Browsing by Author "Medina, Brenda"

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    Endoscopic band ligation versus propranolol for the primary prophylaxis of variceal bleeding in cirrhotic patients with high risk esophageal varices
    (ELSEVIER ESPANA, 2010) Maria Perez Ayuso, Rosa; Valderrama, Sebastian; Espinoza, Manuel; Rollan, Antonio; Sanchez, Rene; Otarola, Francisco; Medina, Brenda; Riquelme, Arnoldo
    Background. Gastroesophageal variceal bleeding is a common complication of portal hypertension. Current guidelines recommend beta -blockers for primary prophylaxis. However, evidence suggests that endoscopic variceal ligation (EVL) reduce bleeding episodes. Aims. To compare endoscopic EVL with propranolol (PPL) for primary prophylaxis of variceal bleeding. Methods. We conducted a randomized controlled trial. Over a 9-year period, 75 patients with cirrhosis and high-risk esophageal varices (HREV) were recruited and allocated to EVL (n=39) or PPL (n=36). Primary outcome was variceal bleeding. Secondary outcomes were survival, source of bleeding and serious adverse events. Analyses were made by intention-to-treat. Results. Baseline characteristics were similar. Medium follow-up was 1647 1096 days. Complete follow-up was achieved in 85% of patients. Variceal bleeding occurred in 12% of EVL and in 25% of PPL group (p=0.17). The actuarial risks of bleeding after 2 years were similar in both groups. Overall mortality was 51% in EVL and 33% in PPL group (p=0.17). Patients in the EVL group showed a lower rate of esophageal variceal bleeding (5.1% v/s 25%, p=0.027) and a higher rate of subcardial variceal bleeding compared with PPL group (7.7% v/s 0%, p=0.027). Serious adverse events related to EVL occurred in 2 patients, including 1 death. Conclusions. The present study supports that PPL should be considered the first choice in primary prophylaxis of variceal bleeding offering similar effects and tower severe adverse events compared with EVL.
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    Non-alcoholic fatty liver disease and its association with obesity, insulin resistance and increased serum levels of C-reactive protein in Hispanics
    (WILEY, 2009) Riquelme Pérez, Arnoldo; Arrese Jiménez, Marco; Soza, Alejandro; Morales, Arturo; Baudrand Biggs, René; Pérez Ayuso, Rosa María; González Donoso, Robinson; Álvarez Lobos, Manuel; Marshall Rivera, Guillermo; Garcia Zattera, María José; Otarola, Francisco; Medina, Brenda; Rigotti, Attilio; Miquel P., Juan Francisco; Nervi, Flavio; Hernández, María José
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    Optimal length of triple therapy for H pylori eradication in a population with high prevalence of infection in Chile
    (BAISHIDENG PUBLISHING GROUP INC, 2007) Riquelme, Arnoldo; Soza, Alejandro; Pedreros, Cesar; Bustamante, Andrea; Valenzuela, Felipe; Otarola, Francisco; Abbott, Eduardo; Arellano, Marco; Medina, Brenda; Pattillo, Alejandro; Greig, Douglas; Arrese, Marco; Rollan, Antonio
    AIM: To compare the efficacy of 7-d versus 14-d triple therapy for the treatment of H pylori infection in Chile, with a prevalence of 73% in general population. METHODS: H pylori-infected patients diagnosed by rapid urease test, with non-ulcer dyspepsia or peptic ulcer disease were randomized to receive omeprazole 20 mg bid, amoxicillin 1 g bid, and clarithromycin 500 mg bid for 7 (OAC7) or 14 (OAC14) d. Primary outcome was eradication rate 6 wk after the treatment. Subgroup analysis was carried out considering the eradication rate among patients with or without peptic ulcer disease and eradication rate among smokers or non-smokers.