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[PMID]: 29509297
[Au] Autor:Chen M; Chen J; Yang Y; Cheng L; Wu HT
[Ad] Address:Department of Otolaryngology - Head and Neck Surgery, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China.
[Ti] Title:Possible association between Helicobacter pylori infection and vocal fold leukoplakia.
[So] Source:Head Neck;, 2018 Mar 06.
[Is] ISSN:1097-0347
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Several studies have indicated the larynx as possible Helicobacter pylori (H. pylori) reservoirs. This study explored the association between H. pylori and vocal fold leukoplakia. METHODS: The case-control study involved 51 patients with vocal fold leukoplakia and 35 control patients with vocal polyps. Helicobacter pylori was detected in tissues by the rapid urease test, nested polymerase chain reaction (PCR), and single-step PCR. The H. pylori-specific immunoglobulin antibodies were detected in plasma by enzyme-linked immunosorbent assay (ELISA). RESULTS: Helicobacter pylori-positive rate of vocal fold leukoplakia and vocal polyps was 23.5% versus 11.4% (P = .157), 37.2% versus 14.3% (P = .020), 27.5% versus 8.6% (P = .031), and 70.6% versus 68.6% (P = .841) detected by rapid urease test, nested PCR, single-step PCR, and ELISA, respectively. Regression analysis indicated that H. pylori infection (P = .044) was the independent risk factor for vocal fold leukoplakia. CONCLUSION: Helicobacter pylori infection exists in the larynx and may be associated with vocal fold leukoplakia.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher
[do] DOI:10.1002/hed.25121

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[PMID]: 29494321
[Au] Autor:Stachler RJ; Francis DO; Schwartz SR; Damask CC; Digoy GP; Krouse HJ; McCoy SJ; Ouellette DR; Patel RR; Reavis CCW; Smith LJ; Smith M; Strode SW; Woo P; Nnacheta LC
[Ad] Address:1 Wayne State University, Detroit, Michigan, USA.
[Ti] Title:Clinical Practice Guideline: Hoarseness (Dysphonia) (Update).
[So] Source:Otolaryngol Head Neck Surg;158(1_suppl):S1-S42, 2018 Mar.
[Is] ISSN:1097-6817
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Objective This guideline provides evidence-based recommendations on treating patients who present with dysphonia, which is characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication and/or quality of life. Dysphonia affects nearly one-third of the population at some point in its life. This guideline applies to all age groups evaluated in a setting where dysphonia would be identified or managed. It is intended for all clinicians who are likely to diagnose and treat patients with dysphonia. Purpose The primary purpose of this guideline is to improve the quality of care for patients with dysphonia, based on current best evidence. Expert consensus to fill evidence gaps, when used, is explicitly stated and supported with a detailed evidence profile for transparency. Specific objectives of the guideline are to reduce inappropriate variations in care, produce optimal health outcomes, and minimize harm. For this guideline update, the American Academy of Otolaryngology-Head and Neck Surgery Foundation selected a panel representing the fields of advanced practice nursing, bronchoesophagology, consumer advocacy, family medicine, geriatric medicine, internal medicine, laryngology, neurology, otolaryngology-head and neck surgery, pediatrics, professional voice, pulmonology, and speech-language pathology. Action Statements The guideline update group made strong recommendations for the following key action statements (KASs): (1) Clinicians should assess the patient with dysphonia by history and physical examination to identify factors where expedited laryngeal evaluation is indicated. These include, but are not limited to, recent surgical procedures involving the head, neck, or chest; recent endotracheal intubation; presence of concomitant neck mass; respiratory distress or stridor; history of tobacco abuse; and whether the patient is a professional voice user. (2) Clinicians should advocate voice therapy for patients with dysphonia from a cause amenable to voice therapy. The guideline update group made recommendations for the following KASs: (1) Clinicians should identify dysphonia in a patient with altered voice quality, pitch, loudness, or vocal effort that impairs communication or reduces quality of life (QOL). (2) Clinicians should assess the patient with dysphonia by history and physical examination for underlying causes of dysphonia and factors that modify management. (3) Clinicians should perform laryngoscopy, or refer to a clinician who can perform laryngoscopy, when dysphonia fails to resolve or improve within 4 weeks or irrespective of duration if a serious underlying cause is suspected. (4) Clinicians should perform diagnostic laryngoscopy, or refer to a clinician who can perform diagnostic laryngoscopy, before prescribing voice therapy and document/communicate the results to the speech-language pathologist (SLP). (5) Clinicians should advocate for surgery as a therapeutic option for patients with dysphonia with conditions amenable to surgical intervention, such as suspected malignancy, symptomatic benign vocal fold lesions that do not respond to conservative management, or glottic insufficiency. (6) Clinicians should offer, or refer to a clinician who can offer, botulinum toxin injections for the treatment of dysphonia caused by spasmodic dysphonia and other types of laryngeal dystonia. (7) Clinicians should inform patients with dysphonia about control/preventive measures. (8) Clinicians should document resolution, improvement or worsened symptoms of dysphonia, or change in QOL of patients with dysphonia after treatment or observation. The guideline update group made a strong recommendation against 1 action: (1) Clinicians should not routinely prescribe antibiotics to treat dysphonia. The guideline update group made recommendations against other actions: (1) Clinicians should not obtain computed tomography (CT) or magnetic resonance imaging (MRI) for patients with a primary voice complaint prior to visualization of the larynx. (2) Clinicians should not prescribe antireflux medications to treat isolated dysphonia, based on symptoms alone attributed to suspected gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR), without visualization of the larynx. (3) Clinicians should not routinely prescribe corticosteroids for patients with dysphonia prior to visualization of the larynx. The policy level for the following recommendation about laryngoscopy at any time was an option: (1) Clinicians may perform diagnostic laryngoscopy at any time in a patient with dysphonia. Disclaimer This clinical practice guideline is not intended as an exhaustive source of guidance for managing dysphonia (hoarseness). Rather, it is designed to assist clinicians by providing an evidence-based framework for decision-making strategies. The guideline is not intended to replace clinical judgment or establish a protocol for all individuals with this condition, and it may not provide the only appropriate approach to diagnosing and managing this problem. Differences from Prior Guideline (1) Incorporation of new evidence profiles to include the role of patient preferences, confidence in the evidence, differences of opinion, quality improvement opportunities, and any exclusion to which the action statement does not apply (2) Inclusion of 3 new guidelines, 16 new systematic reviews, and 4 new randomized controlled trials (3) Inclusion of a consumer advocate on the guideline update group (4) Changes to 9 KASs from the original guideline (5) New KAS 3 (escalation of care) and KAS 13 (outcomes) (6) Addition of an algorithm outlining KASs for patients with dysphonia.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:In-Data-Review
[do] DOI:10.1177/0194599817751030

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[PMID]: 29494316
[Au] Autor:Stachler RJ; Francis DO; Schwartz SR; Damask CC; Digoy GP; Krouse HJ; McCoy SJ; Ouellette DR; Patel RR; Reavis CCW; Smith LJ; Smith M; Strode SW; Woo P; Nnacheta LC
[Ad] Address:1 Wayne State University, Detroit, Michigan, USA.
[Ti] Title:Clinical Practice Guideline: Hoarseness (Dysphonia) (Update) Executive Summary.
[So] Source:Otolaryngol Head Neck Surg;158(3):409-426, 2018 Mar.
[Is] ISSN:1097-6817
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Objective This guideline provides evidence-based recommendations on treating patients presenting with dysphonia, which is characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication and/or quality of life. Dysphonia affects nearly one-third of the population at some point in its life. This guideline applies to all age groups evaluated in a setting where dysphonia would be identified or managed. It is intended for all clinicians who are likely to diagnose and treat patients with dysphonia. Purpose The primary purpose of this guideline is to improve the quality of care for patients with dysphonia, based on current best evidence. Expert consensus to fill evidence gaps, when used, is explicitly stated and supported with a detailed evidence profile for transparency. Specific objectives of the guideline are to reduce inappropriate variations in care, produce optimal health outcomes, and minimize harm. For this guideline update, the American Academy of Otolaryngology-Head and Neck Surgery Foundation selected a panel representing the fields of advanced practice nursing, bronchoesophagology, consumer advocacy, family medicine, geriatric medicine, internal medicine, laryngology, neurology, otolaryngology-head and neck surgery, pediatrics, professional voice, pulmonology, and speech-language pathology. Action Statements The guideline update group made strong recommendations for the following key action statements (KASs): (1) Clinicians should assess the patient with dysphonia by history and physical examination to identify factors where expedited laryngeal evaluation is indicated. These include but are not limited to recent surgical procedures involving the head, neck, or chest; recent endotracheal intubation; presence of concomitant neck mass; respiratory distress or stridor; history of tobacco abuse; and whether the patient is a professional voice user. (2) Clinicians should advocate voice therapy for patients with dysphonia from a cause amenable to voice therapy. The guideline update group made recommendations for the following KASs: (1) Clinicians should identify dysphonia in a patient with altered voice quality, pitch, loudness, or vocal effort that impairs communication or reduces quality of life (QOL). (2) Clinicians should assess the patient with dysphonia by history and physical examination for underlying causes of dysphonia and factors that modify management. (3) Clinicians should perform laryngoscopy, or refer to a clinician who can perform laryngoscopy, when dysphonia fails to resolve or improve within 4 weeks or irrespective of duration if a serious underlying cause is suspected. (4) Clinicians should perform diagnostic laryngoscopy, or refer to a clinician who can perform diagnostic laryngoscopy, before prescribing voice therapy and document/communicate the results to the speech-language pathologist (SLP). (5) Clinicians should advocate for surgery as a therapeutic option for patients with dysphonia with conditions amenable to surgical intervention, such as suspected malignancy, symptomatic benign vocal fold lesions that do not respond to conservative management, or glottic insufficiency. (6) Clinicians should offer, or refer to a clinician who can offer, botulinum toxin injections for the treatment of dysphonia caused by spasmodic dysphonia and other types of laryngeal dystonia. (7) Clinicians should inform patients with dysphonia about control/preventive measures. (8) Clinicians should document resolution, improvement or worsened symptoms of dysphonia, or change in QOL of patients with dysphonia after treatment or observation. The guideline update group made a strong recommendation against 1 action: (1) Clinicians should not routinely prescribe antibiotics to treat dysphonia. The guideline update group made recommendations against other actions: (1) Clinicians should not obtain computed tomography (CT) or magnetic resonance imaging (MRI) for patients with a primary voice complaint prior to visualization of the larynx. (2) Clinicians should not prescribe antireflux medications to treat isolated dysphonia, based on symptoms alone attributed to suspected gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR), without visualization of the larynx. (3) Clinicians should not routinely prescribe corticosteroids in patients with dysphonia prior to visualization of the larynx. The policy level for the following recommendation about laryngoscopy at any time was an option: (1) Clinicians may perform diagnostic laryngoscopy at any time in a patient with dysphonia. Differences from Prior Guideline (1) Incorporating new evidence profiles to include the role of patient preferences, confidence in the evidence, differences of opinion, quality improvement opportunities, and any exclusion to which the action statement does not apply (2) Inclusion of 3 new guidelines, 16 new systematic reviews, and 4 new randomized controlled trials (3) Inclusion of a consumer advocate on the guideline update group (4) Changes to 9 KASs from the original guideline (5) New KAS 3 (escalation of care) and KAS 13 (outcomes) (6) Addition of an algorithm outlining KASs for patients with dysphonia.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:In-Data-Review
[do] DOI:10.1177/0194599817751031

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[PMID]: 29468923
[Au] Autor:Chen M; Hou C; Chen T; Lin Z; Wang X; Zeng Y
[Ad] Address:a Department of Otorhinolaryngology , Fujian Provincial Clinical College of Fujian Medical University , Fuzhou , China.
[Ti] Title:Reflux symptom index and reflux finding score in 91 asymptomatic volunteers.
[So] Source:Acta Otolaryngol;:1-5, 2018 Feb 22.
[Is] ISSN:1651-2251
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: The primary goal of this study was to investigating the symptoms, in addition to the reflux-related laryngopharynx inflammation performance of asymptomatic, volunteers, and verified the 'normal point'. METHODS: A total of 91 asymptomatic subjects were recruited for this cross-sectional study between March 2016 and September 2016. Participants completed the reflux symptom index (RSI) assessment and underwent laryngostroboscopic examination using a rigid endoscope. Their RFS were graded according to the laryngeal findings. The distribution and the relationship of the RSI and the RFS were analyzed. RESULTS: The mean RSI of individuals was 2.24 ± 2.34 [95% confidence interval (CI) = 1.75, 2.72], and the mean RFS of individuals was 5.78 ± 1.74 (95% CI = 5.42, 6.15). The Pearson product-moment correlation coefficient of the RSI and RFS scores was -0.084 (n = 91, p = .428). CONCLUSIONS: Asymptomatic people could present relatively high RFS scores, and no linear relationship existed between RSI and RFS.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180222
[Lr] Last revision date:180222
[St] Status:Publisher
[do] DOI:10.1080/00016489.2018.1436768

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[PMID]: 29462564
[Au] Autor:Holcomb AJ; Hamill CS; Irwin T; Sykes K; Garnett JD; Kraft S
[Ad] Address:1 University of Kansas Medical Center, Kansas City, Kansas, USA.
[Ti] Title:Practice Patterns of Referring Physicians in Management of the Dysphonic Patient.
[So] Source:Otolaryngol Head Neck Surg;:194599818758958, 2018 Feb 01.
[Is] ISSN:1097-6817
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Objective Dysphonia is commonly encountered by primary care physicians and general otolaryngologists. We examine practice patterns of referring physicians to a tertiary voice clinic, including adherence to evidence-based guidelines. Study Design Retrospective case series with chart review. Setting Academic tertiary care hospital. Subjects and Methods In total, 821 charts of patients with voice complaints seen at a tertiary voice clinic between January 2011 and June 2016 were reviewed. Included charts (n = 755) were reviewed for type of referring provider, prior diagnoses, and treatments employed by referring physicians. Additional information regarding findings at the time of laryngoscopy/stroboscopy and diagnoses provided by a laryngologist were also obtained. Statistical analysis was performed to determine significant relationships between variables of interest. Results A total of 244 patients (32.2%) received a diagnosis prior to evaluation in the voice clinic, most commonly laryngopharyngeal reflux disease (n = 134). Prior medical treatment was attempted in 221 (29.3%) patients, typically antireflux medications (n = 141). Of the patients treated with proton pump inhibitors by referring physicians, 65.1% lacked symptoms of gastroesophageal reflux disease. Patients with prior treatment had a median duration of symptoms 6 weeks longer than those without prior treatment ( P = .04). Among previously diagnosed patients, 199 (81.6%) of diagnoses changed after evaluation in the voice clinic. Conclusion Referring physicians frequently treat dysphonic patients empirically, often with antireflux medications. Subspecialist evaluation results in changes in diagnosis in many patients. Empiric treatment can delay referral and appropriate treatment.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180220
[Lr] Last revision date:180220
[St] Status:Publisher
[do] DOI:10.1177/0194599818758958

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[PMID]: 29238875
[Au] Autor:Wang J; Zhao Y; Ren J; Xu Y
[Ad] Address:Department of Oto-Rhino-Laryngology, West China Hospital, West China Medical School, Sichuan University, No. 37 Guo Xue Alley, Chengdu, 610041, Sichuan, China.
[Ti] Title:Pepsin in saliva as a diagnostic biomarker in laryngopharyngeal reflux: a meta-analysis.
[So] Source:Eur Arch Otorhinolaryngol;275(3):671-678, 2018 Mar.
[Is] ISSN:1434-4726
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Pepsin in saliva has been proposed as a biomarker for the diagnosis of laryngopharyngeal reflux (LPR), but the results remain controversial. We assessed the diagnostic value of pepsin in saliva for LPR. METHODS: PubMed, Embase, and Web of Science were searched for studies in English that evaluated the utility of pepsin in saliva in the diagnosis of LPR, published up to 15 March 2017. We used Stata 12.0 to summarize the diagnostic indexes for the meta-analysis. RESULTS: Eleven eligible studies met the inclusion criteria. After the meta-analysis of included studies, the pooled sensitivity and specificity were 64% [95% confidence interval (CI) 43-80%] and 68% (95% CI 55-78%), respectively; the positive (PLR) and negative (NLR) likelihood ratios were 2.0 (95% CI 1.4-2.9) and 0.54 (95% CI 0.33-0.87), respectively; the diagnostic odds ratio (DOR) was 4 (95% CI 2-8); and the area under the curve (AUC) was 0.71 (95% CI 0.67-0.75). CONCLUSION: Pepsin in saliva has moderate value in the diagnosis of LPR. The cutoff value used could affect the diagnostic value. Therefore, further investigations are required to find the optimal method to detect salivary pepsin in diagnosing LPR.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1712
[Cu] Class update date: 180220
[Lr] Last revision date:180220
[St] Status:In-Process
[do] DOI:10.1007/s00405-017-4845-8

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[PMID]: 29446359
[Au] Autor:Kesari SP; Chakraborty S; Sharma B
[Ad] Address:Department of ENT, Sikkim Manipal University, SMIMS, Gangtok, Sikkim, India.
[Ti] Title:Evaluation of Risk Factors for Laryngopharyngeal Reflux among Sikkimese Population.
[So] Source:Kathmandu Univ Med J (KUMJ);15(57):29-34, 2017 Jan.-Mar..
[Is] ISSN:1812-2078
[Cp] Country of publication:Nepal
[La] Language:eng
[Ab] Abstract:Background Laryngopharyngeal reflux is a global health problem and is associated with a huge economic burden and decreased quality of life. Studies describing the epidemiology of laryngopharyngeal reflux are sparse in India and south east Asia. This study becomes significant as it is being conducted in Sikkimese population who resides in high altitude have a different lifestyle. Objective To evaluate the risk factors for laryngopharyngeal reflux among Sikkimese origin. Method Patients of Sikkimese origin visiting Ear Nose Throat outpatient department Were administered with validated questionnaire. The patients were further subjected to validate Reflux symptom Index score. Indirect laryngoscopy was performed to calculate reflux finding score. Presence of laryngopharyngeal reflux was identified with patients having reflux symptom index and reflux finding score of greater or equal to 13 or more and 7 or more. Result Out of 200 subjects analysed, there were 77(38.5%) male and 123(61.5%) female. Heartburn and regurgitation were the most common symptom among the masses. Hoarseness and frequent throat clearance were the commonest laryngopharyngeal reflux symptoms. Various risk factors were computed as mentioned in the results column. Conclusion Study on the above mentioned population differed from rest of the country in terms of dietary habits. Fermented food was found to be one of the important risk factor for the development of laryngopharyngeal reflux in the sikkimise population.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180215
[Lr] Last revision date:180215
[St] Status:In-Process

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[PMID]: 29436212
[Au] Autor:Gelardi M; Silvestri M; Ciprandi G; Relief Study Group: F. Aielli, P. Alessandrini, G. Allosso, S. Angelillo, A. Anni, G. Antoniacomi, S.E. Aragona, A. Armone Caruso, F. Asprea, R. Azzaro, G. Balata, C. Bellini, D. Benedetto, R. Bernardi, M. Buccolieri, G. Caligo, G. Campobasso, F.R. Canevari, A. Cantaffa, A. Capone, S. Carboni, G. Castagna, C. Castellani, I. Clemente, A. Cordier, D. Cossu, M. Costanzo, A. Cugno Garrano, G. Cupido, M. Danteo, C. De Luca, M. Degli Innocenti, A. Dei, G. Denuli, L. Di Bartolo, A. Dolores, S. Falcetti, R. Falciglia, G. Fera, G. Ferraro, O. Fini, F. Giangregorio, F. Grazioli, C. Grillo, M.L. Guiso, F. Ianniello, M. Ierace, F. Ingria, I. La Mantia, G. La Pietra, C. Lambertoni, R. Lauletta, D. Lazzoni, S. Leo, M. Leone, V. Lo Iacono, M. Maio, F.G. Mangiatordi, F. Maniscalco, A. Matricciani, N. Mirra, S.C. Montanaro, P. Montesi, D. Moro, F. Muià, C. Murè, A. Nacci, T. Nipo, A. Pace, G.Panetti, M. Paoletti, G. Pasquarella, I. Pedrotti, A. Pellegrino, D. Petrone, P. Pinto, M.C. Pizzolante, L. Pollastrini, S. Poma, N. Quaranta, G. Reale, S. Rigo, A. Scarpa, F. Scelsi, L. Sellari, E.G. Serraino, G. Spanò, V. Stufano, G. Tomacelli, A. Tombolini and A. Zirone.
[Ad] Address:Section of Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari, Italy
[Ti] Title:Correlation between the reflux finding score and the reflux symptom index in patients with laryngopharyngeal reflux.
[So] Source:J Biol Regul Homeost Agents;32(1 Suppl. 2):29-31, 2018 Jan-Feb,.
[Is] ISSN:0393-974X
[Cp] Country of publication:Italy
[La] Language:eng
[Ab] Abstract:LaryngoPharyngeal Reflux (LPR) is characterized by symptoms, signs, and/or tissue damage resulting from the aggression of the gastrointestinal contents in the upper airways. The Reflux Finding Score (RFS) assesses the laryngeal signs through laryngoscopy. The Reflux Symptom Index (RSI) scores the LPR symptoms. The objective of this real-world study was to compare RFS with RSI in a cohort of Italian LPR patients. Globally, 3932 patients with LPR were evaluated and RFS and RSI were assessed in all subjects. A moderate correlation was found between RSI and RFS (r=0.484, p<0.0001). In conclusion, the RSI and RFS can easily be included in the LPR work-up as objective and consistent parameters, with low cost and high practicality. Based on these clinical outcomes, the specialist can easily use these tests in clinical practice.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[St] Status:In-Data-Review

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[PMID]: 29436210
[Au] Autor:Gelardi M; Silvestri M; Ciprandi G; The Relief Study Group: F. Aielli, P. Alessandrini, G. Allosso, S. Angelillo, A. Anni, G. Antoniacomi, S.E. Aragona, A. Armone Caruso, F. Asprea, R. Azzaro, G. Balata, C. Bellini, D. Benedetto, R. Bernardi, M. Buccolieri, G. Caligo, G. Campobasso, F.R. Canevari, A. Cantaffa, A. Capone, S. Carboni, G. Castagna, C. Castellani, I. Clemente, A. Cordier, D. Cossu, M. Costanzo, A. Cugno Garrano, G. Cupido, M. Danteo, C. De Luca, M. Degli Innocenti, A. Dei, G. Denuli, L. Di Bartolo, A. Dolores, S. Falcetti, R. Falciglia, G. Fera, G. Ferraro, O. Fini, F. Giangregorio, F. Grazioli, C. Grillo, M.L. Guiso, F. Ianniello, M. Ierace, F. Ingria, I. La Mantia, G. La Pietra, C. Lambertoni, R. Lauletta, D. Lazzoni, S. Leo, M. Leone, V. Lo Iacono, M. Maio, F.G. Mangiatordi, F. Maniscalco, A. Matricciani, N. Mirra, S.C. Montanaro, P. Montesi, D. Moro, F. Muià, C. Murè, A. Nacci, T. Nipo, A. Pace, G.Panetti, M. Paoletti, G. Pasquarella, I. Pedrotti, A. Pellegrino, D. Petrone, P. Pinto, M.C. Pizzolante, L. Pollastrini, S. Poma, N. Quaranta, G. Reale, S. Rigo, A. Scarpa, F. Scelsi, L. Sellari, E.G. Serraino, G. Spanò, V. Stufano, G. Tomacelli, A. Tombolini and A. Zirone.
[Ad] Address:Section of Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari, Italy
[Ti] Title:Relieving laryngopharingeral reflux (RELIEF) survey in otolaryngology - the viewpoint of the otorhinolaryngologist.
[So] Source:J Biol Regul Homeost Agents;32(1 Suppl. 2):9-19, 2018 Jan-Feb,.
[Is] ISSN:0393-974X
[Cp] Country of publication:Italy
[La] Language:eng
[Ab] Abstract:Laryngopharyngeal Reflux (LPR) should be considered as part of extraesophageal reflux (EER). This reflux involves respiratory structures other than, or in addition to, the oesophagus. A new medical device for the treatment of gastric reflux, including LPR, has been launched in Italy: Marial®. Therefore, the aim of the present survey was to analyse the prescriptive behaviour both considering the past or current treatments and clinical features during a specialist routine visit. The current survey was conducted in 86 Otorhinolaryngological centers, distributed in all of Italy. Globally, 4.418 subjects [47% males and 53% females, 50.1 (14.5) years-of-age] were visited. The visits included laryngoscopy, Reflux Finding Score (RFS) and Reflux Symptom Index (RSI) questionnaires. The total RSI median score was 15 (12-19) and the total median RFS value was 10 (8-12). Interestingly, a significant change in the new drug prescription was observed (p<0.0001): over two-third of patients (67%) received Marial® as monotherapy, whereas PPI plus add-on were prescribed to almost one-third of the patients. PPI alone was prescribed in less than 1%. In conclusion, LPR is a common disorder characterized by typical signs and symptoms; LPR patients may be correctly identified and scored by evidence-based criteria. In addition, the present survey reported that LPR treatment has been considerably changed by the introduction of a new medical device.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[St] Status:In-Data-Review

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[PMID]: 29436209
[Au] Autor:Gelardi M; Ciprandi G
[Ad] Address:Section of Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari, Italy
[Ti] Title:Focus on gastroesophageal reflux (GER) and laryngopharyngeal reflux (LPR): new pragmatic insights in clinical practice.
[So] Source:J Biol Regul Homeost Agents;32(1 Suppl. 2):41-47, 2018 Jan-Feb,.
[Is] ISSN:0393-974X
[Cp] Country of publication:Italy
[La] Language:eng
[Ab] Abstract:Introduction: Gastroesophageal reflux (GER) is a common disease usually limited to the oesophagus. Laryngopharyngeal reflux (LPR) is an inflammatory reaction of the mucosa of pharynx, larynx, and other associated upper respiratory organs, caused by a reflux of stomach contents outside the oesophagus. LPR is considered to be a relatively new clinical entity with a vast number of clinical manifestations which are treated sometimes empirically and without a correct diagnosis. However, there is disagreement between specialists about its definition and management: gastroenterologists consider LPR to be a substantially rare manifestation of gastroesophageal reflux disease (GERD), whereas otolaryngologists believe that LPR is an independent, but common in their practice, disorder. Patients suffering from LPR firstly consult their general practitioners, but a multidisciplinary approach may be fruitful to define a unified strategy based on specific medications and behavioural changes. The present Supplement would review the topic, considering LPR and GER characteristics, pathophysiology, diagnostic work-up, and new therapeutic strategies also comparing different specialist points of view and patient populations. In particular, new insights derive from an interesting gel compound, containing magnesium alginate and E-Gastryal® (hyaluronic acid, hydrolysed keratin, Tara gum, and Xantana gum). In particular, two very large Italian surveys were conducted in real-world setting, such as outpatient clinics. The most relevant outcomes are presented and discussed in the current Issue. Actually, laryngopharyngeal reflux (LPR) is considered an extraesophageal manifestation of the gastroesophageal reflux disease (GERD). Both GERD and its extraesophageal manifestation are very common in clinical practice. Both disorders have a relevant burden for the society: about this topic most of pharmaco-economic studies were conducted in the United States. In population-based studies, 19.8% of North Americans complain of typical symptoms of GERD (heartburn and regurgitation) at least weekly (1). Also in the late 1990s, GERD accounted for $9.3 to $12.1 billion in direct annual healthcare costs in the United States, higher than any other digestive disease. As a result, acid-suppressive agents were the leading pharmaceutical expenditure in the United States. The prevalence of GERD in the primary care setting becomes even more evident when one considers that, in the United States, 4.6 million office encounters annually are primarily for GERD, whereas 9.1 million encounters include GERD in the top 3 diagnoses for the encounter. GERD is also the most frequently first-listed gastrointestinal diagnosis in ambulatory care visits (2, 3) Extraesophageal manifestations of reflux, including LPR, asthma, and chronic cough, have been estimated to cost $5438 per patient in direct medical expenses in the first year after presentation and $13,700 for 5 years.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[St] Status:In-Data-Review


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