DSpace Angular :: Browsing by Author "Álvarez Lobos, Manuel"

Browsing by Author "Álvarez Lobos, Manuel"

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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.
Aceptación y adherencia de una pauta de preparación de colon el mismo día del examen en población chilena
(2015) Mansilla V., Rodrigo; Corsi S., Oscar; Glasinovic V., Esteban; Uslar N., Thomas; Monrroy Bravo, Hugo Alfonso; Candia Balboa, Roberto; González Donoso, Robinson; Álvarez Lobos, Manuel; Parra Blanco, Adolfo
Achieving the best bowel preparation for colonoscopy
(2014) Parra Blanco, Adolfo; Ruiz, A.; Álvarez Lobos, Manuel; Amoros, A.; Gana Ansaldo, Juan Cristóbal; Ibáñez Lazo, Patricio Fernando; Ono, A.; Fujii, T.
Atypical presentation of pseudomembranous colitis localized in adenomatous polyps
(2013) Hernández Rocha, Cristián Antonio; Barra Carrasco, Jonathan Eduardo; Guzmán Durán, Ana María; Paredes Sabja, Daniel; Lezcano, Gabriel; Zoroquiain Vélez, José Pablo; Álvarez Lobos, Manuel
Characterization of Chicken IgY Specific to Clostridium difficile R20291 Spores and the Effect of Oral Administration in Mouse Models of Initiation and Recurrent Disease
(2017) Pizarro Guajardo, Marjorie; Díaz González, Fernando; Álvarez Lobos, Manuel; Paredes Sabja, Daniel
Claves prácticas para un trasplante de microbiota fecal por colonoscopía en infección por clostridium difficile recurrente. Experiencia en un centro universitario
(2018) Cruz Urrutia, Ricardo Javier; Monrroy Bravo, Hugo Alfonso; Flandez, Jorge; Pérez, Carlos; Álvarez Lobos, Manuel; Hernández Rocha, Cristián Antonio
Colitis de Crohn: Resultados del tratamiento quirúrgico y evolución alejada
(2018) Imigo Gueregat, Felipe Andrés; Molina Pezoa, María Elena; Álvarez Lobos, Manuel; Quintana Villar, Carlos; Klaassen Lobos, Julieta Isabel; Torres Montes, Paula Javiera; Duarte, Ignacio; Bellolio R., Felipe; Zúñiga Díaz, Alvaro
Consenso chileno de prevención, diagnóstico y tratamiento de la diarrea asociada a Clostridium difficile
(2016) Hernández Rocha, Cristián Antonio; Ajenjo Henríquez, María Cristina; Quera R.; Quintanilla M.; Lubascher J.; Jemenao M.; Ibáñez Lazo, Patricio Fernando; Álvarez Lobos, Manuel; Diomedi A.; Marcotti A.; Acuña M.; Arab Verdugo, Juan Pablo; Riquelme Segovia, Alfredo; Candia R.; Carvajal S.; Hernández Rocha, Cristián Antonio; Ajenjo M.; Quera R.; Quintanilla M.; Lubascher J.; Jemenao M.; Ibáñez P.; Álvarez Lobos, Manuel; Diomedi A.; Marcotti A.; Acuña M.; Arab Verdugo, Juan Pablo; Riquelme Segovia, Alfredo; Candia R.; Carvajal S.
Correlation between peak systolic velocity and diameter of cavernosal arteries in flaccid versus dynamic state for the evaluation of erectile dysfunction
(2017) Souper, R.; Hartmann, J.; Álvarez Lobos, Manuel; Fuentes, I.; Astroza Eulufi, Gastón Maximiliano; Marconi Toro, Marcelo Carlos
Do Patients Older Than 60 Years With Inflammatory Bowel Disease Have More Vertebral Fractures Than Age-matched Controls? A Study Using Abdominal and Pelvic CT Scans With Sagittal Reformatting as Screening Tool.
(2020) Besa Vial, Pablo José; Meissner, Arturo; Ledermann, Gerardo; Pérez Valenzuela, Javier; Vergara López, María; Álvarez Lobos, Manuel; Urrutia Escobar, Julio Octavio
Introduction: Inflammatory bowel disease (IBD) has been associated with metabolic bone disease and increased fractures. This association is directly influenced by the disease and indirectly influenced by treatment. Therefore, patients with IBD could develop an elevated risk of osteoporotic fractures, particularly vertebral compression fractures (VCFs); however, symptomatic VCFs have not been shown to be more common in these patients. Our study evaluated the prevalence of VCF, independent of the presence of spinal symptoms, in IBD patients. Methods: We assessed IBD patients previously enrolled in a prospective cohort. All patients from that cohort who underwent computed tomography (CT) scans for nonspinal conditions were evaluated to detect the presence of VCFs. VCFs were classified using the Genant scheme. We evaluated whether patients with or without VCF differed in demographic data, type of IBD, treatment received and time from diagnosis. We used logistic regression to assess the independent effect of each variable. Results: In total, 6.5% of these patients had at least one VCF. Most fractures were Genant I (77%) and mostly at the thoracolumbar junction (T11 to L2, 65%). Bivariate and logistic regression analyses showed that age was the only variable independently associated with VCF (OR 1.12, 1.05 to 1.19). Conclusion: VCFs are not unusual in OBD patients. Radiologists and clinicians should specifically look for the presence of VCFs in patients with IBD, particularly the elderly, by using abdominal and pelvic CT scans.
Efecto de la exposición a cigarrillo sobre la funcionalidad de las células de Paneth y su importancia en el desarrollo y progresión de la enfermedad de Crohn
(2018) Berkowitz Fiebich, Loni; Álvarez Lobos, Manuel; Pontificia Universidad Católica de Chile. Facultad de Medicina
Las células de Paneth son células epiteliales especializadas del intestino delgado. Poseen múltiples gránulos secretorios, ricos en péptidos bactericidas, que son fundamentales para controlar el crecimiento de microorganismos y mantener la homeostasis intestinal. Alteraciones en su funcionamiento se han asociado a desbalances en la microbiota y a procesos inflamatorios intestinales, como la Enfermedad de Crohn (EC). La EC es un desorden inflamatorio crónico del intestino, cuya etiología no está clara, pero se ha postulado que individuos genéticamente susceptibles desarrollarían una respuesta inmune inadecuada contra su microbiota intestinal. Diversos estudios han demostrado que el consumo de cigarrillo, el principal factor de riesgo ambiental para la EC, puede afectar la barrera mucosa del intestino delgado, pero aún no se conoce su impacto a nivel de células de Paneth. En esta tesis nos propusimos evaluar el impacto de la exposición a cigarrillo en la integridad y funcionalidad de las células de Paneth en ratones, y explorar la posible asociación de este efecto en la presentación de la EC en pacientes. Para esto, se implementó un modelo murino de exposición a cigarrillo que genera inflamación intestinal, por medio de la administración intragástrica de Condensado de Humo de Cigarrillo (CHC). Los resultados de esta tesis muestran que el tratamiento con CHC no altera la cantidad ni la distribución de los gránulos de las células de Paneth, ni tampoco el número de estas células por cripta. Sin embargo, la exposición a CHC generó un aumento significativo en el número de gránulos inmaduros, junto a un aumento en el número de células secretoras intermedias presentes en las criptas, sugiriendo la existencia de un proceso regenerativo. Por otro lado, el tratamiento con CHC produjo una reducción significativa en la expresión génica de criptidina-1, criptidina-4 y regIIIγ, tres de los principales péptidos bactericidas expresados por las células de Paneth. Por inmunofluorescencia pudimos observar que las principales diferencias en la expresión de RegIIIγ, recaen a nivel de las vellosidades y no a nivel de criptas, sugiriendo que el CHC pudiera estar dañando diversas células del epitelio intestinal. Además, observamos que los ratones expuestos a CHC son más susceptibles a responder de forma patológica frente a la inoculación con una cepa de S. Typhimurium no virulenta, y presentan cambios significativos en la composición de su microbiota intestinal. Esto permite concluir que una peor capacidad bactericida intestinal, como resultado de alteraciones en las células de Paneth y del resto del epitelio tras la exposición a CHC, puede contribuir al desarrollo de disbiosis y de inflamación intestinal. Para evaluar si estas alteraciones pudieran contribuir en el desarrollo de la EC, se evaluó el impacto de la exposición a CHC en ratones IL-10-/- susceptibles a desarrollar una enterocolitis crónica. Los resultados demuestran que la alteración en la homeostasis intestinal causada por el CHC en ratones genéticamente susceptibles, puede resultar en una enterocolitis sintomática con una inflamación exacerbada, similar a los que ocurre en pacientes con EC. Sin embargo, el impacto no pudo ser atribuido a alteraciones en las células de Paneth, ya que los ratones IL-10-/- presentaron basalmente alteraciones en estas células, independientemente del tratamiento. Por último, se exploró el impacto del consumo de cigarrillo en la integridad de las células de Paneth en humanos, y su asociación con la gravedad de la EC. De acuerdo a los resultados, no fue posible asociar el consumo de cigarrillo a alteraciones en estas células, ni tampoco a una mayor gravedad de la enfermedad. La gran variabilidad observada en los parámetros analizados demuestra la necesidad de modificar los criterios de clasificación, y de aumentar significativamente el número de sujetos reclutados. En conjunto, los resultados obtenidos en esta tesis avalan la participación del cigarrillo en la pérdida de la homeostasis intestinal y en la reducción de su capacidad bactericida, reforzando la relevancia de la interacción microbiota-hospedero en el origen de patologías inflamatorias, como la EC.
Escherichia coli isolates from inflammatory bowel diseases patients survive in macrophages and activate NLRP3 inflammasome
(2014) De La Fuente, M.; Franchi, L.; Araya, D.; Díaz Jimenez, D.; Olivares, M.; Álvarez Lobos, Manuel; Golenbock, D.; Gonzalez, M.
Esporas de Clostridium difficile y su relevancia en la persistencia y transmisión de la infección
(2014) Barra-Carrasco, J.; Hernández Rocha, Cristián Antonio; Ibáñez Lazo, Patricio Fernando; Guzmán Durán, Ana María; Álvarez Lobos, Manuel; Paredes-Sabja, D.
Etiologic and clinical characterization of community acquired gastroenteritis in adult patients in a Chilean emergency room by the FilmArray GI panel
(2018) Valenzuela Abarca, Eduardo; Legarraga Raddatz, Paulette; Peña Riveros, Arturo Nicolás; Arenas, Alex; Berkowitz Fiebich, Loni; Ramírez, Gigliola; Wozniak Banchero, Aniela; García Cañete, Patricia; Álvarez Lobos, Manuel
Heme oxygenase-1 as a modulator of intestinal inflammation development and progression
(2018) Sebastián Quijada, Valentina Pilar; Salazar, Geraldyne; Coronado Arrázola, Irenice; Schultz, Bárbara; Vallejos, Omar; Berkowitz Fiebich, Loni; Álvarez Lobos, Manuel; Riedel, Claudia; Kalergis Parra, Alexis Mikes; Bueno Ramírez, Susan
Impact of cigarette smoking on the gastrointestinal tract inflammation: Opposing effects in Crohn\'s disease and ulcerative colitis
(2018) Berkowitz Fiebich, Loni; Schultz Lombardic, Bárbara M.; Salazar Tapia, Geraldyne Alessandra; Pardo Roa, Catalina; Sebastián Quijada, Valentina Pilar; Álvarez Lobos, Manuel; Bueno Ramírez, Susan
Cigarette smoking is a major risk factor for gastrointestinal disorders, such as peptic ulcer, Crohn's disease (CD), and several cancers. The mechanisms proposed to explain the role of smoking in these disorders include mucosal damage, changes in gut irrigation, and impaired mucosal immune response. Paradoxically, cigarette smoking is a protective factor for the development and progression of ulcerative colitis (UC). UC and CD represent the two most important conditions of inflammatory bowel diseases, and share several clinical features. The opposite effects of smoking on these two conditions have been a topic of great interest in the last 30 years, and has not yet been clarified. In this review, we summarize the most important and well-understood effects of smoking in the gastrointestinal tract; and particularly, in intestinal inflammation, discussing available studies that have addressed the causes that would explain the opposite effects of smoking in CD and UC.
Interleukin-10 plays a key role in the modulation of neutrophils recruitment and lung inflammation during infection by Streptococcus pneumoniae
(2015) Peñaloza, Hernán F.; Nieto Pacheco, Pamela Andrea; Muñoz Durango, Natalia; Salazar Echegarai, Francisco Javier; Torres Montes, Paula Javiera; Parga Ponce, María José; Álvarez Lobos, Manuel; Riedel, Claudia A.; Kalergis Parra, Alexis Mikes; Bueno Ramírez, Susan
Interleukin-10 Production by T and B Cells Is a Key Factor to Promote Systemic Salmomnella enterica Serovar Typhimurium Infection in Mice
(2017) Salazar Tapia, Geraldyne Alessandra; Peñaloza Cerda, Hernán F.; Pardo Roa, Catalina; Schultz Lombardic, Bárbara M.; Muñoz Durango, Natalia; Gómez Johnson, Roberto Sebastián; Salazar Echegarai, Francisco Javier; Pizarro Solar, Daniela Paz; Riedel, Claudia A.; González Muñoz, Pablo Alberto; Álvarez Lobos, Manuel; Kalergis Parra, Alexis Mikes; Bueno Ramírez, Susan
Salmonella enterica serovar Typhimurium (S. Typhimurium) is a Gram-negative bacterium that produces disease in numerous hosts. In mice, oral inoculation is followed by intestinal colonization and subsequent systemic dissemination, which leads to severe pathogenesis without the activation of an efficient anti-Salmonella immune response. This feature suggests that the infection caused by S. Typhimurium may promote the production of anti-inflammatory molecules by the host that prevent efficient T cell activation and bacterial clearance. In this study, we describe the contribution of immune cells producing the anti-inflammatory cytokine interleukin-10 (IL-10) to the systemic infection caused by S. Typhimurium in mice. We observed that the production of IL-10 was required by S. Typhimurium to cause a systemic disease, since mice lacking IL-10 (IL-10(-/-)) were significantly more resistant to die after an infection as compared to wild-type (WT) mice. IL-10(-/-) mice had reduced bacterial loads in internal organs and increased levels of pro-inflammatory cytokines in serum at 5 days of infection. Importantly, WT mice showed high bacterial loads in tissues and no increase of cytokines in serum after 5 days of S. Typhimurium infection, except for IL-10. In WT mice, we observed a peak of il-10 messenger RNA production in ileum, spleen, and liver after 5 days of infection. Importantly, the adoptive transfer of T or B cells from WT mice restored the susceptibility of IL-10(-/-) mice to systemic S. Typhimurium infection, suggesting that the generation of regulatory cells in vivo is required to sustain a systemic infection by S. Typhimurium. These findings support the notion that IL-10 production from lymphoid cells is a key process in the infective cycle of S. Typhimurium in mice due to generation of a tolerogenic immune response that prevents bacterial clearance and supports systemic dissemination.
Modulation of antigen processing by haem-oxygenase 1. Implications on inflammation and tolerance
(2016) Riquelme Colet, Sebastián Alejandro; Carreno, L.; Espinoza Véliz, Janyra Alejandra; Mackern Oberti, Juan Pablo; Álvarez Lobos, Manuel; Riedel, C.; Bueno Ramírez, Susan; Kalergis Parra, Alexis Mikes
Natural history of cholelithiasis and incidence of cholecystectorny in an urban and a Mapuche rural area
(SOC MEDICA SANTIAGO, 2002) Pérez Ayuso, Rosa María; Hernández R., Verónica; González P., Berta; Carvacho P., Claudia; Navarrete R., Claudia; Álvarez Lobos, Manuel; González Donoso, Robinson; Marshall Rivera, Guillermo; Miquel P., Juan Francisco; Nervi, Flavio

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