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Cammarota G.,Catholic University of Medicine and Surgery | Cammarota G.,melli University Hospital | Ianiro G.,Catholic University of Medicine and Surgery | Sparano L.,Catholic University of Medicine and Surgery | And 5 more authors.
Digestive Diseases and Sciences | Year: 2013

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. All patients underwent upper endoscopy using high resolution view in association with i-scan technology. During endoscopy, duodenal villous patterns were evaluated and classified as normal, partial villous atrophy, or marked villous atrophy. Results were then compared with histology. Results: One hundred fifteen subjects were recruited in this study. The endoscopist was able to find marked villous atrophy of the duodenum in 12 subjects, partial villous atrophy in 25, and normal villi in the remaining 78 individuals. The i-scan system was demonstrated to have great accuracy (100 %) in the detection of marked villous atrophy patterns. I-scan technology showed quite lower accuracy in determining partial villous atrophy or normal villous patterns (respectively, 90 % for both items). Conclusions: Image-enhancing endoscopic technology allows a clear visualization of villous patterns in the duodenum. By switching from the standard to the i-scan view, it is possible to optimize the accuracy of endoscopy in recognizing villous alteration in subjects undergoing endoscopic evaluation. © 2012 Springer Science+Business Media New York. Source


Cammarota G.,Catholic University of Medicine and Surgery | Branca G.,Catholic University of Medicine and Surgery | Ardito F.,Catholic University of Medicine and Surgery | Sanguinetti M.,Catholic University of Medicine and Surgery | And 8 more authors.
Clinical Gastroenterology and Hepatology | Year: 2010

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. Methods: In an open-label, randomized controlled trial, 40 subjects with a history of at least 4 H pylori eradication failures were evaluated for biofilm presence, antibiotic susceptibility, and H pylori genotypes. Subjects were assigned randomly to receive (group A) or not (group B) n-acetylcysteine before a culture-guided antibiotic regimen. The primary end point was the H pylori eradication rate as assessed by 13C-labeled urea breath testing. Results: H pylori was eradicated in 13 of 20 (both per-protocol and intention-to-treat analyses, 65%; 95% confidence interval, 44%-86%) group A participants and 4 of 20 (both per-protocol and intention-to-treat analyses, 20%; 95% confidence interval, 3%-37%) group B participants (P < .01). Biofilms persisted only in unsuccessfully treated participants. H pylori genotypes did not influence treatment outcome. Conclusions: N-acetylcysteine pretreatment before a culture-guided antibiotic regimen is effective in overcoming H pylori antibiotic resistance. © 2010 AGA Institute. Source


Rigante M.,Catholic University of Medicine and Surgery | Petrelli L.,Catholic University of Medicine and Surgery | De Corso E.,Catholic University of Medicine and Surgery | Paludetti G.,Catholic University of Medicine and Surgery
Acta Otorhinolaryngologica Italica | Year: 2015

Summary: 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. This surgical technique is the first experience of intracapsular microenucleation of facial nerve schwannoma described in the literature and allows preservation of the nerve without resection and reconstruction. © 2015, Pacini Editore s.r.l. All rights reserved. Source


De Corso E.,Catholic University of Medicine and Surgery | Pandolfini M.,Catholic University of Medicine and Surgery | Battista M.,Catholic University of Medicine and Surgery | Della Marca G.,Catholic University of Medicine and Surgery | Scarano E.,Catholic University of Medicine and Surgery
International Journal of Pediatric Otorhinolaryngology | Year: 2013

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. Results: In this case report we observed that prominent swelling of arytenoid mucosa might sustain a vicious cycle of cough persistence and that laryngeal surgical debridement might interrupt it resolving the particular clinical condition. Conclusion: The description of this case could be of some help for clinicians to draw new insight about diagnosis and therapy of rare selected cases of chronic refractory cough. © 2013 Elsevier Ireland Ltd. Source


Cammarota G.,Catholic University of Medicine and Surgery | Masala G.,Cancer Prevention and Research Institute ISPO | Cianci R.,Catholic University of Medicine and Surgery | Palli D.,Cancer Prevention and Research Institute ISPO | And 5 more authors.
Alimentary Pharmacology and Therapeutics | Year: 2010

Aliment Pharmacol Ther 31, 593-600 SummaryBackground 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. Crude and adjusted prevalence rate ratios (PRR) were computed by a model including gender, age, body mass index, smoking status, alcohol consumption and other confounding factors. Results Wind instrument players reported a higher prevalence of heartburn in the previous year than the other instrument players (adjusted PRR 1.23, CI 95% 1.04-1.46). Wind instrument players also reported higher, although not fully significant, prevalence of regurgitation (adjusted PRR 1.22, CI 95% 0.97-1.54). Flute and double-reed instrument players seem to carry a higher risk of reflux symptoms. Conclusions Wind instrument players reported a prevalence of typical reflux symptoms higher than other instrument players. © 2010 Blackwell Publishing Ltd. Source

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