Browsing by Author "Gandara V."

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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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    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.