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Papers by Ricardo Figueredo

Research paper thumbnail of Guía de práctica clínica tamizaje colorrectal en personas de riesgo promedio basado en TSOMFI

Research paper thumbnail of Does Roux-en-Y Gastric Bypass Really Cure Gastroesophageal Reflux Disease? Analysis of Objective Data

Journal of Laparoendoscopic & Advanced Surgical Techniques, 2021

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is considered the treatment of choice f... more Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is considered the treatment of choice for obesity with gastroesophageal reflux disease (GERD). There are few reports showing objective data based on esophageal function tests (EFTs). The aim of our study was to evaluate the influence of LRYGB on GERD. Methods: Candidates for laparoscopic sleeve gastrectomy (LSG) underwent preoperative esophageal manometry (EM) and 24-hour pH monitoring. Based on the negative influence of LSG on GERD, patients with abnormal pH were offered LRYGB. Those patients repeated EFTs, esophagogastroduodenoscopy, and symptom questionnaire 1 year after surgery. Results: Two hundred fifty LSG candidates underwent preoperative EFTs; 38% were redirected to LRYGB due to abnormal pH and 13 (18%) completed EFTs postoperatively. In ten women, age: 40-7 years, body mass index: 41-1 kg/m 2. EM: lower esophageal sphincter (LES) length increased from 2.6 to 2.9 cm (P = not statistically significant [NS]), and LES pressure decreased from 15 to 14.2 mmHg (P = NS). Preoperatively, LES was normotensive in 12 (92%) patients and postoperatively in 11 (85%) (P = NS). DeMeester score decreased from 35.7 to 11 (P < .001). Postoperatively, 9 (69%) patients resolved their GERD, 3 (23%) improved, and 1 (8%) remained the same (P < .001). Symptoms decreased significantly after surgery. Two patients (15%) had Grade A esophagitis. One of them was able to resolve it, while the other 1 remained the same. Conclusions: Our preliminary data showed that after LRYGB, LES pressure remained the same and DeMeester score decreased, while 69% of patients resolved their GERD. Therefore, LRYGB seems to be an excellent option for obesity and GERD.

Research paper thumbnail of Low Risk of COVID-19 Infection in an Ambulatory Gastrointestinal Endoscopy Center in Argentina

Acta gastroenterológica latinoamericana, 2021

Background and Objectives. Since the onset of the COVID-19 pandemic, concerns have been raised re... more Background and Objectives. Since the onset of the COVID-19 pandemic, concerns have been raised regarding the risk of infection to both healthcare staff and patients during gastrointestinal endoscopy procedures. Given the importance of performing routine endoscopic procedures to an individual’s future health, we sought to estimate the risk of COVID-19 infection for healthcare staff and patients undergoing endoscopic studies at an ambulatory endoscopy center during the pandemic. Material and Methods. This is a prospective(and) analytical cohort study conducted in an ambulatory gastroenterology center located in the Autonomous City of Buenos Aires, Argentina. Patients undergoing different endoscopic procedures were evaluated for COVID-19 between April 14 and August 31, 2020. COVID-19 was also evaluated in all healthcare and associated staff during the same time period. The risk (cumulative incidence) of acquiring COVID-19 in all patients and staff was calculated. Results. Between April...

Research paper thumbnail of Su1665 Adenomas' Detection in Patients Under Post-Surgical Surveillance for Colon Cancer

Gastrointestinal Endoscopy, 2017

Research paper thumbnail of Tu1417 Prevalence of Serrated Adenomas: Experience in a Large Volume Centre in Argentina

Gastrointestinal Endoscopy, 2014

Research paper thumbnail of Clinical practice guidelines: Recommendations for CRC screening in Argentinian population with average risk based on iFOBT

Clinical Epidemiology and Global Health, 2022

Colon cancer (CRC) screening is a cost-effective strategy. A group of experts and methodologists ... more Colon cancer (CRC) screening is a cost-effective strategy. A group of experts and methodologists addressed clinical questions to adapt recommendations and provide guidance for health care providers involved in the continuous care of individuals with average-risk for develop CRC. The development group focused on health system resources and implementation issues. Methods: Following PRISMA guidelines, we carried out a comprehensive systematic review and applied the GRADE-ADOLOPMENT tool. The selected guidelines were appraised through AGREE II tool. The certainty of evidence was rated using GRADE approach. Finally, we use the Evidence-to-Decision (EtD) frameworks providing by GRADE to discuss benefits and harms, values and preferences, feasibility, acceptability, and equity issues in Argentina to adopt, adapt and make de novo recommendations to the local setting. Results: Due to the absence of direct evidence, the panel made their recommendations on simulation models to determine how the screening strategies might affect the population outcomes. The certainty of all the available evidence was very low due to models' assumptions. Since the lack of data about CRC incidence in Argentina and the existing barriers, the panel did not suggest the beginning of screening before 50 years old. The panel highlighted the deficit of colonoscopy availability. Therefore, they suggest that the balance may favor using quantitative over qualitative iFOBT because of the higher specificity to detect CRC and the reduction in colonoscopy required. In our setting and considering adherence, the panel suggests that iFOBT being used annually rather than biannual driving an improvement on the loss of follow-up. Conclusions: The panel the panel did not suggest the beginning of screening before 50 years old, they suggest that the balance may favor using quantitative over qualitative iFOBT and annually iFOBT.

Research paper thumbnail of Tu1417 Prevalence of Serrated Adenomas: Experience in a Large Volume Centre in Argentina

Gastrointestinal Endoscopy, 2014

Research paper thumbnail of Guía de práctica clínica tamizaje colorrectal en personas de riesgo promedio basado en TSOMFI

Research paper thumbnail of Does Roux-en-Y Gastric Bypass Really Cure Gastroesophageal Reflux Disease? Analysis of Objective Data

Journal of Laparoendoscopic & Advanced Surgical Techniques, 2021

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is considered the treatment of choice f... more Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is considered the treatment of choice for obesity with gastroesophageal reflux disease (GERD). There are few reports showing objective data based on esophageal function tests (EFTs). The aim of our study was to evaluate the influence of LRYGB on GERD. Methods: Candidates for laparoscopic sleeve gastrectomy (LSG) underwent preoperative esophageal manometry (EM) and 24-hour pH monitoring. Based on the negative influence of LSG on GERD, patients with abnormal pH were offered LRYGB. Those patients repeated EFTs, esophagogastroduodenoscopy, and symptom questionnaire 1 year after surgery. Results: Two hundred fifty LSG candidates underwent preoperative EFTs; 38% were redirected to LRYGB due to abnormal pH and 13 (18%) completed EFTs postoperatively. In ten women, age: 40-7 years, body mass index: 41-1 kg/m 2. EM: lower esophageal sphincter (LES) length increased from 2.6 to 2.9 cm (P = not statistically significant [NS]), and LES pressure decreased from 15 to 14.2 mmHg (P = NS). Preoperatively, LES was normotensive in 12 (92%) patients and postoperatively in 11 (85%) (P = NS). DeMeester score decreased from 35.7 to 11 (P < .001). Postoperatively, 9 (69%) patients resolved their GERD, 3 (23%) improved, and 1 (8%) remained the same (P < .001). Symptoms decreased significantly after surgery. Two patients (15%) had Grade A esophagitis. One of them was able to resolve it, while the other 1 remained the same. Conclusions: Our preliminary data showed that after LRYGB, LES pressure remained the same and DeMeester score decreased, while 69% of patients resolved their GERD. Therefore, LRYGB seems to be an excellent option for obesity and GERD.

Research paper thumbnail of Low Risk of COVID-19 Infection in an Ambulatory Gastrointestinal Endoscopy Center in Argentina

Acta gastroenterológica latinoamericana, 2021

Background and Objectives. Since the onset of the COVID-19 pandemic, concerns have been raised re... more Background and Objectives. Since the onset of the COVID-19 pandemic, concerns have been raised regarding the risk of infection to both healthcare staff and patients during gastrointestinal endoscopy procedures. Given the importance of performing routine endoscopic procedures to an individual’s future health, we sought to estimate the risk of COVID-19 infection for healthcare staff and patients undergoing endoscopic studies at an ambulatory endoscopy center during the pandemic. Material and Methods. This is a prospective(and) analytical cohort study conducted in an ambulatory gastroenterology center located in the Autonomous City of Buenos Aires, Argentina. Patients undergoing different endoscopic procedures were evaluated for COVID-19 between April 14 and August 31, 2020. COVID-19 was also evaluated in all healthcare and associated staff during the same time period. The risk (cumulative incidence) of acquiring COVID-19 in all patients and staff was calculated. Results. Between April...

Research paper thumbnail of Su1665 Adenomas' Detection in Patients Under Post-Surgical Surveillance for Colon Cancer

Gastrointestinal Endoscopy, 2017

Research paper thumbnail of Tu1417 Prevalence of Serrated Adenomas: Experience in a Large Volume Centre in Argentina

Gastrointestinal Endoscopy, 2014

Research paper thumbnail of Clinical practice guidelines: Recommendations for CRC screening in Argentinian population with average risk based on iFOBT

Clinical Epidemiology and Global Health, 2022

Colon cancer (CRC) screening is a cost-effective strategy. A group of experts and methodologists ... more Colon cancer (CRC) screening is a cost-effective strategy. A group of experts and methodologists addressed clinical questions to adapt recommendations and provide guidance for health care providers involved in the continuous care of individuals with average-risk for develop CRC. The development group focused on health system resources and implementation issues. Methods: Following PRISMA guidelines, we carried out a comprehensive systematic review and applied the GRADE-ADOLOPMENT tool. The selected guidelines were appraised through AGREE II tool. The certainty of evidence was rated using GRADE approach. Finally, we use the Evidence-to-Decision (EtD) frameworks providing by GRADE to discuss benefits and harms, values and preferences, feasibility, acceptability, and equity issues in Argentina to adopt, adapt and make de novo recommendations to the local setting. Results: Due to the absence of direct evidence, the panel made their recommendations on simulation models to determine how the screening strategies might affect the population outcomes. The certainty of all the available evidence was very low due to models' assumptions. Since the lack of data about CRC incidence in Argentina and the existing barriers, the panel did not suggest the beginning of screening before 50 years old. The panel highlighted the deficit of colonoscopy availability. Therefore, they suggest that the balance may favor using quantitative over qualitative iFOBT because of the higher specificity to detect CRC and the reduction in colonoscopy required. In our setting and considering adherence, the panel suggests that iFOBT being used annually rather than biannual driving an improvement on the loss of follow-up. Conclusions: The panel the panel did not suggest the beginning of screening before 50 years old, they suggest that the balance may favor using quantitative over qualitative iFOBT and annually iFOBT.

Research paper thumbnail of Tu1417 Prevalence of Serrated Adenomas: Experience in a Large Volume Centre in Argentina

Gastrointestinal Endoscopy, 2014