Reflux symptoms in professional opera soloists.

Background: Professions distinguished by repeated vocal stress carry a high risk of developing gastroesophageal reflux symptoms (GERS) which may affect vocal performance.

Aims: To investigate the prevalence of self-reported GERS in professional opera soloists.

Methods: A validated questionnaire regarding self-reported GERS (heartburn, regurgitation, chest pain, dysphagia, hoarseness, and cough) and lifestyle habits was administered to 116 professional opera soloists (mean age 34.

Intracapsular microenucleation technique in a case of intraparotid facial nerve schwannoma. Technical notes for a conservative approach.

We report a rare case of a large intraparotid facial nerve schwannoma (IFNS) in a 51-year-old female who presented with a painless, slow growing left parotid mass without peripheral facial nerve palsy, with non-specific findings at preoperative diagnostic work-up, that was treated with conservative surgery. Management of IFNS is very challenging because the diagnosis is often made intra-operatively, and in most cases resection may lead to severe facial nerve paralysis, with important aesthetic sequelae. Our experience suggests a new surgical option, namely intra-capsular enucleation using a microscope, currently used for schwannomas arising from a major peripheral nerve, which should be a safe and reliable treatment for IFNS.

Management of a rare case of arytenoid mucosa oedema inducing stridor and cough.

Objective: Current guidelines recommend a multidisciplinary systematic integrated approach to patient with chronic cough in which nowadays otolaryngologists play an increasingly valuable role as new procedures are used for evaluation and treatment. Surgery has been never taken into consideration to treat refractory chronic cough.

Method: We present a rare case of arytenoid mucosa oedema inducing stridor and cough, lasting 8 months, that critically affected the quality of life of a 15-year-old adolescent arrived to our emergency department with prominent arytenoid oedema causing paroxysmal cough and laryngeal stridor and that was successfully treated by laryngeal debridement.

Image-enhanced endoscopy with I-scan technology for the evaluation of duodenal villous patterns.

Background: I-scan technology is the newly developed endoscopic tool that works in real time and utilizes a digital contrast method to enhance endoscopic image.

Aims: We performed a feasibility study aimed to determine the diagnostic accuracy of i-scan technology for the evaluation of duodenal villous patterns, having histology as the reference standard.

Methods: In this prospective, single center, open study, patients undergoing upper endoscopy for an histological evaluation of duodenal mucosa were enrolled.

Nasal lavage CCL24 levels correlate with eosinophils trafficking and symptoms in chronic sino-nasal eosinophilic inflammation.

Objectives: The aim of our study was to measure CCL24 (eotaxin-2) levels in nasal lavage fluid of patients with different forms of sinonasal chronic eosinophilic inflammation to verify the relationship with nasal hypereosinophilia and symptoms.

Methods: Patients with nasal hypereosinophilia were randomly recruited and grouped in persistent allergic rhinitis, non-allergic rhinitis with eosinophilia syndrome (NARES) and chronic rhinosinusitis with polyps. Non rhinitic volunteers were recruited as controls.

Biofilm demolition and antibiotic treatment to eradicate resistant Helicobacter pylori: a clinical trial.

Background & Aims: Helicobacter pylori attaches to gastric mucosa and grows as a biofilm. This constitutes protection from antimicrobial agents. We assessed the role of a pretreatment with n-acetylcysteine in destroying biofilm and overcoming H pylori antibiotic resistance.

Reflux symptoms in wind instrument players.

Background: An occupation-related susceptibility of orchestral wind instrument players to gastro-oesophageal reflux was hypothesized.

Aim: To compare reflux symptoms reported by wind instrument players with those reported by players of other instruments.

Methods: A questionnaire was distributed to 1083 musicians (414 wind instrument players and 669 players of other instruments) from 21 Italian orchestras to obtain information on reflux symptoms in the year preceding the survey together with selected individual characteristics and lifestyle habits.

Water-immersion technique during standard upper endoscopy may be useful to drive the biopsy sampling of duodenal mucosa in children with celiac disease.

Objective: To evaluate the accuracy of the water-immersion technique during upper endoscopy in recognizing the duodenal villous pattern in a series of children who were undergoing endoscopy to obtain duodenal biopsy for histological analysis.

Materials And Methods: The water-immersion technique was performed in 19 children. Endoscopic findings were compared with histology.

Emerging technologies in upper gastrointestinal endoscopy and celiac disease.

Despite advances in our knowledge of celiac disease, the most current and authoritative recommendations conclude that diagnosis requires at least four biopsy specimens to be taken from the duodenal area. These recommendations are based on the perception that classic endoscopic markers are not adequate to target biopsy sampling to sites of villous damage in the duodenum. In the past few years, newly developed procedures and technologies have improved endoscopic recognition of the duodenum.

Optimal band imaging system: a new tool for enhancing the duodenal villous pattern in celiac disease.

Background: The optimal band imaging (OBI) system is a new technology that can select better spectral images decomposed from ordinary endoscopic images. This technology, first introduced as "FUJI Intelligent Color Enhancement," enhances the contrast of the mucosal surface without the use of dyes.

Objective: This study aimed to evaluate the potential of OBI for predicting the duodenal villous morphologic characteristics in patients with suspected celiac disease.

Role of the "immersion technique" in diagnosing celiac disease with villous atrophy limited to the duodenal bulb.

Goals: To investigate if the so-called immersion technique during upper endoscopy may be helpful to predict patterns of villous atrophy restricted to the duodenal bulb.

Background: Patients with celiac disease may have a patchy distribution of duodenal villous atrophy. In some cases, mucosa of duodenal bulb may be the only intestinal area involved.

Bile acids and total bilirubin detection in saliva of patients submitted to gastric surgery and in particular to subtotal Billroth II resection.

Objective: The aim of our study was to detect bile acids and total bilirubin in saliva of gastrectomized patients, to confirm objectively presence of biliary laryngopharyngeal reflux and its relationship with laryngeal mucosa damage.

Summary Background Data: Recently, it has been hypothesized that biliary-reflux may reach the upper aerodigestive tract and enhance development of laryngeal malignancies; nevertheless, the presence of duodenogastric contents in this region has never been revealed.

Methods: We carried out a prospective observational case-control study on 52 patients (cases) previously submitted to gastric surgery, mainly to subtotal Billroth II resection, and on 51 healthy volunteers (controls).

Reflux symptoms in professional opera choristers.

Background And Aims: A specific, occupation-related susceptibility of professional singers to experience gastroesophageal reflux was hypothesized. We investigated the prevalence of gastroesophageal reflux symptoms in a series of professional opera choristers in comparison with a general population sample.

Methods: A total of 351 professional opera choristers from well-known chorus in different Italian regions were identified and a sample of 578 subjects residing in the same areas with a similar distribution in age and sex was selected.

A highly accurate method for monitoring histological recovery in patients with celiac disease on a gluten-free diet using an endoscopic approach that avoids the need for biopsy: a double-center study.

Background And Study Aim: Endoscopy with duodenal biopsy is often performed in order to assess histological recovery in patients with celiac disease who are on a gluten-free diet. Use of the "immersion" technique during upper endoscopy allows visualization of duodenal villi or detection of total villous atrophy. In this two-center study, we investigated the accuracy of the immersion technique in predicting histological recovery in patients on a gluten-free diet whose initial diagnosis of celiac disease had been made on the basis of total villous atrophy.

Accuracy of laryngeal examination during upper gastrointestinal endoscopy for premalignancy screening: prospective study in patients with and without reflux symptoms.

Background And Study Aims: Gastroesophageal reflux disease may be associated with laryngeal damage caused by reflux material. The aim of this study was to investigate the accuracy of laryngeal examinations during routine upper gastrointestinal endoscopy as a method of screening for major laryngeal injury in a series of patients with reflux symptoms.

Patients And Methods: A total of 100 consecutive patients with reflux symptoms and 100 control individuals underwent upper gastrointestinal endoscopy with standard or high-resolution magnifying video endoscopes.

High accuracy and cost-effectiveness of a biopsy-avoiding endoscopic approach in diagnosing coeliac disease.

Background: The 'immersion' technique during upper endoscopy allows the visualization of duodenal villi and the detection of total villous atrophy.

Aim: To evaluate the accuracy of the immersion technique in detecting total villous atrophy in suspected coeliac patients. The accuracy in diagnosing coeliac disease and the potential cost-sparing of a biopsy-avoiding approach, based on selection of individuals with coeliac disease-related antibodies and on endoscopic detection of absence of villi, were also analysed.

Malignant retroperitoneal paraganglioma: case report and review of the literature.

Paraganglioma is a rare neuroendocrine neoplasm observed in patients of all ages but it has not been characterized in children. The authors describe a retroperitoneal paraganglioma diagnosed by chance in an 11-year-old boy. Many aspects of retroperitoneal paraganglioma are still under investigation.

Direct visualization of intestinal villi by high-resolution magnifying upper endoscopy: a validation study.

Background: New generation videoendoscopes potentially may visualize duodenal villi. This study compared endoscopic findings with this type of instrument to the histopathologic evaluation of duodenal villi.

Methods: A total of 191 patients underwent upper endoscopy for the purpose of obtaining duodenal biopsy specimens.

Association of laryngeal cancer with previous gastric resection.

Objective: To investigate the association between gastric surgery and cancer of the larynx.

Summary Background Data: Biliary reflux is frequent after gastric surgery and may reach the proximal segment of the esophagus and the larynx. It is possible that duodenal content (consisting in bile acids, trypsin), together with pepsin and acid residues when gastric resection is partial, may cause harmful action on the multistratified epithelium of the larynx.

Reliability of the "immersion technique" during routine upper endoscopy for detection of abnormalities of duodenal villi in patients with dyspepsia.

Background: Upper endoscopy is not routinely performed to directly detect abnormalities of the duodenal villi. The reliability of the immersion technique for assessment of duodenal villi was evaluated in a series of patients with dyspepsia.

Methods: A total of 396 patients who were to undergo standard EGD for dyspeptic symptoms were enrolled.

Gastric surgery as a long-term risk factor for malignant lesions of the larynx.

Background: Duodenogastroesophageal reflux is common after total or partial gastrectomy. No data are available on the effect of duodenal reflux on the larynx.

Hypothesis: Premalignant or malignant changes occur more frequently among subjects with gastric surgery.

Bromocriptine for treatment of benign breast disease. A double-blind clinical trial versus placebo.

Over the last few years bromocriptine has been used for treatment of mastodynia and benign breast disease, but with contradictory results. This double-blind clinical trial was performed to determine the efficacy of this prolactin inhibitor as compared with placebo. Subjective discomfort, clinical examination of the breast lesions, echomammography and breast thermography were evaluated before, during and after 3 months of treatment and in a further follow-up.