Browsing by Author "Díaz Piga, Luis Antonio"

Now showing 1 - 13 of 13
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    Academic excellence in Latin America : social accountability of medical schools
    (2020) Puschel Illanes, Klaus; Riquelme Pérez, Arnoldo; Sapag Muñoz de la Peña, Jaime; Moore Clive, Philippa María; Díaz Piga, Luis Antonio; Fuentes López, Eduardo; Jiménez de la Jara, Jorge; Burdick, W.; Norcini, J.; Campos, H.; Valdez, J. E.; Llosa, M. P.; Lamus-Lemus, F.; Yulitta, H.; Grez, M.
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    Alcohol-Related Liver Disease in Latin America: Local Solutions for a Global Problem
    (John Wiley and Sons Inc, 2020) Díaz Piga, Luis Antonio; Roblero Cum, Juan Pablo; Bataller, Ramon; Arab Verdugo, Juan Pablo
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    An artificial intelligence-generated model predicts 90-day survival in alcohol-associated hepatitis: A global cohort study
    (2024) Dunn, Winston; Li, Yanming; Singal, Ashwani K.; Simonetto, Douglas A.; Díaz Piga, Luis Antonio; Idalsoaga Ferrer, Francisco Javier; Ayares, Gustavo; Arnold Alvaréz, Jorge Ignacio; Ayala-Valverde, Maria; Perez, Diego; Gomez, Jaime; Escarate, Rodrigo; Fuentes López, Eduardo; Ramirez-Cadiz, Carolina; Morales-Arraez, Dalia; Zhang, Wei; Qian, Steve; Ahn, Joseph C.; Buryska, Seth; Mehta, Heer; Dunn, Nicholas; Waleed, Muhammad; Stefanescu, Horia; Bumbu, Andreea; Horhat, Adelina; Attar, Bashar; Agrawal, Rohit; Cabezas, Joaquin; Echavaria, Victor; Cuyas, Berta; Poca, Maria; Soriano, German; Sarin, Shiv K.; Maiwall, Rakhi; Jalal, Prasun K.; Higuera-de-la-Tijera, Fatima; Kulkarni, Anand V.; Rao, P. Nagaraja; Guerra-Salazar, Patricia; Skladany, Lubomir; Kubanek, Natalia; Prado, Veronica; Clemente-Sanchez, Ana; Rincon, Diego; Haider, Tehseen; Chacko, Kristina R.; Romero, Gustavo A.; Pollarsky, Florencia D.; Restrepo, Juan C.; Toro, Luis G.; Yaquich, Pamela; Mendizabal, Manuel; Garrido, Maria L.; Marciano, Sebastian; Dirchwolf, Melisa; Vargas, Victor; Jimenez, Cesar; Hudson, David; Garcia-Tsao, Guadalupe; Ortiz, Guillermo; Abraldes, Juan G.; Kamath, Patrick S.; Arrese, Marco; Shah, Vijay H.; Bataller, Ramon; Arab, Juan P.
    Background and Aims: Alcohol-associated hepatitis (AH) poses significant short-term mortality. Existing prognostic models lack precision for 90-day mortality. Utilizing artificial intelligence in a global cohort, we sought to derive and validate an enhanced prognostic model. Approach and Results: The Global AlcHep initiative, a retrospective study across 23 centers in 12 countries, enrolled patients with AH per National Institute for Alcohol Abuse and Alcoholism criteria. Centers were partitioned into derivation (11 centers, 860 patients) and validation cohorts (12 centers, 859 patients). Focusing on 30 and 90-day postadmission mortality, 3 artificial intelligence algorithms (Random Forest, Gradient Boosting Machines, and eXtreme Gradient Boosting) informed an ensemble model, subsequently refined through Bayesian updating, integrating the derivation cohort's average 90-day mortality with each center's approximate mortality rate to produce posttest probabilities. The ALCoholic Hepatitis Artificial INtelligence Ensemble score integrated age, gender, cirrhosis, and 9 laboratory values, with center-specific mortality rates. Mortality was 18.7% (30 d) and 27.9% (90 d) in the derivation cohort versus 21.7% and 32.5% in the validation cohort. Validation cohort 30 and 90-day AUCs were 0.811 (0.779-0.844) and 0.799 (0.769-0.830), significantly surpassing legacy models like Maddrey's Discriminant Function, Model for End-Stage Liver Disease variations, age-serum bilirubin-international normalized ratio-serum Creatinine score, Glasgow, and modified Glasgow Scores (p < 0.001). ALCoholic Hepatitis Artificial INtelligence Ensemble score also showcased superior calibration against MELD and its variants. Steroid use improved 30-day survival for those with an ALCoholic Hepatitis Artificial INtelligence Ensemble score > 0.20 in both derivation and validation cohorts. Conclusions: Harnessing artificial intelligence within a global consortium, we pioneered a scoring system excelling over traditional models for 30 and 90-day AH mortality predictions. Beneficial for clinical trials, steroid therapy, and transplant indications, it's accessible at: https://aihepatology.shinyapps.io/ALCHAIN/.
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    Baveno VI and Expanded Baveno VI criteria successfully predicts the absence of high-risk gastro-oesophageal varices in a Chilean cohort
    (2020) Gaete Celis, María Isabel; Díaz Piga, Luis Antonio; Arenas Fajardo, Cristian Alexis; Gonzalez, K.; Cattaneo, M.; Soza, Alejandro; Arrese, Marco; Barrera Martínez, Francisco José; Arab Verdugo, Juan Pablo; Benítez, Carlos; Fuster, F.; Henriquez, R.
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    Burnout en médicos residentes de especialidades y subespecialidades: estudio de prevalencia y variables asociadas en un centro universitario
    (2017) Díaz Piga, Luis Antonio; Arab Verdugo, Juan Pablo; Núñez Palma, Carolina Verónica; Robles García, Camila; Bitrán Carreño, Marcela; Nitsche Royo, María Pía; Riquelme Pérez, Arnoldo; González Tugas, Matías; Hoyl Moreno, María Trinidad; Lopetegui Lazo, Marcelo; Torres Lisboa, Patricio; Véliz Lagos, Daniela
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    Colangiopancreatografía retrógrada endoscópica con papilotomía de urgencia versus tratamiento conservador en pancreatitis aguda grave por cálculos biliares (APEC trial): un estudio aleatorizado multicéntrico
    (2021) Ruíz-Esquide Soto, Magdalena; Reyes Pérez, Catalina; Rodríguez Gutiérrez, Javier Ignacio; Díaz Piga, Luis Antonio; Riquelme Pérez, Arnoldo; Pimentel Muller, Fernando
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    Follow-up of gallbladder polyps in a high-risk population of gallbladder cancer: a cohort study and multivariate survival competing risk analysis
    (Elsevier B.V., 2021) Candia Balboa, Roberto Andrés; Viñuela Morales, Macarena Rocío; Chahuán Abde, Javier Nicolás; Díaz Piga, Luis Antonio; Gándara, Vicente; Errázuriz Gastellu, Pedro; Bustamante Herrera, Luis Felipe Alberto; Villalón Friedrich, Alejandro Andrés; Huete Garín, Alvaro; Crovari Eulufi, Fernando; Briceño Valenzuela, Eduardo Andrés
    The risk of neoplasia in gallbladder polyps seems to be low, but the evidence from populations at high-risk of gallbladder cancer is limited. We aimed to estimate the risk and to identify the factors associated with neoplastic polyps in a high-risk Hispanic population. Methods: A retrospective cohort was recruited between January 2010 and December 2019 at a Chilean university center. Multivariate survival analyses were conducted. Fine–Gray models were fitted to account for competing risks. Covariate adjustment was conducted using propensity scores. The main outcome was the development of gallbladder adenomas or adenocarcinoma. Results: Overall, 748 patients were included, 59.6% underwent cholecystectomy. The median follow-up of patients not subjected to cholecystectomy was 54.7 months (12–128.6 months). Seventeen patients (2.27%) developed the outcome. After adjustment by age, sex, intralesional blood flow, lithiasis and gallbladder wall thickening, only polyp size (≥10 mm, adjusted-HR: 15.01, 95%CI: 5.4–48.2) and number of polyps (≥3 polyps, adjusted-HR: 0.11, 95%CI: 0.01–0.55) were associated with neoplasia. Conclusion: In a Hispanic population at high-risk for gallbladder cancer, gallbladder polyps seem to have a low risk of neoplasia. Polyp size was the main risk factor, while having multiple polyps was associated with an underlying benign condition.
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    Inpatient Hepatology Consultation: A Practical Approach for Clinicians
    (2023) Díaz Piga, Luis Antonio; Pages, Josefina; Mainardi, Victoria; Mendizabal, Manuel
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    Letter: Optimising public health policies to combat alcohol-associated liver disease in youth—Authors' reply
    (2024) Danpanichkul, Pojsakorn; Tothanarungroj, Primrose; Díaz Piga, Luis Antonio; Arab Verdugo, Juan Pablo; Liangpunsakul, Suthat; Wijarnpreecha, Karn
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    Management of Biliopancreatic Limb Bleeding after Roux-en-Y Gastric Bypass: A Case Report
    (Korean Society of Gastrointestinal Endoscopy, 2021) Riquoir Altamirano, Christophe Francis; Díaz Piga, Luis Antonio; Chiliquinga Morales, David Hernán; Candia Balboa, Roberto Andrés; Pimentel Muller, Fernando; Arenas Aravena, Alex Fabián
    The Roux-en-Y gastric bypass is one of the most extensive surgical treatments for obesity. The treatment of upper gastrointestinal bleeding after Roux-en-Y gastric bypass is complex due to the difficulty of accessing the excluded gastric antrum and duodenal bulb. There is no consensus regarding the management of this complication. While various techniques have been described to access the biliopancreatic limb, double-balloon enteroscopy is the most commonly used. If double-balloon enteroscopy is unavailable, a pediatric colonoscope may be used as an alternative; however, its use in such cases has not been described. We report the case of a 50-year-old male patient who underwent gastric bypass 13 years ago and was admitted for a second episode of upper gastrointestinal bleeding. The initial approach using upper endoscopy, colonoscopy, and abdominal computed tomography angiography did not reveal the cause of gastrointestinal hemorrhage; therefore, an endoscopic study of the biliopancreatic limb was performed using a pediatric colonoscope. A Forrest Ib ulcer was found in the duodenal bulb, and endoscopic therapy was administered. The evolution was found to be satisfactory.
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    Prevention and control of risk factors in metabolic and alcohol-associated steatotic liver disease
    (2024) Desalegn, Hailemichael; Farias Siel, Renata Francisca; Hudson, David; Idalsoaga Ferrer, Francisco Javier; Cabrera, Daniel; Díaz Piga, Luis Antonio; Arab Verdugo, Juan Pablo
    Steatotic liver disease (SLD), including metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-associated liver disease (ALD), is the primary cause of illness and mortality. In particular, MASLD affects more than 30% of the global population, while ALD accounts for 5.1% of all diseases and injuries worldwide. The SLD spectrum includes a variety of clinical conditions, from mild fatty liver and inflammation to different stages of liver fibrosis. Additionally, both conditions (MASLD and ALD) can be complicated by hepatocellular carcinoma (HCC), while around one-third of ALD patients can also develop at least one alcohol associated hepatitis (AH) episode. Both of these diseases are also associated with multiple extrahepatic complications, such as cardiovascular disease, chronic kidney disease, and malignancies. In MASLD, the rapid rise in global obesity and type 2 diabetes mellitus (T2DM) prevalence due to Westernized lifestyles has led to an increase in the prevalence of MASLD. Thus, the prevention and control of cardiometabolic risk factors (CMRFs) are the cornerstone of its treatment. Hypertension and atherogenic dyslipidemia are also important CMRFs associated with MASLD. Susceptible individuals with MASLD are adversely affected by even a small amount of alcohol consumption (though there is no agreed definition of a small amount), increasing the risk of severe outcomes and a faster progression of liver disease. This review explores factors that play a role in the development of SLD, especially focusing on the management of CMRFs and levels of alcohol use to prevent liver disease progression.
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    Symptom Profiles and Risk Factors for Hospitalization in Patients With SARS-CoV-2 and COVID-19 : A Large Cohort From South America
    (2020) Díaz Piga, Luis Antonio; García-Salum, T.; Fuentes López, Eduardo; Ferrés, Marcela; Medina, Rafael; Riquelme Pérez, Arnoldo
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    Vaccination against COVID-19 decreases hospitalizations in patients with cirrhosis: Results from a nationwide analysis
    (John Wiley & Sons Ltd, 2022) Díaz Piga, Luis Antonio; Fuentes López, Eduardo; Lazo, Mariana; Kamath, Patrick S.; Arrese, Marco; Arab Verdugo, Juan Pablo