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| 1 | Management of nonalcoholic fatty liver disease:An evidence-based clinical practice review显示文摘AIM:To build a consensus among Chilean specialists on the appropriate management of patients with nonalcoholic fatty liver disease(NAFLD)in clinical practice.METHODS:NAFLD has now reached epidemic proportions worldwide.The optimal treatment for NAFLD has not been established due to a lack of evidence-based recommendations.An expert panel of members of the Chilean Gastroenterological Society and the Chilean Hepatology Association conducted a structured analysis of the current literature on NAFLD therapy.The quality of the evidence and the level of recommendations supporting each statement were assessed according to the recommendations of the United States Preventive Services Task Force.A modified three-round Delphi technique was used to reach a consensus among the experts.RESULTS:A group of thirteen experts was established.The survey included 17 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 93.8%in the first round and 100%in the second and third rounds.The final recommendations support the indication of lifestyle changes,including diet and exercise,for all patients with NAFLD.Proven pharmacological therapies include only vitamin E and pioglitazone,which can be used in nondiabetic patients with biopsy-proven nonalcoholic steatohepatitis(the progressive form of NAFLD),although the long-term safety and efficacy of these therapies have not yet been established.CONCLUSION:Current NAFLD management is rapidly evolving,and new pathophysiology-based therapies are expected to be introduced in the near future.All NAFLD patients should be evaluated using a three-focused approach that considers the risks of liver disease,diabetes and cardiovascular events. | Juan P Arab Roberto Candia Rodrigo Zapata Cristián Mu?oz Juan P Arancibia Jaime Poniachik Alejandro Soza Francisco Fuster Javier Brahm Edgar Sanhueza Jorge Contreras M Carolina Cuellar Marco Arrese Arnoldo Riquelme | 2014 | World Journal of Gastroenterology2014，20，34： | 11 |
| 2 | Optimal length of triple therapy for H pylori eradication in a population with high prevalence of infection in Chile显示文摘AIM:To compare the efficacy of 7-d versus 14-d triple therapy for the treatment of H pylori infection in Chile,with a prevalence of 73% in general population. METHODS:H pylori-infected patients diagnosed by rapid urease test,with non-ulcer dyspepsia or peptic ulcer disease were randomized to receive omeprazole 20 mg bid,amoxicillin 1 g bid,and clarithromycin 500 mg bid for 7 (OAC7) or 14 (OAC14) d. Primary outcome was eradication rate 6 wk after the treatment. Subgroup analysis was carried out considering the eradication rate among patients with or without peptic ulcer disease and eradication rate among smokers or non-smokers. RESULTS:One hundred and thirty-one patients were randomized to OAC7 (n = 69) or OAC14 (n = 62). The overall eradication rate (intention-to-treat) was 78.3% in OAC7 and 85.5% in OAC14 groups,without a significant difference (P =0.37). No significant difference in the eradication rate was found among the patients with peptic ulcer disease (n = 31) between the OAC7 group (85.7%) and OAC14 group (87.5%). However,smokers had an obviously lower eradication rate compared to non-smokers,particularly in the OAC7 group (57.1% in smokers vs 83.6% in non-smokers; P = 0.06). Adverse effects rate were similar between both groups. CONCLUSION:Short-term efficacy of triple therapy with OAC for 7 d is comparable to 14 d in this high-prevalence population. Longer follow-up,and studies focused to some subgroups of patients (smokers and non-ulcerpatients) are necessary to support widespread use of 7-d instead of 10-14-d triple therapy in a developing country like Chile. | Arnoldo Riquelme Alejandro Soza Cesar Pedreros Andrea Bustamante Felipe Valenzuela Francisco Otarola Eduardo Abbott Marco Arellano Brenda Medina Alejandro Pattillo Douglas Greig Marco Arrese Antonio Rollan | 2007 | World Journal of Gastroenterology2007，13，21： | 3 |
| 3 | High prevalence of hepatic steatosis and vascular thrombosis in COVID-19:A systematic review and meta-analysis of autopsy data显示文摘BACKGROUND Coronavirus disease 2019(COVID-19)disease can frequently affect the liver.Data on hepatic histopathological findings in COVID-19 is scarce.AIM To characterize hepatic pathological findings in patients with COVID-19.METHODS We conducted a systematic review with meta-analysis registered on PROSPERO(CRD42020192813),following PRISMA guidelines.Eligible trials were those including patients of any age and COVID-19 diagnosis based on a molecular test.Histopathological reports from deceased COVID-19 patients undergoing autopsy or liver biopsy were reviewed.Articles including less than ten patients were excluded.Proportions were pooled using random-effects models.Q statistic and I2 were used to assess heterogeneity and levels of evidence,respectively.RESULTS We identified 18 studies from 7 countries;all were case reports and case series from autopsies.All the patients were over 15 years old,and 67.2%were male.We performed a meta-analysis of 5 studies,including 116 patients.Pooled prevalence estimates of liver histopathological findings were hepatic steatosis 55.1%[95%confidence interval(CI):46.2-63.8],congestion of hepatic sinuses 34.7%(95%CI:7.9-68.4),vascular thrombosis 29.4%(95%CI:0.4-87.2),fibrosis 20.5%(95%CI:0.6-57.9),Kupffer cell hyperplasia 13.5%(95%CI:0.6-54.3),portal inflammation 13.2%(95%CI:0.1-48.8),and lobular inflammation 11.6%(95%CI:0.3-35.7).We also identified the presence of venous outflow obstruction,phlebosclerosis of the portal vein,herniated portal vein,periportal abnormal vessels,hemophagocytosis,and necrosis.CONCLUSION We found a high prevalence of hepatic steatosis and vascular thrombosis as major histological liver features.Other frequent findings included portal and lobular inflammation and Kupffer cell hyperplasia or proliferation.Further studies are needed to establish the mechanisms and implications of these findings. | Luis Antonio Díaz Francisco Idalsoaga Macarena Cannistra Roberto Candia Daniel Cabrera Francisco Barrera Alejandro Soza Rondell Graham Arnoldo Riquelme Marco Arrese Michael D Leise Juan Pablo Arab | 2020 | World Journal of Gastroenterology2020，26，48： | 3 |
| 4 | Predictors of Nonalcoholic Steatohepatitis (NASH) in Obese Patients Undergoing Gastric Bypass显示文摘 | Camilo Boza MD Arnoldo Riquelme MD Luis Iba?ez MD Ignacio Duarte MD Enrique Norero MD Paola Viviani MD Alejandro Soza MD Jose Ignacio Fernandez MD Alejandro Raddatz MD Sergio Guzman MD Marco Arrese MD | 2005 | Obesity Surgery2005，，8： | 1 |
| 5 | Predictors of Nonalcoholic Steatohepatitis (NASH) in Obese Patients Undergoing Gastric Bypass显示文摘 | Camilo Boza MD Arnoldo Riquelme MD Luis Iba?ez MD Ignacio Duarte MD Enrique Norero MD Paola Viviani MD Alejandro Soza MD Jose Ignacio Fernandez MD Alejandro Raddatz MD Sergio Guzman MD Marco Arrese MD | 2005 | Obesity Surgery2005，，8： | 1 |
| 6 | Increased Orocecal Transit Time in Patients with Nonalcoholic Fatty Liver Disease显示文摘 | Alejandro Soza MD Arnoldo Riquelme MD Robinson González MD Manuel Alvarez MD Rosa María Pérez-ayuso MD Juan Carlos Glasinovic MD Marco Arrese MD | 2005 | Digestive Diseases and Sciences2005，，6： | 1 |
| 7 | Associations of chemokine system polymorphisms with clinical outcomes and treatment responses of chronic hepatitis C显示文摘 | Kittichai Promrat David H. McDermott Carlos M. Gonzalez David E. Kleiner Deloris E. Koziol Matthew Lessie Maya Merrell Alejandro Soza Theo Heller Marc Ghany Yoon Park Harvey J. Alter Jay H. Hoofnagle Philip M. Murphy T.Jake Liang | 2003 | Gastroenterology2003，，2： | 1 |
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