Browsing by Author "Rollan, Antonio"
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- ItemEndoscopic 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, ArnoldoBackground. 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.
- ItemExperience of continuing online education in gastroenterology for non specialist medical doctors(SOC MEDICA SANTIAGO, 2019) Isbej, Lorena; Uribe, Javier; Carrasco, Olga; Villarroel, Isaac; Pizarro, Margarita; Isabel Jiron, Maria; Sanhueza, Edgar; Alvarez Lobos, Manuel; Hernandez Rocha, Cristian; Rollan, Antonio; Monsalve, Ximena; Antonio Diaz, Luis; Alejandra Cerda, Maria; Kramer, Tomas; Munizaga, Fernando; Riquelme, ArnoldoBackground: Continuing education is essential for health professions and online courses can be a good way for professional development. Aim: To describe the experience with online courses for continuing education in hepatology and gastroenterology and to analyze their educational impact. Material and Methods: A three years' experience in courses on liver diseases and digestive tract is described. Their curricular design, methodology, and the educational impact was analyzed using the four levels of the Kirkpatrick's model. Results: On average, there were 321 students per course (2015-2017). 94% were Chilean and 6% from abroad (20 countries). In the educational impact analysis, in level 1 "reaction": 93% said that the course fulfilled their expectations and 92% would recommend it. In level 2 "learning": 42% approved the courses. Level 3 "behavior" was not evaluated and level 4 "organizational change" highlighted that the traditional face-to-face continuing education model of Chilean Gastroenterology Society (SChG) changed to full distance model in these three courses, with 1284 students from South America, Asia and Europe, in a 3-years-period. Additionally, these programs were included in the Medical Society of Santiago (SMS) continuing education agenda. Conclusions: The alliance between the SMS and the SChG generated on line courses that meet the educational needs of physicians and medical students, with excellent results and student perception.
- ItemGastric cancer is related to early Helicobacter pylori infection in a high-prevalence country(AMER ASSOC CANCER RESEARCH, 2007) Ferreccio, Catterina; Rollan, Antonio; Harris, Paul R.; Serrano, Carolina; Gederlini, Alessandra; Margozzini, Paula; Gonzalez, Claudia; Aguilera, Ximena; Venegas, Alejandro; Jara, AlejandroBackground and Aims: Chile ranks fifth in the world among countries with the highest incidence of gastric cancer. The aim was to quantify the association between Helicobacter pylori infection and gastric cancer mortality at the county of residence.
- ItemInverse correlation between allergy markers and Helicobacter pylori infection in children is associated with elevated levels of TGF-beta(LIPPINCOTT WILLIAMS & WILKINS, 2011) Serrano, Carolina A.; Talesnik, Eduardo; Pena, Alfredo; Rollan, Antonio; Duarte, Ignacio; Torres, Javiera; Majerson, Daniela; Einisman, Helly; Viviani, Paola; Harris, Paul R.Objectives We evaluated allergy/hypersensitivity clinical markers and their correlation with Helicobactor pylori infection in children and adults to analyze how early acquisition of H. pylori could modulate allergic disorder expression.
- ItemManagement of Helicobacter pylori infection in Latin America : A Delphi technique-based consensus(2014) Rollan, Antonio; Arab Verdugo, Juan Pablo; Camargo, M. Constanza; Candia Balboa, Roberto; Harris D., Paul R.; Ferreccio Readi, Catterina; Rabkin, Charles S.; Gana Ansaldo, Juan Cristóbal; Cortés, Pablo; Herrero, Rolando; Durán, Luisa; García, Apolinaria; Toledo, Claudio; Espino Espino, Alberto Antonio; Lustig, Nicole; Sarfatis Feige, Alberto; Figueroa, Catalina; Torres, Javier; Riquelme Pérez, Arnoldo
- ItemNon-invasive diagnosis of gastric mucosal atrophy in an asymptomatic population with high prevalence of gastric cancer(BAISHIDENG PUBLISHING GROUP INC, 2006) Rollan, Antonio; Ferreccio, Catterina; Gederlini, Alessandra; Serrano, Carolina; Torres, Javiera; Harris, PaulAIM: To validate a non-invasive method to detect gastric mucosal atrophy in a Chilean population with high prevalence of gastric cancer and a poor survival rate.
- ItemOptimal 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, AntonioAIM: 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.
- ItemQuadruple therapies show a higher eradication rate compared to standard triple therapy for Helicobacter pylori infection within the LEGACy consortium. A multicenter observational study in European and Latin American countries(2024) Medel-Jara, Patricio; Reyes Placencia, Diego; Fuentes-Lopez, Eduardo; Corsi, Oscar; Latorre, Gonzalo; Anton, Rosario; Jimenez, Elena; Miralles-Marco, Ana; Caballero, Carmelo; Boggino, Hugo; Cantero, Daniel; Barros, Rita; Santos-Antunes, Joao; Diez, Marc; Quinones, Luis A.; Riquelme, Erick; Rollan, Antonio; Cerpa, Leslie C.; Valdes, Ivania; Nyssen, Olga P.; Moreira, Leticia; Gisbert, Javier P.; Camargo, M. Constanza; Ortiz-Olvera, Nayeli; Leon-Takahashi, Alberto M.; Ruiz-Garcia, Erika; Fernandez-Figueroa, Edith A.; Garrido, Marcelo; Owen, Gareth I.; Cervantes, Andres; Fleitas, Tania; Riquelme, ArnoldoIntroduction: Gastric cancer (GC) is one of the most lethal malignancies worldwide. Helicobacter pylori is the primary cause of GC; therefore, its eradication reduces the risk of developing this neoplasia. There is extensive evidence regarding quadruple therapy with relevance to the European population. However, in Latin America, data are scarce. Furthermore, there is limited information about the eradication rates achieved by antibiotic schemes in European and Latin American populations. Objective: To compare the effectiveness of standard triple therapy (STT), quadruple concomitant therapy (QCT), and bismuth quadruple therapy (QBT) in six centers in Europe and Latin America. Methods: A retrospective study was carried out based on the LEGACy registry from 2017 to 2022. Data from adult patients recruited in Portugal, Spain, Chile, Mexico, and Paraguay with confirmed H. pylori infection who received eradication therapy and confirmatory tests at least 1 month apart were included. Treatment success by each scheme was compared using a mixed multilevel Poisson regression, adjusting for patient sex and age, together with country-specific variables, including prevalence of H. pylori antibiotic resistance (clarithromycin, metronidazole, and amoxicillin), and CYP2C19 polymorphisms. Results: 772 patients were incorporated (64.64% females; mean age of 52.93 years). The total H. pylori eradication rates were 75.20% (255/339) with STT, 88.70% (159/178) with QCT, and 91.30% (191/209) with QBT. Both quadruple therapies (QCT-QBT) showed significantly higher eradication rates compared with STT, with an adjusted incidence risk ratio (IRR) of 1.25 (p: <0.05); and 1.24 (p: <0.05), respectively. The antibiotic-resistance prevalence by country, but not the prevalence of CYP2C19 polymorphism, showed a statistically significant impact on eradication success. Conclusions: Both QCT and QBT are superior to STT for H. pylori eradication when adjusted for country-specific antibiotic resistance and CYP2C19 polymorphism in a sample of individuals residing in five countries within two continents.
- ItemRelationship between Helicobacter pylori virulence factors and regulatory cytokines as predictors of clinical outcome(2007) Serrano, Carolina; Diaz, Maria Ines; Valdivia, Alejandra; Godoy, Alex; Pena, Alfredo; Rollan, Antonio; Kirberg, Arturo; Hebel, Eduardo; Fierro, Jaqueline; Klapp, Gabriela; Venegas, Alejandro; Harris, Paul R.Helicobacter pylori infection is highly prevalent in Chile (73%). Usually a minority of infected patients develops complications such as ulcers and gastric cancer that have been associated with the presence of virulence factors (cagA, vacA) and host T helper response (Th1/Th2). Our aim was to evaluate the relationship between strain virulence and host immune response, using a multiple regression approach for the development of a model based on data collected from H. pylori infected patients in Chile. We analyzed levels of selected cytokines determined by ELISA (interleukin (IL)-12, IL-10, interferon (IFN)-gamma and IL-4) and the presence of cagA and vacA alleles polymorphisms determined by PCR in antral biopsies of 41 patients referred to endoscopy. By multiple regression analysis we established a correlation between bacterial and host factors using clinical outcome (gastritis and duodenal ulcer) as dependent variables. The selected model was described by: clinical outcome = 0.867491 (cagA) + 0.0131847 (IL-12/IL-10) + 0.0103503 (IFN-gamma/IL-4) and it was able to explain over 90% of clinical outcomes observations (R-2=96.4). This model considers that clinical outcomes are better explained by the interaction of host immune factors and strain virulence as a complex and interdependent mechanism. (c) 2007 Elsevier Masson SAS. All rights reserved.