Luis Sabbagh - Academia.edu (original) (raw)

Papers by Luis Sabbagh

Revista Colombiana de Gastroenterología, Feb 16, 2017

The main causes of upper digestive tract bleeding are ulcers in the stomach and/or duodenum (pept... more The main causes of upper digestive tract bleeding are ulcers in the stomach and/or duodenum (peptic ulcer disease). With increasing frequency, patients are being seen who have bleeding gastric varices. This may be due to the increasing number of patients who have portal hypertension caused in turn by liver problems, especially cirrhosis. Current options for treatment of gastric varices range include preventive and prophylactic methods. These include therapy using drugs including vasopressin, somatostatin and their analogs, transjugular intrahepatic portosystemic shunts (TIPS) endoscopic methods and surgery. Endoscopic methods include the use of bands and injection sclerotherapy and sealants such as N-Butyl-2-cyanoacrylate (Histoacryl ®). Recently, on the basis of literature with increasingly higher levels of evidence and recommendations, we have started using cyanoacrylate at the Clínica Universitaria Colombia. We present our cases and we review the issue.

Revista Colombiana de Gastroenterologia, Dec 1, 2015

Guía de práctica clínica para el uso de ultrasonido endoscópico en pancreatitis crónica, lesiones... more Guía de práctica clínica para el uso de ultrasonido endoscópico en pancreatitis crónica, lesiones quísticas y sólidas del páncreas en adultos Clinical practice guideline for the use of endoscopic ultrasound in chronic pancreatitis, solid and cystic lesions of pancreas in adults

Objective: To provide an evidence-based clinical practice guideline for the screening of colon an... more Objective: To provide an evidence-based clinical practice guideline for the screening of colon and rectal cancer for patients, caregivers, administrative and government bodies at all levels of care in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated for quality and applicability. None of the guidelines met the criteria for adaptation, so the group decided to develop a de novo guideline. Systematic literature searches were conducted by the Cochrane Group. The tables of evidence and recommendations were made based on the GRADE methodology. The recommendations of the guide were socialized in a meeting of experts with government agenc...

Objective: To provide an evidence-based clinical practice guideline for the management of dyspeps... more Objective: To provide an evidence-based clinical practice guideline for the management of dyspepsia for patients, caregivers, administrative and government bodies at all levels of care in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated for quality and applicability. One guideline met the criteria for adaptation of two of its clinical questions. Systematic literature searches were conducted by the Cochrane STI Group. The tables of evidence and recommendations were made based on the GRADE methodology. The recommendations of the guide were socialized in a meeting of experts with government agencies and patients. Results: An evidence...

Gastrointestinal Endoscopy, 2000

Background. Acute pancreatitis, a common severe disease, remains as an important cause of high mo... more Background. Acute pancreatitis, a common severe disease, remains as an important cause of high morbidity, mortality and costs. Gallstones are by far the main etiologic agents for the disease in our country. The gold standard to identify common bile duct stones in biliary pancreatitis currently is made by endoscopic retrograde cholangiopancreatography (ERCP), an invasive procedure without a 100% of accuracy and with known morbidity and mortality. The main objective of this study was to prospectively evaluate the ability of endosonography (EUS) to identify choledocholithiasis and to assess severity of pancreatic involvement. Methods. The study was conducted at the Clinica Reina Sofia a tertiary care center. The inclusion criteria were patients older than 18 years of age with acute pancreatitis having EUS, abdominal C-T Scan and ERCP when indicated. EUS was performed independently or before the ERCP to every patient included in the study and within 72 hours of admission by the same examiner. The outcome variable was defined as the presence of choledocholithiasis assessed by EUS or by ERCP. Pancreatic involvement findings were correlated with length of hospital stay and compared with the dynamic C-T Scan. Results. Seventy-four patients were prospectively studied during three years. 51 patients had both EUS and ERCP; Normal in 4 (7.8%) vs.12 (23.5%); microlithiasis in 21 (41.2%) vs. 8 (15.7%); biliar sludge in 8 (15.7%) vs. 15 (29.4%); and choledocholithiasis in 18 (35.3%) vs. 16 (31.4%), chi square 12.08, p

British Journal of Clinical Pharmacology, 1996

Somatostatin inhibits hormonal secretions in the gastrointestinal tract. Somatostatin analogues a... more Somatostatin inhibits hormonal secretions in the gastrointestinal tract. Somatostatin analogues are used in the treatment of VIPome-related watery diarrhoea. In addition, more than 10% of patients with AIDS suffer from diarrhoea likely due to the increased intestinal secretion of water and ions. However, the direct effect of somatostatin on the flux of water and ions in the intestine has not been, so far, analyzed in vivo. The aim of the present study was to evaluate the effect of lanreotide, a somatostatin analogue, on the movements of water and ions in the jejunum in man. 2 Accordingly, 10 healthy volunteers (age 18-35 years, mean 27) and two patients with AIDS (26 and 33 years) suffering from water diarrhoea (>800ml day-') underwent intestinal perfusion using a four lumen tube with proximal occluding balloon. The segment tested was 25cm long. The jejunum was infused by an isotonic control saline solution containing polyethylene glycol (PEG) as nonabsorbable marker. Basal jejunal secretions were measured in all subjects. Prostaglandin El (PGE,) was administered intraluminally to stimulate jejunal secretion in healthy volunteers. The effect of intravenous lanreotide on the jejunal PGE,-induced secretions of water and electrolytes was analysed in healthy subjects and on the basal secretions in AIDS patients. Each period was analyzed on the basis of three (10 min) successive intestinal juice collections after 20-30 min equilibration time. The antisecretory effect of lanreotide was evaluated in each subject as the difference between fluxes compared to the control period. 3 In healthy volunteers, PGE, induced secretion of H,O, Na', K + and C1-in the jejunum and lanreotide reduced significantly PGE,-induced response. In both AIDS patients basal fluxes of water and ions were reduced by lanreotide in a dose-dependent manner. 4 Somatostatin can reduce stimulated-jejunal secretion of ions and water in normal subjects and may improve water diarrhoea in AIDS patients.

Gastrointestinal Endoscopy, 2000

Introduction . Gastric lymphomas represent the 3 to 10% of the gastric neoplasms. Endoscopic Ultr... more Introduction . Gastric lymphomas represent the 3 to 10% of the gastric neoplasms. Endoscopic Ultrasonography (EUS) is today the gold standard to evaluate the gastric wall, allowing the reliable measurement of the wall thickness, tumor extension and peri gastric node involvement. These characteristics make this tool the first choice to follow up the response of patients with gastric lymphoma under treatment. The main objective of this study was to prospectively evaluate the utility of EUS in the follow up of patients with superficial involvement of low grade MALT gastric lymphoma (mucosa associated lymphoid tissue) under treatement for Helicobacter pylori. Methods .The study was conducted at the Clinica Reina Sofia a tertiary care center. The inclusion criteria were patients with histology and immuno histochemistry diagnosis of low grade MALT gastric lymphoma with superficial involvement (no deeper than submucosa layer and without node involvement). EUS was performed before and on the 3rd, 6th, 9th, 12th, and 18th month after antibiotic treatment with claritromicin, amoxacilin and lansoprazol for Helicobacter pylori eradication. The main outcome variable was defined as the measurement of the tumor involvement of the gastric wall (in millimeters, normal value of 3 mm) by EUS on the specified times. At the same time, biopsy samples were taken. Results.The study period of time was 18 months; during this time, 14 patients were included in the study. The median of the gastric mucosa before treatment was 7 mm (range 3 - 9 mm). Two patients did not respond to the treatment and remained with the same gastric mucosa thickness and positive biopsy for the neoplasm. There was a significant reduction of the gastric mucosa thickness after the sixth month of treatment in 12 patients (85.7%), with a median of 4 mm. The tumor was not evident at the biopsy specimen in this group of patients and the eradication of the Helicobacter pylori was demonstrated. There was a good correlation between the EUS evaluation and the histological findings for tumor evidence and for Helicobacter pylori infection. Conclusions : The results of the present study showed that EUS is a useful tool for the diagnosis and follow up of patients with low grade MALT gastric lymphoma with superficial involvement. There was a good correlation between H pylori eradication, gastric mucosa thickness reduction by EUS and histopathological findings.

Gastrointestinal Endoscopy, 2002

David B. Páramo-Hernández, MD,1 Rosario Albis, MD, MSc,1 María T. Galiano, MD,1 Belén de Molano, ... more David B. Páramo-Hernández, MD,1 Rosario Albis, MD, MSc,1 María T. Galiano, MD,1 Belén de Molano, MD,1 Reynaldo Rincón, MD,1 Luis F. Pineda-Ovalle, MD,1 Alberto Rodríguez, MD,1 William Otero Regino, MD,1 Albis Hani, MD,1 Luis Carlos Sabbagh, MD,1 Carolina Sandoval-Salinas, MSc,1 Ricardo Sánchez-Pedraza, MD, MSc,1 Prevalence of Gastro-Esophageal Reflux Symptoms and Associated Factors: A Population Survey in the Principal Cities Of Colombia

Objective: To provide a clinical practice guideline with the latest evidence for diagnosis and tr... more Objective: To provide a clinical practice guideline with the latest evidence for diagnosis and treatment of nonalcoholic fatty liver disease for patients, caregivers, administrative and government bodies at all levels of care in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated about quality and applicability. One guideline met the criteria for adaptation, so the group decided to adapt 3 clinical questions. Systematic literature searches were conducted by the Cochrane Group. The tables of evidence and recommendations were made based on the GRADE methodology. The recommendations of the guide were socialized in a meeting of experts w...

Resumen Objetivo: brindar una guia de practica clinica con la evidencia mas reciente para el uso ... more Resumen Objetivo: brindar una guia de practica clinica con la evidencia mas reciente para el uso de ultrasonido en -doscopico en pancreatitis cronica y lesiones quisticas y s olidas en adultos, la cual esta dirigida a pacientes, personal asistencial, administrativo y entes gubernamentales de los servicios de atencion en Colombia.Materiales y metodos: esta guia fue desarrollada por un equipo multidisciplinario con apoyo de la Asociacion Colombiana de Gastroenterologia, el Grupo Cochrane ITS y el Instituto de Investigaciones Clinicas de la Universidad Nacional de Colombia. Se desarrollaron preguntas clinicas relevantes y se realizo la busqueda de guias nacionales e internacionales en bases de datos especializadas. Las guias existentes fueron evaluadas en terminos de calidad y aplicabilidad; ninguna de ellas cumplio con el criterio de adapta -cion, por lo que se decidio construir una guia de novo . El Grupo Cochrane realizo la busqueda sistematica de la literatura. Las tablas de eviden...

Esophageal herpes viral infections are rare condition that have been reported most frequently in ... more Esophageal herpes viral infections are rare condition that have been reported most frequently in immuno-FRPSURPLVHGSDWLHQWV7KLVLQIHFWLRQSULPDULO\DIIHFWVSDWLHQWVZLWKKXPDQLPPXQRGH?FLHQF\YLUXV +,9 DQGpatients receiving immunosuppressants or chemotherapy. The severity of symptoms is related to the degree of esophageal involvement. Odynophagia is the most common clinical presentation while the most common HQGRVFRSLF?QGLQJLVPXOWLSOHZHOOFLUFXPVFULEHGXOFHUV7KHVHW\SLFDOO\RFFXULQWKHGLVWDOWKLUGRIWKHHVRSKD-gus. Standard treatment is oral acyclovir for one to two weeks. Keywords +HUSHVHVRSKDJLWLVKHUSHVVLPSOH[YLUXVW\SH,LPPXQRVXSSUHVVLRQ Case report INTRODUCTION Infectious esophagitis is relatively uncommon, but it can lead to increased morbidity and mortality in immune com -promised when it is not accurately diagnosed (1). This con -dition is most often seen in immunocompromised patients whose resistance has been altered by various conditions (1, 2). Immune deficiencies, malignancies, sever...

Today endoscopic ultrasound (EUS) is the most sensitive test for early diagnosis of chronic pancr... more Today endoscopic ultrasound (EUS) is the most sensitive test for early diagnosis of chronic pancreatitis. Early diagnosis of this disease is of fundamental i...

The main causes of upper digestive tract bleeding are ulcers in the stomach and/or duodenum (pept... more The main causes of upper digestive tract bleeding are ulcers in the stomach and/or duodenum (peptic ulcer disease). With increasing frequency, patients are being seen who have bleeding gastric varices. This may be due to the increasing number of patients who have portal hypertension caused in turn by liver problems, especially cirrhosis. Current options for treatment of gastric varices range include preventive and prophylactic methods. These include therapy using drugs including vasopressin, somatostatin and their analogs, transjugular intrahepatic portosystemic shunts (TIPS) endoscopic methods and surgery. Endoscopic methods include the use of bands and injection sclerotherapy and sealants such as N-Butyl-2-cyanoacrylate (Histoacryl ®). Recently, on the basis of literature with increasingly higher levels of evidence and recommendations, we have started using cyanoacrylate at the Clínica Universitaria Colombia. We present our cases and we review the issue.

Revista Portuguesa De Pneumologia, 2011

Heterotopic pancreatic tissue in the stomach is an uncommon gastric subepithelial lesion. Is usua... more Heterotopic pancreatic tissue in the stomach is an uncommon gastric subepithelial lesion. Is usually an asymptomatic condition which is found incidentally. As with other gastric subepithelial lesions, diagnosis can be challenging. Endoscopic forceps biopsy specimens are of little value. Endoscopic ultrasound findings are helpful in characterize this lesions, but they cannot absolutely determine the type of lesion or whether a lesion is benign or malignant. The sequence endosonography- cap assisted endoscopic mucosal resection allows en bloc resection of small gastric subepithelial lesions with low complication rates. We report a case of an ectopic pancreas of the antrum in the stomach that arises from the second layer of the gastric wall (muscularis mucosa) at endoscopic ultrasound that was removed en bloc with cap-assisted endoscopic mucosal resection technique in one endoscopic session without complications.

Resumen Objetivo: con la evidencia mas reciente, desarrollar una guia de practica clinica para el... more Resumen Objetivo: con la evidencia mas reciente, desarrollar una guia de practica clinica para el manejo de dispepsia dirigida a pacientes, personal asistencial, administrativo y entes gubernamentales de cualquier servicio de atencion en Colombia.Materiales y metodos: esta guia fue desarrollada por un equipo multidisciplinario con el apoyo de la Asociacion Colombiana de Gastroenterologia, el Grupo Cochrane ITS y el Instituto de Investigaciones Clinicas de la Universidad Nacional de Colombia. Se desarrollaron preguntas clinicas relevantes y se realizo la busqueda de guias nacionales e internacionales en bases de datos especializadas. Las guias existentes fueron evaluadas en terminos de calidad y aplicabilidad; una guia cumplio con el criterio de adaptacion, por lo que se adaptaron 2 de sus preguntas. El Grupo Cochrane realizo la busqueda sistematica de la literatura. Las tablas de evidencia y recomendaciones fueron realizadas con base en la metodologia GRADE. Las recomen -daciones de...

Objective: To provide an evidence-based clinical practice guideline for the screening of colon an... more Objective: To provide an evidence-based clinical practice guideline for the screening of colon and rectal cancer for patients, caregivers, administrative and government bodies at all levels of care in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated for quality and applicability. None of the guidelines met the criteria for adaptation, so the group decided to develop a de novo guideline. Systematic literature searches were conducted by the Cochrane Group. The tables of evidence and recommendations were made based on the GRADE methodology. The recommendations of the guide were socialized in a meeting of experts with government agenc...

Objective: To provide an evidence-based clinical practice guideline for detection, diagnosis and ... more Objective: To provide an evidence-based clinical practice guideline for detection, diagnosis and treatment of early gastric cancer considering the efficacy and safety and interventions for patients, caregivers, administrative and government bodies at all levels of care in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated quality and usability. None of the guidelines met criteria for adaptation, so the group decided to develop a de novo guideline. Systematic literature searches were conducted by Cochrane STI. The tables of evidence and recommendations were developed based on the GRADE approach. Results: A Clinical Practice Guideline...

Objective: Design a clinical practice guideline to orient the diagnosis and establishing the clas... more Objective: Design a clinical practice guideline to orient the diagnosis and establishing the classification and pharmacological and non-pharmacological treatment in adult patients with chronic functional constipation in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated for quality and applicability. None of the guidelines met the criteria for adaptation, so the group decided to develop a de novo guideline. Systematic literature searches were conducted by the Cochrane Group. The tables of evidence and recommendations were made based on the GRADE methodology. Results: A clinical practice based on evidence was developed for the diagno...

Revista Colombiana de Gastroenterología, Feb 16, 2017

The main causes of upper digestive tract bleeding are ulcers in the stomach and/or duodenum (pept... more The main causes of upper digestive tract bleeding are ulcers in the stomach and/or duodenum (peptic ulcer disease). With increasing frequency, patients are being seen who have bleeding gastric varices. This may be due to the increasing number of patients who have portal hypertension caused in turn by liver problems, especially cirrhosis. Current options for treatment of gastric varices range include preventive and prophylactic methods. These include therapy using drugs including vasopressin, somatostatin and their analogs, transjugular intrahepatic portosystemic shunts (TIPS) endoscopic methods and surgery. Endoscopic methods include the use of bands and injection sclerotherapy and sealants such as N-Butyl-2-cyanoacrylate (Histoacryl ®). Recently, on the basis of literature with increasingly higher levels of evidence and recommendations, we have started using cyanoacrylate at the Clínica Universitaria Colombia. We present our cases and we review the issue.

Revista Colombiana de Gastroenterologia, Dec 1, 2015

Guía de práctica clínica para el uso de ultrasonido endoscópico en pancreatitis crónica, lesiones... more Guía de práctica clínica para el uso de ultrasonido endoscópico en pancreatitis crónica, lesiones quísticas y sólidas del páncreas en adultos Clinical practice guideline for the use of endoscopic ultrasound in chronic pancreatitis, solid and cystic lesions of pancreas in adults

Objective: To provide an evidence-based clinical practice guideline for the screening of colon an... more Objective: To provide an evidence-based clinical practice guideline for the screening of colon and rectal cancer for patients, caregivers, administrative and government bodies at all levels of care in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated for quality and applicability. None of the guidelines met the criteria for adaptation, so the group decided to develop a de novo guideline. Systematic literature searches were conducted by the Cochrane Group. The tables of evidence and recommendations were made based on the GRADE methodology. The recommendations of the guide were socialized in a meeting of experts with government agenc...

Objective: To provide an evidence-based clinical practice guideline for the management of dyspeps... more Objective: To provide an evidence-based clinical practice guideline for the management of dyspepsia for patients, caregivers, administrative and government bodies at all levels of care in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated for quality and applicability. One guideline met the criteria for adaptation of two of its clinical questions. Systematic literature searches were conducted by the Cochrane STI Group. The tables of evidence and recommendations were made based on the GRADE methodology. The recommendations of the guide were socialized in a meeting of experts with government agencies and patients. Results: An evidence...

Gastrointestinal Endoscopy, 2000

Background. Acute pancreatitis, a common severe disease, remains as an important cause of high mo... more Background. Acute pancreatitis, a common severe disease, remains as an important cause of high morbidity, mortality and costs. Gallstones are by far the main etiologic agents for the disease in our country. The gold standard to identify common bile duct stones in biliary pancreatitis currently is made by endoscopic retrograde cholangiopancreatography (ERCP), an invasive procedure without a 100% of accuracy and with known morbidity and mortality. The main objective of this study was to prospectively evaluate the ability of endosonography (EUS) to identify choledocholithiasis and to assess severity of pancreatic involvement. Methods. The study was conducted at the Clinica Reina Sofia a tertiary care center. The inclusion criteria were patients older than 18 years of age with acute pancreatitis having EUS, abdominal C-T Scan and ERCP when indicated. EUS was performed independently or before the ERCP to every patient included in the study and within 72 hours of admission by the same examiner. The outcome variable was defined as the presence of choledocholithiasis assessed by EUS or by ERCP. Pancreatic involvement findings were correlated with length of hospital stay and compared with the dynamic C-T Scan. Results. Seventy-four patients were prospectively studied during three years. 51 patients had both EUS and ERCP; Normal in 4 (7.8%) vs.12 (23.5%); microlithiasis in 21 (41.2%) vs. 8 (15.7%); biliar sludge in 8 (15.7%) vs. 15 (29.4%); and choledocholithiasis in 18 (35.3%) vs. 16 (31.4%), chi square 12.08, p

British Journal of Clinical Pharmacology, 1996

Somatostatin inhibits hormonal secretions in the gastrointestinal tract. Somatostatin analogues a... more Somatostatin inhibits hormonal secretions in the gastrointestinal tract. Somatostatin analogues are used in the treatment of VIPome-related watery diarrhoea. In addition, more than 10% of patients with AIDS suffer from diarrhoea likely due to the increased intestinal secretion of water and ions. However, the direct effect of somatostatin on the flux of water and ions in the intestine has not been, so far, analyzed in vivo. The aim of the present study was to evaluate the effect of lanreotide, a somatostatin analogue, on the movements of water and ions in the jejunum in man. 2 Accordingly, 10 healthy volunteers (age 18-35 years, mean 27) and two patients with AIDS (26 and 33 years) suffering from water diarrhoea (>800ml day-') underwent intestinal perfusion using a four lumen tube with proximal occluding balloon. The segment tested was 25cm long. The jejunum was infused by an isotonic control saline solution containing polyethylene glycol (PEG) as nonabsorbable marker. Basal jejunal secretions were measured in all subjects. Prostaglandin El (PGE,) was administered intraluminally to stimulate jejunal secretion in healthy volunteers. The effect of intravenous lanreotide on the jejunal PGE,-induced secretions of water and electrolytes was analysed in healthy subjects and on the basal secretions in AIDS patients. Each period was analyzed on the basis of three (10 min) successive intestinal juice collections after 20-30 min equilibration time. The antisecretory effect of lanreotide was evaluated in each subject as the difference between fluxes compared to the control period. 3 In healthy volunteers, PGE, induced secretion of H,O, Na', K + and C1-in the jejunum and lanreotide reduced significantly PGE,-induced response. In both AIDS patients basal fluxes of water and ions were reduced by lanreotide in a dose-dependent manner. 4 Somatostatin can reduce stimulated-jejunal secretion of ions and water in normal subjects and may improve water diarrhoea in AIDS patients.

Gastrointestinal Endoscopy, 2000

Introduction . Gastric lymphomas represent the 3 to 10% of the gastric neoplasms. Endoscopic Ultr... more Introduction . Gastric lymphomas represent the 3 to 10% of the gastric neoplasms. Endoscopic Ultrasonography (EUS) is today the gold standard to evaluate the gastric wall, allowing the reliable measurement of the wall thickness, tumor extension and peri gastric node involvement. These characteristics make this tool the first choice to follow up the response of patients with gastric lymphoma under treatment. The main objective of this study was to prospectively evaluate the utility of EUS in the follow up of patients with superficial involvement of low grade MALT gastric lymphoma (mucosa associated lymphoid tissue) under treatement for Helicobacter pylori. Methods .The study was conducted at the Clinica Reina Sofia a tertiary care center. The inclusion criteria were patients with histology and immuno histochemistry diagnosis of low grade MALT gastric lymphoma with superficial involvement (no deeper than submucosa layer and without node involvement). EUS was performed before and on the 3rd, 6th, 9th, 12th, and 18th month after antibiotic treatment with claritromicin, amoxacilin and lansoprazol for Helicobacter pylori eradication. The main outcome variable was defined as the measurement of the tumor involvement of the gastric wall (in millimeters, normal value of 3 mm) by EUS on the specified times. At the same time, biopsy samples were taken. Results.The study period of time was 18 months; during this time, 14 patients were included in the study. The median of the gastric mucosa before treatment was 7 mm (range 3 - 9 mm). Two patients did not respond to the treatment and remained with the same gastric mucosa thickness and positive biopsy for the neoplasm. There was a significant reduction of the gastric mucosa thickness after the sixth month of treatment in 12 patients (85.7%), with a median of 4 mm. The tumor was not evident at the biopsy specimen in this group of patients and the eradication of the Helicobacter pylori was demonstrated. There was a good correlation between the EUS evaluation and the histological findings for tumor evidence and for Helicobacter pylori infection. Conclusions : The results of the present study showed that EUS is a useful tool for the diagnosis and follow up of patients with low grade MALT gastric lymphoma with superficial involvement. There was a good correlation between H pylori eradication, gastric mucosa thickness reduction by EUS and histopathological findings.

Gastrointestinal Endoscopy, 2002

David B. Páramo-Hernández, MD,1 Rosario Albis, MD, MSc,1 María T. Galiano, MD,1 Belén de Molano, ... more David B. Páramo-Hernández, MD,1 Rosario Albis, MD, MSc,1 María T. Galiano, MD,1 Belén de Molano, MD,1 Reynaldo Rincón, MD,1 Luis F. Pineda-Ovalle, MD,1 Alberto Rodríguez, MD,1 William Otero Regino, MD,1 Albis Hani, MD,1 Luis Carlos Sabbagh, MD,1 Carolina Sandoval-Salinas, MSc,1 Ricardo Sánchez-Pedraza, MD, MSc,1 Prevalence of Gastro-Esophageal Reflux Symptoms and Associated Factors: A Population Survey in the Principal Cities Of Colombia

Objective: To provide a clinical practice guideline with the latest evidence for diagnosis and tr... more Objective: To provide a clinical practice guideline with the latest evidence for diagnosis and treatment of nonalcoholic fatty liver disease for patients, caregivers, administrative and government bodies at all levels of care in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated about quality and applicability. One guideline met the criteria for adaptation, so the group decided to adapt 3 clinical questions. Systematic literature searches were conducted by the Cochrane Group. The tables of evidence and recommendations were made based on the GRADE methodology. The recommendations of the guide were socialized in a meeting of experts w...

Resumen Objetivo: brindar una guia de practica clinica con la evidencia mas reciente para el uso ... more Resumen Objetivo: brindar una guia de practica clinica con la evidencia mas reciente para el uso de ultrasonido en -doscopico en pancreatitis cronica y lesiones quisticas y s olidas en adultos, la cual esta dirigida a pacientes, personal asistencial, administrativo y entes gubernamentales de los servicios de atencion en Colombia.Materiales y metodos: esta guia fue desarrollada por un equipo multidisciplinario con apoyo de la Asociacion Colombiana de Gastroenterologia, el Grupo Cochrane ITS y el Instituto de Investigaciones Clinicas de la Universidad Nacional de Colombia. Se desarrollaron preguntas clinicas relevantes y se realizo la busqueda de guias nacionales e internacionales en bases de datos especializadas. Las guias existentes fueron evaluadas en terminos de calidad y aplicabilidad; ninguna de ellas cumplio con el criterio de adapta -cion, por lo que se decidio construir una guia de novo . El Grupo Cochrane realizo la busqueda sistematica de la literatura. Las tablas de eviden...

Esophageal herpes viral infections are rare condition that have been reported most frequently in ... more Esophageal herpes viral infections are rare condition that have been reported most frequently in immuno-FRPSURPLVHGSDWLHQWV7KLVLQIHFWLRQSULPDULO\DIIHFWVSDWLHQWVZLWKKXPDQLPPXQRGH?FLHQF\YLUXV +,9 DQGpatients receiving immunosuppressants or chemotherapy. The severity of symptoms is related to the degree of esophageal involvement. Odynophagia is the most common clinical presentation while the most common HQGRVFRSLF?QGLQJLVPXOWLSOHZHOOFLUFXPVFULEHGXOFHUV7KHVHW\SLFDOO\RFFXULQWKHGLVWDOWKLUGRIWKHHVRSKD-gus. Standard treatment is oral acyclovir for one to two weeks. Keywords +HUSHVHVRSKDJLWLVKHUSHVVLPSOH[YLUXVW\SH,LPPXQRVXSSUHVVLRQ Case report INTRODUCTION Infectious esophagitis is relatively uncommon, but it can lead to increased morbidity and mortality in immune com -promised when it is not accurately diagnosed (1). This con -dition is most often seen in immunocompromised patients whose resistance has been altered by various conditions (1, 2). Immune deficiencies, malignancies, sever...

Today endoscopic ultrasound (EUS) is the most sensitive test for early diagnosis of chronic pancr... more Today endoscopic ultrasound (EUS) is the most sensitive test for early diagnosis of chronic pancreatitis. Early diagnosis of this disease is of fundamental i...

The main causes of upper digestive tract bleeding are ulcers in the stomach and/or duodenum (pept... more The main causes of upper digestive tract bleeding are ulcers in the stomach and/or duodenum (peptic ulcer disease). With increasing frequency, patients are being seen who have bleeding gastric varices. This may be due to the increasing number of patients who have portal hypertension caused in turn by liver problems, especially cirrhosis. Current options for treatment of gastric varices range include preventive and prophylactic methods. These include therapy using drugs including vasopressin, somatostatin and their analogs, transjugular intrahepatic portosystemic shunts (TIPS) endoscopic methods and surgery. Endoscopic methods include the use of bands and injection sclerotherapy and sealants such as N-Butyl-2-cyanoacrylate (Histoacryl ®). Recently, on the basis of literature with increasingly higher levels of evidence and recommendations, we have started using cyanoacrylate at the Clínica Universitaria Colombia. We present our cases and we review the issue.

Revista Portuguesa De Pneumologia, 2011

Heterotopic pancreatic tissue in the stomach is an uncommon gastric subepithelial lesion. Is usua... more Heterotopic pancreatic tissue in the stomach is an uncommon gastric subepithelial lesion. Is usually an asymptomatic condition which is found incidentally. As with other gastric subepithelial lesions, diagnosis can be challenging. Endoscopic forceps biopsy specimens are of little value. Endoscopic ultrasound findings are helpful in characterize this lesions, but they cannot absolutely determine the type of lesion or whether a lesion is benign or malignant. The sequence endosonography- cap assisted endoscopic mucosal resection allows en bloc resection of small gastric subepithelial lesions with low complication rates. We report a case of an ectopic pancreas of the antrum in the stomach that arises from the second layer of the gastric wall (muscularis mucosa) at endoscopic ultrasound that was removed en bloc with cap-assisted endoscopic mucosal resection technique in one endoscopic session without complications.

Resumen Objetivo: con la evidencia mas reciente, desarrollar una guia de practica clinica para el... more Resumen Objetivo: con la evidencia mas reciente, desarrollar una guia de practica clinica para el manejo de dispepsia dirigida a pacientes, personal asistencial, administrativo y entes gubernamentales de cualquier servicio de atencion en Colombia.Materiales y metodos: esta guia fue desarrollada por un equipo multidisciplinario con el apoyo de la Asociacion Colombiana de Gastroenterologia, el Grupo Cochrane ITS y el Instituto de Investigaciones Clinicas de la Universidad Nacional de Colombia. Se desarrollaron preguntas clinicas relevantes y se realizo la busqueda de guias nacionales e internacionales en bases de datos especializadas. Las guias existentes fueron evaluadas en terminos de calidad y aplicabilidad; una guia cumplio con el criterio de adaptacion, por lo que se adaptaron 2 de sus preguntas. El Grupo Cochrane realizo la busqueda sistematica de la literatura. Las tablas de evidencia y recomendaciones fueron realizadas con base en la metodologia GRADE. Las recomen -daciones de...

Objective: To provide an evidence-based clinical practice guideline for the screening of colon an... more Objective: To provide an evidence-based clinical practice guideline for the screening of colon and rectal cancer for patients, caregivers, administrative and government bodies at all levels of care in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated for quality and applicability. None of the guidelines met the criteria for adaptation, so the group decided to develop a de novo guideline. Systematic literature searches were conducted by the Cochrane Group. The tables of evidence and recommendations were made based on the GRADE methodology. The recommendations of the guide were socialized in a meeting of experts with government agenc...

Objective: To provide an evidence-based clinical practice guideline for detection, diagnosis and ... more Objective: To provide an evidence-based clinical practice guideline for detection, diagnosis and treatment of early gastric cancer considering the efficacy and safety and interventions for patients, caregivers, administrative and government bodies at all levels of care in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated quality and usability. None of the guidelines met criteria for adaptation, so the group decided to develop a de novo guideline. Systematic literature searches were conducted by Cochrane STI. The tables of evidence and recommendations were developed based on the GRADE approach. Results: A Clinical Practice Guideline...

Objective: Design a clinical practice guideline to orient the diagnosis and establishing the clas... more Objective: Design a clinical practice guideline to orient the diagnosis and establishing the classification and pharmacological and non-pharmacological treatment in adult patients with chronic functional constipation in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated for quality and applicability. None of the guidelines met the criteria for adaptation, so the group decided to develop a de novo guideline. Systematic literature searches were conducted by the Cochrane Group. The tables of evidence and recommendations were made based on the GRADE methodology. Results: A clinical practice based on evidence was developed for the diagno...