PubMed Health⌕ Search

Biomedical subjects

F Santalucia

Publications and source records attributed to F Santalucia.

4 recordsLinked to original sources
PubMed1995

Short and long-term outcome of medically treated reflux esophagitis.

The purpose of this retrospective study was to characterize the clinical course of medically-treated reflux esophagitis and to identify factors related to acute healing and relapse of the disease. We investigated 77 patients (56 males, 21 females, mean age 46.9 years) suffering from esophagitis (grade I-IV according to Savary and Miller), who were referred to our Unit during the period between January 1984 and December 1988. Typical GER symptoms were present in 63 patients, 51 of whom had esophageal 24-hour pH-monitoring suggestive of pathological GER, defined as total time with pH < 4 equal to or greater than 7%. All patients received 3 to 6 months of treatment (H2-antagonists = 68, antacids = 6, prokinetic drugs = 1, omeprazole = 2). After 3 months of therapy 39/88 patients (50.7%) had healed, and this figure increased to 56/77 patients (72.7%) after 6 months. The majority of these patients (N = 49) subsequently underwent a 24-week course of treatment, mostly with low-dose H2-antagonists (N = 44). At the end of treatment, 34/49 patients (69.3%) remained healed, while 15/49 (30.7%) relapsed, 40% asymptomatically. 14/21 patients (66.7%) who were not healed after 6 months' therapy, healed when the same treatment was prolonged up to 18 months (median: 11 months). The only factor found to influence acute healing significantly was the type of therapy, while none of the variables analyzed were seen to correlate with disease relapse.

Adolescent↗
PubMed1992

pH fluctuations versus reflux episodes in patients with gastroesophageal reflux disease: their optimal thresholds and significance in diagnosis.

In physiological and pathological conditions, pH monitoring in the esophagus shows small variations as well as more pronounced deflections. However, only the latter are traditionally taken into account in 24-hour pH monitoring analysis. The present study was designed to establish optimal thresholds of pH fluctuations versus reflux episodes in separating physiological and pathological gastroesophageal reflux (GER) and to evaluate their significance in the diagnosis. Twenty-four-hour intraesophageal pH monitoring and endoscopy were performed in 62 patients with GER symptoms and in 42 healthy controls. The results showed that the percentages of the time with pH fluctuations in patients with and without esophagitis and in healthy controls were, on average, 12.65, 9.5 and 2.76% in 24 h, respectively, and the respective percentages of the time with reflux episodes in the same groups in 24 h were, on average, 3.12, 2.04 and 0.18%, respectively. Using a receiver-operating-characteristic curve analysis, less than 6.7% of the time with pH fluctuations and less than 0.1% of the time with reflux episodes were defined as the combined thresholds for physiological versus pathological reflux. The sensitivity of the combined thresholds for the detection of GER patients with and without esophagitis was 96.7 and 90%, respectively, and their specificity for the diagnosis of patients with abnormal GER was 100%. It is concluded that pH fluctuations and reflux episodes, when evaluated together, are more useful for classifying patients with GER and their combined thresholds yield higher diagnostic accuracy in assessing patients with gastroesophageal disease.

Adolescent↗
PubMed1991

Natural history of gastro-oesophageal reflux disease without oesophagitis.

This retrospective study was undertaken to characterise the clinical course and reflux pattern of patients with gastro-oesophageal reflux without evidence of oesophagitis. We investigated 33 patients (12 women, 21 men; mean age 36 years) with typical symptoms, a negative oesophagoscopy, and a 24 hour oesophageal pH-metry indicative of pathological gastro-oesophageal reflux. All patients received antacids or prokinetic drugs or both for three to six months. Nineteen of 33 patients still had symptoms at the end of treatment, of whom five had developed erosive changes of the oesophageal mucosa. The other 14 discontinued treatment and remained asymptomatic during a six month follow up period. Comparison of the pretreatment pH-metry data of the 19 symptomatic patients and the 14 asymptomatic patients showed no differences in the pattern of gastro-oesophageal reflux in the two groups. We conclude that in a substantial proportion of patients with pathological reflux without oesophagitis symptoms may persist and mucosal lesions may develop during conventional treatment without any apparent change in the reflux. Patients who developed endoscopic oesophagitis did not have a more severe pretreatment pattern of gastro-oesophageal reflux when compared with those who did not develop oesophageal mucosal damage.

Adult↗