Browsing by Author "Gobelet, Jaquelina"

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    Diagnóstico precoz de cáncer gástrico. Propuesta de detección y seguimiento de lesiones premalignas gástricas: protocolo ACHED
    (Sociedad Médica de Santiago, 2014) Rollán, Antonio; Cortés, Pablo; Calvo, Alfonso; Araya, Raúl; Bufadel, María Ester; González, Robinson; Heredia, Carolina; Muñoz, Pablo; Squella, Freddy; Nazal, Roberto; Gatica, María de los Ángeles; Gobelet, Jaquelina; Estay, René; Pisano, Raúl; Contreras, Luis; Osorio, Ingrid; Estela, Ricardo; Fluxá, Fernando; Parra-Blanco, Adolfo
    An expert panel analyzed the available evidence and reached a consensus to release 24 recommendations for primary and secondary prevention of gastric cancer (CG) in symptomatic patients, with indication for upper GI endoscopy. The main recommendations include (1) Search for and eradicate H. pylori infection in all cases. (2) Systematic gastric biopsies (Sydney protocol) in all patients over 40 years of age or first grade relatives of patient with CG, to detect gastric atrophy, intestinal metaplasia or dysplasia. (3) Incorporate the OLGA system (Operative Link on Gastritis Assessment) to the pathological report, to categorize the individual risk of CG. (4) Schedule endoscopic follow-up according to the estimated risk of CG, namely annual for OLGA III- IV, every 3 years for OLGA I- II or persistent H. pylori infection, every 5 years for CG relatives without other risk factors and no follow-up for OLGA 0, H. pylori (-). (4) Establish basic human and material resources for endoscopic follow-up programs, including some essential administrative processes, and (5 ) Suggest the early CG/total CG diagnosis ratio of each institution and the proportion of systematic recording of endoscopic images, as quality indicators. These measures are applicable using currently available resources, they can complement any future screening programs for asymptomatic population and may contribute to improve the prognosis of CG in high-risk populations
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    Escurrimiento oleoso anaranjado o «keriorrea», («orange oily anal leakage»): una nueva enfermedad ligada a cambios de hábito alimentario
    (Elsevier España, 2012) Robles, Ignacio; Vásquez, Jose Manuel; Loehnert, Rodrigo; Espino, Alberto; Biel, Francisco; Correa, Ismael; Gobelet, Jaquelina; Sáenz, Marcela; Saenz, Constanza; Sáenz, Roque
    INTRODUCTION: Information is accumulating on exceptional cases of oily orange anal leakage, probably caused by certain foods and their form of consumption. The leakage is usually inadvertent and is worrisome for patients. METHOD: Clinical data was gathered on a case series presenting with massive and inadvertent orange oily anal leakage, without sphincter sensation, causing the patients to feel alarmed. This condition usually occurs after eating fish, especially Japanese cuisine. RESULTS: Eleven patients were included (four women and seven men). The mean age was 47.3 years. Colonoscopy had previously been performed in four patients, with normal results. The symptoms, described as keriorrhea, were probably produced by accumulation of indigestible "wax esters", es Mero present in some oily fish, recently incorporated in raw fish dishes (sashimi) or as Japanese Mero sea bass. These oils, which cannot be absorbed or digested, accumulate in the rectum and may also filter spontaneously and induce toxin-related sphincter dysfunction. The same symptoms are sometimes produced after consumption of cooked versions of these species. The diagnosis is given by clinical data, prior ingestion of these types of fish and the self-limiting nature of the symptoms, without the need for further investigations. CONCLUSION: We describe a case series of a recently described entity associated with dietary changes. This entity is benign and self-limiting. Clinicians should be familiar with the symptoms to inform patients correctly and avoid unnecessary laboratory studies.
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    Plan de tamizaje de cáncer colorrectal ("Mes del Colon") en la Clínica Alemana de Santiago de Chile
    (2011) Silva, María de los Ángeles; Valdivieso, Eduardo; Gobelet, Jaquelina; Santander, Ricardo; Ramírez, María Antonieta; Sáenz, Roque; Alarcón, Gonzalo; Elías, Soledad; Olivares, Lizzy
    La incidencia del cáncer colorrectal (CCR) se está incrementando. Puede ser prevenido y curado si se detectan lesiones precursoras como los pólipos adenomatosos. La resección endoscópica de estas lesiones previene la progresión a CCR y el desarrollo de lesiones avanzadas. Objetivo. De allí surge la necesidad de aplicar un programa de tamizaje, en grupos definidos de mayor riesgo, en pacientes asintomáticos. Método. En la Clínica Alemana de Santiago se diseñó un programa de detección de CCR llamado "Mes del Colon". Se diseñó una campaña de prensa y difusión local. Se programaron charlas sobre el CCR abiertas a la comunidad. Se contó con un consentimiento informado. Se estableció una base de datos prospectiva para el análisis posterior de los resultados. Se incluye ron pacientes mayores de 50 años y pacientes de alto riesgo. Se decidió realizar un estudio colonoscópico total con resección de las lesiones poliposas encontradas. Resultados. Desde 2003 a 2008 se incluyeron 1.158 pacientes. Fueron excluidos del análisis el 1,8% de ellos por no cumplir los criterios de inclusión o porque la información era incompleta. El porcentaje de mujeres fue 54%. La edad promedio fue 58,4 años y el índice de masa corporal promedio fue 25,5 kg/m. El 45% de los pacientes presentaron pólipos. De éstos, 6 (1%) eran adenocarcinomas, 291 adenomas (57%) (98% tubulares), 189 (37%) pólipos hiperplásicos y 25 (5%) de otras patologías. En esta serie el número necesario a investigar para un adenoma fue 3,9. Conclusiones. Se hace necesario realizar campañas de prevención de CCR debido al aumento progresivo de la incidencia de la enfermedad en nuestro medio. Éstas permiten la detección de lesiones precursoras tratables endoscópica o quirúrgicamente.
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    Treatment of Common Bile Duct Injuries After Surgery
    (2012) Navarrete, Claudio; Gobelet, Jaquelina
    The treatment of common biliary duct injuries after surgery is a permanent challenge for physicians, and management by a multidisciplinary team is often required. The endoscopic approach is a valuable tool because it is able to assess the problem and also provide a therapeutic option for both fistulas and stenosis of the biliary tree. This article discusses the endoscopic management of postsurgical injuries of the common bile duct and discusses the application of practical tools.

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