In this review, we present current epidemiologi- cal findings and notable advances in the natural history of lung decline in BE- COPD, as well as conditions modeling the FEV1 trajectory, such as health insults, during the first years of childhood. Evidence shows that women exposed to biomass smoke reach adult life with a lower FEV1 than expect- ed. However, in contrast to the \"horse racing effect\" predicting an excessive lung-function decline in forthcoming years, as observed in smokers, this de- cline is slower in non-smokers, and no rapid decliners are observed. Accord- ingly, BE-COPD might be considered another phenotype of COPD based on assessments of lung function decline. Likewise, other functional and clinical aspects described in this review suggest that this condition might be similar to TE-COPD. More research is needed to fully characterize this subgroup of variants of COPD. CITA: Front Med (Lausanne). 2021 Jul 8;8:700836 DOI: 10.3389/fmed.2021.700836 PMID: 34311514 TÍTULO: [MIA 2021, Comprehensive Asthma Management. Guidelines for Mexico] AUTORES: Larenas-Linnemann D, et al BACKGROUND: Asthma continues to be one of the most frequent chronic respiratory diseases in our country. New methods for diagnosis and treat- ment have been described; accordingly, the international guidelines were renewed. 448

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR Objective: To create a national platform for the development of updated guidelines, solidly based on evidence: Comprehensive Asthma Management (Spanish acronym: MIA). METHODS: MIA uses the ADAPTE method. The MIA development group consists of experts in pulmonology-allergology-methodology and represen- tatives of 13 institutions and societies of specialties that manage asthma. The international reference guidelines (selected with AGREE-II): GINA 2020, GEMA 5.0, BTS/SIGN 2019 and ATS/ERS consensus document 2014-2019 on severe asthma. MIA covers suspected asthma, diagnosis, treatment, and special groups. Key clinical questions were formulated on treatment steps 1-3, biomarkers and severe asthma. RESULTS: Based on evidence, safety, cost and local reality, the core group developed responses. Through a Delphi process the broad MIA develop- ment group suggested adjustments until consensus was reached. CONCLUSION: A document was generated with multiple figures and algo- rithms, solidly based on evidence about asthma management, adjusted for Mexico with a broad base among different societies that participated in its development. It does not include guidelines for acute asthma. CITA: Rev Alerg Mex. 2021;68 Suppl 1:s1-s122 DOI: 10.29262/ram.v68i5.880 PMID: 34325158 TÍTULO: Increased non-attendance at epilepsy clinic in patients with neuro- psychiatric comorbidities: A prospective study AUTORES: Zertuche-Ortuño L, Oropeza-Bustos N, Crail-Meléndez D, Brib- iesca-Contreras E, Sebastián-Díaz MA, Martínez-Bustos V, Santos-Peyret A, Martínez-Medina S, Ochoa A, Jara-Prado A, Martínez-Juárez IE. BACKGROUND: In patients with epilepsy, regular follow-up is vital for ad- equate seizure control, antiseizure drugs' (ASDs) side effects, psychiatric comorbidities, and planning for epilepsy surgery. Non-attendance creates barriers to adequate patient care, inefficient allocation of resources, loss of income, and unnecessary emergency department visits due to lack of seizure control. This study aimed to determine the causes and sociodemo- graphic characteristics of the non-attendant population at the Epilepsy Clinic. METHODS: A prospective and observational study was carried out on pa- tients treated at the Epilepsy Clinic of the National Institute of Neurology and Neurosurgery (NINN) in Mexico from August 2015 to June 2016. A phone interview was made with all those patients who did not attend the epilepsy consultation. This call incorporated ad hoc questions to meet the objectives of this study. RESULTS: During the study period, 1299 patients had an appointment at the epilepsy clinic, where 233 (17.9%) patients missed their consultation, 123 (52.8%) were male, mean age was 35.9 ± 14.42 years. The most fre- quent cause of non-attendance was forgetfulness of the appointment in 62 patients (26.6%). Two patients died; no patient was reported to have expe- rienced SUDEP. Non-attendant patients showed statistically significant over- all prevalence of psychiatric comorbidities (41.6%), particularly depression, anxiety, and interictal psychosis. 449

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34341753 CONCLUSION: Information on non-attendance at various specialist consul- PMID: 34345475 tations is scarce, and to our knowledge, this is the first study to address non-attendance in patients with epilepsy in Latin America. Improving hos- pital protocols to reduce non-attendance can increase patient adherence to follow-up, ultimately improving the quality of care in the epilepsy clinic. CITA: Epilepsy Behav. 2021 Sep;122:108202 DOI: 10.1016/j.yebeh.2021.108202 TÍTULO: What is new in computer vision and artificial intelligence in medical image analysis applications AUTORES: Olveres J, González G, Torres F, Moreno-Tagle JC, Carba- jal-Degante E, Valencia-Rodríguez A, Méndez-Sánchez N, Escalan- te-Ramírez B. SUMMARY: Computer vision and artificial intelligence applications in medi- cine are becoming increasingly important day by day, especially in the field of image technology. In this paper we cover different artificial intelligence advances that tackle some of the most important worldwide medical prob- lems such as cardiology, cancer, dermatology, neurodegenerative disorders, respiratory problems, and gastroenterology. We show how both areas have resulted in a large variety of methods that range from enhancement, de- tection, segmentation and characterizations of anatomical structures and lesions to complete systems that automatically identify and classify several diseases in order to aid clinical diagnosis and treatment. Different imaging modalities such as computer tomography, magnetic resonance, radiography, ultrasound, dermoscopy and microscopy offer multiple opportunities to build automatic systems that help medical diagnosis, taking advantage of their own physical nature. However, these imaging modalities also impose import- ant limitations to the design of automatic image analysis systems for diag- nosis aid due to their inherent characteristics such as signal to noise ratio, contrast and resolutions in time, space and wavelength. Finally, we discuss future trends and challenges that computer vision and artificial intelligence must face in the coming years in order to build systems that are able to solve more complex problems that assist medical diagnosis. CITA: Quant Imaging Med Surg. 2021 Aug;11(8):3830-3853 DOI: 10.21037/qims-20-1151 TÍTULO: Upward transtentorial herniation: A new role for endoscopic third ventriculostomy AUTORES: Moscardini-Martelli J, Ponce-Gomez JA, Alcocer-Barradas V, Romano-Feinholz S, Padilla-Quiroz P, Zazueta MO, Ortega-Porcayo LA. BACKGROUND: The placement of external ventricular drainage (EVD) to treat hydrocephalus secondary to a cerebellar stroke is controversial be- cause it has been associated to upward transtentorial herniation (UTH). This case illustrates the effectiveness of endoscopic third ventriculostomy (ETV) after the ascending herniation has occurred. CASE DESCRIPTION: A 50-year-old man had a cerebellar stroke with hemorrhagic transformation, tonsillar herniation, and non-communicating obstructive hydrocephalus. Considering that the patient was anticoagulated and thrombocytopenic, an EVD was placed initially, followed by clinical de- 450