Browsing by Author "Escalona, Alex"

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    11 beta-Hydroxysteroid Dehydrogenase Type 1 is Overexpressed in Subcutaneous Adipose Tissue of Morbidly Obese Patients
    (SPRINGER, 2009) Munoz, Rodrigo; Carvajal, Cristian; Escalona, Alex; Boza, Camilo; Perez, Gustavo; Ibanez, Luis; Fardella, Carlos
    11 beta-Hydroxysteroid dehydrogenase type 1 (11 beta-HSD1) enzyme catalyzes interconversion of inactive cortisone to active cortisol. Its expression in adipose tissue has been associated with obesity and some of its metabolic disorders. Controversies regarding which fat depots [subcutaneous adipose tissue (SAT) or visceral adipose tissue (VAT)] have higher expression still remain. The aim of this work was to evaluate 11 beta-HSD1 expression in SAT and VAT of obese patients and evaluate its association to metabolic features of metabolic syndrome.
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    Antecolic versus retrocolic alimentary limb in laparoscopic Roux-en-Y gastric bypass: a comparative study
    (2007) Escalona, Alex; Devaud, Nicolas; Perez, Gustavo; Crovari, Fernando; Boza, Carnilo; Viviani, Paola; Ibanez, Luis; Guzman, Sergio
    Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has become the most common surgical treatment for morbid obesity. Intestinal obstruction and internal hernias are cornplications more commonly observed after LRYGB than after open RYGB. The aim of this study was to evaluate the incidence of these cornplications in patients who had undergone LRYGB using an antecolic versus a retrocolic technique.
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    Baseline glycated hemoglobin levels are associated with duodenal-jejunal bypass liner-induced weight loss in obese patients
    (2014) Muñoz, R.; Domínguez de Landa, María Angélica; Muñoz, F.; Muñoz, C.; Slako, M.; Turiel, D.; Pimentel Muller, Fernando; Sharp Pittet, Allan Carlos; Escalona, Alex
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    Bile acids synthesis decreases after laparoscopic sleeve gastrectomy
    (2016) Escalona, Alex; Muñoz, R.; Irribarra Pastenes, Verónica; Solari Gajardo, Sandra; Allende, Fidel; Miquel P., Juan Francisco
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    Distinct patterns in the gut microbiota after surgical or medical therapy in obese patients
    (2017) Medina, D. A.; Pedreros, J. P.; Turiel, D.; Quezada Sanhueza, Nicolás; Pimentel Muller, Fernando; Escalona, Alex; Garrido Cortés, Daniel
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    Electrical stimulation therapy of the lower oesophageal sphincter for refractory gastro-oesophageal reflux disease - interim results of an international multicentre trial
    (2015) Kappelle, W.; Bredenoord, A.; Conchillo, J.; Ruurda, J.; Bouvy, N.; Henegouwen, M.; Chiu, P.; Booth, M.; Hani, A.; Escalona, Alex; Reddy, D.; Bogte, A.; Smout, A.; Wu, J.; Valdovinos, M.; Torres, G.; Siersema, P.
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    Endoscopic removal of eroded adjustable gastric band: lessons learned after 5 years and 78 cases
    (ELSEVIER SCIENCE INC, 2010) Galvao Neto, Manoel Passos; Ramos, Almino C.; Campos, Josemberg M.; Murakami, Abel H.; Falcao, Marcelo; de Moura, Eduardo H. G.; Evangelista, Luis Fernando; Escalona, Alex; Zundel, Natan
    Background: One of the complications of laparoscopic adjustable gastric banding is intragastric erosion, leading to a revisional procedure to remove the band. Our aim was to present the procedure and results of endoscopic band removal in a 5-year multicenter experience from the Gastro Obeso Center and Universidade de Sao Paulo, Sao Paulo, and Universidade Federal de Pernambuco, Recite, Brazil.
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    Gallbladder polyps
    (2006) Escalona, Alex; Leon, Francisca; Bellolio, Felipe; Pimentel, Fernando; Guajardo, Matias; Gennero, Ruben; Cruz, Juan Pablo; Viviani, Paola; Ibanez, Luis
    Background: Gallbladder polyps are becoming a common finding. The management of these polyps is complicated considering that they can bear malignant lesions. Aim: To analyze the ultrasonographic and histopatbologic findings of patients operated due to gallbladder polyps. Patients and methods: The records of patients with ultrasonograpbic diagnosis of gallbladder polyp and that underwent cholecystectomy in a thirteen years period were reviewed, collecting their demographic, ultrasonograpbic and histopathological data. Results: One hundred and twenty three patients were operated. Tbe mean age was 44 +/- 13 years, and 69% were women. The mean size of polyps in ultrasonography was 7.3 +/- 5 mm. Histopathology confirmed the presence of polyps in 79% of patients, with a mean size and number of lesions of 5.1 +/- 3.8 mm and 2.1 +/- 2, respectively. Nine percent of polyps were greater than 10 mm, and single polyps were significantly larger than the multiple ones (p = 0.003). Four cases of adenoma (3.2%) were diagnosed; one of them had in situ carcinoma. All were single and larger than 10 mm. We found a significant correlation between ultrasonograpbic and histopathological polyp size determination (r = 0.47; p = 0.002). Polyp size was also a predictor of the presence of adenoma (p = 0.043; confidence intervals., 1.006-1.424). Conclusions: There is a good correlation between the size of the gallbladder polyp in ultrasonography and the size in the histopathology report. Gallbladder adenoma is uncommon and it correlates with the size of the polyp. In this series, size was the only predictor of the presence of adenoma.
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    Gastrectomía laparoscópica en cáncer gástrico: Experiencia preliminar
    (2007) Escalona, Alex; Pérez Blanco, Gustavo Adolfo; Crovari Eulufi, Fernando; Boza, Camilo; Pimentel Muller, Fernando; Devauda, Nicolás; Guzmán Karadima, Sergio; Ibáñez Anrique, Luis
    Background: The development of the laparoscopic surgery has allowed its incorporation to the surgical treatment of gastric cancer. Aim: To evaluate the feasibility and safety of laparoscopic gastrectomy in gastric cancer in our institution. Patients and methods: Prospective data in four patients who underwent laparoscopic gastrectomy for gastric cancer from May to August of 2005 was reviewed. Demographic data, clinical characteristics and postoperative results were registered. Patients were staged according to TNM-AJJC staging system. Results: Four patients aged 48 to 80 years (three males), underwent a completely laparoscopic R0 gastrectomy with lymph node dissection. Two patients underwent total gastrectomy. A subtotal Billroth II gastrectomy was performed in the other two patients. The mean operative time was 260 minutes (Range 180-330). There were no conversions to open surgery. The mean postoperative hospital stay was 6.5 days (Range 6-7 days). There were no complications. According to pathology, one patient presented carcinoma in stage IA, two patients in stage IB and one patient in stage IIIB. The mean number of lymph nodes dissected was 40 (Range 35-54). Conclusions: Laparoscopic gastrectomy is a feasible procedure with good postoperative results in this preliminary experience.
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    Gastrectomía totalmente laparoscópica por neoplasias gástricas. Experiencia en un centro público
    (2015) Norero Muñoz, Enrique; Báez Vallejos, Sergio Antonio; Briceño, Eduardo; Martínez Belmar, Cristian Antonio; Ceroni Villanelo, Marco; Escalona, Alex; Aguayo Bonniard, Gloria Alejandra; Calvo, Oscar; Díaz Fernández, Alfonso; Viñuela Fawaz, Eduardo Andrés; González, Paulina; Araos, Fernando
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    High Frequency of Internal Hernias After Roux-en-Y Gastric Bypass
    (2015) Quezada Sanhueza, Nicolás; León, Felipe; Jones, Alex; Varas, Julián; Funke, Ricardo; Crovari Eulufi, Fernando; Raddatz Echavarría, Alejandro; Pérez Blanco, Gustavo Adolfo; Escalona, Alex; Boza, Camilo; Quezada Sanhueza, Nicolás; León, Felipe; Jones, Alex; Varas, Julián; Funke, Ricardo; Crovari Eulufi, Fernando; Raddatz, Alejandro; Pérez Blanco, Gustavo Adolfo; Escalona, Alex; Boza, Camilo
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    Importance of Routine Preoperative Upper GI Endoscopy: Why All Patients Should Be Evaluated?
    (2009) Munoz, Rodrigo; Ibanez, Luis; Salinas, Jose; Escalona, Alex; Perez, Gustavo; Pimentel, Fernando; Guzman, Sergio; Boza, Camilo
    Morbid obesity is associated with different gastrointestinal alterations and diseases. Surgically induced weight loss has become the best treatment for morbidly obese patients. Roux-en-Y gastric bypass is the most common procedure performed worldwide. Concerns regarding difficulties in further evaluation of stomach remnant for early detection of gastric cancer, however, have emphasized the routine use of preoperative upper endoscopy, even in asymptomatic patients, to detect upper gastrointestinal abnormalities. The main outcome of this study was to identify the most common preoperative endoscopic findings.
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    Increase of Bone Resorption and the Parathyroid Hormone in Postmenopausal Women in the Long-term after Roux-en-Y Gastric Bypass
    (2009) Valderas, Juan P.; Velasco, Soledad; Solari, Sandra; Liberona, Yessica; Viviani, Paola; Maiz, Alberto; Escalona, Alex; Gonzalez, Gilberto
    The effects of Roux-en-Y Gastric Bypass (RYGB) on bone in the long-term remains unclear. We assessed bone metabolism and bone mineral density (BMD) 1 to 5 years after RYGB.
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    Laparoscopic Roux-en-Y gastric bypass versus laparoscopic adjustable gastric banding: five years of follow-up
    (ELSEVIER SCIENCE INC, 2010) Boza, Camilo; Gamboa, Cristian; Awruch, Diego; Perez, Gustavo; Escalona, Alex; Ibanez, Luis
    Background: Bariatric surgery is an effective treatment for morbid obesity Laparoscopic Rouxen-Y gastric bypass (LRYGB) and laparoscopic adjustable gastric banding (LAGB) are commonly performed procedures The aim of the present study was to evaluate and compare the lone-term outcomes after LRYGB and LAGB
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    Laparoscopic sleeve gastrectomy with ileal transposition (SGIT)
    (2008) Boza, Camilo; Gagner, Michel; Devaud, Nicolas; Escalona, Alex; Munoz, Rodrigo; Gandarillas, Monica
    Iroduction ariatric surgery has evolved into multiple forms in the last decades, combining food restriction and malabsorption. The aim of this study was to develop a new technique based on food restriction and early stimulation of the distal gut, thus maintaining the alimentary tract continuity.
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    Necrosectomía laparoscópica en pancreatitis aguda
    (2010) Funke, Ricardo; Donoso, A.; Rondanelli, M. O.; Patillo, J. C.; Boza, Camilo; Crovari Eulufi, Fernando; Perez, G.; Pimentel Muller, Fernando; Ibañez Anrique, Luis; Guzmán Karadima, Sergio; Jarufe Cassis, Nicolás; Escalona, Alex; Funke, R.; Donoso, A.; Rondanelli, M. O.; Patillo, J. C.; Boza, Camilo; Crovari Eulufi, Fernando; Perez, G.; Pimentel Muller, Fernando; Ibañez Anrique, Luis; Guzman, S.; Jarufe Cassis, Nicolás; Escalona, A.
    Introducción: La pancreatitis aguda grave, asociada a necrosis pancreática infectada, tiene una elevada mortalidad. En la mayoría de los casos, el tratamiento es quirúrgico, sin embargo, este se asocia a una alta morbilidad. El desarrollo de la cirugía mí
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    Overexpression of 11 beta-Hydroxysteroid Dehydrogenase Type 1 in Hepatic and Visceral Adipose Tissue is Associated with Metabolic Disorders in Morbidly Obese Patients
    (SPRINGER, 2010) Baudrand, Rene; Carvajal, Cristian A.; Riquelme, Arnoldo; Morales, Mauricio; Solis, Nancy; Pizarro, Margarita; Escalona, Alex; Boza, Camilo; Perez, Gustavo; Dominguez, Angelica; Arrese, Marco; Fardella, Carlos E.
    The enzyme 11-beta-hydroxysteroid dehydrogenase type 1 (11 beta-HSD1) catalyzes intracellular glucocorticoid reactivation by conversion of cortisone to cortisol in different tissues and have been implicated in several metabolic disorders associated with obesity. The aim of this study was to evaluate the 11 beta-HSD1 expression in liver, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) in morbidly obese patients undergoing bariatric surgery and its correlations with clinical, anthropometric, and biochemical variables.
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    Overexpression of 11 beta-hydroxysteroid dehydrogenase type 1 in visceral adipose tissue and portal hypercortisolism in non-alcoholic fatty liver disease
    (WILEY, 2012) Candia, Roberto; Riquelme, Arnoldo; Baudrand, Rene; Carvajal, Cristian A.; Morales, Mauricio; Solis, Nancy; Pizarro, Margarita; Escalona, Alex; Carrasco, Gonzalo; Boza, Camilo; Perez, Gustavo; Padilla, Oslando; Cerda, Jaime; Fardella, Carlos E.; Arrese, Marco
    Background: The enzyme 11 beta-hydroxysteroid-dehydrogenase type 1 (11 beta HSD1) catalyses the reactivation of intracellular cortisol. We explored the potential role of 11 beta-HSD1 overexpression in visceral adipose tissue (VAT) in non-alcoholic fatty liver disease (NAFLD) assessing sequential changes of enzyme expression, in hepatic and adipose tissue, and the occurrence of portal hypercortisolism in obese mice. 11 beta-HSD1 expression was also assessed in tissues from obese patients undergoing bariatric surgery. Methods: Peripheral and portal corticosterone levels and liver histology were assessed in ob/ob mice at two time points (8-12 weeks of age). 11 beta-HSD1 tissue expression was assessed in by RT-pcr in ob/ob mice and in 49 morbidly obese patients. Results: Portal corticosterone serum levels were higher in obese mice with a 26% decrease between 8 and 12 weeks of age (controls: 78.3 +/- 19.7 ng/ml, 8-week-old ob/ob: 167.5 +/- 14.5 ng/ml and 12-week-old ob/ob: 124.3 +/- 28 ng/ml, P < 0.05). No significant differences were found in peripheral corticosterone serum levels. Expression of 11b-HSD1 was lower in the liver [-45% at 8 weeks and -35% at 12-weeks (P = 0.0001)] and highly overexpressed in VAT in obese mice, compared to controls (128-fold higher in 8-week-old ob/ob and 41-fold higher in 12-week-old ob/ob, P < 0.01). No significant differences were seen in the expression of 11 beta-HSD1 in subcutaneous adipose tissue. In multivariate analysis, human 11 beta-HSD1 expression in VAT (OR: 1.385 +/- 1.010-1.910) was associated with NAFLD. Conclusion: Murine NAFLD is associated with portal hypercortisolism and 11 beta-HSD1 overexpression in VAT. In humans, 11 beta-HSD1 VAT expression was associated with the presence of NAFLD. Thus, local corticosteroid production in VAT may contribute to NAFLD pathogenesis.
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    Overexpression of hepatic 5 alpha-reductase and 11 beta-hydroxysteroid dehydrogenase type 1 in visceral adipose tissue is associated with hyperinsulinemia in morbidly obese patients
    (W B SAUNDERS CO-ELSEVIER INC, 2011) Baudrand Biggs Rene Felipe; Domínguez Ruiz-tagle, José Miguel; Carvajal, Cristian A.; Riquelme, Arnoldo; Campino, Carmen; Macchiavello, Stefano; Bozinovic, Milan; Morales, Mauricio; Pizarro, Margarita; Solis, Nancy; Escalona, Alex; Boza, Camilo; Arrese, Marco; Fardella, Carlos E.
    11 beta-Hydroxysteroid dehydrogenase type 1 (11 beta-HSD1) converts cortisone to cortisol, mainly in the liver and visceral adipose tissue (VAT), and has been implicated in several metabolic disorders. The absence of systemic hypercortisolism in central obesity could be due to increased inactivation of cortisol to its tetrahydrometabolites by the hepatic enzymes 5 alpha-and 5 beta-reductases. Our aim was to assess the expression of the reductases in the liver and of 11 beta-HSD1 in the liver and VAT in morbidly obese patients and to analyze their association with clinical, anthropometric, and biochemical parameters. Hepatic and VAT samples were obtained during bariatric surgery. 5 alpha- and 5 beta-reductases, 11 beta-HSD1, and 18S expression was measured using real-time polymerase chain reaction. Anthropometric and biochemical variables were analyzed. Forty-one patients were recruited (age, 41.8 +/- 10.6 years; body mass index, 42.1 +/- 6.6 kg/m(2); 71% women). The expression of hepatic 5 alpha- and 5 beta-reductases was positively correlated (r = +0.53, P = .004), and their expression levels were correlated with hepatic 11 beta-HSD1 expression (r = +0.61, P < .001 for 5 alpha-reductase and r = +0.50, P < .001 for 5 beta-reductase). Hepatic 5 alpha-reductase was associated with insulin (r = +0.34, P = .015). Visceral adipose tissue 11 beta-HSD1 expression was associated with glucose (r = +0.37, P = .025) and insulin (r = +0.54, P = .002). Our results showed that 5 alpha-reductase and VAT 11 beta-HSD1 expressions were associated with insulinemia. These findings suggest that overexpression of 5 alpha-reductase, through a higher inactivation of cortisol in the liver, could have a protective role in preserving hepatic sensitivity to insulin. The overexpression of liver reductases in obesity could be an adaptive response to an increase in cortisol production by the liver and visceral 11 beta-HSD1 to avoid systemic hypercortisolism. (C) 2011 Elsevier Inc. All rights reserved.