Browsing by Author "Rollan, Antonio"

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    Management of Helicobacter pylori infection in Latin America: A Delphi technique-based consensus
    (Baishideng Publishing Group, 2014) Rollan, Antonio; Arab, Juan; Camargo, Constanza; Candia, Roberto; Harris, Paul; Ferreccio, Catterina; Rabkin, Charles; Gana, Juan; Cortés, Pablo; Herrero, Rolando; Durán, Luisa; García, Apolinaria; Toledo, Claudio; Espino, Alberto; Lustig, Nicole; Sarfatis, Alberto; Figueroa, Catalina; Torres, Javier; Riquelme, Arnoldo
    AIM: To optimize diagnosis and treatment guidelines for this geographic region, a panel of gastroenterologists, epidemiologists, and basic scientists carried out a structured evaluation of available literature. METHODS: Relevant questions were distributed among the experts, who generated draft statements for consideration by the entire panel. A modified three-round Delphi technique method was used to reach consensus. Critical input was also obtained from representatives of the concerned medical community. The quality of the evidence and level of recommendation supporting each statement was graded according to United States Preventive Services Task Force criteria. RESULTS: A group of ten experts was established. The survey included 15 open-ended questions that were distributed among the experts, who assessed the articles associated with each question. The levels of agreement achieved by the panel were 50% in the first round, 73.3% in the second round and 100% in the third round. Main consensus recommendations included: (1) when available, urea breath and stool antigen test (HpSA) should be used for non-invasive diagnosis; (2) detect and eradicate Helicobacter pylori (H. pylori) in all gastroscopy patients to decrease risk of peptic ulcer disease, prevent o retard progression in patients with preneoplastic lesions, and to prevent recurrence in patients treated for gastric cancer; (3) further investigate implementation issues and health outcomes of H. pylori eradication for primary prevention of gastric cancer in high-risk populations; (4) prescribe standard 14-d triple therapy or sequential therapy for first-line treatment; (5) routinely assess eradication success post-treatment in clinical settings; and (6) select second- and third-line therapies according to antibiotic susceptibility testing. CONCLUSION: These achievable steps toward better region-specific management can be expected to improve clinical health outcomes.
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    Proposal of minimum elements for screening and diagnosis of gastric cancer by an international Delphi consensus
    (2022) Kakushima, Naomi; Fujishiro, Mitsuhiro; Chan, Shannon Melissa; Cortas, George Adel; Dinis-Ribeiro, Mario; González, Robinson; Kodashima, Shinya; Lee, Sun-Young; Linghu, Enqiang; Mabe, Katsuhiro; Pan, Wensheng; Parra-Blanco, Adolfo; Pioche, Mathieu; Rollan, Antonio; Sumiyama, Kazuki; Tanimoto, Miguel; World Endoscopy Organization Stomach and Duodenal Diseases Committee
    The World Endoscopy Organization Stomach and Duodenal Diseases Committee extracted minimum elements for screening and diagnosis of gastric cancer (GC) in aim to support countries that do not have national guidelines on screening and diagnosis of GC. Current national or international guidelines were collected worldwide and recommendations were classified according to the quality of evidence and were finalized through a modified Delphi method. The minimum elements consist of seven categories: [1] Extraction of high-risk patients of GC before esophagogastroduodenoscopy (EGD), [2] Patients who need surveillance of GC, [3] Method to ensure quality of EGD for detection of GC, [4] Individual GC risk assessment by EGD, [5] Extraction of high-risk patients of GC after EGD [6] Qualitative or differential diagnosis of GC by EGD, and [7] Endoscopic assessment to choose the therapeutic strategy for GC. These minimum elements will be a guide to promote the elimination of GC among countries with a high incidence of GC who lack national guidelines or screening programs.
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    Quadruple therapies show a higher eradication rate compared to standard triple therapy for Helicobacter pylori infection within the LEGACy consortium. A multicenter observational study in European and Latin American countries
    (2024) Medel-Jara, Patricio; Reyes Placencia, Diego; Fuentes-López, Eduardo; Corsi, Oscar; Latorre, Gonzalo; Antón, Rosario; Jiménez, Elena; Miralles-Marco, Ana; Caballero, Carmelo; Boggino, Hugo; Cantero, Daniel; Barros, Rita; Santos-Antunes, João; Díez, Marc; Quiñones, Luis A.; Riquelme, Erick; Rollan, Antonio; Cerpa, Leslie C.; Valdés, Ivania; Nyssen, Olga P.; Moreira, Leticia; Gisbert, Javier P.; Camargo, M. Constanza; Ortiz-Olvera, Nayeli; Leon‐Takahashi, Alberto, M.; Ruiz-Garcia, Erika; Fernández-Figueroa, Edith A.; Garrido, Marcelo; Owen, Gareth I.; Cervantes, Andrés; Fleita, Tania; Riquelme, Arnoldo
    Introduction: Gastric cancer (GC) is one of the most lethal malignancies worldwide.Helicobacter pylori is the primary cause of GC; therefore, its eradication reduces therisk of developing this neoplasia. There is extensive evidence regarding quadrupletherapy with relevance to the European population. However, in Latin America, dataare scarce. Furthermore, there is limited information about the eradication ratesachieved by antibiotic schemes in European and Latin American populations.Objective: To compare the effectiveness of standard triple therapy (STT), quadrupleconcomitant therapy (QCT), and bismuth quadruple therapy (QBT) in six centers inEurope and Latin America.Methods: A retrospective study was carried out based on the LEGACy registry from2017 to 2022. Data from adult patients recruited in Portugal, Spain, Chile, Mexico,and Paraguay with confirmed H. pylori infection who received eradication therapyand confirmatory tests at least 1 month apart were included. Treatment success by each scheme was compared using a mixed multilevel Poisson regression, adjustingfor patient sex and age, together with country‐specific variables, including preva-lence of H. pylori antibiotic resistance (clarithromycin, metronidazole, and amoxi-cillin), and CYP2C19 polymorphisms.Results: 772 patients were incorporated (64.64% females; mean age of 52.93 years).The total H. pylori eradication rates were 75.20% (255/339) with STT, 88.70% (159/178) with QCT, and 91.30% (191/209) with QBT. Both quadruple therapies (QCT‐QBT) showed significantly higher eradication rates compared with STT, with anadjusted incidence risk ratio (IRR) of 1.25 (p: <0.05); and 1.24 (p: <0.05), respectively.The antibiotic‐resistance prevalence by country, but not the prevalence of CYP2C19polymorphism, showed a statistically significant impact on eradication success.Conclusions: Both QCT and QBT are superior to STT for H. pylori eradication whenadjusted for country‐specific antibiotic resistance and CYP2C19 polymorphism in asample of individuals residing in five countries within two continents.
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    Terapias cuádruples son superiores a terapia triple estándar en primera línea de erradicación de Helicobacter pylori en Chile
    (2022) Reyes, Diego; Ortiz, Javier; Fuentes-López, Eduardo; Budnik, Sigall; Gándara, Vicente; Gallardo, Andrea; Seydewitz, María Francisca; Candia, Roberto; Vargas, José Ignacio; Rollan, María Paz; Godoy, Javiera; Rollan, Antonio; Mansilla, Rodrigo; Arenas, Alex; Chahuán, Javier; Espino, Alberto; Pizarro, Margarita; Riquelme, Arnoldo
    Introducción: La infección por Helicobacter pylori afecta aproximadamente al 70% de lapoblación chilena. Es un problema de salud pública cuyo tratamiento de erradicación formaparte de políticas públicas en Chile.Objetivos: Caracterizar los esquemas de erradicación de primera línea de H. pylori más uti-lizados en nuestro medio y evaluar su eficacia.Métodos: Se realizó un estudio observacional retrospectivo donde, en pacientes con infecciónpor H. pylori certificada, se evaluó el esquema de erradicación indicado por el médico tratante,su eficacia, adherencia y efectos adversos.Resultados: Se analizaron 242 pacientes y 4 esquemas de erradicación; terapia triple estándar,terapia dual, concomitante y cuadriterapia con bismuto. Se observaron tasas de erradicaciónde 81,9% (IC 95% 74,44---87,63), 88,5% (IC 95% 73,13---95,67), 93,7% (IC 95% 78,07---98,44) y 97,6%(IC 95% 84,81---99,67) respectivamente, siendo más eficaces la terapia concomitante (RR: 1,14;IC 95% 1,01---1,29; p = 0,028) y cuadriterapia con bismuto (RR: 1,19; IC 95% 1,09---1,31; p <0,001) que la triple terapia estándar. La tasa de efectos adversos reportados fue de 58,5%(IC 95% 50,66---65,92), 35,4% (IC 95% 24,6---48,11), 22,9% (IC 95% 11,81---37,14) y 63,4% (IC95% 47,8---76,64), para la terapia triple estándar, dual, concomitante, y cuádruple con bis-muto, respectivamente. La terapia dual y concomitante tuvieron menos efectos adversos encomparación con la terapia estándar.Conclusiones: Las cuadriterapias son superiores a la triple terapia estándar por lo que deberíanser consideradas como tratamiento de primera línea en Chile. La terapia dual es promisoria.Más estudios serán requeridos para determinar qué esquemas son más costo-efectivos.© 2021 Elsevier Espa˜na, S.L.U. Todos los derechos reservados.

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