RESUMEN INVESTIGADORES-2

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34345954 terioration and UTH. We performed a suboccipital craniectomy immediately PMID: 34349856 after clinical worsening, but the patient did not show clinical or radiological improvement. On the 5th day, we did an ETV, which reverses the upward herniation and hydrocephalus. The patient improved progressively with good neurological recovery. CONCLUSION: ETV is an effective and safe procedure for obstructive hy- drocephalus. The successful resolution of the patient's upward herniation after the ETV offers a potential option to treat UTH and advocates further research in this area. CITA: Surg Neurol Int. 2021 Jul 6;12:334 DOI: 10.25259/SNI_140_2021 TÍTULO: Correction to: 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: Erratum CITA: Biol Trace Elem Res. 2021 Aug 4 DOI: 10.1007/s12011-021-02853-5 TÍTULO: Prevalence and Molecular Profile of Breast Carcinoma Using Im- munohistochemistry Markers in Mexican Women AUTORES: Macari A, Soberanis-Pina P, Varela-Santoyo E, Valle-San- chez MA, Leal-Hidalgo JL, Torres-Guillen VM, Motola-Kuba D, Ruiz-Mo- rales JM, Dorantes-Heredia R. BACKGROUND: In Mexico, breast cancer is the leading cause of death by malignant tumors in women aged 20 and older. The World Health Organiza- tion estimates that 69% of deaths caused by breast cancer occur in devel- oping countries. Little is known about the prevalence of breast carcinoma in Mexico and its molecular subclassification. METHODS: This retrospective cross-sectional study included patients who underwent a mastectomy (single, radical or lumpectomy) or a breast tumor biopsy (core-needle or excisional) from January 2002 to December 2018. The primary purpose of the study was to determine the prevalence and mo- lecular profile of breast in comprehensive cancer center in Mexico and com- pare our results with those published in the US. This study was approved by our scientific and bioethical committee. RESULTS: The final analysis included 379 patients. The youngest patient was 23 years old and the oldest patient was 89; the mean age at diagnosis was 54.63 years. Patients of 40 years old or younger accounted for 48 of the cases (12.66%) and those older than 40 accounted for 331 of the cases (87.33%). The molecular subclassification showed luminal A subtype in 139 cases (36.67%), luminal B subtype in 143 cases (37.73%), human epidermal growth factor receptor 2-positive carcinomas in 32 cases (8.44%) and tri- 451

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34353468 ple-negative carcinomas in 65 cases (17.15%). Diabetes mellitus was pres- ent in 43 patients (11.34%), hypertension in 78 patients (20.58%), obesity in 82 patients (21.63%) and 66 patients reported being treated with exogenous hormone therapy (17.41%). CONCLUSIONS: Breast carcinoma occurs at an earlier age in Mexican women compared to women in the US. Hormone-positive tumors were found to be more prevalent in older patients, while high-grade tumors were more frequently identified in younger patients. CITA: World J Oncol. 2021 Aug;12(4):119-123 DOI: 10.14740/wjon1392 TÍTULO: Rapid Exclusion of COVID Infection With the Artificial Intelligence Electrocardiogram AUTORES: Attia ZI, Kapa S, Dugan J, Pereira N, Noseworthy PA, Jimenez FL, Cruz J, Carter RE, DeSimone DC, Signorino J, Halamka J, Chenna- iah Gari NR, Madathala RS, Platonov PG, Gul F, Janssens SP, Narayan S, Upadhyay GA, Alenghat FJ, Lahiri MK, Dujardin K, Hermel M, Dominic P, Turk-Adawi K, Asaad N, Svensson A, Fernandez-Aviles F, Esakof DD, Bar- tunek J, Noheria A, Sridhar AR, Lanza GA, Cohoon K, Padmanabhan D, Par- do Gutierrez JA, Sinagra G, Merlo M, Zagari D, Rodriguez Escenaro BD, Pahlajani DB, Loncar G, Vukomanovic V, Jensen HK, Farkouh ME, Luescher TF, Su Ping CL, Peters NS, Friedman PA OBJECTIVE: To rapidly exclude severe acute respiratory syndrome coro- navirus 2 (SARS-CoV-2) infection using artificial intelligence applied to the electrocardiogram (ECG). METHODS: A global, volunteer consortium from 4 continents identified patients with ECGs obtained around the time of polymerase chain reac- tion-confirmed COVID-19 diagnosis and age- and sex-matched controls from the same sites. Clinical characteristics, polymerase chain reaction results, and raw electrocardiographic data were collected. A convolutional neural network was trained using 26,153 ECGs (33.2% COVID positive), validated with 3826 ECGs (33.3% positive), and tested on 7870 ECGs not included in other sets (32.7% positive). Performance under different prevalence values was tested by adding control ECGs from a single high-volume site. RESULTS: The area under the curve for detection of acute COVID-19 infec- tion in the test group was 0.767 (95% CI, 0.756 to 0.778; sensitivity, 98%; specificity, 10%; positive predictive value, 37%; negative predictive value, 91%). To more accurately reflect a real-world population, 50,905 normal controls were added to adjust the COVID prevalence to approximately 5% (2657/58,555), resulting in an area under the curve of 0.780 (95% CI, 0.771 to 0.790) with a specificity of 12.1% and a negative predictive value of 99.2%. CONCLUSION: Infection with SARS-CoV-2 results in electrocardiographic changes that permit the artificial intelligence-enhanced ECG to be used as a rapid screening test with a high negative predictive value (99.2%). This may permit the development of electrocardiography-based tools to rapidly screen individuals for pandemic control. CITA: Mayo Clin Proc. 2021 Aug;96(8):2081-2094 DOI: 10.1016/j.mayocp.2021.05.027 452

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34384610 TÍTULO: Developing a standardized approach for assessing mast cells and eosinophils on tissue biopsies: A Work Group Report of the AAAAI Allergic PMID: 34398593 Skin Diseases Committee PMID: 34402474 AUTORES: Zimmermann N, Abonia JP, Dreskin SC, Akin C, Bolton S, Hap- pel CS, Geller M, Larenas-Linnemann D, Nanda A, Peterson K, Wasan A, Wechsler J, Zhang S, Bernstein JA. SUMMARY: Mast cells and eosinophils are commonly found, expectedly or unexpectedly, in human tissue biopsies. Although the clinical significance of their presence, absence, quantity, and quality continues to be investigated in homeostasis and disease, there are currently gaps in knowledge related to what constitutes quantitatively relevant increases in mast cell and eosinophil number in tissue specimens for several clinical conditions. Diagnostically rel- evant thresholds of mast cell and eosinophil numbers have been proposed and generally accepted by the medical community for a few conditions, such as systemic mastocytosis and eosinophilic esophagitis. However, for other mast cell- and eosinophil-associated disorders, broad discrepancies remain regarding diagnostic thresholds and how samples are processed, routine- ly and/or specially stained, and interpreted and/or reported by pathologists. These discrepancies can obfuscate or delay a patient's correct diagnosis. Therefore, a work group was assembled to review the literature and develop a standardized consensus for assessing the presence of mast cells and eo- sinophils for a spectrum of clinical conditions, including systemic mastocyto- sis and cutaneous mastocytosis, mast cell activation syndrome, eosinophilic esophagitis, eosinophilic gastritis/enteritis, and hypereosinophilia/hypereo- sinophilic syndrome. The intent of this work group is to build a consensus among pathology, allergy, dermatology, hematology/oncology, and gastro- enterology stakeholders for qualitatively and quantitatively assessing mast cells and eosinophils in skin, gastrointestinal, and bone marrow pathologic specimens for the benefit of clinical practice and patients. CITA: J Allergy Clin Immunol. 2021 Oct;148(4):964-983 DOI: 10.1016/j.jaci.2021.06.030 TÍTULO: Sjögren Syndrome Induced by Immune Checkpoint Inhibitors in a Patient with Advanced Renal Cell Carcinoma AUTORES: Conde-Flores E, Remolina-Bonilla Y, Castro-Alonso F, Martínez-Ibarra N, Hernández-Molina G, Chapa-Ibargüengoitia M, Gam- boa-Domínguez A, Bourlon MT. SUMMARY: This clinical quandary details a Mexican man, aged 77 years, who presented to the oncology clinic with a sternal mass. Based on the re- sults, the patient fulfilled the 2016 American College of Rheumatology/Eu- ropean League Against Rheumatism classification criteria for Sjögren syn- drome, thus the diagnosis triggered by immune checkpoint inhibitors was definitively established. CITA: Oncology (Williston Park). 2021 Aug 14;35(8):486-490 DOI: 10.46883/ONC.2021.3508.0486 TÍTULO: Long-standing effect of cholecystectomy in patients with metabol- ic-associated fatty liver disease AUTORES: Méndez-Sánchez N, Valencia-Rodríguez A, Cer- da-Reyes E, Montejo-Velázquez C, Higuera de la Tijera F, Servin- 453

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR Caamaño A, Icaza-Chávez ME, Chi-Cervera LA, Montalvo-Gordon I, Qi X, Jiménez-Gutiérrez C. OBJECTIVE: The role of cholecystectomy as a risk factor in patients with metabolic-associated fatty liver disease (MAFLD) remains unclear. This study aimed to investigate if long-standing cholecystectomy is associated with advanced liver fibrosis and cirrhosis in patients with recently diagnosed MAFLD. METHODS: A retrospective observational study was performed in four hos- pitals in Mexico including patients with recently diagnosed MAFLD and a history of cholecystectomy. Subjects were divided into those with cholecys- tectomy ≥6 months before MAFLD diagnosis (ChBM), and those with cho- lecystectomy at the time of MAFLD diagnosis (ChAM). Odds ratios (OR) for the association of advanced liver fibrosis and cirrhosis with the timing of cho- lecystectomy were calculated. RESULTS: Mean age of 211 participants was 49.06 ± 15.12 years and the majority were female (72.5%). Patients from the ChBM (n = 70) group were significantly older (53.14 vs. 47.03 years; P = 0.003), had higher BMI (30.54 vs. 28.52 kg/m2; P = 0.011) and lower platelet count (236.23 vs. 266.72 × 103/µL; P = 0.046) compared with patients from ChAM group (n = 141). In multivariable-adjusted analysis, age (OR = 2.37; P = 0.024), dyslipidemia (OR = 4.28; P = 0.005) and severe liver fibrosis (OR = 4.68; P = 0.0) were independent risk factors associated with long-standing cholecystectomy. CONCLUSION: Patients with long-standing cholecystectomy (≥6 months) are at increased risk of severe liver fibrosis and cirrhosis at the time of MA- FLD diagnosis compared to those with recently done cholecystectomy. Ad- vanced age (>50 years) and dyslipidemia are also commonly found in these subjects. CITA: Eur J Gastroenterol Hepatol. 2021 Dec 1;33 (1S Suppl 1):e824-e830 DOI: 10.1097/MEG.0000000000002274 PMID: 34408789 TÍTULO: A comparative study of immunotherapy as second-line treatment and beyond in patients with advanced non-small-cell lung carcinoma AUTORES: Rodríguez-Cid JR, Chards SC, González-Espinoza IR, García-Montes V, Garibay-Díaz JC, Hernández-Flores O, Riera-Sala R, Gozalishvili-Boncheva A, Alatorre-Alexander JA, Martínez-Barrera LM, Sán- chez-Ríos CP, Martinez-Camacho A, Martínez-Herrera JF, Guzmán-Casta J, Flores-Mariñelarena RR, Diaz-Rico J, Santillán-Doherty P. BACKGROUND: Immunotherapy has demonstrated an improved overall survival (OS) and progression-free survival (PFS) as second-line treatment and subsequent lines compared with chemotherapy. MATERIALS & METHODS: This was a retrospective review among eight medical centers comprising 100 patients with a confirmed diagnosis of non- small-cell lung carcinoma, in their second-line treatment or beyond with im- mune checkpoints inhibitors treatment. The current study aimed to analyze effectiveness of immunotherapy in second-line treatment or further in the Mexican population, using PFS rate, OS rate and the best objective re- sponse to treatment by RECIST 1.1 as a surrogate of effectiveness. 454

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34415095 RESULTS: In total, 100 patients met the criteria for enrollment in the current PMID: 34430555 study. From the total study population, 49 patients (49.0%) were male and 51 (51.0%) were female, with an average age of 60 years and stage IV as the most prevalent clinical stage at the beginning of the study. A total of 61 patients (61.0%) had partial response; 11 (11.0%) stable disease; 2 (2.0%), complete response, 4 (4.0%), progression; and 22 (22.0%) were nonevalu- able. We found a median PFS of 4 months (95% CI: 3.2-4.7 months) and an OS of 9 months (95% CI: 7.2-10.7 months). CONCLUSION: The response to immunotherapy is similar, with an improve- ment in OS and PFS, independent of which drug is used. Patients using nivolumab had a better survival, although that was not statistically significant. CITA: Lung Cancer Manag. 2021 Mar 11;10(3):LMT47 DOI: 10.2217/lmt-2020-0027 TÍTULO: Acute kidney injury in critically ill patients after oncological surgery: Risk factors and 1-year mortality AUTORES: Córdova-Sánchez BM, Joffre-Torres A, Joachín-Sánchez E, Morales Buenrostro LE, Ñamendys-Silva SA. AIM: We aimed to identify risk factors associated with acute kidney injury (AKI) and to analyse 1-year mortality after oncological surgery. METHODS: We retrospectively included 434 adult patients admitted to the intensive care unit (ICU) after oncological surgery, and classified AKI according to the Kidney Disease: Improving Global Outcomes criteria. We performed logistic regression and Cox regression analyses to evaluate AKI and mortality risk factors. RESULTS: Sixty-one percent of patients (n = 264) developed AKI. Previous abdominal radiotherapy and abdominal surgical packing were independently associated with stage 2 and 3 AKI, with adjusted odds ratio (OR) of 2.6 (95% confidence interval [CI] 1.3-5.5, p = .010) and OR of 2.6 (95% CI 1.2-5.5, p = .014), respectively. Other independent risk factors were: glomerular filtration rate (eGFR) <60 ml/min/1.73m2 (OR 3.6, 95% CI 1.2-11.4, p = .028), ab- dominal surgery 2.6 (1.4-4.9, p = .003), intraoperative diuresis <1 ml/k/h (OR 2.4, 95% CI 1.4-4.0, p = .001), sepsis (OR 2.5, 95% CI 1.3-4.6, p = .002) and mechanical ventilation at ICU admission (OR 7.7, 95% CI 3.2-18.6, p < .001). Stage 2 and stage 3 AKI were independently associated with 1-year mortali- ty, with adjusted hazard ratios (HR) of 2.6 (95% CI 1.3-5.0, p = .005) and HR of 5.0 (95% CI 2.6-9.6, p < .001), respectively. Additionally, patients who had postsurgical AKI, had a lower eGFR at 1-year follow-up. These findings may be limited by the retrospective single centre design of our study. CONCLUSION: In addition to the conventional risk factors, our results sug- gest that abdominal radiotherapy and abdominal surgical packing could be independent risk factors for AKI after oncological surgery. CITA: Nephrology (Carlton). 2021 Dec;26(12):965-971 DOI: 10.1111/nep.13964 TÍTULO: Human albumin infusion strategy in liver cirrhosis: liberal or re- strictive? AUTORES: Bai Z, Cheng G, Méndez-Sánchez N, Qi X. 455

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34440450 SUMMARY: Editorial PMID: 34449539 CITA: Ann Transl Med. 2021 Jul;9(14):1114 DOI: 10.21037/atm-21-2136 TÍTULO: Hypomethylation of AHRR (cg05575921) Is Related to Smoking Status in the Mexican Mestizo Population AUTORES: Bravo-Gutiérrez OA, Falfán-Valencia R, Ramírez-Venegas A, Sansores RH, Hernández-Zenteno RJ, Hernández-Pérez A, García-Gómez L, Osio-Echánove J, Abarca-Rojano E, Pérez-Rubio G. SUMMARY: Tobacco smoking results in a multifactorial disease involving environmental and genetic factors; epigenome-wide association studies (EWAS) show changes in DNA methylation levels due to cigarette consump- tion, partially reversible upon tobacco smoking cessation. Therefore, meth- ylation levels could predict smoking status. This study aimed to evaluate the DNA methylation level of cg05575921 (AHRR) and cg23771366 (PRSS23) and their correlation with lung function variables, cigarette consumption, and nicotine addiction in the Mexican smoking population. We included 114 non-smokers (NS) and 102 current tobacco smokers (TS); we then further subclassified them as heavy smokers (HS) (n = 53) and light smokers (LS) (n = 49). We used restriction enzymes (MspI/HpaII) and qPCR to determine the DNA methylation level. We observed significant hypomethylation of cg05575921 in smokers compared to NS (p = 0.003); further analysis found a difference between HS and NS (p = 0.02). We did not observe differences between other groups or a positive correlation between methylation levels and age, BMI, cigarette consumption, nicotine addiction, or lung function. In conclusion, the cg05575921 site of AHRR is significantly hypomethylated in Mexican smokers, especially in HS (≥20 cigarettes per day). CITA: Genes (Basel). 2021 Aug 20;12(8):1276 DOI: 0.3390/genes12081276 TÍTULO: Protective Role of Genetic Variants in HSP90 Genes-Complex in COPD Secondary to Biomass-Burning Smoke Exposure and Non-Severe COPD Forms in Tobacco Smoking Subjects AUTORES: Ambrocio-Ortiz E, Pérez-Rubio G, Ramírez-Venegas A, Hernández-Zenteno RJ, Paredes-López A, Sansores RH, Ramírez-Díaz ME, Cruz-Vicente F, Martínez-Gómez ML, Falfán-Valencia R. BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is an in- flammatory disease characterized by airflow obstruction, commonly present in smokers and subjects exposed to noxious particles product of biomass-burn- ing smoke (BBS). Several association studies have identified single-nucleotide polymorphisms (SNP) in coding genes related to the heat shock proteins fam- ily-genes that codify the heat shock proteins (Hsp). Hsp accomplishes critical roles in regulating immune response, antigen-processing, eliminating protein aggregates and co-activating receptors. The presence of SNPs in these genes can lead to alterations in immune responses. We aimed to evaluate the associ- ation of SNPs in the HSP90 gene complex and COPD. METHODS: We enrolled 1549 participants, divided into two comparison groups; 919 tobacco-smoking subjects (cases COPD-TS n = 294 and, con- 456

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR trols SWOC n = 625) and 630 chronic exposed to BBS (cases COPD-BBS n = 186 and controls BBES n = 444). We genotyped 2 SNPs: the rs13296 in HSP90AB1 and rs2070908 in HSP90B1. RESULTS: Through the dominant model (GC + CC), the rs2070908 is as- sociated with decreased risk (p < 0.01, OR = 0.6) to suffer COPD among chronic exposed BBS subjects. We found an association between rs13296 GG genotype and lower risk (p = 0.01, OR = 0.22) to suffer severe COPD-TS forms in the severity analysis. CONCLUSIONS: single-nucleotide variants in the HSP90AB1 and HSP90B1 genes are associated with decreased COPD risk in subjects exposed to BBS and the most severe forms of COPD in tobacco-smoking subjects. CITA: Curr Issues Mol Biol. 2021 Aug 3;43(2):887-899 DOI: 10.3390/cimb43020063 PMID: 34456329 TÍTULO: A Review of the Increasing Prevalence of Metabolic-Associated Fatty Liver Disease (MAFLD) in Children and Adolescents Worldwide and in Mexico and the Implications for Public Health AUTORES: Ramírez-Mejía MM, Díaz-Orozco LE, Barranco-Fragoso B, Méndez-Sánchez N. SUMMARY: Non-alcoholic fatty liver disease (NAFLD) affects almost a quar- ter of the world's population and is the most common cause of chronic liver disease in children and adolescents. The recent proposal to replace the termi- nology of NAFLD with metabolic-associated fatty liver disease (MAFLD) aims to reflect the pathophysiology and risk factors for this disease. Importantly, the risk factors for MAFLD may be prenatal, such as genetic factors, or postnatal, such as obesity and insulin resistance. MAFLD is increasingly recognized in children and adolescents. Early diagnosis and identification of high-risk indi- viduals with type 2 diabetes mellitus and metabolic syndrome is important. The diagnosis and management of MAFLD in children and adolescents should fol- low international clinical guidelines, such as those from the American Diabetes Association (ADA) and the International Society for Pediatric and Adolescent Diabetes (ISPAD). Current guidelines recommend lifestyle and dietary modifi- cations, exercise, screening, individualized patient assessment, and multidis- ciplinary patient management. This review assesses the revised terminology and discusses the epidemiology, risk factors, pathophysiology, diagnosis, and prevention of MAFLD in children and adolescents worldwide and in Mexico, and also considers the implications for public health. CITA: Med Sci Monit. 2021 Aug 30;27:e934134 DOI: 10.12659/MSM.934134 PMID: 34461380 TÍTULO: Do ventilatory parameters influence outcome in patients with se- vere acute respiratory infection? Secondary analysis of an international, mul- ticentre14-day inception cohort study AUTORES: Sakr Y, Midega T, Antoniazzi J, Solé-Violán J, Bauer PR, Oster- mann M, Pellis T, Szakmany T, Zacharowski K, Ñamendys-Silva SA, Pham T, Ferrer R, Taccone FS, van Haren F, Brochard L 457

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34465482 PURPOSE: To investigate the possible association between ventilatory set- PMID: 34526783 tings on the first day of invasive mechanical ventilation (IMV) and mortality in patients admitted to the intensive care unit (ICU) with severe acute respira- tory infection (SARI). MATERIALS AND METHODS: In this pre-planned sub-study of a prospec- tive, multicentre observational study, 441 patients with SARI who received controlled IMV during the ICU stay were included in the analysis. RESULTS: ICU and hospital mortality rates were 23.1 and 28.1%, respec- tively. In multivariable analysis, tidal volume and respiratory rate on the first day of IMV were not associated with an increased risk of death; however, higher driving pressure (DP: odds ratio (OR) 1.05; 95% confidence interval (CI): 1.01-1.1, p = 0.011), plateau pressure (Pplat) (OR 1.08; 95% CI: 1.04- 1.13, p < 0.001) and positive end-expiratory pressure (PEEP) (OR 1.13; 95% CI: 1.03-1.24, p = 0.006) were independently associated with in-hospital mortality. In subgroup analysis, in hypoxemic patients and in patients with acute respiratory distress syndrome (ARDS), higher DP, Pplat, and PEEP were associated with increased risk of in-hospital death. CONCLUSIONS: In patients with SARI receiving IMV, higher DP, Pplat and PEEP, and not tidal volume, were associated with a higher risk of in-hospital death, especially in those with hypoxemia or ARDS. CITA: J Crit Care. 2021 Dec;66:78-85 DOI: 10.1016/j.jcrc.2021.08.008 TÍTULO: Erratum regarding \"delirious mania as a frequent and recognizable neuropsychiatric syndrome in patients with anti-NMDAR encephalitis\" AUTORES: Restrepo-Martínez M, Ramírez-Bermúdez J, Bayliss L, Espino- la-Nadurille M. SUMMARY: Letter to the editor CITA: Gen Hosp Psychiatry. Sep-Oct 2021;72:151 DOI: 10.1016/j.genhosppsych.2021.06.010 TÍTULO: Intranasal Corticosteroids: Topical Potency, Systemic Activity and Therapeutic Index AUTORES: Daley-Yates PT, Larenas-Linnemann D, Bhargave C, Verma M. SUMMARY: Intranasal corticosteroid (INCS) therapy is the preferred treat- ment option for allergic rhinitis (AR). Although all INCSs for the treatment of AR are considered safe and effective, differences in potency, molecular structure features and physicochemical and pharmacokinetic properties could result in differences in clinical efficacy and safety. Higher glucocor- ticoid receptor (GR) binding affinity of INCS is associated with higher lipo- philicity, nasal tissue retention and topical potency. Higher topical potency is also accompanied by low oral bioavailability and high systemic clearance conferring low systemic exposure, reduced potential for systemic adverse effects and an improved therapeutic index. It has been shown that adverse events related to systemic exposure of INCSs in children are low. Although 458

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34528262 INCSs mostly produce low systemic effects, use of an INCS with low sys- temic exposure in patients on multiple corticosteroid (CS) therapies could help reduce the total systemic burden of CS therapy. Despite differences in topical potency, physicochemical and pharmacokinetic properties between INCSs, clinical studies of INCSs in the treatment of AR generally show no clinically important differences between these compounds, and poor cor- relation between INCS topical potency and clinical response. However, the lack of head-to-head comparisons of INCSs in clinical studies conducted in more severe AR patients should be noted. This narrative review provides an assessment of the therapeutic relevance of topical potency and the physi- cochemical and pharmacokinetic properties of INCSs and describes for the first time the relationship between topical potency and therapeutic index us- ing pharmacological features of INCSs. It concludes that higher GR binding affinity and topical potency can potentially improve the therapeutic index of an INCS. Therefore, both efficacy and systemic exposure profiles should be considered when comparing INCS regimens in terms of therapeutic equiva- lence, to aid clinical decision-making and avoid the assumption that all INCS formulations are the same when considering treatment options. CITA: J Asthma Allergy. 2021 Sep 8;14:1093-1104 DOI: 10.2147/JAA.S321332 TÍTULO: Out-of-field mean photon energy and dose from 6 MV and 6 MV FFF beams measured with TLD-300 and TLD-100 dosimeters AUTORES: López-Guadalupe VM, Rodríguez-Laguna A, Poitevin-Chacón MA, López-Pineda E, Brandan ME. PURPOSE: To measure the out-of-field mean photon energy and dose im- parted by the secondary radiation field generated by 6 MV and 6 MV FFF beams using TLD-300 and TLD-100 dosimeters and to use the technique to quantify the contributions from the different sources that generate out-of- field radiation. METHODS: The mean photon energy and the dose were measured using the TLD-300 glow curve properties and the TLD-100 response, respective- ly. The TLD-300 glow curve shape was energy-calibrated with gamma rays from 99m Tc, 18 F, 137 Cs, and 60 Co sources, and its energy dependence was quantified by a parameter obtained from the curve deconvolution. The TLD-100 signal was calibrated in absorbed dose-to-water inside the primary field. Dosimeters were placed on the linac head, and on the surface and at 4.5 cm depth in PMMA at 1-15 cm lateral distances from a 10 × 10 cm2 field edge at the isocenter plane. Three configurations of dosimeters around the linac were defined to identify and quantify the contributions from the different sources of out-of-field radiation. RESULTS: Typical energies of head leakage were about 500 keV for both beams. The mean energy of collimator-scattered radiation was equal to or larger than 1250 keV and, for phantom-scattered radiation, mean photon energies were 400 keV for the 6 MV and 300 keV for the 6 MV FFF beam. Relative uncertainties to determine mean photon energy were better than 15% for energies below 700 keV, and 40% above 1000 keV. The technique lost its sensitivity to the incident photon energy above 1250 keV. On the phantom surface and at 1-15 cm from the field edge, 80%-90% of out-of-field dose came from scattering in the secondary collimator. At 4.5 cm deep in the phantom and 1-5 cm from the field edge, 50%-60% of the out-of-field dose originated in the phantom. At the points of measurement, the head leakage 459

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34547479 imparted less than 0.1% of the dose at the isocenter. The 6 MV FFF beam PMID: 34567526 imparted 8-36% less out-of-field dose than the 6 MV beam. These energy results are consistent with general Monte Carlo simulation predictions and show excellent agreement with simulations for a similar linac. The measured out-of-field doses showed good agreement with independent evaluations. CONCLUSIONS: The out-of-field mean photon energy and dose imparted by the secondary radiation field were quantified by the applied TLD-300/ TLD-100 method. The main sources of out-of-field dose were identified and quantified using three configurations of dosimeters around the linac. This technique could be of value to validate Monte Carlo simulations where the linac head design, configuration, or material composition are unavailable. CITA: Med Phys. 2021 Nov;48(11):6567-6577 DOI: 10.1002/mp.15233 TÍTULO: The multifaceted aspects of modern hepatology AUTORES: Tapia NC, Tiribelli C. SUMMARY: Editorial CITA: Ann Hepatol. 2021 Dec;26:100536 DOI: 10.1016/j.aohep.2021.100536 TÍTULO: Validity, reliability, and responsiveness of daily monitoring visual analog scales in MASK-air® AUTORES: Sousa-Pinto B, (…) Larenas Linnemann DE, et al. BACKGROUND: MASK-air® is an app that supports allergic rhinitis patients in disease control. Users register daily allergy symptoms and their impact on activities using visual analog scales (VASs). We aimed to assess the concur- rent validity, reliability, and responsiveness of these daily VASs. METHODS: Daily monitoring VAS data were assessed in MASK-air® users with allergic rhinitis. Concurrent validity was assessed by correlating daily VAS values with those of the EuroQol-5 Dimensions (EQ-5D) VAS, the Con- trol of Allergic Rhinitis and Asthma Test (CARAT) score, and the Work Pro- ductivity and Activity Impairment Allergic Specific (WPAI-AS) Questionnaire (work and activity impairment scores). Intra-rater reliability was assessed in users providing multiple daily VASs within the same day. Test-retest re- liability was tested in clinically stable users, as defined by the EQ-5D VAS, CARAT, or \"VAS Work\" (i.e., VAS assessing the impact of allergy on work). Responsiveness was determined in users with two consecutive measure- ments of EQ-5D-VAS or \"VAS Work\" indicating clinical change. RESULTS: A total of 17,780 MASK-air® users, with 317,176 VAS days, were assessed. Concurrent validity was moderate-high (Spearman correlation co- efficient range: 0.437-0.716). Intra-rater reliability intraclass correlation coeffi- cients (ICCs) ranged between 0.870 (VAS assessing global allergy symptoms) and 0.937 (VAS assessing allergy symptoms on sleep). Test-retest reliability ICCs ranged between 0.604 and 0.878-\"VAS Work\" and \"VAS asthma\" pre- sented the highest ICCs. Moderate/large responsiveness effect sizes were observed-the sleep VAS was associated with lower responsiveness, while the global allergy symptoms VAS demonstrated higher responsiveness. 460

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34572893 CONCLUSION: In MASK-air®, daily monitoring VASs have high intra-rater PMID: 34597281 reliability and moderate-high validity, reliability, and responsiveness, pointing to a reliable measure of symptom loads. CITA: Clin Transl Allergy. 2021 Sep 19;11(7):e12062 DOI: 10.1002/clt2.12062 TÍTULO: ALK-Negative Anaplastic Large Cell Lymphoma: Current Concepts and Molecular Pathogenesis of a Heterogeneous Group of Large T-Cell Lym- phomas AUTORES: Pina-Oviedo S, Ortiz-Hidalgo C, Carballo-Zarate AA, Za- rate-Osorno A. SUMMARY: Anaplastic large cell lymphoma (ALCL) is a subtype of CD30+ large T-cell lymphoma (TCL) that comprises ~2% of all adult non-Hodgkin lymphomas. Based on the presence/absence of the rearrangement and ex- pression of anaplastic lymphoma kinase (ALK), ALCL is divided into ALK+ and ALK-, and both differ clinically and prognostically. This review focuses on the historical points, clinical features, histopathology, differential diagno- sis, and relevant cytogenetic and molecular alterations of ALK- ALCL and its subtypes: systemic, primary cutaneous (pc-ALCL), and breast implant-as- sociated (BIA-ALCL). Recent studies have identified recurrent genetic alter- ations in this TCL. In systemic ALK- ALCL, rearrangements in DUSP22 and TP63 are detected in 30% and 8% of cases, respectively, while the remain- ing cases are negative for these rearrangements. A similar distribution of these rearrangements is seen in pc-ALCL, whereas none have been detect- ed in BIA-ALCL. Additionally, systemic ALK- ALCL-apart from DUSP22-re- arranged cases-harbors JAK1 and/or STAT3 mutations that result in the activation of the JAK/STAT signaling pathway. The JAK1/3 and STAT3 muta- tions have also been identified in BIA-ALCL but not in pc-ALCL. Although the pathogenesis of these alterations is not fully understood, most of them have prognostic value and open the door to the use of potential targeted therapies for this subtype of TCL. CITA: Cancers (Basel). 2021 Sep 17;13(18):4667 DOI: 10.3390/cancers13184667 TÍTULO: Evolution of Nonmalignant Portal Vein Thrombosis in Liver Cirrho- sis: A Pictorial Review AUTORES: Xu S, Guo X, Yang B, Romeiro FG, Primignani M, Méndez-Sá- nchez N, Yoshida EM, Mancuso A, Tacke F, Noronha Ferreira C, De Stefano V, Qi X. SUMMARY: Portal vein thrombosis (PVT) is a common complication in liver cirrhosis, especially in advanced cirrhosis. It may be related to a higher risk of liver-related events and liver function deterioration. Imag- ing examinations can not only provide an accurate diagnosis of PVT, such as the extent of thrombus involvement and the degree of lumen occupied, but also identify the nature of thrombus (i.e., benign/malignant and acute/ chronic). Evolution of PVT, mainly including development, recanalization, progression, stability, and recurrence, could also be assessed based on the imaging examinations. This article briefly reviews the pathophysiology, diagnosis, classification, and evolution of PVT with an emphasis on their computed tomography imaging features. 461

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR CITA: Clin Transl Gastroenterol. 2021 Oct 1;12(10):e00409 DOI: 10.14309/ctg.0000000000000409 PMID: 34625146 TÍTULO: Comorbidity burden in terms of disability in patients with osteoar- thritis in Mexico. The IMPACTAR registry AUTORES: Vega-Morales D, Esquivel-Valerio JA, Vázquez-Fuentes BR, Díaz-Borjón A, Arce-Salinas CA, Álvarez-Hernández E, Torres-Roldán JF, Aguilera-Zepeda JM, Toledo-Infanson V, Alcántar-Luna E, Aldrete-Velasco JA, Martínez Hernández JL, Gutiérrez-Gómez JJ, Espinosa-Morales R OBJECTIVE: To determine the comorbidities associated with disability in pa- tients with OA in Mexico (2013-2015). MATERIAL AND METHODS: A cross-sectional, retrospective and multi- center IMPACTAR study (n=7703) in Mexican patients (2013-2015). Comor- bidities associated with disability were identified in 4971 patients diagnosed with OA from the IMPACTAR registry (n=7073). An adjusted logistic regres- sion analysis was carried out by demographic, economic, clinical and med- ical variables. RESULTS: Mean age was 63 years; and 75% of the patients were women. Subjects with OA and presence of comorbidities are 42% more likely to de- velop disabilities than patients without associated comorbidity, considering age, sex, family income, OA diagnosis duration, and education level. The highest rate of people with disability (28.9%) was concentrated in Region 7, which corresponds to Mexico City. There are also significant differences between median family incomes, when the income of persons with disability is under $13 000 (IQR: 9000-16 000) Mexican pesos, compared to patients without disability. Almost half of the subjects (49.6%) reported having at least one comorbidity. Arterial hypertension was the risk factor with a sta- tistically significant difference (32.8%) among those with disability (34.7%). CONCLUSIONS: Programs and interventions for OA patients should take into consideration comorbidity factors, being female, family income, and the region of residence as variables that may increase the possibility of develop- ing an OA-associated disability. CITA: Reumatol Clin (Engl Ed). 2021 Oct;17(8):440-446 DOI: 10.1016/j.reumae.2020.03.004 PMID: 34626089 TÍTULO: Ten-year course of treated bipolar I disorder: The role of polarity at onset AUTORES: Yoldi-Negrete M, Fresán-Orellana A, Jiménez-Tirado M, Martínez-Camarillo S, Palacios-Cruz L, Vieta E, Ortega-Ortiz H, Becer- ra-Palars C, Gutiérrez-Mora D, Camarena Medellín B. INTRODUCTION: Early-stage predictors of illness course are needed in bi- polar disorder (BD). Differences among patients with a first depressive ver- sus maniac/hypomanic episode have been stated, although in most studies, memory bias and time from onset to start of specialized treatment might interfere. The aim was to compare the first 10 years of illness course accord- ing to polarity at onset. 462

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34722722 METHODS: 49 type I BD patients admitted for treatment for a first-time af- PMID: 34729153 fective episode and a following 10-year attendance to the institution were included. A retrospective year by year comparison according to polarity at onset (depressive (DPO) or maniac (MPO)) was performed. Cramer's V and Cohen d were computed to determine effect size. RESULTS: 59.2% (n = 29) started with MPO. Both groups were similar in demographic and social outcome characteristics, clinical features, and treat- ment variables. Patients with DPO reported more depressive episodes than MPO patients (U = 149.0 p < .001, Cohen's d = 0.87); both groups had a similar number of manic episodes. Only during the first year of follow-up, suicide attempts (SA) were more frequent in patients with DPO while the presence of a psychotic episode and psychiatric hospitalizations were more frequent in the MPO group. CONCLUSION: According to these findings, it can be concluded that illness on- set is only indicative of depressive predominant polarity but is not related to other poor prognostic variables after the first year of illness onset, in treated BD. SA in the first year of an affective disorder could represent a marker of BD. CITA: Brain Behav. 2021 Nov;11(11):e2279 DOI: 10.1002/brb3.2279 TÍTULO: Obesity and Gallstones AUTORES: Parra-Landazury NM, Cordova-Gallardo J, Méndez-Sánchez N. BACKGROUND: The prevalence of obesity has been increasing globally and represents the main risk factor for the development of gallstone dis- ease (GD). SUMMARY: Excess body weight represents the main cause for the devel- opment of GD; nevertheless, there have been described multiple risk fac- tors for its development, among them modifiable risk factors as diet, lifestyle, physical inactivity, and non-modifiable risk factors as ethnicity, female sex, advanced age, parity, and genetic mutations. Body mass index, abdominal perimeter, and waist-hip index have been used to determine the degree of adiposity of a person. Hence, central abdominal fat has been mostly asso- ciated with insulin resistance with the consequent increase in the hepatic cholesterol secretion; contributing as one of the multiple mechanisms asso- ciated with the development of gallstones. This disease has a low mortality; however, it has been associated with multiple diseases such as cardiovas- cular diseases, carotid atherosclerosis, metabolic associated fatty liver dis- ease, and gallbladder cancer, probably because they share many of the risk factors. CITA: Visc Med. 2021 Oct;37(5):394-402 DOI: 10.1159/000515545. TÍTULO: Prognostic factors in cancer patients infected with SARS-CoV-2: a Latin American country results AUTORES: Ruiz-Garcia E, Peña-Nieves A, Alegria-Baños J, Corne- jo-Juarez P, Meneses-García A, Rivera SR, Sánchez JJ, Gerson-Cwilich R, Gerson DS, Franco HM, Buerba GA, Espinoza AA, Mijares NV, Fernán- dez-Figueroa EA, Vázquez RA, Vilar-Compte D. 463

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34762622 PURPOSE: The aim of this study was to evaluate the demographic char- PMID: 34768009 acteristics, clinical and pathological factors, and the outcome of cancer and COVID-19 patients in Mexico. PATIENTS AND METHODS: A prospective, multicentric study was per- formed through a digital platform to have a national registry of patients with cancer and positive SARS-CoV-2 test results through reverse transcription quantitative polymerase chain reaction (RT-qPCR). We performed the anal- ysis through a multivariate logistic regression model and Cox proportional hazard model. RESULTS: From May to December 2020, 599 patients were registered with an average age of 56 years with 59.3% female; 27.2% had hyperten- sion. The most frequent diagnoses were breast cancer (30.4%), lymphoma (14.7%), and colorectal cancer (14.0%); 72.1% of patients had active cancer and 23.5% of patients (141/599) were deceased, the majority of which were men (51.7%). This study found that the prognostic factors that reduced the odds of death were gender (OR = 0.42, p = 0.031) and oxygen saturation (OR = 0.90, p = 0.0001); meanwhile, poor ECOG (OR = 5.4, p = 0.0001), active disease (OR = 3.9, p = 0.041), dyspnea (OR = 2.5, p = 0.027), and nausea (OR = 4.0, p = 0.028) increased the odds of death. In the meantime, the factors that reduce survival time were age (HR = 1.36, p = 0.035), COPD (HR = 8.30, p = 0.004), having palliative treatment (HR = 10.70, p = 0.002), and active cancer without treatment (HR = 8.68, p = 0.008). CONCLUSION: Mortality in cancer patients with COVID-19 is determined by prognostic factors whose identification is necessary. In our cancer popula- tion, we have observed that being female, younger, non-COPD, with non-ac- tive cancer, good performance status, and high oxygen levels reduce the probability of death. CITA: Ther Adv Chronic Dis. 2021 Sep 26;12:20406223211047755 DOI: 10.1177/20406223211047755 TÍTULO: The key to simplified management of an undescended parathyroid adenoma AUTORES: Ruiz-Hernández H, Meza-Venegas J, Snyder SK. SUMMARY: Undescended parathyroid adenoma is a rare cause of primary hyperparathyroidism that happens < 1% of cases. If not suspected, it can lead to a negative bilateral parathyroid exploration and extensive iatrogenic trauma. We propose that with proper imaging the correct diagnosis can be established to simplify surgical management. We describe two cases of pa- tients who underwent a targeted neck exploration due to an undescended parathyroid adenoma diagnosed with an appropriate preoperative imaging protocol. With an appropriate imaging protocol for primary hyperparathy- roidism and parathyroid hormone aspirates, an undescended parathyroid adenoma can be primarily diagnosed to guide a focused parathyroidectomy. CITA: Cir Cir. 2021;89(S1):37-42 DOI: 10.24875/CIRU.20001056 TÍTULO: Clinical and Patient-Reported Outcomes From Patients With Nonalcoholic Fatty Liver Disease Across the World: Data From the Global Non-Alcoholic Steatohepatitis (NASH)/ Non-Alcoholic Fatty Liver Disease (NAFLD) Registry 464

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR AUTORES: Younossi ZM, (…) Méndez-Sánchez N, et al. BACKGROUND & AIMS: Globally, nonalcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease. We assessed the clinical pre- sentation and patient-reported outcomes (PROs) among NAFLD patients from different countries. METHODS: Clinical, laboratory, and PRO data (Chronic Liver Disease Questionnaire-nonalcoholic steatohepatitis [NASH], Functional Assessment of Chronic Illness Therapy-Fatigue, and the Work Productivity and Activity Index) were collected from NAFLD patients seen in real-world practices and enrolled in the Global NAFLD/NASH Registry encompassing 18 countries in 6 global burden of disease super-regions. RESULTS: Across the global burden of disease super-regions, NAFLD patients (n = 5691) were oldest in Latin America and Eastern Europe and youngest in South Asia. Most men were enrolled at the Southeast and South Asia sites. Latin America and South Asia had the highest employment rates (>60%). Rates of cirrhosis varied (12%-21%), and were highest in North Af- rica/Middle East and Eastern Europe. Rates of metabolic syndrome compo- nents varied: 20% to 25% in South Asia and 60% to 80% in Eastern Europe. Chronic Liver Disease Questionnaire-NASH and Functional Assessment of Chronic Illness Therapy-Fatigue PRO scores were lower in NAFLD patients than general population norms (all P < .001). Across the super-regions, the lowest PRO scores were seen in Eastern Europe and North Africa/Middle East. In multivariate analysis adjusted for enrollment region, independent predictors of lower PRO scores included younger age, women, and nonhe- patic comorbidities including fatigue (P < .01). Patients whose fatigue scores improved over time experienced a substantial PRO improvement. Nearly 8% of Global NAFLD/NASH Registry patients had a lean body mass index, with fewer metabolic syndrome components, fewer comorbidities, less cirrhosis, and significantly better PRO scores (P < .01). CONCLUSIONS: NAFLD patients seen in real-world practices in different countries experience a high comorbidity burden and impaired quality of life. Future research using global data will enable more precise management and treatment strategies for these patients. CITA: Clin Gastroenterol Hepatol. 2021 Nov 9; S1542-3565(21)01183-6 DOI: 10.1016/j.cgh.2021.11.004 PMID: 34774158 TÍTULO: An online survey detected knowledge gaps and cost-saving oppor- tunities in asthma maintenance treatment among allergists, pulmonologists, ENTs and primary care AUTORES: Désirée LL, Margarita FV, Mónica RG, María Del Carmen CS, Jorge Agustín LP, José Antonio OM, Blanca DR, Erika Del Carmen LE, Jade RL, Juan Carlos VG, Jorge SP. BACKGROUND: In April 2017 the Mexican Asthma Guidelines (GUIMA) were published. Before the launch, physicians' knowledge was explored re- lated to key issues of the guideline. Methods: A SurveyMonkey® survey was sent out to board-certified physicians of 5medical specialties treating asth- ma. Replies were analyzed per specialty against the GUIMA evidence-based recommendations. We present the treatment part here. 465

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR RESULTS: A total of 364 allergists (ALLERG), 161 pulmonologists (PULM), 34 ENTs, 239 pediatricians (PED) and 62 general practitioners (GPs) replied to the survey and 247-83-14-135-37 respectively finished it. Spirometry is not routinely indicated when asthma is very probable by ALLERG 54%, PULM 47%, ENT 39%, PED 65%, GP 64%. A fictitious case proposed to the physicians with intermittent asthma was erroneously treated with ICS by ALLERG 9%, PULM 11%, ENT 28%, PED 10%, GP 11%. The mild persistent case received mistakenly ICS-LABA by ALLERG 25%, PULM 26%, ENT 33%, PED 27%, GP 23%. The first-line option for moderate persistent asthma was ICS(median dose) instead of ICS(low)+LABA for ALLERG 29%, PULM 25%, ENT 17%, PED 27%, GP 23% and in severe asthma maintenance treatment PULM20%,ALLERG-ENT-PED-GP 22-34% failed to indicate LABA. Con- cerning the guidelines' recommendation to use one inhaler for maintenance & rescue in moderate-to-severe asthma, PULM45%, ALLERG-ENT-PED-GP 56-80% (p < 0.00001), erroneously indicated ICS-salmeterol could be used, instead of ICS-formoterol. Oral β2 or theophylline are no longer recommend- ed, but PULM 37% and ALLERG-ENT-PED-GP 42-62% (p < 0.01) still in- dicate their use. In severe asthma 61-73% of physicians consider adding LTRA to the treatment; only PULM38%, OTHERS12-25% consider adding tiotropium (p < 0.001) and 3-17% consider adding omalizumab, both guide- lines recommended add-ons. As for asthma in pregnancy, most surveyed are not aware budesonide is the 1st line option ICS. Finally, 81-97% of the group-members recognized allergen immunotherapy, as a viable add-on, in line with GINA/GEMA/GUIMA recommendations. CONCLUSIONS: An online survey could detect knowledge-gaps related to asthma treatment. Interestingly, surveyed physicians tended to over-treat the milder asthma cases, thus clearly leaving room for cost-savings. Caution should be taken in the promotion of the SMART (single-maintenance-and-re- liever-treatment) approach, which can only be done with ICS-formoter- ol. Many physicians opt for other combinations not apt for this approach. Among all surveyed specialties there is ample room for improvement in mild and severe asthma management. CITA: World Allergy Organ J. 2019 Nov 19; 12(12):100084 DOI: 10.1016/j.waojou.2019.100084 PMID: 34778306 TÍTULO: Role of Galectins in the Liver Diseases: A Systematic Review and Meta-Analysis AUTORES: An Y, Xu S, Liu Y, Xu X, Philips CA, Chen J, Méndez-Sánchez N, Guo X, Qi X. BACKGROUND: Galectins, a family of β-galactoside-binding proteins, are related to the development and progression of various human diseases such as cancer, heart failure, and chronic kidney disease. However, its role in liver diseases is unclear. METHODS: The PubMed, Embase, and Cochrane Library databases were searched. Hazard ratios (HRs), odds ratios (ORs), and mean differences (MDs) with 95% CIs were pooled to evaluate the association of the galectins with the outcomes and risk of liver diseases by a random effects model. RESULTS: Thirty three studies involving 43 cohorts and 4,168 patients with liver diseases were included. In the patients with hepatocellular carcinoma (HCC), high expression of galectin-1 and -3 in the tissues was significantly associated with worse overall survival (galectin-1: HR = 1.94, 95% CI = 1.61- 466

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR 2.34, p < 0.001; galectin-3: HR = 3.29, 95% CI = 1.62-6.68, p < 0.001) and positive vascular invasion (galectin-1: OR = 1.74, 95% CI = 1.18-2.58, p = 0.005; galectin-3: OR = 2.98, 95% CI = 1.58-5.60, p = 0.001); but, high ex- pression of galectin-4 and -9 in the tissues was significantly associated with better overall survival (galectin-4: HR = 0.53, 95% CI = 0.36-0.79, p = 0.002; galectin-9: HR = 0.56, 95% CI = 0.44-0.71, p < 0.001) and negative vascular invasion (galectin-4: OR = 0.36, 95% CI = 0.19-0.72, p = 0.003; galectin-9: OR = 0.60, 95% CI = 0.37-0.97, p = 0.037). Serum galectin-3 level was sig- nificantly higher in HCC (MD = 3.06, 95% CI = 1.79-4.32, p < 0.001), liver failure (MD = 0.44, 95% CI = 0.23-0.66, p < 0.001), liver cirrhosis (MD = 1.83, 95% CI = 1.15-2.51, p < 0.001), and chronic active hepatitis B (MD = 18.95, 95% CI = 10.91-27.00, p < 0.001); serum galectin-9 level was significantly higher in HCC (MD = 3.74, 95% CI = 2.57-4.91, p < 0.001) and autoimmune hepatitis (MD = 8.80, 95% CI = 7.61-9.99, p < 0.001). CONCLUSION: High galectin-1 and -3 and low galectin-4 and -9 expression indicate worse outcomes of patients with HCC. Serum galectin-3 and -9 lev- els are positively associated with the risk of chronic liver diseases. CITA: Front Med (Lausanne). 2021 Oct 27;8:744518 DOI: 10.3389/fmed.2021.744518. PMID: 34785911 TÍTULO: Impact of Socioeconomic Status on Adult Patients with Asthma: A Population-Based Cohort Study from UK Primary Care AUTORES: Busby J, Price D, Al-Lehebi R, Bosnic-Anticevich S, van Boven JFM, Emmanuel B, FitzGerald JM, Gaga M, Hansen S, Hew M, Iwanaga T, Larenas Linnemann D, Mahboub B, Mitchell P, Morrone D, Pham J, Porsb- jerg C, Roche N, Wang E, Eleangovan N, Heaney LG. INTRODUCTION: Asthma morbidity and health-care utilization are known to exhibit a steep socioeconomic gradient. Further investigation into the modu- lators of this effect is required to identify potentially modifiable factors. METHODS: We identified a cohort of patients with asthma from the Opti- mum Patient Care Research Database (OPCRD). We compared demo- graphics, clinical variables, and health-care utilization by quintile of the UK 2011 Indices of Multiple Deprivation based on the location of the patients' general practice. Multivariable analyses were conducted using generalized linear models adjusting for year, age, and sex. We conducted subgroup analyses and interaction tests to investigate the impact of deprivation by age, sex, ethnicity, and treatment step. RESULTS: Our analysis included 127,040 patients with asthma. Patients from the most deprived socio-economic status (SES) quintile were more likely to report uncontrolled disease (OR: 1.54, 95% CI: 1.16, 2.05) and to have an exacerbation during follow-up (OR: 1.27, 95% CI: 1.13, 1.42) than the least deprived quintile. They had higher blood eosinophils (ratio: 1.03; 95% CI: 1.00, 1.06) and decreased peak flow (ratio: 0.95, 95% CI: 0.94, 0.97) when compared to those in the least deprived quintile. The effect of deprivation on asthma control was greater among those aged over 75 years (OR = 1.81, 95% CI: 1.20, 2.73) compared to those aged less than 35 years (OR: 1.22, 95% CI: 0.85, 1.74; pinteraction=0.019). Similarly, socioeconomic disparities in exacerbations were larger among those from ethnic minority groups (OR: 1.94, 95% CI: 1.40, 2.68) than white patients (OR: 1.24, 95% CI: 1.10, 1.39; pinteraction=0.012). 467

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34794923 CONCLUSION: We found worse disease control and increased exacerba- PMID: 34804280 tion rates among patients with asthma from more deprived areas. There was evidence that the magnitude of socioeconomic disparities was elevated among older patients and those from ethnic minority groups. The drivers of these differences require further exploration. CITA: J Asthma Allergy. 2021 Nov 10;14:1375-1388 DOI: 10.2147/JAA.S326213 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 ashort follow-up period. CITA: Rev Gastroenterol Mex (Engl Ed). 2021 Nov 15; S2255-534X(21)00060-8 DOI: 10.1016/j.rgmxen.2021.06.002 TÍTULO: Impact of Testicular Germ Cell Tumor Laterality on Recur- rence-Free Survival in the Mexican Population AUTORES: Davila Dupont D, Motola Kuba D, Alcantara Velarde TLM, Martinez Castaneda EA, Dorantes Heredia R, Ruiz Morales JM. BACKGROUND: To date, the prognostic value of laterality for testicular germ cell tumors remains unknown. Herein, we describe this prognostic fac- tor in the Mexican population. METHODS: A retrospective single-center study that included 37 patients with primary testicular germ cell tumors was conducted. Primary outcome was recurrence-free survival (RFS) at 2 years. Secondary outcomes were 468

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34893190 RFS by histology, progression-free survival by laterality, and 2-year overall PMID: 34900500 survival. RESULTS: Thirty-seven patients were included, of which five showed relaps- es. By laterality, the 2-year RFS rate was 100% for left tumors and 77.3% for right tumors, with a trend toward statistical significance (P = 0.058). By his- tology, the RFS rate was higher for seminomas than non-seminomas (89% vs. 83%, respectively) without this difference being statistically significant. Progression-free survival was higher for right tumors than left tumors (91% vs. 80%, respectively) but without reaching statistical significance. The over- all survival rate for the entire cohort was 94.5%. CONCLUSIONS: Our study show+s that patients with primary germ cell tu- mors of the right testicle have a higher risk of recurrence than those with primary germ cell tumors of the left testicle, with a trend toward statistical significance. CITA: World J Oncol. 2021 Oct;12(5):173-177 DOI: 10.14740/wjon1404 TÍTULO: Leukotriene Receptor Antagonists and the Risk of Neuropsychiatric Disease: Could There Be a Genetic Predisposition? AUTORES: Larenas-Linnemann D. SUMMARY: Editorial CITA: J Allergy Clin Immunol Pract. 2021 Dec;9(12):4298-4299 DOI: 10.1016/j.jaip.2021.09.017 TÍTULO: Diagnostic and Neurological Overview of Brain Tuberculomas: A Review of Literature AUTORES: Perez-Malagon CD, Barrera-Rodriguez R, Lopez-Gonzalez MA, Alva-Lopez LF. SUMMARY: Tuberculosis is a disease caused by a bacteria named Myco- bacterium tuberculosis (M. tb). It is estimated by World Health Organization (WHO) that nearly a quarter of the world's population is infected. Tubercu- loma of the brain is one of the most severe extrapulmonary forms that af- fects patients younger than 40 years of age. Brain parenchymal tuberculoma develops in nearly one of 300 non-treated cases of pulmonary tuberculosis cases. In endemic regions, tuberculomas account for as many as 50% of all intracranial masses. Tuberculoma results in a hematogenous spread of M. tb from an extracranial source. Tuberculomas can mimic a variety of dis- eases and can present themselves in a subacute or chronic course, from asymptomatic to severe intracranial hypertension. Diagnosis is based on computed tomography (CT) scan and magnetic resonance imaging (MRI) studies with a similar ring-enhancing lesion. Treatment is primarily medical, and the duration for brain tuberculoma can vary from six to 36 months. In certain cases, surgery is recommended. CITA: Cureus. 2021 Dec 3;13(12):e20133 DOI: 10.7759/cureus.20133 469

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34904293 TÍTULO: An independent in-depth analysis proposing adjusted Global Initia- tive on Asthma Step 1-2 treatment suggestions AUTORES: Larenas-Linnemann D, Navarrete-Rodríguez EM, Luna-Pech JA, Benítez R, Cano-Salas MC, Del Rio-Navarro BE, García-Ramírez UN, Gochicoa L, López-Estrada EDC, Ortega-Martell JA, Salas Hernández J. SUMMARY: The Global Initiative on Asthma (GINA) strategy included major changes for the treatment of mild asthma in the 2020 version that are even taken to the next level in 2021, leaving a preferred track with only rescue therapy with inhaled corticosteroid and formoterol (ICS-FORM) for steps 1-2 in 12+ years old. It has been questioned how solid the evidence behind these recommendations is. We decided to independently conduct an in- depth analysis of published evidence based on a comprehensive evaluation of original articles and related appendices and publications, including quality of evidence and risk of bias per article. We first defined the major asthma treatment goals and proceeded to review how these were met in publica- tions referenced in the main asthma guidelines. For patients with GINA (2021) Step 1 characteristics, the analysis supports GINA's decision to avoid SABA monotherapy and to prefer ICS-FORM rescue with an alternative ICS rescue every time a SABA is used for ≥12 years, even though evidence is extrapolated from step 2 patients. For 6- to 11-year-olds, we propose to con- sider ICS-FORM rescue as an alternative, as its use has been approved in this age group, be it not as rescue medication. For patients with GINA 2021 Step 2 characteristics, our proposal slightly differs from GINA 2021. We propose to continue avoiding the separate use of SABA, using ICS rescue whenever a fast-acting bronchodilator is taken (even with ICS maintenance). Also, the superiority of ICS-FORM rescue over classical step 2 treatment is not uniform and year-long experience is lacking. Consequently, for now, both treatment options seem equal: ICS-FORM rescue or ICS maintenance with SABA (+ICS) rescue. For 6- to 11-year-olds, ICS rescue every time a SABA is used has the advantage of lower total ICS dose; as alternative we suggest ICS-FORM rescue. The best treatment option depends on patient character- istics and treatment goals. Recommendations should be reviewed as soon as new evidence becomes available. CITA: Clin Exp Allergy. 2021 Dec 13 DOI: 10.1111/cea.14079 PMID: 34932829 TÍTULO: Development and validation of combined symptom-medication scores for allergic rhinitis AUTORES: Sousa-Pinto B, (…) Larenas-Linnemann DE, et al. BACKGROUND: Validated combined symptom-medication scores (CSMSs) are needed to investigate the effects of allergic rhinitis treatments. This study aimed to use real-life data from the MASK-air® app to generate and validate hypothesis- and data-driven CSMSs. METHODS: We used MASK-air® data to assess the concurrent validity, test-retest reliability and responsiveness of one hypothesis-driven CSMS (modified CSMS: mCSMS), one mixed hypothesis- and data-driven score (mixed score), and several data-driven CSMSs. The latter were generated with MASK-air® data following cluster analysis and regression models or factor analysis. These CSMSs were compared with scales measuring (i) the impact of rhinitis on work productivity (visual analogue scale [VAS] of work of 470

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34965789 MASK-air® , and Work Productivity and Activity Impairment: Allergy Specific PMID: 34968579 [WPAI-AS]), (ii) quality-of-life (EQ-5D VAS) and (iii) control of allergic diseas- es (Control of Allergic Rhinitis and Asthma Test [CARAT]). RESULTS: We assessed 317,176 days of MASK-air® use from 17,780 us- ers aged 16-90 years, in 25 countries. The mCSMS and the factor analy- ses-based CSMSs displayed poorer validity and responsiveness compared to the remaining CSMSs. The latter displayed moderate-to-strong correla- tions with the tested comparators, high test-retest reliability and moder- ate-to-large responsiveness. Among data-driven CSMSs, a better perfor- mance was observed for cluster analyses-based CSMSs. High accuracy (capacity of discriminating different levels of rhinitis control) was observed for the latter (AUC-ROC = 0.904) and for the mixed CSMS (AUC-ROC = 0.820). CONCLUSION: The mixed CSMS and the cluster-based CSMSs presented medium-high validity, reliability and accuracy, rendering them as candidates for primary endpoints in future rhinitis trials. CITA: Allergy. 2021 Dec 21 DOI: 10.1111/all.15199 TÍTULO: Prevalence, attitude, knowledge, and risk perception towards COVID-19 in COPD patients associated to biomass exposure AUTORES: Montiel-Lopez F, Rodríguez-Ramírez D, Miranda-Márquez MC, Cassou-Martínez M, Perea-Gutiérrez H, Hernández-Pérez A, Martínez Gómez ML, Sansores RH, Hernández-Zenteno R, Pérez-Padilla R, Ramírez-Venegas A. SUMMARY: Chronic obstructive pulmonary disease (COPD) patients due to biomass exposure (BE-COPD) could be more affected than COPD due to to- bacco smoke (TE-COPD) by the coronavirus disease 2019 (COVID-19) pan- demic. The aim of this work was to determine the prevalence of COVID-19 in BE-COPD and TE-COPD and if housing conditions, poor attitude, knowl- edge, and risk perception towards COVID-19, particularly in BE-COPD women, could represent a risk factor for contagion.An 11% prevalence of COVID-19 was found with no significant difference between COPD groups. The BE-COPD group showed poorer socioeconomic status. No significant differences were found to be associated with SARS-CoV-2 infection re- garding housing conditions, poor knowledge, attitude, and risk perception towards COVID-19. Living in urban areas and perceiving risk in COVID-19 were significantly associated with increased adherence to sanitary mea- sures and concern of contagion. Around 40% of all patients showed poor risk perception and adherence to sanitary measures towards COVID-19. CITA: Int J Environ Health Res. 2021 Dec 29;1-10 DOI: 10.1080/09603123.2021.2013449 TÍTULO: Latin American Association of Pediatrics (ALAPE) endorses the MAFLD definition of fatty liver disease AUTORES: Méndez-Sánchez N, Maris-Gil S, Alonso-Rivera CG. SUMMARY: Letter to the editor 471

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR CITA: J Hepatol. 2021 Dec 27;S0168-8278(21)02297-2 DOI: 10.1016/j.jhep.2021.12.020 PMID: 34985050 TÍTULO: Metabolic associated fatty liver disease and acute-on-chronic liver PMID: 35059081 failure: common themes for common problems AUTORES: Córdova-Gallardo J, Keaveny AP, Qi X, Méndez-Sánchez N. SUMMARY: Metabolic associated fatty liver disease (MAFLD) affects 20- 30% of the worldwide population and is becoming the most common cause of chronic liver disease, cirrhosis and hepatocellular carcinoma (HCC). MA- FLD is the hepatic expression of metabolic dysfunction correlated with a variety of metabolic comorbidities including obesity, dyslipidemia, hyperten- sion and type 2 diabetes (T2DM). Obesity, altered gut permeability, chronic inflammation and dysbiosis related to MAFLD might predispose patients with cirrhosis to the development of acute-on-chronic liver failure (ACLF); however, this relationship remains unclear. ACLF is a syndrome with high short-term mortality, presenting with acute hepatic decompensation associ- ated with organ failures in patients with underlying chronic liver disease with or without an identifiable precipitating event. While this syndrome can occur in any patient with cirrhosis, the increasing prevalence of cirrhosis due to MAFLD is of great concern because, in a recent analysis, MAFLD was the fastest rising cause of cirrhosis associated with ACLF among patients listed for LT in the US. In this review, we will discuss the current knowledge on MAFLD and the development of ACLF. CITA: Eur J Gastroenterol Hepatol. 2021 Dec 1; 33(1S Suppl 1):e84-e93 DOI: 10.1097/MEG.0000000000002335 TÍTULO: Epithelial-Cadherin Expression Is Associated With Better Recur- rence-Free and Overall Survival in Invasive Lobular Breast Cancer in Mexi- can Women AUTORES: Fernandez-Ferreira R, Dorantes-Heredia R, Motola-Kuba D, Ruiz-Morales JM, Alvarado-Luna G, Kinney-Novelo IM, Munoz-Montano WR, Fuentes-Calvo KJ. BACKGROUND: There are different clinicopathological characteristics that are associated with the prognosis in patients with breast cancer. To date, the prognostic valor of for epithelial cadherin (E cadherin) expression in invasive lobular breast cancer remains unknown. METHODS: A retrospective single-center study that included 207 patients with primary invasive lobular breast cancer was conducted. The primary outcome was to report the correlation of the different clinical pathological characteristics including the expression of epithelial-cadherin (E-cadherin) in invasive lobular breast cancer in Mexican women with recurrence-free sur- vival (RFS) and overall survival (OS). RESULTS: After 11 years of follow-up of patients with invasive lobular breast cancer, RFS was 89.4% and OS of 96.1%. The best prognosis in RFS was in patients with negative nodes 95.2% (P = 0.0001) and OS was 98.6-100% (P = 0.0001). Regarding tumor size, an RFS of 98.3% was observed in those measuring ≤ 2 cm (P = 0.0001) and OS of 99.2% (P = 0.0001). Negative 472

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 35088975 Her2 was related to an RFS of 92.1% (P = 0.0001), and had better OS of PMID: 35088997 98.3% (P = 0.0001). Ki67 proliferation index ≤ 14% was associated with an RFS of 93.2% (P = 0.005). Negative lymph vascular invasion (LVI) increases the RFS of 91.8% (P = 0.032). The rate of positive expression of E-cadherin was associated with an increase in the RFS of 97.4%, with a mean of 128.6 ± 2.4 months (95% confidence interval (CI): 123.75 - 133.45 months) com- pared to the absence of expression E-cadherin: signal log ratio (SLR) 68.9%, a mean of 95 ± 6 months (95% CI: 83.28 - 106.88 months), P <0.001. When the OS was analyzed, the presence of E-cadherin expression increased the OS of 100% vs. 86.9% with the absence, P = 0.015. CONCLUSIONS: The prognostic impact of the different clinicopathological characteristics known worldwide was confirmed. Results of the analysis in the presented study indicate that positive expression of E-cadherin cor- relates with an improvement in OS and RFS in invasive lobular breast cancer in Mexican women. CITA: World J Oncol. 2021 Dec;12(6):214-224 DOI: 10.14740/wjon1426 TÍTULO: Treatment of Locally Advanced Cervical Cancer With Kidney Fail- ure and Comorbidities AUTORES: Arango Bravo E, Carmona T, Castro-Eguiluz D, Gallardo-Rincón D, Flores E, Cetina-Pérez LDC. SUMMARY: A woman aged 63 years presented at the gynecological oncolo- gy outpatient clinic with the following medical history: smoking history (smok- ing index of 10); systemic arterial hypertension diagnosed 6 years ago; menarche at 16 years; menopause at 52 years; 4 pregnancies, 4 deliveries; beginning of active sexual life at 18 years; 3 sexual partners; and no early cancer detection method in her life. Her performance status per ECOG cri- teria was 1. The patient presented with transvaginal bleeding with 5 months of evolution. Upon physical exploration, a 5 x 5 cm tumor in the cervix was detected, with the following characteristics: exophytic, friable, bleeding, with invasion to the lower third of the vagina, affection to the cul-de-sac and para- metria, and bilaterally fixed to the pelvic wall. A biopsy of the cervix showed moderately differentiated invasive squamous cell carcinoma. CITA: Oncology (Williston Park). 2021 Nov 16;35(11):741-745 DOI: 10.46883/ONC.2021.3511.0741 TÍTULO: Management of Residual Disease After First-line Chemotherapy in a Patient With a Nonseminomatous Germ Cell Tumor AUTORES: Barragán-Carrillo R, Mateos-Corella S, Ortiz-Hidalgo C, Izqui- erdo-Echavarri E, Castillejos-Molina R, Angel M, Barragan-Arteaga I, Flaig T, Bourlon M. SUMMARY: The case An 18-year-old male presented with a one-month his- tory of a nonpainful right testicular enlargement. He had no family history of neoplasia, nor any relevant past medical history. The physical examination was only remarkable for an enlarged right testicle. A testicular ultrasound revealed a 2.5-cm tumor, and serum tumor markers revealed an elevated β-human chorionic gonadotropin (β-HCG), 22 mUI/L (normal, < 0.06 mUI/L); elevated alpha-fetoprotein (AFP), 329 ng/mL (normal, 0-9 ng/mL); and nor- 473

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 35111010 mal lactate dehydrogenase (LDH), 135 /L (normal, 179 U/L). A right radical PMID: 35111012 inguinal orchiectomy was performed. Pathological examination revealed a 2.4 cm by 2 cm embryonal carcinoma with tumor invasion into the tunica albuginea. Postsurgical tumor markers obtained 3 weeks after orchiectomy were β-hCG, 100.5 mUI/L (normal, < 0.06 mUI/L); AFP, 1075 ng/mL (normal, 0-9 ng/mL); and LDH, 180 U/L (normal, 179 U/L). A chest, abdomen, and pelvis CT scan showed a 2.7-cm retroperitoneal lymph node enlargement, without visceral metastasis. Given the presence of node-positive disease with S2 serum markers, the diagnosis of a stage IIIB intermediate risk non- seminomatous germ cell tumor (NSGCT) was determined, and the patient underwent sperm banking. The patient was started on chemotherapy with 4 cycles of BEP (bleomycin, etoposide, and cisplatin), with a favorable tumor marker decline according to the Gustave-Roussy nomogram. After comple- tion of the fourth chemotherapy cycle, serum tumor markers were negative, and 8 weeks after chemotherapy, the follow-up CT showed a 1.6-cm residual retroperitoneal lymph node conglomerate. CITA: Oncology (Williston Park). 2021 Dec 17;35(12):816-819 DOI: 10.46883/2021.25920932 TÍTULO: Neuroendocrine Tumor of the Common Bile Duct: Case Report AUTORES: Fernández-Ferreira R, Medina-Ceballos E, Soberanis-Piña PD, Conde-Flores E, Arroyave-Ramírez AM, Izquierdo-Tolosa CD, Moto- la-Kuba D, Ruiz-Morales JM, Dorantes-Heredia R. SUMMARY: Carcinoma of the extrahepatic biliary tract accounts for <2% of all cancers. Neuroendocrine tumor of the extrahepatic bile duct is very rare, and there are <200 cases reported since 1959. The preoperative diagnosis is infrequent (5.12%). The definite diagnosis relies on postoperative pathol- ogy which utilized immunohistochemistry study on many biomarkers to diag- nose the histological subtypes of neuroendocrine neoplasms, such as chro- mogranin A, synaptophysin, and neuron-specific enolase. When the primary tumor has no metastases, radical removal of the lesion appears as curative treatment. The treatment of the carcinoid syndrome or other functioning syn- drome is the first priority. We report a case of a 12-year-old Mexican woman with neuroendocrine tumor of the extrahepatic bile duct (common bile duct neuroendocrine tumor) seen in our hospital. Resection of the common bile duct, cholecystectomy, end to side Roux-en-y hepaticojejunostomy, and por- tal lymphadenectomy was performed. A review of the pertinent literature was performed. Given the rarity of the disease, treatment principles are based mainly on retrospective series and case reports. We present the eighth case in adolescence in the literature. CITA: Case Rep Oncol. 2021 Dec 20;14(3):1785-1791 DOI: 10.1159/000519662 TÍTULO: Paraneoplastic Cerebellar Degeneration with Anti-CV2/CRMP5 An- tibodies in Ovarian Cancer: Case Report and Review of the Literature AUTORES: Juárez-Vignon Whaley JJ, Carrera-Muiños A, Hernandez-Guti- errez KG, Rodriguez-Cid JR, Otero-Cerdeira ME, Garcia-Montes V. SUMMARY: Paraneoplastic neurological syndromes (PNS) are rare presen- tations of an underlying oncological disease and more unusual during an 474

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 35111021 oncological disease. They most likely present in small-cell lung carcinomas PMID: 35138055 and thymomas, but present in <1% of the gynecological neoplasms. Ac- knowledging the pathophysiology is essential for management, explaining its clinical presentation, and future research. We present a patient with an underlying gynecological cancer that during her disease developed a PNS with an unusual autoantibody (anti-CV2/CRMP5) mediating the disease. We report a case of a 62-year-old female diagnosed with ovarian cancer who in the course of her disease developed neurological symptoms associated with cerebellar degeneration. After ruling out differential diagnoses such as metastases, a PNS was suspected and studied, in which anti-CV2/CRMP5 antibodies were positive. With her clinical presentation, radiological features, autoantibody positivity on cerebrospinal fluid, and an underlying oncological disease, cerebellar degeneration was diagnosed. The pathophysiology of PNS is not fully understood; therefore, its diagnosis and management are complex. Diagnosis is based on clinical presentation and specific antibod- ies associated. Unfortunately, patients have a bad prognosis and diminished quality of life, and therefore a multidisciplinary approach is needed. It is im- portant to mention that the presentation of PNS does not mandatorily appear before the diagnosis of cancer, and multiple cases have been reported in which patients with an underlying oncological disease develop these syn- dromes. As medical oncologists and neurologists, we must consider and study these syndromes as a possible etiology in cases with an underlying cancer who develop neurological symptoms in the course of their disease. CITA: Case Rep Oncol. 2021 Dec 20;14(3):1799-1805 DOI: 10.1159/000519969 TÍTULO: Acute Cardiac Tamponade Secondary to Cardiac Vascular-Type Pleomorphic Leiomyosarcoma: Case Report AUTORES: Fernández-Ferreira R, Soberanis-Piña PD, Conde-Flores E, Arroyave-Ramírez AM, Mackinney-Novelo I, Motola-Kuba D, Ruiz-Mo- rales JM, Alvarado-Luna G, Chable-Montero F. SUMMARY: Soft tissue sarcomas represent <1% of all neoplasms. Leiomyo- sarcomas comprise only 5-7% of cases, and only 2% of these are vascular. Vascular leiomyosarcomas are extremely rare and represent only 0.001% of all neoplasms, the venous type being up to 5 times more frequent. Arte- rial leiomyosarcomas most frequently affect the great vessels, being fatal in most cases. In the reported cases of arterial leiomyosarcomas, the most frequently affected site is the pulmonary artery. We present the clinical case of 2 patients (a 42-year-old woman and a 36-year-old man) with a diagnosis of arterial pleomorphic leiomyosarcoma that conditioned cardiac tamponade as the initial manifestation. As it is an exceptionally rare neoplasm and with few cases reported in the literature, it is important to identify and describe this pathology which, due to the impossibility of offering surgical treatment, represents a therapeutic challenge. CITA: Case Rep Oncol. 2021 Dec 30;14(3):1860-1867 DOI: 10.1159/000520358 TÍTULO: Human leukocyte antigen Class II alleles associated with acral len- tiginous melanoma in Mexican Mestizo patients: A case-control study AUTORES: Roldan-Marin R, Rangel-Gamboa L, Vega-Memije ME, Hernán- dez-Doño S, Ruiz-Gómez D, Granados J. 475

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 35139587 BACKGROUND: Melanoma is an aggressive cutaneous cancer. Acral len- tiginous melanoma is a melanoma subtype arising on palms, soles, and nail-units. The incidence, prevalence and prognosis differ among popula- tions. The link between expression of major histocompatibility complex Class II alleles and melanoma progression is known. However, available studies report variable results regarding the association of melanoma with specific HLA Class II loci. AIMS: The aim of the study was to determine HLA Class II allele frequen- cies in acral lentiginous melanoma patients and healthy Mexican Mestizo individuals. METHODS: Eighteen patients with acral lentiginous melanoma and 99 healthy controls were recruited. HLA Class II typing was performed based on the sequence-specific oligonucleotide method. RESULTS: Three alleles were associated with increased susceptibility to develop acral lentiginous melanoma, namely: HLA-DRB1*13:01; pC = 0.02, odds ratio = 6.1, IC95% = 1.4-25.5, HLA-DQA1*01:03; pC = 0.001, odds ratio = 9.3, IC95% = 2.7-31.3 and HLA-DQB1*02:02; pC = 0.01, odds ratio = 3.7, IC95% = 1.4-10.3. LIMITATIONS: The small sample size was a major limitation, although it in- cluded all acral lentiginous melanoma patients seen at the dermatology depart- ment of Dr. Manuel Gea González General Hospital during the study period. CONCLUSION: HLA-DRB1*13:01, HLA-DQB1*02:02 and HLA-DQA*01:03 alleles are associated with increased susceptibility to develop acral lentigi- nous melanoma in Mexican Mestizo patients. CITA: Indian J Dermatol Venereol Leprol. 2021 Dec 28;1-7 DOI: 10.25259/IJDVL_627_19 TÍTULO: [Hallux valgus mild and moderate; treatment by minimally invasive surgery and its follow-up to 2 years] AUTORES: King-Martínez AC, Estevez-Jaramillo MA, King-Hayata MA, Martínez-de Anda MC, Cuellar-Avaroma A. INTRODUCTION: The hallux valgus is a very frequent and complex orthope- dic pathology. It involves the bone and soft tissue structures of the first toe. There are multiple techniques described for the alignment of the first toe. All technics aim to restore the normal angulation of the toe while using a stable osteotomy through a painless surgical procedure. The minimal invasive tech- niques have been growing in acceptance since the year 2000, as a viable surgical alternative to treat this pathology. MATERIAL AND METHODS: We included patients with a diagnostic of mild or moderate hallux valgus on whom a minimal invasive procedure was per- formed to correct the deformity of the first toe. We performed a distal Rever- din/Isham osteotomy on the first metatarsal and an akin osteotomy in the proximal phalanx, a lateral capsular release and a abductor tenotomy. These patients were followed for 24 months after their surgery. RESULTS: Our patients had an adequate correction angular correction, for a distal osteotomy. They had a good pain control, with an adequate mobility in the postoperative period. The patients presented an adequate personal 476

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR 2022 satisfaction, 87% of them had good results. We found an important and sta- tistically significant improvement in the Kitaoka scale. PMID: 33190866 CONCLUSION: The minimal invasive technics for the correction of mild or moderated hallux valgus are a good alternative. Our patients are satisfied with the functional, and cosmetic results. CITA: Acta Ortop Mex. Jul-Aug 2021;35(4):305-310 TÍTULO: Periodontal plastic surgery for the management of an ankylosed permanent maxillary lateral incisor: A clinical report with 5-year follow-up AUTORES: Grageda E, Grageda E. SUMMARY: Anterior maxillary tooth ankylosis disturbs the development of the alveolar bone process, leading to discrepancies between the cervical gingival margin and incisal edge position of the affected tooth, and therefore, the esthetics is compromised. Proposed treatments in adults and growing patients have been used successfully, but they have disadvantages and are contraindicated in some circumstances. This article proposes an alternative treatment for an ankylosed permanent maxillary anterior tooth with a slow replacement resorption rate in an adult patient, for whom a combination of a periodontal plastic surgery procedure and a fixed dental prosthesis was used to correct the esthetics. This treatment has less risk of complications, preserves the ankylosed tooth as long as possible, creates an optimal gingi- val contour, and maintains the alveolar bone for further treatment should the tooth be lost. CITA: J Prosthet Dent. 2022 Jan;127(1):27-31 DOI: 10.1016/j.prosdent.2020.06.024 PMID: 33203290 TÍTULO: Beyond eosinophilia: inflammatory patterns in patients with asthma AUTORES: Bedolla-Barajas M, Morales-Romero J, Hernández-Colín DD, Lare- nas-Linnemann D, Mariscal-Castro J, Flores-Razo MM, Bedolla-Pulido A. Background: Recently, inflammatory cell ratios have gained importance as useful indicators in the categorization of asthma. OBJECTIVE: We compared the concentration of white blood cells in periph- eral blood, as well as their respective inflammatory cell ratios, between pa- tients with asthma and a healthy control group. METHODS: We performed cross-sectional analyses of the data obtained from 53 adult patients with asthma and 109 adult controls. In our study, we estimated and compared the following inflammatory cell ratios: Neutro- phil-Lymphocyte Ratio (NLR), Eosinophil-Lymphocyte Ratio (ELR), Eosino- phil-Neutrophil Ratio (ENR), Eosinophil-Monocyte Ratio (EMR), and Plate- let-Lymphocyte Ratio (PLR). The magnitude of association was quantified with the odds ratio. RESULTS: In both groups, the average age was 33 years. In asthmatic patients, we obtained the following results: eosinophils ≥ 400 cells/µl, ac- 477

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34139984 counted for 37.7%; basophils ≥ 110 cells/µl, comprised 37.7%; and mono- PMID: 34536239 cytes < 320 cells/µl, reached 11.3%. In the control group, the results were as follows: 4.6%, 9.2% and 0.9%, respectively. When compared to the control group, asthmatic patients had higher odds of eosinophils ≥ 400 cells/µl (OR = 12.61, p < 0.0001); higher odds of basophils ≥ 110 cells/µl (OR = 6.00, p < 0.0001); and increased odds of monocytes < 320 cells/µl (OR = 13.79, p = 0.017). NLR did not differ between our two groups; however, ELR, ENR, EMR and PLR were significantly higher in the asthma group. CONCLUSIONS: Overall, patients with asthma have a higher concentration of eosinophils and basophils, fewer monocytes in their blood, and higher ra- tios of increased chronic inflammation. CITA: J Asthma. 2022 Feb;59(2):255-263 DOI: 10.1080/02770903.2020.1852413 TÍTULO: Dapsone, an effective Neuro, and Cytoprotective Drug and More AUTORES: Diaz-Ruiz A, Nader-Kawachi J, Calderón-Estrella F, Mata-Ber- mudez A, Alvarez-Mejia L, Ríos C. SUMMARY: Dapsone (4,4'-diamino-diphenyl sulfone) is a synthetic deriva- tive of sulfones, with the antimicrobial activity described since 1937. It is also a drug traditionally used in dermatological therapies due to its anti-inflamma- tory effect. In recent years its antioxidant, antiexcitotoxic, and antiapoptotic effects have been described in different ischemic damage models, traumatic damage, and models of neurodegenerative diseases, such as Parkinson's (PD) and Alzheimer's diseases (AD). Finally, dapsone has proven to be a safe and effective drug as a protector against heart, renal and pulmonary cells damage; that is why it is now employed in clinical trials with patients as a neuroprotective therapy by regulating the main mechanisms of damage that lead to cell death ObjectiveThe objective of this study is to provide a descriptive review of the evidence demonstrating the safety and therapeutic benefit of dapsone treatment, evaluated in animal studies and various hu- man clinical trials Methods: We conducted a review of PubMed databases looking for scientific research in animals and humans, oriented to demon- strate the effect of dapsone on regulating and reducing the main mecha- nisms of damage that lead to cell death CONCLUSION: The evidence presented in this review shows that dapsone is a safe and effective neuro and cytoprotective treatment that should be considered for translational therapy. CITA: Curr Neuropharmacol. 2022;20(1):194-210 DOI: 10.2174/1570159X19666210617143108 TÍTULO: The international EAACI/GA²LEN/EuroGuiDerm/APAAACI guide- line for the definition, classification, diagnosis, and management of urticaria AUTORES: Zuberbier T, (…) Larenas-Linnemann D, et al. SUMMARY: This update and revision of the international guideline for urti- caria was developed following the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evalua- tion (GRADE) working group. It is a joint initiative of the Dermatology Section 478

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34678406 of the European Academy of Allergology and Clinical Immunology (EAACI), PMID: 34752847 the Global Allergy and Asthma European Network (GA²LEN) and its Urticar- PMID: 34798363 ia and Angioedema Centers of Reference and Excellence (UCAREs and PMID: 34808394 ACAREs), the European Dermatology Forum (EDF; EuroGuiDerm), and the Asia Pacific Association of Allergy, Asthma and Clinical Immunology with the participation of 64 delegates of 50 national and international societies and from 31 countries. The consensus conference was held on 3 December 2020. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease that presents with wheals, angioedema, or both. The lifetime prevalence for acute urticaria is approximately 20%. Chronic spontaneous or inducible ur- ticaria is disabling, impairs quality of life, and affects performance at work and school. This updated version of the international guideline for urticaria covers the definition and classification of urticaria and outlines expert-guided and evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria. CITA: Allergy. 2022 Mar;77(3):734-766 DOI: 10.1111/all.15090 TÍTULO: One not like the other: The weakness of the blood sugar-MAFLD analogy AUTORES: Fouad YM, Méndez-Sánchez N, Zheng MH. SUMMARY: Letter to the editor CITA: J Hepatol. 2022 Feb;76(2):482-484. DOI: 10.1016/j.jhep.2021.10.010 TÍTULO: Tuberous Sclerosis Complex AUTORES: Vázquez-Lavista LG, Ramírez-Muciño JA, López-Almanza PX, Janka-Zires M. SUMMARY: Case report CITA: Urology. 2022 Feb;160:19-21 DOI: 10.1016/j.urology.2021.10.024 TÍTULO: SELNET clinical practice guidelines for soft tissue sarcoma and GIST AUTORES: Blay JY, (…) Martinez-Said H, et al. SUMMARY: Review article CITA: Cancer Treat Rev. 2022 Jan;102:102312 DOI: 10.1016/j.ctrv.2021.102312 TÍTULO: Hepatitis B infection in Mexican adults: Results of a nationally rep- resentative survey 479

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR AUTORES: Carnalla M, Vidaña-Pérez D, Alpuche-Aranda C, Chávez-Tapia NC, Romero-Martínez M, Shamah-Levy T, Barrientos-Gutiérrez T. INTRODUCTION AND OBJECTIVES: Hepatitis B virus (HBV) infection can lead to cirrhosis, hepatocellular carcinoma, and death if untreated. In Mex- ico, HBV vaccination for all children and adolescents was implemented in 1999. In 2000 the estimated HBV was 0.21% in the population aged 20 years and older. We estimated the national prevalence for hepatitis B surface an- tigen (HBsAg) and its association with sociodemographic characteristics, in- cluding sexual behavior information for those aged 20 to 49 years. MATERIALS AND METHODS: From the 2018 National Health and Nutri- tion Survey, blood samples were collected from a subsample of 2,280 adults to determine HBsAg. We estimated the national prevalence for HBsAg and evaluated its association with sociodemographic characteristics, adding sex- ual behavior information for those aged 20 to 49 years. We performed a mul- tiple logistic regression to estimate the association of HBsAg and relevant variables. RESULTS: The 2018 estimated prevalence of HBsAg in the Mexican adult population was 0.51% (95%CI 0.19, 2.33), which represents 411,000 cases. This prevalence was higher than previously estimated and it was higher in women than in men (0.54% versus 0.46%, respectively). We did not find an association between HBsAg and sociodemographic characteristics or sexual behaviors. CONCLUSIONS: Vaccination and screening strategies towards the elimina- tion of viral hepatitis should be reinforced to further reduce the prevalence over the next years. CITA: Ann Hepatol. 2022 Jan;27 Suppl 1:100583 DOI: 10.1016/j.aohep.2021.100583 PMID: 34859396 TÍTULO: Immunohistochemistry in Historical Perspective: Knowing the Past to Understand the Present AUTORES: Ortiz Hidalgo C. SUMMARY: Immunohistochemistry is an extraordinary and extensively used technique whereby antibodies are used to detect antigens in cells within a tissue section. It has numerous applications in medicine, particularly in can- cer diagnosis. It was Albert Hewett Coons, Hugh J Creech, Norman Jones, and Ernst Berliner who conceptualized and first implemented the proce- dure of immunofluorescence in 1941. They used fluorescein isothiocyanate (FITC)-labelled antibodies to localize pneumococcal antigens in infected tis- sues. Since then, with improvement and development of protein conjugation, enzyme labels have been introduced, such as peroxidase and alkaline phos- phatase. The history of immunohistochemistry (IHC) combines physiology, immunology, biochemistry, and the work of various Nobel Prize laureates. From von Behring who was awarded de first Nobel Prize in 1901 for his work on serum therapy to the 1984 Nobel Prize for the discovery of monoclonal antibodies by Milstein, Kohler, and Jerne, IHC is a story of cooperation and collaboration which led to the development of this magnificent technique that is used daily in anatomical pathology laboratories worldwide. CITA: Methods Mol Biol. 2022;2422:17-31 DOI: 10.1007/978-1-0716-1948-3_2 480

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34896638 TÍTULO: Laparoscopic cholecystectomy: Histopathological analysis of meta- bolic associated fatty liver disease and fibrosis AUTORES: Rodríguez-Antonio I, López-Sánchez GN, Reyes-Gómez VA, Contreras-Flores EH, Farías-García F, Espejel-Deloiza M, Durán-Padilla MA, Chablé-Montero F, Uribe M, Chávez-Tapia NC, Montalvo-Javé EE, Nuño-Lámbarri N. INTRODUCTION: Metabolic (dysfunction) associated fatty liver disease (MAFLD) and cholelithiasis are highly prevalent and are associated with common risk factors such as obesity, hypertriglyceridemia, and fasting glu- cose levels; however, it is not clear whether cholelithiasis is associated with MAFLD or fibrosis. OBJECTIVE: To determine MAFLD severity and associated risk factors in patients diagnosed with cholelithiasis. MATERIALS AND METHODS: Observational, cross-sectional and prolec- tive study (from October 2018 to March 2020) of patients undergoing elec- tive laparoscopic cholecystectomy with liver biopsy, excluding other causes of hepatic disease or significant alcohol consumption. MAFLD detection was based on histology using the Kleiner score and one of the following crite- ria: overweight/obesity, T2DM, or evidence of metabolic dysregulation. The AST to Platelet Ratio Index, the NAFLD Fibrosis Score, the fibrosis-4 index and the hepatic steatosis index were performed to assess the relationship of non-invasive hepatic scores with histopathology. RESULTS: 80 patients median age (interquartile range) was 42 (18) years, with a BMI of 27.9 (6.11) Kg/m2. Of all patients, 58.8% had MAFLD, 78.7% were women, and 13.8% had the severe form (formerly named NASH). No substantial correlation between biochemical parameters and histopathologi- cal analysis of MAFLD and fibrosis was observed. CONCLUSION: Because cholelithiasis and MAFLD are highly prevalent dis- eases, it is essential to conduct studies on the relationship between both pathologies. Currently, liver biopsy is the best diagnostic method since the predictive biochemical models did not show a substantial correlation to clas- sify MAFLD. Its early detection is relevant since a considerable percentage of advanced fibrosis (8.7%) was found. CITA: Ann Hepatol. Mar-Apr 2022;27(2):100651 DOI: 10.1016/j.aohep.2021.100651 PMID: 34931448 TÍTULO: Outcomes of chronic total occlusion percutaneous coronary inter- vention in patients with prior coronary artery bypass graft surgery: Insights from the LATAM CTO registry AUTORES: Hernandez-Suarez DF, Azzalini L, Moroni F, Tinoco de Paula JE, Lamelas P, Campos CM, Harada Ribeiro M, Martins Filho E, Damas de Los San- tos F, Padilla L, Alcantara-Melendez M, Abud MA, Almodóvar-Rivera IA, Moura Schmidt M, Echavarria M, Botelho AC, Del Rio V, Quadros A, Santiago R. OBJECTIVES: To evaluate the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in patients with and without prior coronary artery bypass graft (CABG) surgery. 481

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34975228 BACKGROUND: Data on the outcomes of CTO PCI in patients with versus without CABG remains limited and with scarce representation from develop- ing regions like Latin America. METHODS: We evaluated patients undergoing CTO PCI in 42 centers par- ticipating in the LATAM CTO registry between 2008 and 2020. Statistical analyses were stratified according to CABG status. The outcomes of interest were technical and procedural success and in-hospital major adverse cardi- ac and cerebrovascular events (MACCE). RESULTS: A total of 1662 patients were included (n = 1411 [84.9%] no- CABG and n = 251 [15.1%] prior-CABG). Compared with no-CABG, those with prior-CABG were older (67 ± 11 vs. 64 ± 11 years; p < 0.001), had more comorbidities and lower left ventricular ejection fraction (52.8 ± 12.8% vs. 54.4 ± 11.7%; p = 0.042). Anatomic complexity was higher in the prior-CABG group (J-CTO score 2.46 ± 1.19 vs. 2.10 ± 1.22; p < 0.001; PROGRESS CTO score 1.28 ± 0.89 vs. 0.91 ± 0.85; p < 0.001). Absence of CABG was associated with lower risk of technical and procedural failure (OR: 0.60, 95% CI: 0.43-0.85 and OR: 0.58, 95% CI: 0.40-0.83, respectively). No significant differences in the incidence of in-hospital MACCE (3.8% no-CABG vs. 4.4% prior-CABG; p = 0.766) were observed between groups. CONCLUSION: In a contemporary multicenter CTO-PCI registry from Latin America, prior-CABG patients had more comorbidities, higher anatomical complexity, lower success, and similar in-hospital adverse event rates com- pared with no-CABG patients. CITA: Catheter Cardiovasc Interv. 2022 Feb;99(2):245-253 DOI: 10.1002/ccd.30041 TÍTULO: Stent-Save a Life international survey on the practice of primary percutaneous coronary intervention during the COVID-19 pandemic AUTORES: Pereira H, Naber C, Wallace S, Gabor T, Abdi S, Alekyan B, Al- exander T, Artucio C, Batista I, Candiello A, Delport R, De Luca L, Erglis A, Farto-Abreu P, Huang WC, Kanakakis J, Lee M, Mohamed A, Orlić D, Ortiz P, Sobh M, Shokry K, Terzic I, Win K, Piek J. AIM: To assess the impact of the COVID-19 pandemic on admissions of patients with acute coronary syndromes (ACS) and primary percutaneous coronary intervention (PPCI) in countries participating in the Stent-Save a Life (SSL) global initiative. METHODS AND RESULTS: We conducted a multicenter observational sur- vey to collect data on patient admissions for ACS, ST-elevation myocardial infarction (STEMI) and PPCI in participating SSL member countries through a period during the COVID-19 outbreak (March and April 2020) compared with the equivalent period in 2019. Of the 32 member countries of the SSL global initiative, 17 agreed to participate in the survey (three in Africa, five in Asia, six in Europe and three in Latin America). Overall reductions of 27.5% and 20.0% were observed in admissions for ACS and STEMI, respectively. The decrease in PPCI was 26.7%. This trend was observed in all except two countries. In these two, the pandemic peaked later than in the other countries. CONCLUSIONS: This survey shows that the COVID-19 outbreak was asso- ciated with a significant reduction in hospital admissions for ACS and STEMI 482

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34980441 as well as a reduction in PPCI, which can be explained by both patient- and PMID: 34990638 system-related factors. CITA: Rev Port Cardiol. 2022 Mar;41(3):221-227 DOI: 10.1016/j.repc.2021.04.006 TÍTULO: [An unusual association of malakoplakia and adenocarcinoma of the prostate] AUTORES: Enríquez-Pineda ÓM, Segura-Rivera JR, Ruiz-Morales JM, Mendoza-Valdés A, Dorantes-Heredia R. SUMMARY: Malakoplakia is a chronic inflammatory process caused by a lysosomal defect in bacterial digestion. Although rare, it occurs more fre- quently in the genitourinary tract and in patients with immune dysfunction. The bladder is the most commonly affected site, although cases have been reported in other organs, including the prostate gland. Clinically, this lesion can be confused with malignant tumours, both on physical examination and imagining techniques. This is particularly pronounced in the prostate, mak- ing the differential diagnosis challenging. Histologically, characteristic aggre- gates of histiocytes with basophilic intracytoplasmic inclusions composed of calcium and iron salts are found. We present a case diagnosed on transrec- tal biopsy as acinar adenocarcinoma with a Gleason 5 + 5 = 10 score. Pros- tatectomy revealed an unusual association of diffuse prostate malakoplakia and an area of acinar adenocarcinoma with a Gleason score of 3 + 4 = 7. CITA: Rev Esp Patol. Jan-Mar 2022;55(1):46-51 DOI: 10.1016/j.patol.2019.06.002 TÍTULO: Looking for factors affecting functioning in euthymic patients with bipolar I disorder: the importance of cognitive complaints and BDNF's Val- 66Met polymorphism AUTORES: Yoldi-Negrete M, Palacios-Cruz L, Tirado-Durán E, Jiménez-Ro- dríguez LI, Jiménez-Pavón J, Hernández S, Aguilar A, Morales-Cedillo IP, Jiménez-Tirado M, Fresán-Orellana A, Juárez García F, Becerra-Palars C, Camarena-Medellin B. INTRODUCTION: Functioning in Bipolar Disorder (BD) is affected in a sub- stantial proportion of patients. The impact of demographic, clinical, cognitive, and genetic factors on functioning has been shown individually; however, as a complex phenomenon, a global approach to identify the most relevant as well as possible interactions is needed. METHODS: 102 patients with type I BD in euthymia were invited for evalu- ation of demographic, clinical, and cognitive characteristics as well as geno- type for Val66Met polymorphism of BDNF gene to determine those associat- ed with poor functioning according to the FAST scale cut-off score. Clinical evaluation included assessment of residual affective symptoms and anxiety. Cognitive evaluation included the COBRA scale, verbal memory, and execu- tive functions testing. RESULTS: Residual depressive symptoms, anxiety, cognitive complaints and being a Met carrier were more frequent in the poor functioning group and were entered in a logistic regression model. Being a Met carrier (OR=4.46, 483

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR CI=1.19-16.67) and cognitive complaints (OR=1.29, CI= 1.13-1.46) were the most important predictors of poor functioning in type I BD. LIMITATIONS: Cross-sectional study, with select population limiting gener- alizability of findings. CONCLUSIONS: A better understanding of underlying factors affecting cognition, including the possible involvement of BDNF Val66Met polymor- phism, its systematic evaluation and a continued search for targeted treat- ment, along with recognition and attention of residual affective and anxious symptoms might improve psychosocial outcomes such as functioning in this population. CITA: J Affect Disord. 2022 Apr 1;302:131-138 DOI: 10.1016/j.jad.2022.01.006 PMID: 34990866 TÍTULO: Global Variability in Administrative Approval Prescription Criteria for Biologic Therapy in Severe Asthma AUTORES: Porsbjerg CM, (…) Larenas-Linnemann D, et al. BACKGROUND: Regulatory bodies have approved five biologics for severe asthma. However, regional differences in accessibility may limit the global potential for personalized medicine. OBJECTIVE: To compare global differences in ease of access to biologics. METHODS: In April 2021, national prescription criteria for omalizumab, mepolizumab, reslizumab, benralizumab, and dupilumab were reviewed by severe asthma experts collaborating in the International Severe Asth- ma Registry. Outcomes (per country, per biologic) were (1) country-specific prescription criteria and (2) development of the Biologic Accessibility Score (BACS). The BACS composite score incorporates 10 prescription criteria, each with a maximum score of 10 points. Referenced to European Medi- cines Agency marketing authorization specifications, a higher score reflects easier access. RESULTS: Biologic prescription criteria differed substantially across 28 countries from five continents. Blood eosinophil count thresholds (usually ≥300 cells/μL) and exacerbations were key requirements for anti-IgE/anti-IL- 5/5R prescriptions in around 80% of licensed countries. Most countries (40% for dupilumab to 54% for mepolizumab) require two or more moderate or se- vere exacerbations, whereas numbers ranged from none to four. Moreover, 0% (for reslizumab) to 21% (for omalizumab) of countries required long-term oral corticosteroid use. The BACS highlighted marked between-country differences in ease of access. For omalizumab, mepolizumab, benralizum- ab, and dupilumab, only two, one, four, and seven countries, respectively, scored equal or higher than the European Medicines Agency reference BACS. For reslizumab, all countries scored lower. CONCLUSIONS: Although some differences were expected in country-spe- cific biologic prescription criteria and ease of access, the substantial differ- ences found in the current study present a challenge to implementing preci- sion medicine across the world. CITA: J Allergy Clin Immunol Pract. 2022 Jan 3; S2213-2198(21)01454-9 DOI: 10.1016/j.jaip.2021.12.027 484

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 34992134 TÍTULO: Clinical, histological and molecular profiling of different stages of PMID: 35046670 alcohol-related liver disease AUTORES: Ventura-Cots M, (…) Mendez-Sanchez N, et al. OBJECTIVE: Alcohol-related liver disease (ALD) ranges from never-decom- pensated ALD (ndALD) to the life-threatening decompensated phenotype, known as alcohol-related hepatitis (AH). A multidimensional study of the clin- ical, histological and molecular features of these subtypes is lacking. DESIGN: Two large cohorts of patients were recruited in an internation- al, observational multicentre study: a retrospective cohort of patients with ndALD (n=110) and a prospective cohort of patients with AH (n=225). Clini- cal, analytical, immunohistochemistry and hepatic RNA microarray analysis of both disease phenotypes were performed. RESULTS: Age and mean alcohol intake were similar in both groups. AH patients had greater aspartate amino transferase/alanine amino transferase ratio and lower gamma-glutamyl transferase levels than in ndALD patients. Patients with AH demonstrated profound liver failure and increased mortality. One-year mortality was 10% in ndALD and 50% in AH. Histologically, ste- atosis grade, ballooning and pericellular fibrosis were similar in both groups, while advanced fibrosis, Mallory-Denk bodies, bilirubinostasis, severe neu- trophil infiltration and ductular reaction were more frequent among AH pa- tients. Transcriptome analysis revealed a profound gene dysregulation within both phenotypes when compare to controls. While ndALD was characterised by deregulated expression of genes involved in matrisome and immune re- sponse, the development of AH resulted in a marked deregulation of genes involved in hepatocyte reprogramming and bile acid metabolism. CONCLUSIONS: Despite comparable alcohol intake, AH patients present- ed with worse liver function compared with ndALD patients. Bilirubinostasis, severe fibrosis and ductular reaction were prominent features of AH. AH pa- tients exhibited a more profound deregulation of gene expression compared with ndALD patients. CITA: Gut. 2022 Jan 6;gutjnl-2021-324295 DOI: 10.1136/gutjnl-2021-324295 TÍTULO: Real World Biologic Use and Switch Patterns in Severe Asthma: Data from the International Severe Asthma Registry and the US CHRONI- CLE Study AUTORES: Menzies-Gow AN, (…) Larenas-Linnemann D, et al. INTRODUCTION: International registries provide opportunities to describe use of biologics for treating severe asthma in current clinical practice. Our aims were to describe real-life global patterns of biologic use (continuation, switches, and discontinuations) for severe asthma, elucidate reasons under- lying these patterns, and examine associated patient-level factors. METHODS: This was a historical cohort study including adults with se- vere asthma enrolled into the International Severe Asthma Registry (ISAR; http://isaregistries.org, 2015-2020) or the CHRONICLE Study (2018-2020) and treated with a biologic. Eleven countries were included (Bulgaria, Can- ada, Denmark, Greece, Italy, Japan, Kuwait, South Korea, Spain, UK, and USA). Biologic utilization patterns were defined: 1) continuing initial biolog- 485

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR ic; 2) stopping biologic treatment; or 3) switching to another biologic. Rea- sons for discontinuation/switching were recorded and comparisons drawn between groups. RESULTS: A total of 3531 patients were included. Omalizumab was the most common initial biologic in 2015 (88.2%) and benralizumab in 2019 (29.6%). Most patients (79%; 2791/3531) continued their first biologic; 10.2% (356/3531) stopped; 10.8% (384/3531) switched. The most frequent first switch was from omalizumab to an anti-IL-5/5R (49.6%; 187/377). The most common subsequent switch was from one anti-IL-5/5R to another (44.4%; 20/45). Insufficient efficacy and/or adverse effects were the most frequent reasons for stopping/switching. Patients who stopped/switched were more likely to have a higher baseline blood eosinophil count and exacerbation rate, lower lung function, and greater health care resource utilization. CONCLUSION: The description of real-life patterns of continuing, stopping, or switching biologics enhances our understanding of global biologic use. Prospective studies involving structured switching criteria could ascertain optimal strategies to identify patients who may benefit from switching. CITA: J Asthma Allergy. 2022 Jan 13;15:63-78 DOI: 10.2147/JAA.S328653 PMID: 35055177 TÍTULO: Inulin Improves Diet-Induced Hepatic Steatosis and Increases In- PMID: 35099342 testinal Akkermansia Genus Level AUTORES: Pérez-Monter C, Álvarez-Arce A, Nuño-Lambarri N, Escalo- na-Nández I, Juárez-Hernández E, Chávez-Tapia NC, Uribe M, Barbe- ro-Becerra VJ. SUMMARY: Hepatic steatosis is characterized by triglyceride accumulation within hepatocytes in response to a high calorie intake, and it may be related to intestinal microbiota disturbances. The prebiotic inulin is a naturally oc- curring polysaccharide with a high dietary fiber content. Here, we evaluate the effect of inulin on the intestinal microbiota in a non-alcoholic fatty liver disease model. Mice exposed to a standard rodent diet or a fat-enriched diet, were supplemented or not, with inulin. Liver histology was evaluated with oil red O and H&E staining and the intestinal microbiota was determined in mice fecal samples by 16S rRNA sequencing. Inulin treatment effectively prevents liver steatosis in the fat-enriched diet group. We also observed that inulin re-shaped the intestinal microbiota at the phylum level, were Verru- comicrobia genus significantly increased in the fat-diet group; specifically, we observed that Akkermansia & muciniphila increased by 5-fold with inulin supplementation. The family Prevotellaceae was also significantly increased in the fat-diet group. Overall, we propose that inulin supplementation in liver steatosis-affected animals, promotes a remodeling in the intestinal microbi- ota composition, which might regulate lipid metabolism, thus contributing to tackling liver steatosis. CITA: Int J Mol Sci. 2022 Jan 17;23(2):991 DOI: 10.3390/ijms23020991 TÍTULO: Consensus on mild asthma management: results of a modified Del- phi study AUTORES: Domingo C, Garcia G, Gemicioglu B, Van GV, Lare- nas-Linnemann D, Neffen H, Poachanukoon O, Sagara H, Berend N, Piz- zichini E, Irusen E, Aggarwal B, Eken V, Levy G. 486

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR OBJECTIVE: In order to understand the role of regular controller inhaled corticosteroids (ICS) versus as-needed ICS-formoterol in managing mild asthma, we performed a modified Delphi procedure. METHODS: Opinions from 16 respiratory experts to three surveys and during a virtual scientific workshop helped to develop final consensus state- ments (pre-defined as 70% agreement). RESULTS: Thirteen participants completed all rounds (response rate 81%). At the end of the procedure, there was final consensus on: regular daily ICS being the recommended treatment approach in mild persistent asthma, with better symptom control and robust long-term clinical data compared with as-needed ICS-formoterol (85%); to avoid noncompliance, frequently seen in mild asthma patients, regular ICS dosing should be accompanied by on- going education on treatment adherence (100%); treatment aims should be targeting asthma control (92%) and reduction of exacerbation risk (85%). No consensus was reached on whether GINA or national guidelines most influ- ence prescribing decisions. CONCLUSIONS: It is important to encourage patients to be adherent and to target both asthma control and exacerbation risk reduction. There is ro- bust clinical evidence to support proactive regular dosing with ICS controller therapy plus as-needed short-acting beta-agonists for the management of patients with mild asthma. CITA: J Asthma. 2022 Feb 21;1-13 DOI: 10.1080/02770903.2022.2034850 PMID: 35103228 TÍTULO: Multiple Audiometric Analysis in the Screening of Vestibular Schwannoma AUTORES: Celis-Aguilar E, Obeso-Pereda A, Castro-Bórquez KM, Dehesa- -Lopez E, Vega-Alarcon A, Coutinho-De Toledo H. SUMMARY: Introduction Asymmetric sensorineural hearing loss is the main early symptom of retrocochlear lesions, hence its importance in screening for vestibular schwannomas. Currently, there is no consensus regarding its definition. The objective was to identify the audiometric pattern that would serve as a predictor for vestibular schwannoma in patients with asymmetric hearing loss. Materials and methods A cross-sectional study was conducted that included patients with asymmetric hearing loss attending a secondary care center and a tertiary care center. Clinical, audiometric and imaging (MRI with gadolinium) variables were collected. Asymmetric hearing loss was defined as a difference of 15 dB in one or more frequencies between both ears. The sensitivity, specificity, positive predictive value (PPV), neg- ative predictive value (NPV) and accuracy of different audiometric patterns were analyzed. Results A total of 107 patients were studied and divided into two groups: group 1 without vestibular schwannoma (n=98); and group 2 with vestibular schwannoma (n=9). No significant difference in demographic characteristics or audiometric patterns was found in patients with and with- out vestibular schwannoma. The audiometric pattern with the best sensitivity as a screening test was a difference >20 dB in the 4,000 Hz frequency, with a sensitivity of 77.78%, specificity of 30.61%, PPV of 8.33%, NPV of 93.75% and accuracy of 34.50%. Conclusion The audiometric pattern with the best results was a difference >20 dB in the 4,000 Hz frequency range; howev- er, patients with asymmetric hearing loss could not be differentiated from patients with retrocochlear lesions based only on audiometry. Asymmetrical hearing loss must be studied with MRI. 487

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 35120101 CITA: Cureus. 2022 Jan 22;14(1):e21492 PMID: 35169806 DOI: 10.7759/cureus.21492 TÍTULO: The latest anatomical discovery: the parathyroid glands or Glandu- lae parathyreoideae of Owen-Sandström-Gley AUTORES: Ortiz-Hidalgo C. SUMMARY: In 1852, Owen, a prominent British anatomist, described the parathyroid glands. While dissecting a rhinoceros, he noted a small compact yellow body, attached to the thyroid. Virchow and later Remak described the human parathyroids around 1960, but credit for the first complete description goes to the Sandström in 1980. More than a decade later Gley, showed that it was the removal of the parathyroids that accounted for the tetany that followed thyroidectomy. The association of parathyroid pathology and skel- etal abnormalities was made in 1914 by Erdheim and Schlagenhaufer, and Mandl, was the first surgeon to successfully treat a case of osteitis fibrosa by surgical removal of a parathyroid adenoma in 1925. The most extensive work on hyperparathyroidism was done in the 1930s by Albright form Boston, who described parathyroid hyperplasia, and differentiated between primary, secondary and tertiary hyperparathyroidism. Progresses in anatomy, phys- iology and surgery of the parathyroid glands, have contributed to various effective modalities of diagnosis and treatment. CITA: Cir Cir. 2022;90(1):140-149 DOI: 10.24875/CIRU.20001307 TÍTULO: Safety and immunogenicity of a live recombinant Newcastle dis- ease virus-based COVID-19 vaccine (Patria) administered via the intramus- cular or intranasal route: Interim results of a non-randomized open label phase I trial in Mexico AUTORES: Ponce-de-León S, Torres M, Soto-Ramírez LE, José Calva J, Santillán-Doherty P, Carranza-Salazar DE, Carreño JM, Carranza C, Juárez E, Carreto-Binaghi LE, Ramírez-Martínez L, la Rosa GP, Vigueras-Moreno R, Ortiz-Stern A, López-Vidal Y, Macías AE, Torres-Flores J, Rojas-Martínez O, Suárez-Martínez A, Peralta-Sánchez G, Kawabata H, González-Domín- guez I, Martínez-Guevara JL, Sun W, Sarfati-Mizrahi D, Soto-Priante E, Cha- goya-Cortés HE, López-Macías C, Castro-Peralta F, Palese P, García-Sastre A, Krammer F, Lozano-Dubernard B. SUMMARY: There is still a need for safe, efficient and low-cost coronavi- rus disease 2019 (COVID-19) vaccines that can stop transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here we evalu- ated a vaccine candidate based on a live recombinant Newcastle disease virus (NDV) that expresses a stable version of the spike protein in infected cells as well as on the surface of the viral particle (AVX/COVID-12-HEXA- PRO, also known as NDV-HXP-S). This vaccine candidate can be grown in embryonated eggs at low cost similar to influenza virus vaccines and it can also be administered intranasally, potentially to induce mucosal immunity. We evaluated this vaccine candidate in prime-boost regimens via intramus- cular, intranasal, or intranasal followed by intramuscular routes in an open label non-randomized non-placebo-controlled phase I clinical trial in Mexico in 91 volunteers. The primary objective of the trial was to assess vaccine safety and the secondary objective was to determine the immunogenicity 488

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 35192523 of the different vaccine regimens. In the interim analysis reported here, the PMID: 35248211 vaccine was found to be safe and the higher doses tested were found to be immunogenic when given intramuscularly or intranasally followed by intra- muscular administration, providing the basis for further clinical development of the vaccine candidate. The study is registered under ClinicalTrials.gov identifier NCT04871737 . Funding was provided by Avimex and CONACYT. CITA: medRxiv. 2022 Feb 9;2022.02.08.22270676 DOI: 10.1101/2022.02.08.22270676 TÍTULO: Ruxolitinib as a treatment strategy for SARS-CoV-2 pneumonia: clinical experience in a real-world setting AUTORES: Ovilla-Martinez R, (…) Cervera Ceballos E, Zapata Canto NP, García Mendez JO, et al. INTRODUCTION: Severe acute respiratory syndrome-related coronavi- rus (SARS-CoV-2) infection is characterised by a viral phase and a severe pro-inflammatory phase. The inhibition of the JAK/STAT pathway limits the pro-inflammatory state in moderate to severe COVID-19. METHODOLOGY: We analysed the data obtained by an observational co- hort of patients with SARS-CoV-2 pneumonia treated with ruxolitinib in 22 hospitals of Mexico. The applied dose was determined based on physician's criteria. The benefit of ruxolitinib was evaluated using the 8-points ordinal scale developed by the NIH in the ACTT1 trial. Duration of hospital stay, changes in pro-inflammatory laboratory values, mortality, and toxicity were also measured. RESULTS: A total of 287 patients were reported at 22 sites in Mexico from March to June 2020; 80.8% received ruxolitinib 5 mg BID and 19.16% re- ceived ruxolitinib 10 mg BID plus standard of care. At beginning of treatment, 223 patients were on oxygen support and 59 on invasive ventilation. The percentage of patients on invasive ventilation was 53% in the 10 mg and 13% in the 5 mg cohort. A statistically significant improvement measured as a reduction by 2 points on the 8-point ordinal scale was described (baseline 5.39 ± 0.93, final 3.67± 2.98, p = 0.0001). There were 74 deaths. Serious adverse events were presented in 6.9% of the patients. CONCLUSIONS: Ruxolitinib appears to be safe in COVID-19 patients, with clinical benefits observed in terms of decrease in the 8-point ordinal scale and pro-inflammatory state. Further studies must be done to ensure efficacy against mortality. CITA: J Infect Dev Ctries. 2022 Jan 31;16(1):63-72 DOI: 10.3855/jidc.15126 TÍTULO: Global multi-stakeholder endorsement of the MAFLD definition AUTORES: Méndez-Sánchez N, et al; Global multi-stakeholder consensus on the redefinition of fatty liver disease. SUMMARY: Letter to the editor CITA: Lancet Gastroenterol Hepatol. 2022 Mar 3; S2468-1253(22)00062-0 DOI: 10.1016/S2468-1253(22)00062-0 489

RESÚMENES DE ARTÍCULOS PUBLICADOS POR MÉDICOS E INVESTIGADORES DE MÉDICA SUR PMID: 35258105 TÍTULO: Behavioural patterns in allergic rhinitis medication in Europe: A study using MASK-air(®) real-world data AUTORES: Sousa-Pinto B, (…) Larenas-Linnemann DE, et al. BACKGROUND: Co-medication is common among patients with allergic rhinitis (AR), but its dimension and patterns are unknown. This is particu- larly relevant since AR is understood differently across European countries, as reflected by rhinitis-related search patterns in Google Trends. This study aims to assess AR co-medication and its regional patterns in Europe, using real-world data. METHODS: We analysed 2015-2020 MASK-air® European data. We com- pared days under no medication, monotherapy, and co-medication using the visual analogue scale (VAS) levels for overall allergic symptoms (\"VAS Glob- al Symptoms\") and impact of AR on work. We assessed the monthly use of different medication schemes, performing separate analyses by region (defined geographically or by Google Trends patterns). We estimated the average number of different drugs reported per patient within one year. RESULTS: We analysed 222,024 days (13,122 users), including 63,887 days (28.8%) under monotherapy, and 38,315 (17.3%) under co-medication. The median \"VAS Global Symptoms\" was 7 for no medication days, 14 for monotherapy and 21 for co-medication (p<0.001). Medication use peaked during the spring, with similar patterns across different European regions (defined geographically or by Google Trends). Oral H1 -antihistamines were the most common medication in single and co-medication. Each patient re- ported using an annual average of 2.7 drugs, with 80% reporting two or more. CONCLUSIONS: AR medication patterns are similar across European re- gions. One third of treatment days involved co-medication. These findings suggest that patients treat themselves according to their symptoms (irre- spective of how they understand AR), and that co-medication use is driven by symptom severity. CITA: Allergy. 2022 Mar 8 DOI: 10.1111/all.15275 490

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