Nekkar LAB

Salso-bromo-iodine thermal water: a nonpharmacological alternative treatment

2018-07-03T09:05:20Z

Titolo: Salso-bromo-iodine thermal water: a nonpharmacological alternative treatment for postnasal drip-related cough in children with upper respiratory tract infections

Pubblicato su: Journal of Biological Regulators & Homeostatic Agents Volume 32, No (S2), January-February, 2018

Autori: I. La Mantia, G. Ciprandi, A. Varricchio, F. Cupido and C. Andaloro

Abstract: Postnasal drip (PND)-related cough is a very common symptom in patients with upper respiratory tract infections (URTIs). At present, there is not a standard treatment for postnasal drip and postnasal drip-related cough. The aim of this pilot study was to evaluate the efficacy of a specific salso-bromo-iodine thermal water containing hyaluronic acid and grapefruit seed extract (SBI-H-GSE) comparing it with a normal saline solution in children with URTIs who refer PND-related symptoms. The study was randomized, single-blind, and controlled. Study group (75 children) was treated with SBI-H-GSE and control group (65 children) was treated with a normal saline solution; both compounds were administered by nasal nebulization with Rinowash nasal douche twice/day for 10 days a month for 3 consecutive months. Parent Cough-Specific Quality of Life questionnaire (PC-QOL) average score, the prevalence of symptoms and signs related to post-nasal drip, nasal mucociliary transport time (NMTT), duration and number of URTI episodes, antibiotic usage and days of absence from school were evaluated at baseline and after treatment. SBI-H-GSE therapy shows better and statistically significant trend after treatment when compared to control group for PC-QOL average score (p=0.011), NMTT (p=0.047), symptoms and signs related to post-nasal drip (all p<0.005, except for the cobblestone appearance of the mucosa), duration (in days) with URTI symptoms (p=0.023) and a usage of antibiotic therapy (p=0.011). The current randomized-controlled pilot study demonstrated that SBI-H-GSE solution was effective in the treatment of children with URTIs who refer PND-related symptoms.

To receive a copy of the article contact us

L'articolo Salso-bromo-iodine thermal water: a nonpharmacological alternative treatment sembra essere il primo su Nekkar LAB.

Focus on gastroesophageal reflux (GER) and laryngopharyngeal reflux (LPR)

2018-07-09T09:37:37Z

Titolo:Focus on gastroesophageal reflux (GER) and laryngopharyngeal reflux (LPR): new pragmatic insights in clinical practice

Pubblicato su: Journal of Biological Regulators & Homeostatic Agents Volume 32, No (S2), January-February, 2018

Autori: M. Gelardi and G. Ciprandi.

Abstract: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.

To receive a copy of the article contact us

L'articolo Focus on gastroesophageal reflux (GER) and laryngopharyngeal reflux (LPR) sembra essere il primo su Nekkar LAB.

Relieving laryngopharingeral reflux (RELIEF) survey in otolaryngology – Part I

2018-07-03T08:39:43Z

Titolo:Relieving laryngopharingeral reflux (RELIEF) survey in otolaryngology - the viewpoint of the otorhinolaryngologist.

Pubblicato su: Journal of Biological Regulators & Homeostatic Agents Volume 32, No (S2), January-February, 2018

Autori: M. Gelardi, M. Silvestri, G. Ciprandi and The Relief Study Group*.

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.

To receive a copy of the article contact us

L'articolo Relieving laryngopharingeral reflux (RELIEF) survey in otolaryngology – Part I sembra essere il primo su Nekkar LAB.

Relieving laryngopharingeral reflux (RELIEF) survey in otolaryngology – Part II

2018-07-03T08:52:23Z

Titolo:Relieving laryngopharingeral reflux (RELIEF) survey in otolaryngology - the viewpoint of the patient.

Pubblicato su: Journal of Biological Regulators & Homeostatic Agents Volume 32, No (S2), January-February, 2018

Autori: M. Gelardi, M. Silvestri, G. Ciprandi and The Relief Study Group*.

Abstract:As LPR diagnostic work-up is complex in the absence of a definitive gold standard diagnostic test, patient symptoms have become a primary method to identify those with LPR. In this regard, Reflux Symptom Index (RSI) is a reliable self-administered questionnaire useful also to monitor changes after treatment. An Italian survey on patients with LPR evaluated the effect of treatments for LPR that were prescribed in a real-world setting, such as Otolaryngological clinics. In this part of the survey, 1,680 subjects [45.2% males, 54.8% females, 50.4 (14.7) years] were visited in the 86 Italian ORL centers. About 70% of patients were treated with Marial® alone, 27% with PPI plus add-on. RSI change assessment was the primary outcome. Both therapeutic options significantly (p<0.0001) reduced RSI score interestingly since the second week. The inter-group comparison demonstrated the Marial® monotherapy induced a greater reduction of RSI than PPI plus add-on since the second week. In conclusion, the present survey reported that a new medical device (Marial®) may be considered a valid option for the treatment of LPR.

To receive a copy of the article contact us

L'articolo Relieving laryngopharingeral reflux (RELIEF) survey in otolaryngology – Part II sembra essere il primo su Nekkar LAB.

Correlation between the reflux finding score and the reflux symptom index

2018-07-03T08:55:20Z

Titolo:Correlation between the reflux finding score and the reflux symptom index in patients with laryngopharyngeal reflux

Pubblicato su: Journal of Biological Regulators & Homeostatic Agents Volume 32, No (S2), January-February, 2018

Autori: M. Gelardi, M. Silvestri, G. Ciprandi and The Relief Study Group*.

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.

To receive a copy of the article contact us

L'articolo Correlation between the reflux finding score and the reflux symptom index sembra essere il primo su Nekkar LAB.

Gastric reflux: comparison between the gastroenterologist and the otorhinolaryngologist’s approach.

2018-07-03T09:01:47Z

Titolo: Gastric reflux: comparison between the gastroenterologist and the otorhinolaryngologist’s approach. Pragmatic conclusive remarks

Pubblicato su: Journal of Biological Regulators & Homeostatic Agents Volume 32, No (S2), January-February, 2018

Autori: G. Ciprandi and M. Gelardi.

Abstract: Gastroesophageal reflux (GER) is a normal physiological process that usually happens after eating in healthy infants, children, young people and adults. In contrast, gastroesophageal reflux disease (GERD) occurs when the effect of GER leads to symptoms severe enough to merit medical treatment. In clinical practice, it is difficult to differentiate between GER and GERD, and health professionals and families use the terms interchangeably alike. There is no simple, reliable and accurate diagnostic test to confirm whether the condition is GER or GERD, and this in turn affects research and clinical decisions (1-6). Furthermore, the term GERD covers a number of specific conditions that have different effects and present in different ways. This makes it difficult to identify the person who genuinely has GERD, and to estimate the real prevalence and burden of the problem

To receive a copy of the article contact us

L'articolo Gastric reflux: comparison between the gastroenterologist and the otorhinolaryngologist’s approach. sembra essere il primo su Nekkar LAB.

The gastric reflux: the therapeutical role of Marial.

2018-07-03T09:36:00Z

Pubblicato su: Journal of Biological Regulators & Homeostatic Agents Volume 32, No (S2), January-February, 2018

Autori: Aragona SE, Mereghetti G, Ciprandi G.

Abstract: The worldwide relevance of gastroesophageal reflux disease (GERD) has had a considerable increase in recent years. The guidelines for the diagnosis and treatment of GERD are well consolidated and continuously updated. Recently, the extra-esophageal manifestations of reflux have been considered from a multidisciplinary point of view, so the symptoms of the laryngo-pharyngeal reflux (LPR) have been precisely defined. At present, a new Medical Compound (Marial®) has the indication for the treatment of both GERD and LPR. Clinical experience has initially confirmed its effectiveness in both disorders.

To receive a copy of the article contact us

L'articolo The gastric reflux: the therapeutical role of Marial. sembra essere il primo su Nekkar LAB.

The EMERGE: an Italian Survey- Part I

2018-07-03T08:21:53Z

Titolo: The EMERGE (emerging from Gastroesophageal Reflux): an Italian Survey-I the viewpoint of the Gastroenterologist.

Pubblicato su: Journal of Biological Regulators & Homeostatic Agents Volume 32, No (S2), January-February, 2018

Autori: Bianchetti M, Peralta S, Nicita R, Aragona SE, Ciprandi G and the EMERGE Study Group

Abstract: Gastroesophageal reflux disease (GERD) is defined as a “disease that develops when the reflux of stomach contents induces troublesome symptoms and/or complications”. From a therapeutic point of view, many options have been proposed, including proton pump inhibitors (PPI), antihistamines (H2- receptor antagonists), antacid chemical compounds, antireflux barrier (using alginates), prokinetics, inhibitors of gastric sphincters, protection of mucosal tissue, neuromodulators, nociceptor antagonists, lifestyle modification, and surgery. A new medical compound has been recently launched in Italy: Marial® (manufactured by Aurora, Milan, Italy) containing magnesium alginate and E-Gastryal®. The aim of this survey was to analyse the patients’ characteristics and the prescriptive approach considering both the past or current treatments and clinical features during a visit in 56 gastroenterological centers, distributed in the whole of Italy. One thousand eight hundred forty-nine patients (46.5% males, and 53.5% females, mean age 48.59 years) were visited. Patients with positive reflux symptoms index (RSI+) had higher GIS scores than RSI- subjects. PPIs (both as monotherapy or plus add-on) were the most common medication prescribed before the visit. There was a significant change of prescription to Marial® at the visit. More precisely,, Marial® was preferentially prescribed to about a quarter of the patients, particularly to those with lower GIS score, whereas PPI plus add-on option was preferred for patients with higher GIS score. In conclusion, the current experience demonstrated that GERD may be managed considering a patient-centred work-up by using the GIS questionnaire. GIS score may be able to define the medication choice that includes also the new medical compound Marial®.

To receive a copy of the article contact us

L'articolo The EMERGE: an Italian Survey- Part I sembra essere il primo su Nekkar LAB.

The EMERGE: an Italian Survey- Part II

2018-07-03T08:27:30Z

Titolo: The EMERGE (emerging from Gastroesophageal Reflux): an Italian Survey-II the viewpoint of the Gastroenterologist.

Pubblicato su: Journal of Biological Regulators & Homeostatic Agents Volume 32, No (S2), January-February, 2018

Autori: Bianchetti M, Peralta S, Nicita R, Aragona SE, Ciprandi G and the EMERGE Study Group

Abstract: Gastroesophageal reflux disease (GERD) is a very common disease, as about a quarter of the Western population has GERD symptoms at least weekly and GERD is the most frequent reason for outpatient gastroenterology consultation. GERD treatment is based on proton pump inhibitor (PPI) use, but PPI may be ineffective in some patients and potentially unsafe if administered for very long time. A new medical compound (Marial®) has been introduced on the Italian market. This product contains magnesium alginate and a phytopolymer: it may be able to repair ulcer/erosion, protect mucosal tissue, and contrast acid contents. The current survey was conducted on a large group of GERD patients visited at 56 Italian gastroenterological offices. Patients were treated with PPI alone, PPI plus add-on, or Marial® for 4 weeks: the choice was decided by each gastroenterologist on the basis of the best practice criterion. A reflux symptoms index (RSI) questionnaire was used to weekly assess the clinical features. Marial® and PPI plus add-on significantly reduced RSI scores, from the second week. Noteworthy, Marial® was more effective than PPI plus add-on. In conclusion, the current survey demonstrated that patients with GERD perceived a significant improvement of GERD symptoms measured by the RSI questionnaire. Marial® was as effective as PPI plus add-on.

To receive a copy of the article contact us

L'articolo The EMERGE: an Italian Survey- Part II sembra essere il primo su Nekkar LAB.

Correlation between the Reflux Finding Score and the GERD Impact Scale

2018-07-03T08:29:33Z

Titolo: Correlation between the Reflux Finding Score and the GERD Impact Scale in patients with Gastroesophageal Reflux Disease. J Biol Reg Mol Ag 2018 (in press)

Pubblicato su: Journal of Biological Regulators & Homeostatic Agents Volume 32, No (S2), January-February, 2018

Autori: Bianchetti M, Peralta S, Nicita R, Aragona SE, Ciprandi G and the EMERGE Study Group

Abstract: Gastroesophageal reflux disease (GERD) is a very common disorder. As there is no gold standard diagnostic tool, patient-based strategy is adopted in clinical practice. In this regard, there are questionnaires able to easily and rapidly assess symptom severity directly by the patient. The GERD Impact Scale (GIS) and the Reflux Symptom Index (RSI) have been validated as diagnostic tools in routine clinical care. The present study aimed to correlate RIS values with GIS scores in a large cohort of GERD patients visited at gastroenterological clinics. Globally, 785 subjects (51.2% males, 48.8% females, mean age: 49.59 years) were visited in 56 Italian gastroenterological offices. The current study demonstrates that a GIS value >19 may be a reliable cut-off to define the positivity of the test, and GIS and RSI were significantly correlated. Therefore, both tests may be recommended for GERD patients in clinical practice.

To receive a copy of the article contact us

L'articolo Correlation between the Reflux Finding Score and the GERD Impact Scale sembra essere il primo su Nekkar LAB.