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10 results on '"Martha Arevalo-Mora"'

1. Cholangioscopy-based convoluted neuronal network vs. confocal laser endomicroscopy in identification of neoplastic biliary strictures

Author

Carlos Robles-Medranda, Jorge Baquerizo-Burgos, Miguel Puga-Tejada, Domenica Cunto, Maria Egas-Izquierdo, Juan Carlos Mendez, Martha Arevalo-Mora, Juan Alcivar Vasquez, Hannah Lukashok, and Daniela Tabacelia

Subjects
Pancreatobiliary (ERCP/PTCD), Cholangioscopy, Tissue diagnosis, Strictures, Diseases of the digestive system. Gastroenterology, RC799-869
Published
2024
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2. Outcomes of lumen apposing metal stent placement in patients with surgically altered anatomy: Multicenter international experience

Author

Benedetto Mangiavillano, Daryl Ramai, Michel Kahaleh, Amy Tyberg, Haroon Shahid, Avik Sarkar, Jayanta Samanta, Jahnvi Dhar, Michiel Bronswijk, Schalk Van der Merwe, Abdul Kouanda, Hyun Ji, Sun-Chuan Dai, Pierre Deprez, Jorge Vargas-Madrigal, Giuseppe Vanella, Roberto Leone, Paolo Giorgio Arcidiacono, Carlos Robles-Medranda, Juan Alcivar Vasquez, Martha Arevalo-Mora, Alessandro Fugazza, Christopher Ko, John Morris, Andrea Lisotti, Pietro Fusaroli, Amaninder Dhaliwal, Massimiliano Mutignani, Edoardo Forti, Irene Cottone, Alberto Larghi, Gianenrico Rizzatti, Domenico Galasso, Carmelo Barbera, Francesco Maria Di Matteo, Serena Stigliano, Cecilia Binda, Carlo Fabbri, Khanh Do-Cong Pham, Roberto Di Mitri, Michele Amata, Stefano Francesco Crinó, Andrew Ofosu, Luca De Luca, Abed Al-Lehibi, Francesco Auriemma, Danilo Paduano, Federica Calabrese, Carmine Gentile, Cesare Hassan, Alessandro Repici, and Antonio Facciorusso

Subjects
Endoscopy Lower GI Tract, Stenting, Endoscopy Small Bowel, Endoscopic ultrasonography, Diseases of the digestive system. Gastroenterology, RC799-869
Published
2024
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3. Correction: Outcomes of lumen apposing metal stent placement in patients with surgically altered anatomy: Multicenter international experience

Author

Benedetto Mangiavillano, Daryl Ramai, Michel Kahaleh, Amy Tyberg, Haroon Shahid, Avik Sarkar, Jayanta Samanta, Jahnvi Dhar, Michiel Bronswijk, Schalk Van der Merwe, Abdul Kouanda, Hyun Ji, Sun-Chuan Dai, Pierre Deprez, Jorge Vargas-Madrigal, Giuseppe Vanella, Roberto Leone, Paolo Giorgio Arcidiacono, Carlos Robles-Medranda, Juan Alcivar Vasquez, Martha Arevalo-Mora, Alessandro Fugazza, Christopher Ko, John Morris, Andrea Lisotti, Pietro Fusaroli, Amaninder Dhaliwal, Massimiliano Mutignani, Edoardo Forti, Irene Cottone, Alberto Larghi, Gianenrico Rizzatti, Domenico Galasso, Carmelo Barbera, Francesco Maria Di Matteo, Serena Stigliano, Cecilia Binda, Carlo Fabbri, Khanh Do-Cong Pham, Roberto Di Mitri, Michele Amata, Stefano Francesco Crinó, Andrew Ofosu, Luca De Luca, Abed Al-Lehibi, Francesco Auriemma, Danilo Paduano, Federica Calabrese, Carmine Gentile, Cesare Hassan, Alessandro Repici, and Antonio Facciorusso

Subjects
Diseases of the digestive system. Gastroenterology, RC799-869
Published
2024
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5. Impact of Antibiotic Prophylaxis on Infection Rate after Endoscopic Ultrasound Through-the-Needle Biopsy of Pancreatic Cysts: A Propensity Score-Matched Study

Author

Antonio Facciorusso, Martha Arevalo-Mora, Maria Cristina Conti Bellocchi, Laura Bernardoni, Daryl Ramai, Paraskevas Gkolfakis, Domenico Loizzi, Nicola Muscatiello, Antonio Ambrosi, Nicola Tartaglia, Carlos Robles-Medranda, Elisa Stasi, Andrew Ofosu, and Stefano Francesco Crinò

Subjects
endoscopic ultrasound, through-the-needle biopsy, pancreas, antibiotics, Medicine (General), R5-920
Abstract

Background: Despite weak evidence, antibiotic prophylaxis prior to endoscopic ultrasound-guided through-the-needle biopsy (EUS-TTNB) of pancreatic cystic lesions (PCLs) is routinely used in clinical practice. We aim to compare a group of patients treated with antibiotics before EUS-TTNB of PCLs and a group who did not undergo antimicrobial prophylaxis. Methods: Out of 236 patients with pancreatic cystic lesions referred to two high-volume centers between 2016 and 2021, after propensity score matching, two groups were compared: 98 subjects who underwent EUS-TTNB under antibiotic prophylaxis and 49 subjects without prophylaxis. Results: There was no difference in terms of baseline parameters between groups. Final diagnosis was serous cystadenoma in 36.7% of patients in the group not treated with prophylaxis and in 37.7% of patients in the control group, whereas IPMN and mucinous cystadenoma were diagnosed in 3 (6.1%) and 16 (32.6%) versus 6 (6.1%) and 32 (32.6%) patients in the two groups, respectively (p = 0.23). Overall, the adverse event rate was 6.1% in the group not treated with antibiotic prophylaxis and 5.1% in the control group (p = 0.49). Only a single infectious adverse event occurred in each group (p = 0.48). The diagnostic yields were 89.7% and 90.8% in the two groups (p = 0.7), and the diagnostic accuracy rate was 81.6% in both groups (p = 1.0). Conclusions: Prophylactic antibiotics do not seem to influence the risk of infection, and their routine use should be discouraged.

Published
2022
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6. ENDOSCOPIC ULTRASOUND GUIDED GALLBLADDER DRAINAGE VERSUS PERCUTANEOUS DRAINAGE IN PATIENTS WITH ACUTE CHOLECYSTITIS UNDERGOING ELECTIVE CHOLECYSTECTOMY

Author

Amy, Tyberg, Rodrigo, Duarte-Chavez, Haroon M, Shahid, Avik, Sarkar, Alexa, Simon, Sardar M, Shah-Khan, Monica, Gaidhane, Tayyaba F, Mohammad, John, Nosher, Susannah S, Wise, Victoria, Needham, Marin, Kheng, Michael, Lajin, Badal, Sojitra, Bryan, Wey, Shivangi, Dorwat, Hameed, Raina, Jaseem, Ansari, Ashish, Gandhi, Amol, Bapaye, Sardar M, Shah-Khan, Matthew R, Krafft, Shyam, Thakkar, Shailendra, Singh, Janele R, Bane, John Y, Nasr, David P, Lee, Prashant, Kedia, Martha, Arevalo-Mora, Raquel S, Del Valle, Carlos, Robles-Medranda, Miguel, Puga-Tejada, Giuseppe, Vanella, Jose Celso, Ardengh, Mohammad, Bilal, DellʼAnna, Giuseppe, Paolo G, Arcidiacono, and Michel, Kahaleh

Published
2023
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7. Prophylactic EUS-guided gallbladder drainage prevents acute cholecystitis in patients with malignant biliary obstruction and cystic duct orifice involvement: a randomized trial (with video)

Author

Carlos, Robles-Medranda, Roberto, Oleas, Miguel, Puga-Tejada, Juan, Alcivar-Vasquez, Raquel, Del Valle, Juan, Olmos, Martha, Arevalo-Mora, Maria, Egas-Izquierdo, Daniela, Tabacelia, Jorge, Baquerizo-Burgos, and Hannah, Pitanga-Lukashok

Subjects
Gastroenterology, Radiology, Nuclear Medicine and imaging
Abstract

Patients with distal malignant biliary obstruction (MBO) and cystic duct orifice tumoral involvement have an increased risk of developing acute cholecystitis following self-expandable metallic stent (SEMS) placement. We aimed to determine whether primary endoscopic ultrasound (EUS)-guided gallbladder drainage prevents the occurrence of acute cholecystitis in these patients.This was a single-center, randomized control trial in patients with distal MBO enrolled from July 2018 to July 2020. Patients were randomized into two groups: an interventional group, treated with conventional ERCP biliary drainage with SEMS placement and subsequent primary EUS-guided gallbladder drainage (EUS-GBD), and a control group, treated with conventional biliary drainage alone. The primary outcome of the study was the occurrence of posttreatment acute cholecystitis, assessed for up to 12 months or until death. The secondary outcomes were the hospitalization length and median survival time.Forty-four patients were included in the study: 22 in each group. Five in the control group (22.7%) and none in the intervention group developed acute cholecystitis. The median hospitalization time was significantly lower in the interventional group than in the control group (2 days vs. 1 day, P=0.017). There was no difference in the observed survival rates median for the primary EUS-guided gallbladder drainage group (2.9 months) and control group (2.8 months) (P=0.580).In this single center study of patients with unresectable MBO and occlusion of the cystic duct orifice, prophylactic EUS-guided gallbladder drainage demonstrated a reduced incidence of acute cholecystitis.

Published
2023
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8. Artificial intelligence for diagnosing neoplasia on digital cholangioscopy: development and multicenter validation of a convolutional neural network model

Author

Carlos Robles-Medranda, Jorge Baquerizo-Burgos, Juan Alcivar-Vasquez, Michel Kahaleh, Isaac Raijman, Rastislav Kunda, Miguel Puga-Tejada, Maria Egas-Izquierdo, Martha Arevalo-Mora, Juan C. Mendez, Amy Tyberg, Avik Sarkar, Haroon Shahid, Raquel del Valle-Zavala, Jorge Rodriguez, Ruxandra C. Merfea, Jonathan Barreto-Perez, Gabriela Saldaña-Pazmiño, Daniel Calle-Loffredo, Haydee Alvarado, and Hannah P. Lukashok

Subjects
Gastroenterology
Abstract

Background We aimed to develop a convolutional neural network (CNN) model for detecting neoplastic lesions during real-time digital single-operator cholangioscopy (DSOC) and to clinically validate the model through comparisons with DSOC expert and nonexpert endoscopists. Methods In this two-stage study, we first developed and validated CNN1. Then, we performed a multicenter diagnostic trial to compare four DSOC experts and nonexperts against an improved model (CNN2). Lesions were classified into neoplastic and non-neoplastic in accordance with Carlos Robles-Medranda (CRM) and Mendoza disaggregated criteria. The final diagnosis of neoplasia was based on histopathology and 12-month follow-up outcomes. Results In stage I, CNN2 achieved a mean average precision of 0.88, an intersection over the union value of 83.24 %, and a total loss of 0.0975. For clinical validation, a total of 170 videos from newly included patients were analyzed with the CNN2. Half of cases (50 %) had neoplastic lesions. This model achieved significant accuracy values for neoplastic diagnosis, with a 90.5 % sensitivity, 68.2 % specificity, and 74.0 % and 87.8 % positive and negative predictive values, respectively. The CNN2 model outperformed nonexpert #2 (area under the receiver operating characteristic curve [AUC]-CRM 0.657 vs. AUC-CNN2 0.794, P Conclusions The proposed CNN model distinguished neoplastic bile duct lesions with good accuracy and outperformed two nonexpert and one expert endoscopist.

Published
2023
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10. P- 45 ENDOSCOPIC ULTRASOUND SHEAR-WAVE ELASTOGRAPHY OF THE RIGHT AND LEFT HEPATIC LOBE PREDICTS LIVER CIRRHOSIS: A DIAGNOSTIC TRIAL

Author

Carlos Robles-Medranda, Raquel Del Valle Zavala, Miguel Puga-Tejada, Martha Arévalo-Mora, Jorge Baquerizo-Burgos, Gabriela Egas-Izquierdo, Daniela Tabacelia, Roberto Oleas, Fernanda Dal Bello, Juan Alcivar-Vasquez, Haydee Alvarado, Carlos Cifuentes, and Hannah Pitanga-Lukashok

Subjects
Specialties of internal medicine, RC581-951
Abstract

Introduction and Objectives: The diagnostic work-up of chronic liver disease includes less invasive procedures such as transient elastography (TE), abdominal ultrasonography, esophagogastroduodenoscopy, and more invasive procedures, mainly portal gradient pressure measurement and liver biopsy. Endoscopic ultrasound (EUS) recently included shear-wave elastography (tissue elasticity), defined as the elastic modulus by measuring shear-wave velocity. This study aimed to evaluate EUS shear-wave of the liver to predict liver cirrhosis. Materials and Methods: a single-center, diagnostic cohort study. Consecutive patients with a history of chronic liver disease were evaluated with an EUS shear-wave elastography of the right and left hepatic lobes. Patients without any medical condition history despite subepithelial lesions were included as a control. A TE was performed to study and control patients to correlate with elastography. We calculated the overall accuracy of EUS shear-wave elastography of the liver in the prediction of liver cirrhosis. Results: Among the 28 patients included, 14 had liver cirrhosis. Baseline data is described in table 1. EUS shear-wave elastography of the right hepatic lobe has a direct, proportional and significant correlation (r=0.693 [95% CI 0.431 – 0.847; P

Published
2023
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