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Browsing by Author "Barrera Martínez, Francisco"

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Accuracy of the BAR score in the prediction of survival after liver transplantation
(2019) Martinez Castillo, Jorge Arturo; Pacheco, Sergio; Bachler, J.; Jarufe Cassis, Nicolás; Briceño, Eduardo; Guerra Castro, Juan Francisco; Benitez, Carlos; Wolff, Rodrigo; Barrera Martínez, Francisco; Arrese Jiménez, Marco
Acute liver failure and liver transplantation secondary to flutamide treatment in a prostate cancer patient
(2020) Rojas, Pablo A.; Iglesias, Tomas G.; Barrera Martínez, Francisco; Mendez, Gonzalo P.; Torres, Javiera; San Francisco, Ignacio F.
Flutamide is a first-generation nonsteroidal antiandrogen, used for treatment of advanced prostate cancer (PCa). We present the clinical case of a patient with localized high-risk PCa who started flutamide before radical prostatectomy and evolved with acute liver failure and liver transplantation. Hepatotoxicity induced by antiandrogen therapy, and current indications for first generation anti-androgen therapy were reviewed. To our knowledge, this is the first report of a man diagnosed with PCa who evolved with acute liver failure secondary to flutamide, and finally required liver transplantation.
Baveno VI and Expanded Baveno VI criteria successfully predicts the absence of high-risk gastro-oesophageal varices in a Chilean cohort
(2020) Gaete Celis, María Isabel; Díaz Piga, Luis Antonio; Arenas Fajardo, Cristian Alexis; Gonzalez, K.; Cattaneo, M.; Soza, Alejandro; Arrese, Marco; Barrera Martínez, Francisco; Arab Verdugo, Juan Pablo; Benítez, Carlos; Fuster, F.; Henriquez, R.
Beneficial effects of mineralocorticoid receptor blockade in experimental non-alcoholic steatohepatitis
(2015) Pizarro, M.; Solís, Nancy; Quintero, P.; Barrera Martínez, Francisco; Cabrera, D.; Rojas-de Santiago, P.; Arab Verdugo, Juan Pablo; Padilla, O.; Roa Strauch, Juan Carlos Enrique; Moshage, H.; Wree, A.; Inzaugarat, E.; Feldstein, A.; Fardella B., Carlos; Baudrand Biggs, René; Riquelme, A.; Arrese Jiménez, Marco
Bile acids and portal hypertension
(2017) Arab Verdugo, Juan Pablo; Barrera Martínez, Francisco; Arrese Jiménez, Marco
Cholestasis secondary to hyperthyroidism in Graves' disease : Report of one case
(2020) Barra, M. I.; Olmos Borzone, Roberto Ignacio; Barrera Martínez, Francisco; Mosso Gómez, Lorena; Domínguez Ruiz-Tagle, José Miguel
Hyperthyroidism can induce elevation in several liver function tests including aminotransferases, alkaline phosphatases and, less frequently, serum bilirubin. These alterations are usually mild and asymptomatic. We report a 26 year-old male presenting with palpitations, progressive jaundice, choluria and generalized itching. Laboratory tests were compatible with hyperthyroidism and a mild elevation of bilirubin, alkaline phosphatases and gamma glutamyl transpeptidase. A liver biopsy showed portal hepatitis with canalicular cholestasis. The patient was treated temporarily with glucocorticoids, cholestyramine and betablockade. Thereafter, he was treated with radioactive iodine, after which serum bilirubin decreased steadily until normalization in ten weeks.
Concurrent nonalcoholic fatty liver disease and type 2 diabetes: diagnostic and therapeutic considerations
(2019) Arrese Jiménez, Marco; Barrera Martínez, Francisco; Triantafilo, Nicólas; Arab Verdugo, Juan Pablo
Conversion to mycophenolate mofetil monotherapy in liver recipients: Calcineurin inhibitor levels are key
(2017) Norero, Blanca; Serrano Honeyman, Carolina; Sánchez Fueyo, A.; Duarte, Ignacio; Torres Montes, Paula Javiera; Ocqueteau Tachini, Mauricio; Barrera Martínez, Francisco; Arrese Jiménez, Marco; Soza, Alejandro; Benítez, Carlos
Diet-Induced Nonalcoholic Fatty Liver Disease Is Associated with Sarcopenia and Decreased Serum Insulin-Like Growth Factor-1
(2016) Cabrera, D.; Ruiz, A.; Cabello Verrugio, Claudio Alejandro; Brandan, Enrique; Estrada, L.; Pizarro, M.; Solis, N.; Torres Montes, Paula Javiera; Barrera Martínez, Francisco; Arrese Jiménez, Marco
Disparities in steatosis prevalence in the United States by Race or Ethnicity according to the 2023 criteria
(2024) Díaz, Luis Antonio; Lazarus, Jeffrey V.; Fuentes López, Eduardo; Idalsoaga Ferrer, Francisco Javier; Ayares Campos, Gustavo Ignacio; Desaleng, Hailemichael; Danpanichkul, Pojsakorn; Cotter, Thomas G.; Dunn, Winston; Barrera Martínez, Francisco; Wijarnpreecha, Karn; Noureddin, Mazen; Alkhouri, Naim; Singal, Ashwani K.; Wong, Robert J.; Younossi, Zobair M.; Rinella, Mary E.; Kamath, Patrick S.; Bataller, Ramon; Loomba, Rohit; Arrese Jiménez, Marco; Arab Verdugo, Juan Pablo
© The Author(s) 2024.Introduction: The 2023 nomenclature defined criteria for steatotic liver disease (SLD), including metabolic dysfunction-associated SLD (MASLD), alcohol-associated liver disease (ALD), and the overlapping MASLD/ALD (MetALD). We aimed to assess racial and ethnic disparities in the SLD prevalence among United States (US) adults based on this new nomenclature. Methods: We undertook a cross-sectional study employing the 2017–2018 National Health and Nutrition Examination Survey (NHANES) database. We identified SLD according to a controlled attenuation parameter ≥288 dB/m, liver stiffness ≥7.2 kPa, or elevated aminotransferase levels. Alcohol use thresholds were established according to the updated SLD definition. We estimated prevalences using the complex design of the NHANES survey. Multivariable logistic regressions with complex design weights were employed. Results: A total of 5532 individuals are included. The mean age is 45.4 years, and 50.9% are women. The adjusted estimated prevalence of MASLD is 42.4% (95% CI: 41.1–43.8%), MetALD 1.7% (95% CI: 1.3–2.0%), and ALD 0.6% (95% CI: 0.3–0.8%). Hispanics exhibit a higher prevalence of SLD, but there are no significant differences in advanced fibrosis prevalence due to SLD among racial/ethnic groups. In MASLD, men, individuals aged 40–64 and ≥65 years, Hispanics, those with health insurance, higher BMI, diabetes, hypertension, hypertriglyceridemia, and low high-density lipoprotein (HDL) cholesterol or use of lipid-lowering agents are independently associated with a higher risk, while Blacks have the lowest risk. In MetALD, men and higher BMI are independently associated with a higher risk of MetALD in adjusted multivariable analysis. In ALD, the adjusted multivariable analysis shows that only health insurance is independently associated with a lower ALD risk. Conclusions: MASLD prevalence is high in the US, especially in men, older individuals, and Hispanics. MetALD and ALD prevalence was substantial but could be underestimated.
Effect of cholecystectomy on bile acid synthesis and circulating levels of fibroblast growth factor 19
(2015) Barrera Martínez, Francisco; Azocar, Lorena; Molina, Héctor; Schalper, Kurt A.; Ocares, Marcia; Liberona, Jessica; Villarroel del Pino, Luis A.; Pimentel Muller, Fernando; Perez Ayuso, Rosa Maria; Nervi, Flavio; Groen, Albert K.; Miquel P., Juan Francisco
¿Es flumazenil una alternativa para el tratamiento de la encefalopatía hepática?
(2017) Reyes, Diego; Barrera Martínez, Francisco
Estimating mortality and disability in Peru before the COVID-19 pandemic: a systematic analysis from the Global Burden of the Disease Study 2019
(2023) Ríos-Blancas, María Jesus; Pando-Robles, Victoria; Razo, Christian; Carcamo, César P.; Mendoza, Walter; Pacheco-Barríos, Kevin; Miranda, J. Jaime; Lansingh, Van Charles; Demie, Takele Gezahegn; Saha, Manika; Okonji, Osaretin Christabel; Yigit, Arzu; Cahuana-Hurtado, Lucero; Chacón-Uscamaita, Pamela R.; Bernabe, Eduardo; Culquichicon, Carlos; Chirinos-Caceres, Jesus Lorenzo; Cárdenas, Rosario; Alcalde-Rabanal, Jacqueline Elizabeth; Barrera Martínez, Francisco; Ayala Quintanilla, Beatriz Paulina; Shorofi, Seyed Afshin; Nuwan, Darshana Wickramasinghe; Nuno, Ferreira; Louay, Almidani; Vivek, Kumar Gupta; Hanie, Karimi; Alayu, Daniel Shewaye; Benziger, Catherine P.; Takeshi, Fukumoto; Ebrahim, Mostafavi; Elrashdy, Moustafa Mohamed Redwan; Mesfin, Gebrehiwot; Khaled, Khatab; Ai, Koyanagi; Krapp, Fiorella; Lee, Seung; Noori, Maryam; Qattea. Ibrahim; Rosenthal, Victor Daniel; Sakshaug, Joseph W.; Wagaye, Birhanu; Iman, Zare; Ortega-Altamirano, Doris V.; Murillo-Zamora, Efrén; Vervoort, Dominique; Santos Silva, Diego Augusto; Abderrahim, Oulhaj; Herrera-Serna, Brenda Yuliana; Mehra, Rahul; Mehrdad, Amir-Behghadami; Nasrin, Adib; Cortés Arancibia, Sandra; Anh, Kim Dang; Binh, Thanh Nguyen; Ali, H. Mokdad; Hay, Simon I.; Murray, Christopher J. L.; Lozano, Rafael; García, Patricia J.; CEDEUS (Chile)
Background Estimating and analyzing trends and patterns of health loss are essential to promote efficient resource allocation and improve Peru’s healthcare system performance.MethodsUsing estimates from the Global Burden of Disease (GBD), Injuries, and Risk Factors Study (2019), we assessed mortality and disability in Peru from 1990 to 2019. We report demographic and epidemiologic trends in terms of population, life expectancy at birth (LE), mortality, incidence, prevalence, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) caused by the major diseases and risk factors in Peru. Finally, we compared Peru with 16 countries in the Latin American (LA) region.ResultsThe Peruvian population reached 33.9 million inhabitants (49.9% women) in 2019. From 1990 to 2019, LE at birth increased from 69.2 (95% uncertainty interval 67.8–70.3) to 80.3 (77.2–83.2) years. This increase was driven by the decline in under-5 mortality (−80.7%) and mortality from infectious diseases in older age groups (+60 years old). The number of DALYs in 1990 was 9.2 million (8.5–10.1) and reached 7.5 million (6.1–9.0) in 2019. The proportion of DALYs due to non-communicable diseases (NCDs) increased from 38.2% in 1990 to 67.9% in 2019. The all-ages and age-standardized DALYs rates and YLLs rates decreased, but YLDs rates remained constant. In 2019, the leading causes of DALYs were neonatal disorders, lower respiratory infections (LRIs), ischemic heart disease, road injuries, and low back pain. The leading risk factors associated with DALYs in 2019 were undernutrition, high body mass index, high fasting plasma glucose, and air pollution. Before the COVID-19 pandemic, Peru experienced one of the highest LRIs-DALYs rates in the LA region.ConclusionIn the last three decades, Peru experienced significant improvements in LE and child survival and an increase in the burden of NCDs and associated disability. The Peruvian healthcare system must be redesigned to respond to this epidemiological transition. The new design should aim to reduce premature deaths and maintain healthy longevity, focusing on effective coverage and treatment of NCDs and reducing and managing the related disability.
Fragmento sérico de citoqueratina-18 como marcador no invasivo de esteatohepatitis no alcohólica en población chilena
(2017) Arab Verdugo, Juan Pablo; Hernández Rocha, Cristián Antonio; Morales, Carolina; Vargas Domínguez, José Ignacio; Solis, Nancy; Pizarro Rojas, Margarita Alicia; Robles, Camila; Sandoval, Daniela; Ponthus, Simon; Benítez Gajardo, Carlos Esteban; Barrera Martínez, Francisco; Soza, Alejandro; Riquelme Pérez, Arnoldo; Arrese, Marco
La esteatohepatitis no alcohólica (EHNA) es la forma más agresiva de hígado graso no alcohólico (HGNA) e involucra el riesgo de progresión a etapas más avanzadas de enfermedad hepática. Se requieren métodos no invasivos para identificar a pacientes con EHNA. Objetivo: Evaluar el rendimiento diagnóstico de la determinación de los niveles séricos de citoqueratina-18 como marcador no invasivo de EHNA en población chilena. Métodos: Se determinaron los niveles séricos de CK-18 en un grupo de 41 pacientes con HGNA-probado por biopsia. El diagnóstico de EHNA se basó en los criterios histológicos recomendados (presencia de balonamiento) y se calculó el puntaje de actividad del HGNA (PAH) y grado de fibrosis. Mediante correlación de Spearman se evaluó la asociación entre CK-18 y PAH. Se confeccionó una curva ROC para evaluar la capacidad de CK-18 como test diagnóstico para EHNA. Además, se evaluó el rendimiento del puntaje de fibrosis en hígado graso no alcohólico (NFS) para pesquisa de fibrosis y EHNA y se lo comparó con CK-18 por regresión lineal simple. Los datos son expresados en medianas [percentil 25-75] y evaluados con test de rangos de Wilcoxon. Resultados: La edad promedio del grupo estudiado (23% hombres) fue de 50,4±11,1 años. Un 34,2% fue diagnosticado con EHNA (PAH≥5). Los niveles de CK-18 fueron mayores en los pacientes con EHNA versus los sin EHNA (183,6 UI/l [97,4-734,4] vs. 117,2 UI/l [83,8-954,8], p=0,016). Los niveles de CK-18 fueron buenos predictores de la presencia de EHNA en la biopsia con un área bajo la curva (AUC) de 0,732 (IC95% 0,572-0,897). Un punto de corte de 130,5 UI/l de CK-18 exhibió una sensibilidad de 92,9% y una especificidad de 63%, con un VPP de 56,5% y un VPN 94,4%, y clasificó correctamente al 73,2% de los pacientes con EHNA. El NFS tuvo un buen rendimiento para diagnóstico de fibrosis avanzada (AUC 0,739, IC95% 0,56–0,91), pero limitado para identificar EHNA (AUC 0,413, IC95% 0,21-0,61). Conclusión: La determinación de CK-18 es un buen marcador no invasivo de EHNA. Si bien, NFS tiene un buen rendimiento en la identificación de pacientes con fibrosis avanzada, no fue de utilidad para diagnosticar EHNA. En pacientes con HGNA, la determinación de CK-18 y NFS es útil en la pesquisa de EHNA y fibrosis hepática respectivamente.
High prevalence of undiagnosed liver cirrhosis and advanced fibrosis in type 2 diabetic patients
(2016) Arab Verdugo, Juan Pablo; Barrera Martínez, Francisco; Gallego C.; Valderas Igor, Juan Patricio; Uribe Arancibia, Sergio A.; Tejos Núñez, Cristián Andrés; Serrano, C.; Huete, Isidro; Liberona, J.; Labbé P.; Quiroga, T.; Benitez, Carlos; Irarrázaval Mena, Pablo; Riquelme, A.; Arrese Jiménez, Marco
Indicaciones inhabituales de trasplante hepático Resultados
(2020) Briceño, Eduardo; Soriano Brucher, Humberto Eduardo; Gana Ansaldo, Juan Cristóbal; Benítez, Carlos; Barrera Martínez, Francisco; Montaña Rodríguez, Rodrigo; Concha P., Mario; Jarufe Cassis, Nicolás; Guerra Castro, Juan Francisco; Dib Marambio, Martín Javier; Martínez Castillo, Jorge; Troncoso T., Andrés; Cancino M., Alejandra; Dellepiane M., Paulina; Wolff R., Rodrigo; Pattillo Silva, Juan Carlos
Latin American Association for the study of the liver (ALEH) practice guidance for the diagnosis and treatment of non-alcoholic fatty liver disease
(2020) Pablo Arab, Juan; Dirchwolf, Melisa; Alvares-da-Silva, Mario Reis; Barrera Martínez, Francisco; Benitez, Carlos; Castellanos-Fernandez, Marlene; Castro-Narro, Graciela; Chavez-Tapia, Norberto; Chiodi, Daniela; Cotrim, Helma; Cusi, Kenneth; Marques Souza de Oliveira, Claudia Pinto; Diaz, Javier; Fassio, Eduardo; Gerona, Solange; Girala, Marcos; Hernandez, Nelia; Marciano, Sebastian; Masson, Walter; Mendez-Sanchez, Nahum; Leite, Nathalie; Lozano, Adelina; Padilla, Martin; Panduro, Arturo; Parana, Raymundo; Parise, Edison; Perez, Marlene; Poniachik, Jaime; Carlos Restrepo, Juan; Ruf, Andres; Silva, Marcelo; Tagle, Martin; Tapias, Monica; Torres, Kenia; Vilar-Gomez, Eduardo; Costa Gil, Jose Eduardo; Gadano, Adrian; Arrese, Marco
Non-alcoholic fatty liver disease (NAFLD) currently represents an epidemic worldwide. NAFLD is the most frequently diagnosed chronic liver disease, affecting 20-30% of the general population. Furthermore, its prevalence is predicted to increase exponentially in the next decades, concomitantly with the global epidemic of obesity, type 2 diabetes mellitus (T2DM), and sedentary lifestyle. NAFLD is a clinical syndrome that encompasses a wide spectrum of associated diseases and hepatic complications such as hepatocellular carcinoma (HCC). Moreover, this disease is believed to become the main indication for liver transplantation in the near future. Since NAFLD management represents a growing challenge for primary care physicians, the Asociacion Latinoamericana para el Estudio del Higado (ALEH) has decided to organize this Practice Guidance for the Diagnosis and Treatment of Non-Alcoholic Fatty Liver Disease, written by Latin-American specialists in different clinical areas, and destined to general practitioners, internal medicine specialists, endocrinologists, diabetologists, gastroenterologists, and hepatologists. The main purpose of this document is to improve patient care and awareness of NAFLD. The information provided in this guidance may also be useful in assisting stakeholders in the decision-making process related to NAFLD. Since new evidence is constantly emerging on different aspects of the disease, updates to this guideline will be required in future. (C) 2020 Published by Elsevier Espana, S.L.U. on behalf of Fundacion Cilnica Medica Sur, A.C.
LDL particle size and antioxidant HDL function improve after sustained virological response in patients with chronic HCV
(2022) Ignacio Vargas, Jose; Rivera, Katherine; Arrese, Marco; Benitez, Carlos; Barrera Martínez, Francisco; Hugo, Monrroy; Pablo Arab, Juan; Pino, Karla; Barrera, Aldo; Lopez-Lastra, Marcelo; Rigotti, Attilio; Soza, Alejandro
HCV infection is associated with an increased incidence of cardiovascular (CV) events. Mechanisms underlying this association remain unknown. In our study, twenty HCV patients (median age 60.5 years, 65% male and 80% with cirrhosis) were evaluated prior, during and after direct-acting antiviral treatment. Ninety percent of patients achieved sustained virological response (SVR). Significant changes were observed in LDL particle size index, measured by LDL-C/apoB ratio, which increased after treatment (p = 0.023). In addition, HDL antioxidant capacity improved gradually from 34.4% at baseline to 42.4% at 4 weeks (p = 0.011), 65.9% at end of treatment EOT (p = 0.002) and remained elevated at 12-week (p = 0.001) after EOT compared to baseline values. Our findings suggest that a shift to a less atherogenic lipid profile may be a possible mechanism associated with CV risk reduction in patients with HCV infection achieving SVR. (c) 2021 Fundacion Clinica Medica Sur, A.C. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Medición volumétrica de grasa visceral abdominal con RM y su relación con elastografía hepática en una población diabética
(2012) Serrano, C.; Barrera Martínez, Francisco; Riquelme Pizarro, Carlos Rodrigo; Vidal, H.; Labbé, P.; Cruz, F.; Arrese Jiménez, Marco; Irarrázaval Mena, Pablo; Tejos, C.; Uribe, S.
Introducción. La acumulación de grasa visceral se asocia al desarrollo de enfermedad hepática. La elastografía hepática es un método novedoso no invasivo para evaluar fibrosis hepática. Objetivo. Evaluar la relación entre el volumen de tejido adiposo visceral (VAT), volumen de tejido adiposo subcutáneo (SAT) medido por resonancia magnética (RM), con índices de elastografía hepática (EH) utilizando ARFI (fuerza de impulso de radiación acústica) en pacientes con Diabetes Mellitus tipo 2 (DM2). Métodos. Fueron incluidos 20 pacientes (edad promedio: 62 años, rango: 55-75 años, peso promedio: 77,8 kg, rango: 61,5-97 kg) con DM2. Los pacientes se sometieron a un examen de RM en un resonador Philips Intera 1.5T. Al protocolo de RM se agregó una secuencia de excitación espectral centrada en el peak de grasa. La secuencia incluyó 32 cortes transversales, grosor 7mm, desde la cúpula diafragmática hasta el borde inferior renal. En las imágenes se midió VAT utilizando el software Image J (freeware). En cada paciente se realizó una EH, utilizando ARFI con 10 medidas en lóbulo hepático derecho. Finalmente, se realizó un análisis estadístico a través de la correlación de Pearson entre los volúmenes de grasa abdominal y ARFI. Resultados. El promedio de VAT fue 2472 ± 861 cc, (1173-4020 cc), el promedio de ARFI fue 1,62 ± 0,8 m/s, (0,8-3,4 m/s). Se obtuvieron correlaciones de r=-0,08 entre VAT y ARFI (p=0,72), de 0,13 entre SAT y ARFI (p=0,57), y de -0,06 entre (VAT+SAT) con ARFI (p=0,77). Subdividiendo el universo muestral, se encontró que el grupo con ARFI mayor que 1,6 m/s (7 pacientes) obtuvo una correlación de 0,63 entre VAT y ARFI (p=0,12), de 0,66 entre SAT y ARFI (p=0,10), y de 0,94 entre (VAT+SAT) con ARFI (p=0,001). En el subgrupo con ARFI inferior a 1,6 m/s (13 pacientes) la correlación fue 0,11 entre VAT y ARFI (p=0,71), de 0,26 entre SAT y ARFI (p=0,38), y de 0,32 entre (VAT+SAT) y ARFI (p=0,28). Al ajustar por género en el subgrupo de mujeres con ARFI mayor que 1,6 m/s (6 pacientes), se encontró que la correlación de ARFI y VAT fue de 0,79 (p=0,05), y de 0,92 (p=0,009) para VAT+SAT. Conclusiones. En los pacientes DM2 con índices ARFI superior a 1,6 m/s habría una buena correlación con VAT y VAT+ SAT, indicando que aquellos con mayor daño hepático tendrían más acumulación de grasa abdominal.
Mineralocorticoid receptor modulation by dietary sodium influences NAFLD development in mice
(ELSEVIER ESPANA, 2021) Cabrera, Daniel; Rao, Isabel; Raasch, Fabiola; Solis, Nancy; Pizarro, Margarita; Freire, Mariela; De Urturi, Diego Saenz; Ramirez, Carolina A.; Triantafilo, Nicolas; Leon, Jonathan; Riquelme, Arnoldo; Barrera Martínez, Francisco; Baudrand, Rene; Aspichueta, Patricia; Arrese, Marco; Arab, Juan P.
Introduction and Objectives: Nonalcoholic-fatty-liver disease (NAFLD) is considered the hepatic manifestation of metabolic syndrome (MetS). Mineralocorticoid receptor (MR) activation is associated with increased risk of MetS but few studies have assessed the role of liver MR on NAFLD. We aimed to evaluate the effect of MR modulation by sodium intake in liver injury in experimental models of NAFLD.

Browsing by Author "Barrera Martínez, Francisco"

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