Browsing by Author "Espino Espino, Alberto Antonio"

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    805 Complications of Gastrointestinal Endoscopy in 85,391 Procedures
    (Mosby-Elsevier, 2012) Espino Espino, Alberto Antonio; García Astorquiza, Ximena Andrea; Mac Namara, Macarena; Richter Roca, Hugo Michael; Pimentel Muller, Fernando; Biel Morales, Francisco Javier; Robles García, Camila Fernanda; Callejas, Matías F.; Sharp Pittet, Allan Carlos; Donoso, Andrés; Candia Balboa, Roberto Andrés; González Donoso, Robinson; Jarufe Cassis, Nicolás; Arrese, Marco; Álvarez Lobos, Manuel; Padilla Pérez, Oslando
    Background: Complications are inherent to GI endoscopy (GIE) and do not necessarily imply endoscopist's negligence. They may occur even using highest standards of practice. Objectives: To analyze the frequency and severity of complications occurring within 30 days after of the GIE at a single university hospital in Chile. Methods: We reviewed the records about patients who underwent GIE from January 2001 through May 2011. Results: A total of 85,391 GIE were evaluated. Procedures: 46,928 (55%) esophagogastroduodenoscopy (EGD); 27,993 (32.8%) diagnostic colonoscopies; 1427 (1.7%) polypectomies; and other procedures (hemostasis, variceal band ligation (VBL), foreign-body removal, dilation, stents, PEG, ERCP, EUS and double balloon endoscopy) 9043 (10.5%). A total of 299 complications were associated with GIE (59 % female, mean age 63 years, range 5 - 99). The overall complications rate was 0.35% (cardiopulmonary (CP) 0.1%, bleeding 0.07%, perforation 0.06%, infection 0.04%, pancreatitis 0.03% and other). The overall complication rate was higher in therapeutic procedures (TP) vs diagnostic procedures (DP) (2.7% v/s 0.16%, p<0.0001). The percentage of severe complications was higher in TP vs DP (52.3% vs 28.4%, p<0.0001). The overall complication rate for EGD was 0.14% (CP 0.07%, perforation 0.017%, bleeding 0.019%); diagnostic colonoscopy, 0.27% (CP 0.1%, perforation 0.06%, bleeding 0.02%); and polypectomy, 1.8% (CP 0.14%, perforation 0.28%, bleeding 0.98%). A total of 15 deaths occurred (overall rate 0.018%, 83% in TP). The overall mortality rate was higher in TP vs DP (0.2% v/s 0.003%, p<0.0001). The mortality rate for PEG was 0.7%; VBL 0.4%; ERCP 0.2%; diagnostic colonoscopy 0.004%; EGD 0.004%; and polypectomy 0%. Conclusions: GIE is associated with complications and mortality. The severity and risk of complications are higher in therapeutic procedures. These risks should be clearly explained to patients and their family before the procedure.
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    Aceptabilidad y resultados de detección de infección por virus de hepatitis B, C y virus de inmunodeficiencia humana mediante test rápido en pacientes sometidos a endoscopía ambulatoria
    (2024) Muñoz, Ana; Espino Espino, Alberto Antonio; Soza Ried, Alejandro; Arenas Aravena, Alex Fabián; José Gran; Blanca Norero
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    Actualizaciones en el manejo general de pacientes postrasplante hepático y de sus complicaciones más frecuentes
    (2024) Díaz Piga, Luis Antonio; Villalón Friedrich, Alejandro Andrés; Ochoa, Gabriela; García Castillo, Sergio Adrián Nicolas; Severino Cuevas, Nicolás Felipe; Ayares Campos, Gustavo Ignacio; Idalsoaga Ferrer, Francisco Javier; Dib Marambio, Martín Javier; Briceño Valenzuela, Eduardo Andrés; Viñuela Fawaz, Eduardo Andrés; Martínez Castillo, Jorge Arturo; Jarufe Cassis, Nicolás Patricio; Rabagliati Borie, Ricardo Miguel; Meneses Quiroz, Luis Andrés; Muñoz Schuffenegger, Pablo; Vargas Domínguez, José Ignacio; Espino Espino, Alberto Antonio; Vera Alarcón, María Magdalena; Benítez Gajardo, Carlos Esteban; Wolff Rojas, Rodrigo Mauricio; Norero Muñoz, Blanca Gabriela; Barrera Álvarez, Francisco Benjamín; Soza Ried, Alejandro; Arrese Jiménez, Marco Antonio; Arab Verdugo, Juan Pablo
    Liver transplantation (LT) is a cost-effective therapy for advanced liver disease. Although LT significantly improves long-term survival, it requires strict control of immunosuppressants and their potential complications. Several available immunosuppressive drugs include glucocorticoids, calcineurin inhibitors, mycophenolate, mTOR inhibitors, and anti-CD25 antibodies. These drugs act particularly in T lymphocytes, depleting them, deviating their traffic, or blocking their response pathways. The main complications after LT include renal failure and infectious, immunological, biliary, vascular adverse events, metabolic, cardiovascular, and neoplastic diseases, especially during the first months. Bacteria, viruses, and fungi can cause infections in these patients. Prophylaxis against Herpes simplex virus, Varicella zoster virus, Cytomegalovirus, Pneumocystis jirovecii, Candida spp., and Aspergillus spp. should be considered according to the presence of risk factors. Among immunological complications, acute cellular rejection is common (30% of LT) but usually responds to immunosuppressive escalation. Also, chronic rejection appears in 3-17% of LT, but only half of the recipients respond to increased immunosuppressants. Appropriate treatment of the underlying etiology is essential, especially in autoimmune diseases, hepatitis B and C virus infection. Lifestyle changes must be encouraged in all patients, and alcohol consumption avoided (especially in alcohol use disorder). Due to the increased risk of cancer, neoplasms must be actively monitored, as well as osteoporosis and other metabolic disorders such as diabetes and cardiovascular disease.
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    Cobertura del cribado endoscópico para cáncer gástrico en Chile según la Encuesta Nacional de Salud 2016-2017
    (2025) Óscar Felipe, Corsi Sotelo; Eduardo, Fuentes López; Latorre Selvat, Gonzalo Ignacio; Espinoza Sepúlveda, Manuel Antonio; Margozzini Maira, Paula Andrea; Monrroy Bravo, Hugo Alfonso; Espino Espino, Alberto Antonio; Riquelme Pérez, Arnoldo Javier
    Introducción: El cáncer gástrico (CG) es la primera causa de muerte oncológica en Chile. Desde 2006 la autoridad sanitaria recomienda endoscopía digestiva alta (EDA) a la población sintomática ≥40 años. En 2010 se estimó una cobertura de EDA durante el último año en este grupo de 14%. Objetivo: Describir la cobertura de EDA para el cribado del CG en Chile a partir de la Encuesta Nacional de Salud (ENS) 2016-17. Materiales y métodos: La ENS 2016- 17 realizó 6.233 encuestas a adultos sobre la presencia de epigastralgia persistente, posible hemorragia digestiva alta y realización de EDA. Se compararon las prevalencias de EDA entre distintos grupos y se construyeron modelos multivariados ajustados por sexo, edad, ingresos, educación, área de residencia y pertenencia a un pueblo originario. Resultados: Tanto la epigastralgia persistente como una posible hemorragia digestiva alta fueron reportadas por el 4,7%, siendo mayores en el grupo ≥40 años y menor nivel educacional. La prevalencia de EDA realizada alguna vez en la vida alcanzó 20,8%, siendo mayor en mujeres, ≥40 años, seguros de salud privado y población hispana no perteneciente a pueblo originario. La cobertura de EDA de último año en el grupo sintomático ≥40 años aumentó a 19,8%, sin diferencias significativas en el análisis multivariado. Conclusión: La cobertura de EDA el último año en ≥40 años sintomáticos para el cribado del CG en Chile es de 19,8%. Se observa menor cobertura en el estrato socioeconómico bajo y pueblos originarios.
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    Esofagitis eosinofílica : Diagnóstico y manejo
    (2020) Ballart, M. J.; Monrroy Bravo, Hugo Alfonso; Iruretagoyena B., Mirentxu; Parada Daza, Alejandra; Torres Montes, Paula Javiera; Espino Espino, Alberto Antonio
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    Features of gastrointestinal amyloidosis reply
    (2021) Latorre Selvat, Gonzalo Ignacio; Vargas Domínguez, José Ignacio; Espino Espino, Alberto Antonio
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    High Helicobacter pylori Bacterial Load and Low Cytokine Expression Levels Are Associated with Nodular Gastropathy
    (2020) Mansilla-Vivar, R.; Serrano Honeyman, Carolina; Palma, C.; Vera, M.; Hernandez, C.; Pizarro Rojas, Margarita Alicia; Torres Montes, Paula Javiera; Harris D., Paul R.; Fuentes López, Eduardo; Riquelme Pérez, Arnoldo; Espino Espino, Alberto Antonio; Mansilla-Vivar, R.; Serrano Honeyman, Carolina; Palma, C.; Vera, M.; Hernandez, C.; Pizarro Rojas, Margarita Alicia; Torres, Javiera; Harris D., Paul R.; Fuentes López, Eduardo; Riquelme Pérez, Arnoldo; Espino Espino, Alberto Antonio
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    Management 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
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    Metástasis pancreática como debut de carcinoma papilar de tiroides : caso clínico y revisión del perfil clínico patológico y molecular
    (2020) Uslar, T.; Chahuán, J.; Olmos Borzone, Roberto Ignacio; Rodríguez Poblete, Carolina Elena; Zoroquiain Vélez, José Pablo; Solar González, Antonieta Alejandra; Espino Espino, Alberto Antonio; León Ramírez, Augusto; Fardella B., Carlos; Domínguez Ruiz-Tagle, José Miguel; Astudillo, R.
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    Plasminogen activator inhibitor type 1 serum levels and 4G/5G gene polymorphism in morbidly obese Hispanic patients with non-alcoholic fatty liver disease
    (Elsevier España, 2011) Espino Espino, Alberto Antonio; Villagran Torres, Andrea Alejandra; Vollrath Reyes, Valeska Yolanda; Hanckes Mayo, Maria Paulina; Salas Ocaranza, Roberto Ignacio; Farah Samaan, Andrea Catherina; Solis, Nancy; Pizarro Rojas, Margarita Alicia; Escalona Perez, Alex Gamaliel; Boza Wilson, Camilo; Perez, Gustavo; Carrasco, Gonzalo; Padilla, Orlando; Francisco Miguel, Juan; Nervi Oddone, Flavio; Chavez Tapia, Norberto C.; Arab Verdugo, Juan Pablo; Alvarez Lobos, Manuel Marcelo; Arrese Jimenez, Marco Antonio; Riquelme Perez, Arnoldo Javier
    Background. The plasminogen activator inhibitor type-1 (PAI-1) has been implicated in the regulation of fibrinolysis and extracellular matrix components. The single base pair guanine insertion/deletion polymorphism (4G/5G) within the promoter region of the PAI-1 gene influences PAI-1 synthesis and may modulate hepatic fibrogenesis. Aim. To evaluate the influence of PAI-1 serum levels and 4G/5G polymorphism on the risk of liver fibrosis associated to non-alcoholic fatty liver disease (NAFLD) in morbidly obese patients. Material and methods. Case-control study of 50 obese patients undergoing bariatric surgery and 71 non-obese subjects matched by age and sex. Anthropometric and biochemical measurements were performed, including PAI-1 serum levels. Genomic DNA was obtained to assess the presence of 4G/5G polymorphism. Results. BMI, insulinemia, triglycerides, HOMA-IR, hypertension and diabetes were significantly higher in obese patients compared to control subjects. PAI-1 serum levels observed in obese patients were significantly lower (10.63 +/- 4.82) compared to controls (14.26 +/- 11.4; p < 0.05). No differences were observed in the PAI-1 4G/5G promoter genotypes frequencies (p = 0.12). No differences were observed in PAI-1 plasma levels among obese patients with liver fibrosis (10.64 +/- 4.35) compared to patients without liver fibrosis (10.61 +/- 5.2; p = 0.985). PAI-1 4G/5G promoter genotypes frequencies were similar in patients with or without liver fibrosis associated to NASH (p = 0.6). Conclusions. Morbidly obese patients had significantly Lower PAI-1 serum levels with similar PAI-1 4G/5G genotypes frequencies compared to non-obese subjects. The frequency of 4G/5G genotypes in Chilean Hispanic healthy subjects was similar to that described in other populations. No association was found between PAI-1 serum levels or 4G/5G genotype with liver fibrosis in obese patients.
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    Use of N-acetylcysteine plus simethicone to improve mucosal visibility during upper GI endoscopy: a double-blind, randomized controlled trial
    (2018) Monrroy Bravo, Hugo Alfonso; Vargas Domínguez, José Ignacio; Glasinovic, Esteban; Candia, Roberto; Azua, Emilio; Galvez, Camila; Rojas, Camila; Cabrera, Natalia; Vidaurre, Josefa; Alvarez, Natalia; Gonzalez, Jessica; Espino Espino, Alberto Antonio; González Donoso, Robinson; Parra-Blanco
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    Validez y confiabilidad de una escala de clasificación de limpieza gástrica en endoscopia digestiva alta en población chilena
    (2016) Mansilla V., Rodrigo; Uslar N., Thomas; Chahuán A., Javier; Latorre S., Gonzalo; Cruz N., Rodrigo; Cruz Urrutia, Ricardo Javier; Sirhan Nahum, Marisol; Espino Espino, Alberto Antonio; Honold G., Francisca; Huenur F., Julieth; Miranda B., Paula; Riquelme Pérez, Arnoldo