Publications by authors named "Alejandro Piscoya"

We systematically evaluated effects of Mediterranean diets (MED) on cardiovascular (CV) disease and risk factors in overweight or obese adults. Five engines and two registries were searched until October 2023 for randomized controlled trials (RCTs) evaluating any type of MED compared to other diets or advice in adults. Outcomes of interest were clinical outcomes and CV risk factors (anthropometric, lipids, blood pressure, glucose metabolism, liver function).

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Emerging in the 1800s under the label "fat in the liver" and later gaining prominence in the 1980 as non-alcoholic fatty liver disease (NAFLD), the disease predominantly attributed to metabolic dysfunction presents a formidable health issue marked by substantial morbidity and mortality. It was 2020 when a change of one letter "NAFLD" to metabolic dysfunction-associated fatty liver disease "MAFLD" linked with the change in the definition and diagnostic criteria began a new controversy around the globe. Metabolic dysfunction-associated fatty liver disease (MAFLD) criteria represent a substantial departure from previous diagnostic measures of NAFLD, and provide the first set of positive criteria for diagnosis of the disease in adults and children that emphasise the key attribute of metabolic dysfunction in the pathogenesis, and acknowledges that the disease is a continuum across the life span.

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  • The study aimed to assess the effectiveness of scheduled second-look endoscopy compared to a single endoscopy for treating patients with acute peptic ulcer bleeding (PUB).
  • Researchers reviewed multiple databases for randomized controlled trials, focusing on outcomes like rebleeding, surgery needs, mortality rates, and blood transfusions.
  • Results indicated no significant differences in rebleeding rates or other outcomes between the two methods, leading to the conclusion that routine second-look endoscopy does not offer additional benefits over single endoscopy for PUB patients.
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  • A systematic review and meta-analysis was conducted to evaluate the effectiveness and safety of ivermectin in treating early COVID-19 in non-hospitalized patients, using data from five databases up to October 2023.
  • The analysis included 12 randomized controlled trials with over 7,000 adult patients, comparing ivermectin to standard care, placebo, or other active drugs, focusing on outcomes like hospitalization, mortality, adverse events, and clinical improvement.
  • The findings indicated that ivermectin did not significantly reduce hospitalization, mortality, or adverse events compared to control groups, leading to the conclusion that it should not be recommended for treating non-hospitalized COVID-19 patients.
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Background & Aims: Barrett's esophagus (BE) is the precursor to esophageal adenocarcinoma (EAC). Endoscopic eradication therapy (EET) can be effective in eradicating BE and related neoplasia and has greater risk of harms and resource use than surveillance endoscopy. This clinical practice guideline aims to inform clinicians and patients by providing evidence-based practice recommendations for the use of EET in BE and related neoplasia.

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  • Vegetarian diets (VDs) have been systematically assessed to determine their impact on individuals with overweight and obesity, focusing on weight, metabolism, and blood pressure outcomes.
  • Results show that VDs resulted in a significant reduction in weight and fasting glucose levels, but did not significantly affect waist circumference, body mass index, or blood pressure.
  • The overall quality of evidence was rated very low, indicating a need for further large-scale randomized controlled trials to provide clearer insights into the effects of vegetarian diets on health outcomes.
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Endoscopy is a competitive field in clinical practice, in which skilled endoscopists are in high demand. The learning process for Junior Gastrointestinal Endoscopists (JGEs) is difficult, quite long, and technically demanding. This directs JGEs to seek additive learning sources, including online sources.

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Background: Clinical trials evaluating the effect of probiotics on cardiovascular intermediate outcomes have been scarce in recent years. We systematically evaluated the efficacy of probiotics on intermediate cardiovascular outcomes in patients with overweight or obesity.

Methods: We searched for randomized controlled trials (RCTs) in four databases (until August 2021) that evaluated the effects of probiotics versus controls on intermediate cardiovascular outcomes.

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Background: Endoscopic submucosal dissection (ESD) is now considered the standard treatment for early gastric cancer (EGC). However, the widespread adoption of ESD in western countries has been slow. We performed a systematic review to evaluate short-term outcomes of ESD for EGC in non-Asian countries.

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Helicobacter pylori remains a major health problem worldwide, causing considerable morbidity and mortality due to peptic ulcer disease and gastric cancer. The burden of disease falls disproportionally on less well-resourced populations. As with most infectious diseases, the largest impact on reducing this burden comes from improvement in socioeconomic status, which interrupts transmission.

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Background: Since the emergence of the novel corona virus (SARS-Cov-2) in the late 2019 and not only the endoscopy practice and training but also the health care systems around the globe suffers. This systematic review focused the impact of Corona Virus Disease (COVID-19) on the endoscopy practice.

Methods: A web search of different databases combining different search terms describing the endoscopy practice and the COVID-19 pandemic was done.

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Background: We systematically assessed beneficial and harmful effects of monoclonal antibodies for coronavirus disease 2019 (COVID-19) treatment, and prophylaxis in individuals exposed to severe acute respiratory syndrome coronavirus 2.

Methods: We searched 5 engines and 3 registries until November 3, 2021 for randomized controlled trials evaluating monoclonal antibodies vs control in hospitalized or non-hospitalized adults with COVID-19, or as prophylaxis. Primary outcomes were all-cause mortality, COVID-19-related death, and serious adverse events; hospitalization for non-hospitalized; and development of symptomatic COVID-19 for prophylaxis.

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Introduction: No early treatment intervention for COVID-19 has proven effective to date. We systematically reviewed the efficacy of hydroxychloroquine as early treatment for COVID-19.

Material And Methods: Randomized controlled trials (RCTs) evaluating hydroxychloroquine for early treatment of COVID-19 were searched in five engines and preprint websites until September 14, 2021.

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Introduction: We systematically assessed benefits and harms of tocilizumab (TCZ), which is an antibody blocking IL-6 receptors, in hospitalized COVID-19 patients.

Methods: Five electronic databases and two preprint webpages were searched until March 4, 2021. Randomized controlled trials (RCTs) and inverse probability treatment weighting (IPTW) cohorts assessing TCZ effects in hospitalized, COVID-19 adult patients were included.

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Introduction: This article summarizes the clinical practice guidelines (CPG) for the diagnosis and treatment of chronic infection of hepatitis viral C of the Peruvian Health Social Security (EsSalud).

Objective: To provide clinical recommendations based on evidence for the diagnosis and treatment of chronic infection of hepatitis viral C in EsSalud.

Methods: A guideline development group (GDG) was established, including medical specialists and methodologists.

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Background And Aims: endoscopic submucosal dissection (ESD) is the standard treatment for differentiated early gastric cancer (EGC). However, its expanded indication for undifferentiated EGC is controversial. In this study, the efficacy and safety of ESD versus surgery in patients with undifferentiated EGC were compared.

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