Browsing by Author "Lucero, Yalda"

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    Adaptation to the reality of Latin America of the NASPGHAN/ESPGHAN 2016 Guidelines on the Diagnosis, Prevention and Treatment of Helicobacter pylori Infection in Pediatrics
    (Sociedad Chilena de Pediatría, 2020) Harris Diez Paul Richard; Calderón Guerrero, Otto Gerardo; Vera Chamorro, José Fernando; Lucero, Yalda; Vásquez, Margarita; Kazuo Ogata, Silvio; Angulo, Diana; Madrazo, Armando; Gonzales, José; Rivero, Anelsy; Gana Ansaldo, Juan Cristóbal; Sociedad Latinoamericana Gastroenterología
    Introduction: The latest joint H. pylon NASPGHAN and ESPGHAN clinical guidelines published in 2016, contain 20 statements that have been questioned in practice regarding their applicability in Latin America (LA); in particular in relation to gastric cancer prevention. Methods: We conducted a critical analysis of the literature, with special emphasis on LA data and established the level of evidence and level of recommendation of the most controversial claims in the Joint Guidelines. Two rounds of voting were conducted according to the Delphi consensus technique and a Likert scale (from 0 to 4) was used to establish the "degree of agreement" among a panel of SLACHNP experts. Results: There are few studies regarding diagnosis, treatment effectiveness and susceptibility to antibiotics of H. pylon in pediatric patients of LA. Based on these studies, extrapolations from adult studies, and the clinical experience of the participating expert panel, the following recommendations are made. We recommend taking biopsies for rapid urease and histology testing (and samples for culture or molecular techniques, when available) during upper endoscopy only if in case of confirmed H. pylon infection, eradication treatment will be indicated. We recommend that selected regional centers conduct antimicrobial sensitivity/resistance studies for H. pylori and thus act as reference centers for all LA. In case of failure to eradicate H. pylori with first-line treatment, we recommend empirical treatment with quadruple therapy with proton pump inhibitor, amoxicillin, metronidazole, and bismuth for 14 days. In case of eradication failure with the second line scheme, it is recommended to indicate an individualized treatment considering the age of the patient, the previously indicated scheme and the antibiotic sensitivity of the strain, which implies performing a new endoscopy with sample extraction for culture and antibiogram or molecular resistance study. In symptomatic children referred to endoscopy who have a history of first or second degree family members with gastric cancer, it is recommended to consider the search for H. pylori by direct technique during endoscopy (and eradicate it when detected). Conclusions: The evidence supports most of the general concepts of the NASPGHAN/ESPGHAN 2016 Guidelines, but it is necessary to adapt them to the reality of LA, with emphasis on the development of regional centers for the study of antibiotic sensitivity and to improve the correct selection of the eradication treatment. In symptomatic children with a family history of first or second degree gastric cancer, the search for and eradication of H. pylori should be considered.
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    Antimicrobial Resistance of Helicobacter pylori Isolated From Latin American Children and Adolescents (2008–2023): A Systematic Review
    (2024) Cabrera, Camila; Torres, Joaquín; Serrano Honeyman, Carolina Andrea; Gallardo, Paulina; Orellana, Vicente; George, Sergio; O'Ryan, Miguel; Lucero, Yalda
    Background: Latin America has a high prevalence of Helicobacter pylori in children that may lead to peptic ulcer disease andeventually gastric cancer in adulthood. Successful eradication is hindered by rising antimicrobial resistance. We summarize H.pylori resistance rates in Latin American children from 2008 to 2023.Material and Methods: Systematic review following PRISMA guidelines and National Heart, Lung, and Blood Institute check-list to assess risk of bias (PROSPERO CRD42024517108) that included original cross-sectional observational studies reportingresistance to commonly used antibiotics in Latin American children and adolescents. We searched in PubMed, LILACS, andSciELO databases.Results: Of 51 studies, 45 were excluded. The quality of the six analyzed studies (297 H. pylori-positive samples) was satisfactory.Phenotypic methods (N = 3) reported higher resistance rates than genotypic studies (N = 3). Clarithromycin resistance rangedfrom 8.0% to 26.7% (6 studies; 297 samples), metronidazole from 1.9% to 40.2% (4 studies; 211 samples), amoxicillin from 0% to10.4% (3 studies; 158 samples), tetracycline resistance was not detected (3 studies; 158 samples), and levofloxacin resistance was2.8% (1 study; 36 samples).Conclusion: Scarce Latin American studies on H. pylori resistance, along with methodological heterogeneity, hinder conclusivefindings. Clarithromycin and metronidazole (first-line drugs) resistance is worrisome, likely impacting lower eradication rates.Urgent systematic surveillance or individual testing before treatment is necessary to enhance eradication.
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    Helicobacter pylori Infection Is Associated with Decreased Expression of SLC5A8, a Cancer Suppressor Gene, in Young Children
    (2016) Orellana Manzano, Andrea; O’Ryan, Miguel G.; Lagomarcino, Anne J.; George, Sergio; Muñoz, Mindy S.; Mamani, Nora; Serrano Honeyman, Carolina; Harris D., Paul R.; Ramilo, Octavio; Mejías, Asunción; Torres, Juan P.; Lucero, Yalda; Quest, Andrew F. G.; Orellana Manzano, Andrea; O’Ryan, Miguel G.; Lagomarcino, Anne J.; George, Sergio; Muñoz, Mindy S.; Mamani, Nora; Serrano Honeyman, Carolina; Harris D., Paul R.; Ramilo, Octavio; Mejías, Asunción; Torres, Juan P.; Lucero, Yalda; Quest, Andrew F. G.
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    Predominance of Rotavirus G8P[8] in a City in Chile, a Country Without Rotavirus Vaccination
    (2018) Lucero, Yalda; O'Ryan, Miguel; Liparoti, Giulia; Huerta, Nicole; Mamani, Nora; Ramani, Sasirekha; Lagomarcino, Anne J.; Del Canto, Felipe; Qüense, Jorge
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    Rotavirus genotypes in children with gastroenteritis assisted in two public hospitals from Chile: viral strains circulating in a country without a universal vaccination against rotavirus
    (SOC CHILENA INFECTOLOGIA, 2012) Lucero, Yalda; Mamani, Nora; Cortes, Hector; Pena, Alfredo; Vergara, Rodrigo; O'Ryan, Miguel
    Background: Rotavirus is the main cause of severe gastroenteritis (GE) in children. Two vaccines currently available have proven efficacy against the predominant genotypes. Rotavirus genotypes vary both geographically and/or temporally. Genotype surveillance is important to monitor trends associated or not with vaccine use. Aim: To update information on rotavirus genotypes circulating in two main cities of Chile. Methodology: Between May 2009-March 2010, children < 5y of age receiving medical care for GE in two large hospitals were recruited; none of these children had received rotavirus vaccine previously. Epidemiological information was recorded in an ad-hoc form and stool samples were collected for rotavinis detection by a commercial ELISA. Genotyping was performed by semi-nested RT-PCR. Results: A total of 296/967 samples (31%) were positive for rotavirus, with a peak in November/December mostly in children 7-24 months old (67%). G9P[8] was the predominant genotype (76%), followed for G1P[8] (6%) and G2P[4] (6%) in both cities. Conclusions: Rotavirus caused one third of GE requiring emergency room care and/or hospitalization, mostly in children within an age range susceptible to benefit from rotavirus vaccines. G9P[8], a genotype against which rotavirus vaccines have demonstrated high efficacy, was by far the most frequent rotavirus variant. Continued surveillance in Chile is crucial for providing background information on disease burden and strain diversity before the introduction of rotavirus vaccines.