Browsing by Author "Espino A."

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    Adherence to a gluten-free diet and quality of life in Chilean celiac patients
    (ARAN Ediciones S.A., 2021) Parada A.; Espino A.; Parada A.; Méndez C.; Reyes Á.; Santibáñez H.
    © 2021 ARAN Ediciones S.A.. All rights reserved.Introduction: a gluten-free diet (GFD) is the treatment for celiac disease (CD), with adherence oscillating between 42 % and 91 %. The purpose of this study was to assess adherence to GFD and its relation to quality of life in Chilean celiac patients. Methods: three surveys were performed on-line: sociodemographic-health status, adherence to GFD and quality of life. Results: forty-eight per cent of respondents reported an excellent adherence to GFD and 49 % a good quality of life. Conclusions: adherence to GFD is low among Chilean celiac patients.
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    Endoscopic features of gastrointestinal amyloid light-chain amyloidosis
    (HUMANA PRESS INC, 2021) Latorre G.; Vargas J.I.; Espino A.; Latorre G.; Vargas J.I.; Espino A.
    © 2021. The American Astronomical Society. All rights reserved..We discuss the largest and most homogeneous spectroscopic data set of field RR Lyrae variables (RRLs) available to date. We estimated abundances using both high-resolution and low-resolution (ΔS method) spectra for fundamental (RRab) and first overtone (RRc) RRLs. The iron abundances for 7941 RRLs were supplemented with similar estimates that are available in the literature, ending up with 9015 RRLs (6150 RRab, 2865 RRc). The metallicity distribution shows a mean value of [Fe/H] = -1.51 ± 0.01, and σ(standard deviation) = 0.41 dex with a long metal-poor tail approaching [Fe/H] ≃ - 3 and a sharp metal-rich tail approaching solar iron abundance. The RRab variables are more metal-rich ([Fe/H]ab = -1.48 ± 0.01, σ = 0.41 dex) than RRc variables ([Fe/H]c = -1.58 ± 0.01, σ = 0.40 dex). The relative fraction of RRab variables in the Bailey diagram (visual amplitude versus period) located along the short-period (more metal-rich) and the long-period (more metal-poor) sequences are 80% and 20%, while RRc variables display an opposite trend, namely 30% and 70%, respectively. We found that the pulsation period of both RRab and RRc variables steadily decreases when moving from the metal-poor to the metal-rich regime. The visual amplitude shows the same trend, but RRc amplitudes are almost two times more sensitive than RRab amplitudes to metallicity. We also investigated the dependence of the population ratio (N c /Ntot) of field RRLs on the metallicity and we found that the distribution is more complex than in globular clusters. The population ratio steadily increases from ∼0.25 to ∼0.36 in the metal-poor regime, it decreases from ∼0.36 to ∼0.18 for -1.8 ≤ [Fe/H] ≤ -0.9 and it increases to a value of ∼0.3 approaching solar iron abundance.
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    Evaluation of trefoil factor 3 as a non-invasive biomarker of gastric intestinal metaplasia and gastric cancer in a high-risk populationEvaluación de Trefoil factor 3 como un biomarcador no invasivo para la detección de metaplasia intestinal y cáncer gástrico en una población de alto riesgo
    (2022) Latorre G.; Pizarro M.; Vargas J.I.; Espino A.; Aguero C.; Gonzalez R.; Riquelme A.; Gandara V.; Munoz G.; Ford J.S.; Araya J.C.; Bellolio E.; Villaseca M.; Fuentes-Lopez E.; Cortes P.; Rollan A.; Bufadel M.E.; Araya R.; Sharp A.; Donoso A.; Bresky G.; Pedrero P.; Rueda C.; Calvo A.; Parra-Blanco A.; Odagaki T.; Moriyama T.; Ishida T.; Camargo M.C.; Corvalan A.H.
    © 2022 Elsevier España, S.L.U.Background: Adenocarcinoma is preceded by chronic atrophic gastritis, gastric intestinal metaplasia and dysplasia. Trefoil factor 3 (TFF3) is a peptide secreted by goblet cells, which is abundantly present in intestinal metaplasia. Aim: To evaluate the utility of serum TFF3 as a non-invasive biomarker for the diagnosis of intestinal metaplasia and gastric cancer. Methods: Single-center, cross-sectional study of 274 patients who consecutively underwent upper gastrointestinal endoscopy with gastric biopsies (updated Sydney system). TFF3 levels were measured in serum by a commercial ELISA kit. Patients with normal histology or chronic atrophic gastritis without intestinal metaplasia comprised the control group. In addition, 14 patients with invasive gastric cancer were included as a reference group. The association between TFF3 levels and intestinal metaplasia was assessed by logistic regression. Results: Patients with intestinal metaplasia (n = 110) had a higher median TFF3 level as compared to controls (n = 164), 13.1 vs. 11.9 ng/mL, respectively (p = 0.024). Multivariable logistic regression showed a no significant association between TFF3 levels and intestinal metaplasia (OR = 1.20; 95%CI: 0.87–1.65; p-trend = 0.273). The gastric cancer group had a median TFF3 level of 20.5 ng/mL, and a significant association was found (OR = 3.26; 95%CI: 1.29–8.27; p-trend = 0.013). Conclusion: Serum levels of TFF3 do not discriminate intestinal metaplasia in this high-risk Latin American population. Nevertheless, we confirmed an association between TFF3 levels and invasive gastric cancer.
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    Gastrointestinal bleeding due to vascular malformation secondary to mesenteric-gonadal portosystemic shunt in pre-transplant chronic liver disease
    (Springer, 2023) Moya Abuhadba R.; Steffens Venegas E.; Iglesias Bettini A.; Roa J.C.; Besa C.; Espino A.; Larach J.T.; CEDEUS (Chile)
    © The Author(s), under exclusive license to Springer Nature Switzerland AG 2021. All rights reserved.This chapter addresses the study of the validity of high-stakes assessments, such as those used in the admissions to higher education and professional certification. This study requires, as an initial stage, making explicit the uses that will be given to the scores obtained in those instruments. The specification of the uses can be done through the study of the program theory or logic model. The chapter discusses and gives examples of validity studies that examine the most frequent uses for these types of measures: predictive validity studies and the validity of performance standards. It is argued that the adequate use of high-stakes assessments requires measures that do not present irrelevant variance of the construct. Methodologies for those analyses are presented. It is also proposed that the validity argument should not be limited to the empirical verification of the measures intended goals, but it should also include the possible occurrence of unexpected consequences. Some of the most frequent unexpected consequences in the literature are discussed.
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    High prevalence of SARS-CoV-2 detection and prolonged viral shedding in stools: A systematic review and cohort studyElevada detección de SARS-CoV-2 y prolongada excreción viral en deposiciones: Estudio de cohorte y revisión sistemática
    (2022) Diaz L.A.; Chahuan J.; Alvarez M.; Pavez C.; Candia R.; Monrroy H.; Espino A.; Pizarro M.; Riquelme A.; Garcia-Salum T.; Levican J.; Almonacid L.I.; Valenzuela G.H.; Serrano E.; Ferres M.; Salinas E.; Medina R.A.; Fuentes-Lopez E.; Riquelme A.; Reyes D.; Ortiz J.; Rada G.; Valderrama S.; Budnik S.; Gandara V.; Gallardo A.; Seydewitz M.F.; Cofre C.; Rada G.; Ortiz L.; Rada G.; Toro A.; Ortega M.; Ortega M.
    © 2022 Elsevier España, S.L.U.Objectives: To: 1. Describe the frequency of viral RNA detection in stools in a cohort of patients infected with SARS-CoV-2, and 2. Perform a systematic review to assess the clearance time in stools of SARS-CoV-2. Methods: We conducted a prospective cohort study in two centers between March and May 2020. We included SARS-CoV-2 infected patients of any age and severity. We collected seriated nasopharyngeal swabs and stool samples to detect SARS-CoV-2. After, we performed a systematic review of the prevalence and clearance of SARS-CoV-2 in stools (PROSPERO-ID: CRD42020192490). We estimated prevalence using a random-effects model. We assessed clearance time by using Kaplan–Meier curves. Results: We included 32 patients; mean age was 43.7 ± 17.7 years, 43.8% were female, and 40.6% reported gastrointestinal symptoms. Twenty-five percent (8/32) of patients had detectable viral RNA in stools. The median clearance time in stools of the cohort was 11[10–15] days. Systematic review included 30 studies (1392 patients) with stool samples. Six studies were performed in children and 55% were male. The pooled prevalence of viral detection in stools was 34.6% (twenty-four studies, 1393 patients; 95%CI:25.4–45.1); heterogeneity was high (I2:91.2%, Q:208.6; p ≤ 0.001). A meta-regression demonstrates an association between female-gender and lower presence in stools (p = 0.004). The median clearance time in stools was 22 days (nineteen studies, 140 patients; 95%CI:19–25). After 34 days, 19.9% (95%CI:11.3–29.7) of patients have a persistent detection in stools. Conclusions: Detection of SARS-CoV-2 in stools is a frequent finding. The clearance of SARS-CoV-2 in stools is prolonged and it takes longer than nasopharyngeal secretions.
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    Quadruple therapies are superior to standard triple therapy for Helicobacter pylori first-line eradication in ChileTerapias cuádruples son superiores a terapia triple estándar en primera línea de erradicación de Helicobacter pylori en Chile
    (2021) Candia R.; Vargas J.I.; Mansilla R.; Arenas A.; Chahuan J.; Espino A.; Pizarro M.; Riquelme A.; Reyes D.; Ortiz J.; Fuentes-Lopez E.; Riquelme A.; Budnik S.; Gandara V.; Gallardo A.; Seydewitz M.F.; Rollan A.; Rollan M.P.; Godoy J.; Mansilla R.; Vargas J.I.; Arenas A.
    © 2021 Elsevier España, S.L.U.Introduction: Helicobacter pylori infection affects approximately 70% of the Chilean population. It is a public health problem whose eradication treatment is part of the explicit health guarantees in Chile. Objectives: Characterize the most widely used H. pylori first-line eradication therapies in our environment and evaluate their efficacy. Methods: A retrospective observational study was carried out where, in patients with certified H. pylori infection, the eradication therapy indicated by the treating physician, its efficacy, adherence and adverse effects, in addition to the eradication certification method used, were evaluated. Results: 242 patients and 4 main therapies were analyzed: standard triple therapy, dual therapy, concomitant therapy, and bismuth quadruple therapy. Eradication rates of 81.9% (95% CI 74.44–87.63), 88.5% (95% CI 73.13–95.67), 93.7% (95% CI 78.07–98.44) and 97.6% (95% CI 84.81–99.67) were observed respectively, with concomitant therapy (RR: 1.14; 95% CI 1.01–1.29; p = .028) and quadruple therapy with bismuth (RR: 1.19; 95% CI 1.09–1.31; p < .001) being significantly more effective than standard triple therapy. Regarding the rate of reported adverse effects, it was 58.5% (95% CI 50.66–65.92), 35.4% (95% CI 24.6–48.11), 22.9% (95% CI 81–37.14) and 63.4% (95% CI 47.8–76.64), having the dual and concomitant therapy significantly fewer adverse effects compared with standard therapy. Conclusions: Quadruple therapies are superior to standard triple therapy and should be considered as first-line treatment in Chile. Dual therapy is promising. More studies will be required to determine which therapies are most cost-effective.
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    Reduction in Helicobacter pylori infection among patients referred for upper gastrointestinal endoscopy in Santiago, Chile, between 2010-2020Reducción de la infección por Helicobacter pylori en pacientes derivados a endoscopia digestiva alta en Santiago de Chile entre 2010-2020
    (2024) Silva F.; Latorre G.; Medel P.; Bustamante M.; Montero I.; Robles C.; Dukes E.; Martinez F.; Binder M.V.; Uribe J.; Reyes D.; Bittner M.; Sirhan M.; Espinoza M.; Fuentes-Lopez E.; Candia R.; Aguero C.; Vargas J.I.; Espino A.; Riquelme A.
    Latin America presents a high prevalence of Helicobacter pylori(Hp) infection. Between1996-2003, the prevalence in Santiago, Chile, was 70%; recent studies indicate a decreasein this infection. Updating the frequency of Hp is crucial due to its associated health impact. OBJECTIVE: Our objective was to describe the trend in Hp infection in patients undergoingambulatory esophagogastroduodenoscopy (EGD) in a Chilean population. MATERIALS AND METHODS: A retrospective observational study was conducted on patients over 18 years old who attended a first EGD with a rapid urease test between 2010-2020. Time trendswere described through time series analysis. A Poisson model was constructed to estimatethe risk of infection, adjusted for age and gender. RESULTS: 11,355 patients were included[66.9% females; mean age 52 years; Hp 41.6%]. Male gender presented a higher frequencyof Hp infection [RR 1.13; (95% CI: 1.08-1.18)].Hp frequency infection decreased significantlyfrom 45.1% in 2010 to 29% in 2020, with a 36% lower probability of Hp infection in 2020 compared to 2010 [RR 0.64;(95% CI: 0.55-0.74)]. A progressive decline in Hp infectiontrend was projected, reaching values close to 25% by year 2025. CONCLUSION: A significantreduction in Hpinfection was observed between 2010-2020. This decrease could be explained by the implementation of public health policies in the last decade associated with socio-sanitary changes.