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Ítem Solo Metadatos Human visceral leishmaniasis prevalence by different diagnostic methods in latin america: a systematic review and meta-analysis(EDIMES Edizioni Medico Scientifiche, 2021)Visceral leishmaniasis is a neglected zoonotic disease that affects animals and humans in different tropical and subtropical regions and even beyond, with variable prevalence among infected hosts. To date, there have been no systematic reviews on human visceral leishma-niasis prevalence in Latin America. We therefore performed a systematic literature review with meta-analy-sis, using six databases to assess prevalence of visceral leishmaniasis in human patients in Latin American countries. Observational studies were included but analyzed separately. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95%CI). In all, 10,435 articles were retrieved for the time frame (1950-2019). After ini-tial screening, 120 articles were selected for full-text as-sessment, 97 being finally included for qualitative and quantitative analyses. Overall, VL pooled prevalence was estimated at 38.8% (95% CI 33.8-43.8%), derived from 97 studies, including 44,986 individuals. Many aspects of the transmission dynamics of Leishmania and the exact burden of this parasitosis on public health re-main largely unknown. Although the elimination of zoonotic VL in the Americas appears an unrealistic goal, additional efforts need to be put in place to achieve bet-ter diagnosis, treatment, and prevention of VL. © 2021, EDIMES Edizioni Medico Scientifiche. All rights reserved.Ítem Solo Metadatos Historical evolution and filtering characteristics of masks and respirators in dentistry in the context of COVID-19: a literature review(Wolters Kluwer (UK) Ltd., 2021)Objectives: At present, it is very important to identify the available literature regarding the use of masks and respirators by analyzing their historical evolution in the medical field. In addition, consideration should be given to the major filtering characteristics of those most used due to the current SARS-CoV-2 pandemic. Therefore, the purpose of this literature review is to describe the qualitative evolution that facemasks and respirators have undergone along with their different characteristics. Materials and Methods: This literature review was conducted between September and December 2020. Articles were identified from PubMed Central, Scopus, and Web of Science. The following keywords were used: 'COVID-19,' 'dentistry,' and 'masks.' These MeSH terms were combined with the Boolean operators 'AND' and 'OR.'Results: We found 36 articles in PubMed Central, 21 in Scopus, and 17 in Web of Science, which included reviews, clinical, descriptive, and experimental trials. Conclusion: The emergence of new pathogens leads to continuous improvement in masks and respirators. It was determined that for the dental field, respirators with filtration characteristics greater than 95%, such as FFP3, N100, N95, and KN95, are indicated in addition to their decontamination and reuse processes. © 2021 Journal of International Society of Preventive and Community Dentistry | Published by Wolters Kluwer - Medknow.Ítem Solo Metadatos Histologic findings and related diagnostic methods in condylar hyperactivity(Churchill Livingstone, 2021)Condylar hyperactivity (CH) is a rare condition that entails a progressive deviation and deformation of the mandible. There is no consensus regarding characteristic histopathological features or a standardized diagnostic process; thus, histopathological analysis of the condyle cannot confirm or exclude an active CH after condylectomy is performed. An electronic search was performed in Medline, Embase, Web of Science, LILACS and grey literature up to December 2019. Additionally, a manual search was performed. Risk of bias of the included studies was assessed using the Newcastle–Ottawa Scale and the Institute of Health Economics Quality Appraisal. All analyses were performed independently and in duplicate. Seventeen articles from 660 were included. Six articles were cross-sectional studies and 11 were case series. Almost all the articles (14) described an augmented thickness of the cartilage layer associated with cartilage islands within the subchondral bone in patients affected by CH. Histological findings seem to be mostly related to the age of the sample rather than a characteristic description of CH. No clear association was found between SPECT/scintigram uptake and a specific histological finding. Hence, there is a necessity for the development of specific tools for evaluating and reporting studies where histology is needed for diagnosis confirmation. © 2020 International Association of Oral and Maxillofacial SurgeonsÍtem Solo Metadatos Hepatocarcinoma y colangiocarcinoma en nódulos separados. Reporte de caso y revisión de literatura [Hepatocarcinoma and cholangiocarcinoma in separate nodules. Case report and literatura review](Publicaciones Permanyer, 2021)The incidence of synchronous primary liver malign neoplasm is extremely low. We report a case of a 59 years old woman with Hepatitis B without surveillance, who was hospitalized for an incidental finding of 2 liver neoplasm. The patient underwent surgery (liver segmentectomy VII and VIII) and the pathology report described primary Hepatocarcinoma and primary Cholangiocarcinoma. The chronic hepatitis B increase the risk of malign primary liver neoplasm; thus, these patients should be regularly evaluated with image studies. © 2021 Publicaciones Permanyer. All rights reserved.Ítem Solo Metadatos Global data analysis and risk factors associated with morbidity and mortality of COVID-19(Elsevier Inc., 2022)This review was focused on global data analysis and risk factors associated with morbidity and mortality of coronavirus disease 2019 from different countries, including Bangladesh, Brazil, China, Central Eastern Europe, Egypt, India, Iran, Pakistan, and South Asia, Africa, Turkey and UAE. Male showed higher confirmed and death cases compared to females in most of the countries. In addition, the case fatality ratio (CFR) for males was higher than for females. This gender variation in COVID-19 cases may be due to males' cultural activities, but similar variations in the number of COVID-19 affected males and females globally. Variations in the immune system can illustrate this divergent risk comparatively higher in males than females. The female immune system may have an edge to detect pathogens slightly earlier. In addition, women show comparatively higher innate and adaptive immune responses than men, which might be explained by the high density of immune-related genes in the X chromosome. Furthermore, SARS-CoV-2 viruses use angiotensin-converting enzyme 2 (ACE2) to enter the host cell, and men contain higher ACE2 than females. Therefore, males may be more vulnerable to COVID-19 than females. In addition, smoking habit also makes men susceptible to COVID-19. Considering the age-wise distribution, children and older adults were less infected than other age groups and the death rate. On the contrary, more death in the older group may be associated with less immune system function. In addition, most of these group have comorbidities like diabetes, high pressure, low lungs and kidney function, and other chronic diseases. Due to the substantial economic losses and the numerous infected people and deaths, research examining the features of the COVID-19 epidemic is essential to gain insight into mitigating its impact in the future and preparedness for any future epidemics. © 2022 Elsevier Inc.Ítem Solo Metadatos Future challenges of COVID-19 and oral manifestations in daily dental practice: a literature review(Wolters Kluwer (UK) Ltd., 2021)Objective: Some patients reportedly present with oral manifestations of coronavirus disease 2019 (Covid-19). It is unknown if this is due to the virus itself or a side effect of treatment; however, severe acute respiratory syndrome coronavirus 2 has been shown to have a predilection for angiotensin-converting enzyme receptors that are present in the respiratory tract, oral mucosa, tongue, and salivary glands, causing alterations in taste and smell. Therefore, the objective of this review was to present the future challenges of Covid-19 and oral manifestations in daily dental practice through a literature review. Materials and Methods: Scientific evidence in the databases Scopus and PubMed was searched using the Boolean operators. Articles published in Spanish and English between January and December 2020 were included. Results: Of the 89 articles found in Scopus, 69 were of the open access type and 20 were in the 'others' category; only 22 scientific articles were found in PubMed. Conclusion: It is important to take into account these clinical manifestations such as loss of taste and smell in order to detect the disease. Good oral hygiene is also recommended as a preventive measure to reduce viral load, which considerably reduces the probability of infecting other people who are in contact with the infected patient. © 2021 Journal of International Society of Preventive and Community Dentistry | Published by Wolters Kluwer - Medknow.Ítem Solo Metadatos Factors associated with COVID-19 in people with Parkinson’s disease: a systematic review and meta-analysis(John Wiley and Sons Inc, 2021)Background: There is debate as to whether there is an increased risk of COVID-19 infection in people with Parkinson's disease (PD), possibly due to associated factors. This study aimed to systematically review the factors associated with COVID-19 in people with PD. Methods: A search was carried out in PubMed, Scopus, and Web of Science up to November 2020 (updated until 1 April 2021). Observational studies that analyzed factors associated with COVID-19 in people with PD were selected and revised. Results: The authors included six studies (four case-controlled studies and two cross-sectional studies) in the qualitative and quantitative syntheses. The authors found that the following factors were associated with COVID-19 in people with PD: obesity (OR: 1.79, 95% CI: 1.07–2.99, I2: 0%), any pulmonary disease (OR: 1.92, 95% CI: 1.17–3.15, I2: 0%), COVID-19 contact (OR: 41.77, 95% CI: 4.77 – 365.56, I2: 0%), vitamin D supplementation (OR: 0.50, 95% CI: 0.30–0.83, I2: 0%), hospitalization (OR: 11.78, 95% CI: 6.27–22.12, I2: 0%), and death (OR: 11.23, 95% CI: 3.92–32.18, I2: 0%). The authors did not find any significant association between COVID-19 and hypertension, diabetes, cardiopathy, cancer, any cognitive problem, dementia, chronic obstructive pulmonary disease, renal or hepatic disease, smoking, and tremor. Conclusions: Meta-analyses were limited by the number of events and some methodological limitations. Despite this, the authors assessed the available evidence, and the results may be useful for future health policies. © 2021 European Academy of NeurologyÍtem Solo Metadatos Factors affecting quality of life in patients with systemic lupus erythematosus: important considerations and potential interventions(Taylor and Francis Ltd, 2018)Introduction: Patients with systemic lupus erythematosus (SLE) have a better survival than decades ago; nevertheless, they still experience a low health-related (HR) quality of life (QoL). Areas covered: After defining QoL and HRQoL, we review the need to assess it, its elements, how to measure it, its predictors, and its impact and potential interventions to improve it. Expert commentary: Physicians assessments of disease activity and damage do not capture the patients’ perspective of their health, and these differences could lead to nonadherence to therapy. Based on that, a comprehensive evaluation of SLE should include the assessment of HRQoL or the sum of the physical, psychological, and social perception of wellbeing, influenced by the patient’s illness. The most consistent predictors of low HRQoL are older age, poverty, lower educational level, behavioral issues, some clinical manifestations, and comorbidities. HRQoL impacts negatively on dealing with stress, intimal relationship, home and job-related activities, and treatment adherence. At the present, there are no successful specific therapeutic strategies aimed at improving it. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.Ítem Solo Metadatos Evidence-based appraisal of blood pressure reduction in spontaneous intracerebral hemorrhage: a scoping review and overview(Elsevier B.V., 2021)Background and aim: There is a current debate on the best approach for blood pressure (BP) reduction in patients with spontaneous intracerebral hemorrhage (ICH). Through this scoping review, we aimed to examine how research on reducing BP in ICH patients has been conducted and to clarify the evidence on which approach is the best (intensive vs. standard BP reductions). Methods: We performed a scoping review and overview of reviews of the literature. We systematically searched clinical practice guidelines (CPGs), systematic reviews (SRs), and randomized controlled trials (RCTs) that compared intensive versus standard BP reduction. We searched in three databases from inception until March 2020. Two independent authors conducted the study selection, data extraction, quality assessment, and overlapping analysis of SRs. We performed a description and critical appraisal of the current body of evidence. Results: We included three CPGs (with moderate to high quality); all of them recommended intensive reduction in specific clinical settings. We included eight SRs (with high overlap and critically low quality): two supported intensive reduction and four supported its safety, but not effectiveness. One SR reported that patients with intensive reduction had a significant risk of renal adverse events. We included seven RCTs (with limitations in randomization process); trials with large population did not found significant differences in mortality and disability. One RCT reported a significantly higher number of renal adverse events. Conclusions: CPGs support the use of intensive BP reduction; however, most recent SRs partially supported or did not support it due to the association with renal events. It seems the range goal between 140 and 180 mmHg could be safe and equally effective than intensive reduction. We recommend further research in serious and non-serious events promoted by intensive reduction and outcomes homogenization across studies to ensure correct comparison. © 2021 Elsevier B.V.Ítem Solo Metadatos Uso etnomedicinal, fitoquímica y actividad biológica de la planta andina Buddleja incana Ruiz & Pav. (scrophulariaceae) [Ethnomedical use, phytochemistry and biological activity of the Andean plant Buddleja incana Ruiz & Pav. (Scrophulariaceae)](Ilia State University, Institute of Botany, Department of Ethnobotany, 2020)Background: Buddleja incana Ruiz & Pav. (Scrophulariaceae) is an ancestral medicinal plant from the South American Andes used in traditional medicine since the Inca culture, but little studied in its chemical components at present. The aim of this review is to gather all the scientific information about this plant in order to use it in alternative medicine and at the same time to stimulate its study in research groups in the Andean countries. Materials and methods: Several electronic search engines and specialized reference tools were used, such as Google, Google Scholar, Scopus, Web of Science, publication sites and electronic databases (Pubmed, Springer, Wiley and Science Direct). Results: Phytochemical studies have found the following chemical components:flavonoids, steroids, saponins, leukoanthocyanidins, triterpenes, phenols, tannins, reducing sugars, coumarins, alkaloids, terpenes and verbascosides. This plant is used to treat several diseases and pathological conditions, having demonstrated anti-inflammatory, antineoplastic, antispasmodic, antibacterial, antifungal and febrifuge effects, in the following conditions. wounds, neuralgias, cutaneous and gastrointestinal ulcers, papillomatosis, skin cancer, photosensitization, immunomodulator. Conclusions: Buddleja incana was a sacred and medicinal plant of the Incas. Nowadays it is used for the treatment of hepatic, bronchial and urogenital diseases. It has diuretic, anti-inflammatory, analgesic, antirheumatic, antimicrobial, antihyperglycemic, wound regenerating effects, for the treatment of warts, skin ulcers, antiproliferative, and for its photoprotective effect on the skin. In veterinary medicine it is used to treat skin photosensitization in sheep, in bovine warts and in oral canine papillomatosis. © 2020, Ilia State University, Institute of Botany, Department of Ethnobotany. All rights reserved.Ítem Solo Metadatos Efficacy of omega-3 supplementation on sertraline continuous therapy to reduce depression or anxiety symptoms: a systematic review and meta-analysis(Elsevier Ireland Ltd, 2021)We aimed to synthesize the evidence from randomized controlled trials (RCTs) that determined the efficacy of adding omega-3 supplementation to the continuous sertraline therapy in adults with depression. Meta-analyses were performed using random effects. We used the Revised Cochrane risk of bias tool for randomized trials version 2.0. to assess the risk of bias. Four RCTs were included. The follow-up ranged from eight to 12 weeks. Regarding the Beck Depression Inventory, the pooled SMD was 0.50 (95% CI: -0.51, 1.50; I2: 94.1%). A subgroup analysis was performed regarding the presence of coronary disease: SMD -0.17 (95% CI: -0.41, 0.07; I2: 0.0%). Regarding the Beck Anxiety Inventory, the pooled MD was 0.03 (95% CI: -2.22, 2.28; I2: 0.0%). Regarding the Hamilton Depression Rating Scale, the pooled MD was 0.42 (95% CI: -1.44, 2.29; I2: 35.7%). All pooled outcomes presented a very low certainty of the evidence. Three RCTs presented a low risk of bias in all domains; however, one study presented some concerns in two domains. No essential reductions in the outcomes were found. A subgroup analysis suggested that may be better not to provide the supplementation in patients with coronary disease. The evidence is not enough to make recommendations. © 2020Ítem Solo Metadatos Economy or health, constant dilemma in times of pandemic: the case of Coronavirus disease 2019 (COVID-19)(Journal of Pure and Applied Microbiology, 2020)The multiple faces of the Coronavirus Disease 2019 (COVID-19), also included the impact on the economy. As a consequence of the significant life and society disruption, multiple implications are derived from the COVID-19 crisis and pandemic, including a significant backward on the economy. In the current mini-review, we discuss some potential considerations about it, including some specific examples of the COVID-19 impact on the economy. © The Author(s) 2020.Ítem Solo Metadatos Development of a framework for the implementation of synchronous digital mental health: realist synthesis of systematic reviews(JMIR Publications Inc., 2022)Background: The use of technologies has served to reduce gaps in access to treatment, and digital health interventions show promise in the care of mental health problems. However, to understand what and how these interventions work, it is imperative to document the aspects related to their challenging implementation. Objective: The aim of this study was to determine what evidence is available for synchronous digital mental health implementation and to develop a framework, informed by a realist review, to explain what makes digital mental health interventions work for people with mental health problems. Methods: The SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, and Research type) framework was used to develop the following review question: What makes digital mental health interventions with a synchronous component work on people with mental health problems, including depression, anxiety, or stress, based on implementation, economic, quantitative, qualitative, and mixed methods studies? The MEDLINE, EBM Reviews, PsycINFO, EMBASE, SCOPUS, CINAHL Complete, and Web of Science databases were searched from January 1, 2015, to September 2020 with no language restriction. A Measurement Tool to Assess Systematic Reviews-2 (AMSTAR-2) was used to assess the risk of bias and Confidence in Evidence from Reviews of Qualitative Research (CERQual) was used to assess the confidence in cumulative evidence. Realist synthesis analysis allowed for developing a framework on the implementation of synchronous digital mental health using a grounded-theory approach with an emergent approach. Results: A total of 21 systematic reviews were included in the study. Among these, 90% (n=19) presented a critically low confidence level as assessed with AMSTAR-2. The realist synthesis allowed for the development of three hypotheses to identify the context and mechanisms in which these interventions achieve these outcomes: (1) these interventions reach populations otherwise unable to have access because they do not require the physical presence of the therapist nor the patient, thereby tackling geographic barriers posed by in-person therapy; (2) these interventions reach populations otherwise unable to have access because they can be successfully delivered by nonspecialists, which makes them more cost-effective to implement in health services; and (3) these interventions are acceptable and show good results in satisfaction because they require less need of disclosure and provide more privacy, comfortability, and participation, enabling the establishment of rapport with the therapist. Conclusions: We developed a framework with three hypotheses that explain what makes digital mental health interventions with a synchronous component work on people with mental health problems. Each hypothesis represents essential outcomes in the implementation process. © 2022 JMIR Publications Inc.. All Rights Reserved.Ítem Solo Metadatos Depressive states in patients with chronic noncommunicable diseases [Estados depresivos en pacientes con enfermedades crónicas no transmisibles](Editorial Ciencias Medicas, 2022)Introduction: The relationship between chronic noncommunicable diseases and mental disorders, such as anxiety and depression, occur in a bidirectional way, that is, the presence of one condition predisposes the development of the other. Objective: To investigate, in the literature reviewed, about the aspects related to depressive states in patients with chronic noncommunicable diseases of major impact on public health. Methods: Documental research that consisted in the systematic literature review of studies about depressive states and being affected by chronic noncommunicable diseases, published in open access medical journals in Spanish or English and that contribute to the understanding the comorbidity of these conditions. Conclusions: Poor diagnosis and control of chronic noncommunicable diseases and depressive states can lead to lack of adherence to treatment, which increases the morbimortality of chronic noncommunicable diseases. Depressive states and chronic noncommunicable diseases share biological mechanisms of immune activity that, in a complex balance, determined by the activation of specific genes, together contribute to the onset of depressive states and aggravation of chronic noncommunicable diseases. It is necessary to have a comprehensive vision at the diagnostic and control levels that allows to decide together the most adequate treatment according to the patient's characteristics, in order to proceed with the opportune and appropriate referral in each case. © 2022, Editorial Ciencias Medicas. All rights reserved.Ítem Solo Metadatos Humanized mouse models for the study of periodontitis: an opportunity to elucidate unresolved aspects of its immunopathogenesis and analyze new immunotherapeutic strategies(Frontiers Media S.A., 2021)Periodontitis is an oral inflammatory disease in which the polymicrobial synergy and dysbiosis of the subgingival microbiota trigger a deregulated host immune response, that leads to the breakdown of tooth-supporting tissues and finally tooth loss. Periodontitis is characterized by the increased pathogenic activity of T helper type 17 (Th17) lymphocytes and defective immunoregulation mediated by phenotypically unstable T regulatory (Treg), lymphocytes, incapable of resolving the bone-resorbing inflammatory milieu. In this context, the complexity of the immune response orchestrated against the microbial challenge during periodontitis has made the study of its pathogenesis and therapy difficult and limited. Indeed, the ethical limitations that accompany human studies can lead to an insufficient etiopathogenic understanding of the disease and consequently, biased treatment decision-making. Alternatively, animal models allow us to manage these difficulties and give us the opportunity to partially emulate the etiopathogenesis of periodontitis by inoculating periodontopathogenic bacteria or by placing bacteria-accumulating ligatures around the teeth; however, these models still have limited translational application in humans. Accordingly, humanized animal models are able to emulate human-like complex networks of immune responses by engrafting human cells or tissues into specific strains of immunodeficient mice. Their characteristics enable a viable time window for the study of the establishment of a specific human immune response pattern in an in vivo setting and could be exploited for a wider study of the etiopathogenesis and/or treatment of periodontitis. For instance, the antigen-specific response of human dendritic cells against the periodontopathogen Porphyromonas gingivalis favoring the Th17/Treg response has already been tested in humanized mice models. Hypothetically, the proper emulation of periodontal dysbiosis in a humanized animal could give insights into the subtle molecular characteristics of a human-like local and systemic immune response during periodontitis and support the design of novel immunotherapeutic strategies. Therefore, the aims of this review are: To elucidate how the microbiota-elicited immunopathogenesis of periodontitis can be potentially emulated in humanized mouse models, to highlight their advantages and limitations in comparison with the already available experimental periodontitis non-humanized animal models, and to discuss the potential translational application of using these models for periodontitis immunotherapeutics. © Copyright © 2021 Rojas, García, Polanco, González-Osuna, Sierra-Cristancho, Melgar-Rodríguez, Cafferata and Vernal.Ítem Solo Metadatos Corporate impunity in Taucamarca: 19 years on, still no justice(Cambridge University Press, 2019)Ítem Solo Metadatos Costs related to frontotemporal dementia in Latin America: a scoping review of economic health studies(Frontiers Media S.A., 2021)Introduction: Frontotemporal dementia (FTD) is a complex syndrome characterized by changes in behavior, language, executive control, and motor symptoms. Its annual economic burden per patient in developed countries has been classified as considerable, amounting to US$119,654 per patient, almost double the patient costs reported for Alzheimer's disease. However, there is little information regarding cost-of-illness (COI) for FTD in Latin-America (LA). Aim: To describe the costs related to FTD in LA. Methods: We included COI studies on FTD conducted in LA published in English, Spanish, or Portuguese from inception to September 2020. We carried out a systematic search in Pubmed/Medline, Scopus, Web of Science, Scielo, Cochrane, and gray literature. For quality assessment, we used a COI assessment tool available in the literature. All costs were reported in USD for 1 year and adjusted for inflation. Results: We included three studies from Argentina, Brazil, and Peru. Direct costs (DCs) included medication (from US$959.20 to US$ 4,279.20), health care costs (from US$ 2,275.80 to US$7,856.16), and caregiver costs (from US$9,634.00 to US$28,730.28). Indirect costs (ICs) amounted to US$43,076.88. Conclusions: In LA countries, the reporting of costs related to FTD continues to be oriented toward DCs. They remain lower than in developed countries, possibly due to the limited health budget allocated. Only one Brazilian report analyzed ICs, representing the highest percentage of the total costs. Therefore, studies on the COI of this disease in LA are essential, focusing on both out-of-pocket spending and the potential economic loss to patients' homes and families. © Copyright © 2021 Alva-Dìaz, Malaga, Rodriguez-Calienes, Morán-Mariños, Velásquez-Rimachi and Custodio.Ítem Solo Metadatos Clinical pathway for the diagnosis and management of patients with Relapsing–Remitting Multiple Sclerosis: a first proposal for the Peruvian population(Frontiers Media S.A., 2021)Background: Relapsing–remitting multiple sclerosis (RRMS) is a subtype of degenerative inflammatory demyelinating disease of multifactorial origin that affects the central nervous system and leads to multifocal neurological impairment. Objectives: To develop a clinical pathway (CP) for the management of Peruvian patients with RRMS. Methods: First, we performed a literature review using Medline, Embase, Cochrane, ProQuest, and Science direct. Then, we structured the information as an ordered and logical series of five topics in a defined timeline: (1) How should MS be diagnosed? (2) How should a relapse be treated? (3) How should a DMT be initiated? (4) How should each DMT be used? and (5) How should the patients be followed? Results: The personnel involved in the care of patients with RRMS can use a series of flowcharts and diagrams that summarize the topics in paper or electronic format. Conclusions: We propose the first CP for RRMS in Peru that shows the essential steps for diagnosing, treating, and monitoring RRMS patients based on an evidence-based medicine method and local expert opinions. This CP will allow directing relevant clinical actions to strengthen the multidisciplinary management of RRMS in Peru. Copyright © 2021 Caparó-Zamalloa, Velásquez-Rimachi, Mori, Dueñas-Pacheco, Huerta-Rosario, Farroñay-García, Molina and Alva-Díaz.Ítem Solo Metadatos Clinical, laboratory and imaging features of COVID-19: a systematic review and meta-analysis(Elsevier USA, 2020)Introduction: An epidemic of Coronavirus Disease 2019 (COVID-19) began in December 2019 in China leading to a Public Health Emergency of International Concern (PHEIC). Clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews on COVID-19 have been published to date. Methods: We performed a systematic literature review with meta-analysis, using three databases to assess clinical, laboratory, imaging features, and outcomes of COVID-19 confirmed cases. Observational studies and also case reports, were included, and analyzed separately. We performed a random-effects model meta-analysis to calculate pooled prevalences and 95% confidence intervals (95%CI). Results: 660 articles were retrieved for the time frame (1/1/2020-2/23/2020). After screening, 27 articles were selected for full-text assessment, 19 being finally included for qualitative and quantitative analyses. Additionally, 39 case report articles were included and analyzed separately. For 656 patients, fever (88.7%, 95%CI 84.5–92.9%), cough (57.6%, 95%CI 40.8–74.4%) and dyspnea (45.6%, 95%CI 10.9–80.4%) were the most prevalent manifestations. Among the patients, 20.3% (95%CI 10.0–30.6%) required intensive care unit (ICU), 32.8% presented with acute respiratory distress syndrome (ARDS) (95%CI 13.7–51.8), 6.2% (95%CI 3.1–9.3) with shock. Some 13.9% (95%CI 6.2–21.5%) of hospitalized patients had fatal outcomes (case fatality rate, CFR). Conclusion: COVID-19 brings a huge burden to healthcare facilities, especially in patients with comorbidities. ICU was required for approximately 20% of polymorbid, COVID-19 infected patients and hospitalization was associated with a CFR of >13%. As this virus spreads globally, countries need to urgently prepare human resources, infrastructure and facilities to treat severe COVID-19. © 2020 Elsevier LtdÍtem Solo Metadatos Clinical efficacy of lip repositioning technique and its modifications for the treatment of gummy smile: systematic review and meta-analysis(Springer Science and Business Media Deutschland GmbH, 2022)Objective: To systematically review the literature regarding the clinical efficacy of reducing excessive gingival display (EGD) using the surgical lip repositioning technique (LRT) and its modifications. The question to address was: “What is the clinical efficacy of the surgical LRT and its modifications in patients with EGD?” Material and methods: Four databases (MEDLINE-PubMed, Scopus, EMBASE, and CENTRAL) were searched up to December 2021 (PROSPERO-CRD42020205987). Randomized, non-randomized controlled and prospective case series with a minimum of 6-month follow-up were eligible for inclusion. Two meta-analyses were performed using the mean difference (MD) between baseline and different follow-up periods (6 and 12 months). Subgroup analyses were performed using the different modifications of LRT. Results: The electronic research retrieved 783 studies. Only 13 met the inclusion criteria and were included in the statistical analysis. Six modifications of the original LRT were identified. An overall EGD reduction of −3.06 mm (95%CI: −3.71–2.40), −2.91 mm; (95%CI: −3.66–2.15) and −2.76 mm; (95%CI: −3.83–−1.70) was achieved after 6, 12, and 36 months, respectively, compared to baseline (P < 0.01). Meta-analysis revealed that the use of LRT with periosteal suturing showed the greatest decrease in EGD with 5.22 mm (95% CI: 4.23–6.21; P < 0.01) at 6 months and 4.94 mm (95% CI: 3.86–6.02; P < 0.01) at 12 months. Conclusions: Both the original LRT and its different modifications reduce EGD and provide good results and overall patient satisfaction at 6, 12, and 36 months of follow-up. Clinical relevance: Evaluating the different modifications of the LRT can be a guiding aspect for the clinical and surgical approach to be used in patients with EGD. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.