Fundoplicatio sec. Nissen videolaparoscopica e metaplasia intestinale in esofago: osservazioni preliminari

The aim of this preliminary study conducted in a few cases was the retrospective evaluation of the effects of laparoscopic Nissen fundoplication on oesophageal intestinal metaplasia. Seventy-seven patients with hiatal hernia underwent digital videofluorography, endoscopy with biopsies, motility studies and 24-h oesophageal pH-monitoring. On the basis of the results of the diagnostic procedures and considering the patients' ages and response to proton-pump inhibitor treatment, 8 patients underwent laparoscopic Nissen fundoplication; in 5 cases intestinal metaplasia was present at histopathological examination. Two of these had Barrett's oesophagus at endoscopy and intestinal metaplasia was a…

Local neck symptoms before and after thyroidectomy: a possible correlation with gastroesophageal reflux and reflux laryngopharingitis.

P02.25 LOCAL NECK SYMPTOMS BEFORE AND AFTER THYROIDECTOMY: A POSSIBLE CORRELATION WITH GASTROESOPHAGEAL REFLUX AND REFLUX LARYNGOPHARYNGITIS. Alessia Cusimano1, Achille Mastrosimone2, Eugenio Fiorentino1 1Policlinico Of Palermo, Palermo/ITALY, 2Policlinico Of Palermo, Agrigento/ITALY Background: Swallowing, voice disorders and throat discomfort are usually reported by patients with a thyroid nodule. it may frequently occur in patients who have undergone uncomplicated TT complain of symptoms such as swallowing disorders, hoarseness, a sensation of strangling or of a lump in the neck, a cough and sore throat, all usually attributed to oro- tracheal intubation. Swallowing, voice and throat dis…

Laparoscopic Nissen fundoplication and short segment Barrett's esophagus

Significance of P16INK4A hypermethylation gene in primary head/neck and colorectal tumors: it is a specific tissue event? Results of a 3-year GOIM (Gruppo Oncologico dell'Italia Meridionale) prospective study

Background Methylation of the p16 promoter is one of the most frequent mechanisms of gene inactivation; its incidence is extremely variable according to the type of tumor involved. Our purpose was to analyze the hypermethylation of the p16 promoter in laryngeal squamous cell carcinomas (LSCC), salivary gland (SG) tumors and in colorectal cancer (CRC), to detect any possible association with the clinicopathological features and to determine the prognostic significance of the p16 gene in the tumors analyzed. Patients and methods The hypermethylation of the p16 promoter was prospectively analyzed, by MSP, in a consecutive series of 64 locally advanced LSCC patients, in a consecutive series of …

Barium study associated with water siphon test in gastroesophageal reflux disease and its complications.

PURPOSE: The aim of this study was to evaluate the role of digital cineradiography associated with the water siphon test (WST) in the diagnosis of gastroesophageal reflux and to compare the results with oesophageal motility study, pH monitoring and endoscopy associated with biopsy and histology. MATERIALS AND METHODS: One hundred and sixty consecutive patients underwent digital cineradiography with WST, motility study, pH monitoring and endoscopy with biopsy. The presence of gastroesophageal reflux, oesophagitis, Barrett''s oesophagus and intestinal metaplasia was evaluated. RESULTS: WST vs. pH monitoring showed sensitivity of 71%, specificity of 31%, positive predictive value (PPV) of 53% …

Are erlotinib and gefitinib interchangeable, opposite or complementary for non-small cell lung cancer treatment? Biological, pharmacological and clinical aspects

Abstract: Gefitinib and erlotinib are the two anti-epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) approved for treatment of advanced NSCLC patients. These drugs target one of the most important pathways in lung carcinogenesis and are able to exploit the phenomenon of 'oncogene addiction', with different efficacy according to EGFR gene mutational status in tumor samples. Gefitinib has been approved only for EGFR mutation bearing patients regardless the line of treatment, while erlotinib is also indicated in patients without EGFR mutation who undergo second- or third-line treatment. Some studies evaluated the main differences between these drugs both for direct comp…

HepatomiRNoma: The proposal of a new network of targets for diagnosis, prognosis and therapy in hepatocellular carcinoma

Abstract: The diagnosis and treatment of hepatocellular carcinoma (HCC) underwent a huge advancement in the last years. Recently, microRNAs (miRNAs) have been also studied to provide a new tool for early diagnosis of high risk patients, for prognostic classification to identify those patients who benefit cancer treatment and for predictive definition to select the right targeted drug. In this review we revised all the available data obtained to explore the role of miRNAs in HCC. This analysis led to identification of miRNAs which could gain a diagnostic, prognostic or predictive role. The results of studies on miRNAs involved in HCC are initial and far from providing scientific evidences to…

Analysis of tissue and circulating microRNA expression during metaplastic transformation of the esophagus

Genetic changes involved in the metaplastic progression from squamous esophageal mucosa toward Barrett's metaplasia and adenocarcinoma are almost unknown. Several evidences suggest that some miRNAs are differentially expressed in Barrett's esophagus (BE) and esophageal adenocarcinoma. Among these, miR-143, miR-145, miR-194, miR-203, miR-205, miR-215 appear to have a key role in metaplasia and neoplastic progression. The aim of this study was to analyze deregulated miRNAs in serum and esophageal mucosal tissue biopsies to identify new biomarkers that could be associated with different stages of esophageal disease. Esophageal mucosal tissue biopsies and blood samples were collected and analyz…

Digital cineradiographic study of swallowing in infants with neurologic disease. Our experience

Aurora-A overexpression as an early marker of reflux-related columnar mucosa and Barrett's oesophagus.

Abstract BACKGROUND: The development of oesophageal adenocarcinoma is generally closely associated with the presence of a specialised intestinal-type epithelium such as that found in Barrett's oesophagus (BO). A particular histological condition is when the distal oesophagus showing cardiac and/or fundic mucosa without intestinal metaplasia cannot be defined as 'Barrett's mucosa' [condition that we call 'columnar-lined oesophagus' (CLO)] and up till now, there has been no agreement in literature about the management of this condition. Aurora-A overexpression leads to centrosome amplification, chromosomal instability and aneuploidy in mammalian cells. PATIENTS AND METHODS: A prospective stud…

The role of targeted therapy for gastrointestinal tumors

Abstract: Many targeted drugs have been studied to target the molecular pathways involved in the development of gastrointestinal cancers. Anti-VEGF, anti-EGFR agents, and recently also multi-kinase inhibitor regorafenib, have already been available for the treatment of metastatic colorectal cancer patients. To date, Her-2 positive, gastric cancer patients, are also treated with trastuzumab, while the multi-targeted inhibitor, sorafenib, represents the standard treatment for hepatocellular carcinoma patients. Finally, sunitinib and everolimus, have been approved for the treatment of the neuroendocrine gastroenteropancreatic tumors. Actually a great number of further drugs are under preclinic…

Evaluation of routine follow-up after surgery for breast carcinoma.

Close postoperative follow-up of patients with breast cancer permits the early detection of possible recurrence of disease. Such follow-up allows for the detection of a tumor mass, that is small enough to permit adequate treatment leading to an increased survival time and better quality of life. Thus we studied 85 patients treated by radical mastectomy in stages I, II, and III during the period from December 1977 to June 1982. Among 82 patients, 41 had axillary node involvement and received adjuvant chemotherapy with C.M.F. All patients received a strict follow-up. Thirty-two patients showed recurrence of the disease, with 28. 1% being discovered while still asymptomatic. Seventy-five perce…

Immunotherapy for recurrent ovarian cancer: a further piece of the puzzle or a striking strategy?

Introduction: Treatment of ovarian cancer has been long standardized with the inclusion of surgery and chemotherapy based on platinum and taxanes, this strategy reaching high remission rates. However, when this treatment fails, further options are available with little benefit. Since ovarian cancer has specific immunologic features, actually immunotherapy is under evalua- 15 tion to overcome treatment failure in patients experiencing recurrence. Areas covered: Immunogenicity of ovarian cancer and its relationship with clinical outcomes is briefly reviewed. The kinds of immunotherapeutic strategies are summarized. The clinical trials investigating immunotherapy in recurrent ovarian cancer pa…

Has videofluorography a value in detecting GERD and Its Complications ?.

Fibronectin (FN), epidermal growth factor-receptor (EGF-R) and heparin-binding epidermal growth factor-like (HB-EGF) urinary expressions and topical toxicity of adjuvant intravesical therapy for non muscle invasive bladder cancer (NMI-BC)

NMI bladder cancer, EGF-R, intravesical therapy. fibronectin

Achalasia and carcinoma of the esophagus

Different figures regarding the relationship between achalasia and carcinoma of the esophagus can be found in the literature. Often achalasia is considered as a risk factor. The author analyzing the data collected from the Shanghai Chest Hospital (S.C.H.) and the Pathophysiology Department of the University of Palermo, both referring centers for esophageal diseases conclude that carcinoma of the esophagus in achalasic patients is just a coincidence and no relationship can be found between the two diseases.

Targeted Therapies in Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is one of the main causes of death in patients affected by chronic liver diseases. The awareness of the biomolecular mechanisms underlying the complex carcinogenic process led to the development of targeted molecules, which are able to block this process. Sorafenib is a tyrosine-kinase inhibitor, and currently, it is the only drug approved by the US Food and Drug Administration (FDA) for the treatment of HCC. However, some studies have demonstrated the efficacy of single drug therapies or combination therapies. They showed an improvement with regard to overall survival, time to progression, and progression-free survival, although these therapies were not free …

Videofluorografia digitale ed acalasia esofagea: dalla diagnosi al follow-up postoperatorio

Laryngopharyngeal reflux as a potential cause of persistent local neck symptoms after total thyroidectomy

Abstract Purpose Local neck symptoms (LNS) may be related to goiter, but are also reported by patients suffering from laryngeal–pharyngeal reflux (LPR). The aim of this study was to investigate whether LPR could play a role in the persistence of some LNS after total thyroidectomy (TT). Methods A consecutive case series of 160 patients with multinodular goiter (MNG) candidate for TT were included in this study. Each patient was closely studied for both the thyroid pathology and reflux disease before and 6 months after surgery to assess the persistence of LNS after surgery. Results Only throat discomfort showed a significant improvement (p  = 0.031) after surgery. On the other hand, swallowin…

[Esophageal digital videofluorography with water siphon test in the post-operative evaluation of the anti-reflux laparoscopic surgery].

Background: In recent years digital videoefluorography (VFG) with water siphon test (WST) has been proposed just for diagnosing biatal bernia and/or gastroesophageal reflux. Patients and Methods: Fifteen patients undergone Laparoscopic Nissen (LN) for complicated GFRD associated to biatal bernia, were referred for VFG and WST in order to evaluate the functional results of surgery. At one- month videofluorographic control thirteen patients had just a minimal prolonged esophageal transit time hut only six of these had an early postoperative dysphagia, whereas at six montJh control the prolonged esophageal transit time was present in three patients two of which complained a very light dysphagi…

Trans-visceral migration of retained surgical gauze as a cause of intestinal obstruction: a case report

AbstractIntroductionA retained surgical sponge in the abdomen is uncommon although it is likely that this finding is underreported in the medical literature. The intravisceral migration of retained surgical gauze is even rarer, as demonstrated by the very few cases reported.Case presentationThree years after undergoing anterior resection of the rectum, a 75-year-old man presented with symptoms of small bowel obstruction. Plain abdominal radiography and CT showed a radio-opaque marker; a foreign body was suspected, probably a piece of retained surgical gauze. An ileotomy of about 5 cm. was performed to confirm this diagnosis and remove the gauze.ConclusionAlthough rare, retained gauze in the…

La cineradiografia digitale nella diagnosi e nel trattamento chirurgico dei disordini motori della giunzione faringo-esofagea

The aim of the study was to report our experience with the use of radiology in functional disorders of the cricopharyngeal muscle and their surgical therapy using digital cineradiology. Five-hundred and seventy dysphagic patients underwent dynamic study of the oral and pharyngeal phases of swallowing (Videofluoroscopic Swallowing Study, VFSS). A motor disorder of the cricopharyngeal muscle was diagnosed by videofluorography in 19 patients: the disorder was mild in 8, moderate in 7 and severe in 4. Two of these underwent cricopharyngeal myotomy, with an improvement in their dysphagia and swallowing mechanisms. VFSS provides a morphological and functional view of the aero-digestive tracts: th…

Laser Pressure Catapulting (LPC): Optimization LPC-System and Genotyping of Colorectal Carcinomas

Genotype analysis is becoming more and more useful in clinical practice, since specific mutations in tumors often correlate with prognosis and/or therapeutic response. Unfortunately, current molecular analytical techniques often require time-consuming and costly steps of analysis, thus making their routine clinical use difficult. Moreover, one of the most difficult problems arising during tumor research is that of their cell heterogeneity, which depends on their clear molecular heterogeneity. SSCP analysis discriminates by means of aberrant electrophoresis migration bands, mutated alleles which may represent as little as 15-20% of their total number. Nevertheless, in order to identify by se…

A minor modification of Lichtenstein repair of primary inguinal hernia: postoperative discomfort evaluation.

The aim of this study was to evaluate the usefulness of a modification of the Lichtenstein hernioplasty procedure by evaluating its impact on postoperative discomfort. From December 1999 to May 2006, the Lichtenstein inguinal hernioplasty was performed in 406 patients with noncomplicated unilateral inguinal hernia. During reconstruction, the mesh was fixed to the inguinal canal floor without stitching its upper margin to the internal oblique muscle. Control of postoperative pain proved to be satisfactory; 72 hours after surgery, 26.1 per cent of patients no longer felt any pain, whereas 54.4 per cent had slight pain without the need for painkillers; on Day 7, 92.8 per cent felt no pain at …

Cancer of the Esophagus

In 2015 esophageal cancer (OC) was globally the 11th most common cancer with 483,000 new cases and the 7th most common cause of cancer-related deaths, with 439,000 deaths. Esophageal cancer is a highly lethal disease of older age, sixth to seventh decades, associated with a remarkable decline in health-related quality of life, high mortality, and poor prognosis with an overall 5-year survival no greater than 20%. The two major histological types, squamous cell carcinoma (SCC) and adenocarcinoma (ADC), while sharing the esophageal site, can be considered like two different neoplastic diseases as they differ in their epidemiology, risk factors, pathogenesis, and treatment. Other malignancies …

Nintedanib in NSCLC: evidence to date and place in therapy

The treatment of advanced non-small cell lung cancer (NSCLC) is currently driven by the detection of targetable oncogenic drivers, i.e. epidermal growth factor receptor, echinoderm microtubule-associated protein-like 4–anaplastic lymphoma kinase, etc. Those patients who are wildtype for known and valuable oncogenes can receive standard chemotherapy as first-line treatment, with the possibility of adding bevacizumab. With regard to second-line treatment, nintedanib can improve the efficacy of docetaxel. Nintedanib is a tyrosine kinase inhibitor targeting three angiogenesis-related transmembrane receptors. The usefulness of nintedanib as an anticancer agent for NSCLC has been proved by both …

How uncomplicated total thyroidectomy could aggravate the laryngopharyngeal reflux disease?

Swallowing, voice disorders, throat discomfort and subjective neck discomfort are usually reported by patients with a known thyroid nodule and are correlated to nodular thyroid disease itself. Moreover, in endemic goitrous areas, total thyroidectomy (TT) is the most frequently performed surgical procedure. We are used to relate swallowing, voice and throat discomfort to the mechanical effects of nodular goiter or to thyroidectomy itself, but in both these cases the relationship between symptoms and the thyroid mass or its removal is not always clear or easily demonstrated. How can we explain the persistence of local neck symptoms after TT? And how can TT worsen the dysphagic or dysphonic di…

Farletuzumab for NSCLC: Exploiting a well-known metabolic pathway for a new therapeutic strategy

Abstract: Introduction: The therapeutic options for NSCLC are limited barring targeted drugs, such as EGFR tyrosine-kinase inhibitors and anaplastic lymphoma kinase inhibitors, for patients bearing oncogenic mutations. Platinum-based chemotherapy remains the best strategy for most patients. New targeted drugs, including mAbs and small molecules, are currently under clinical investigation for treating NSCLC patients. Areas covered: The authors of this article focus on farletuzumab, a mAb targeting folate receptor, which has been studied in ovarian cancer and various other malignancies. In this review, the authors review its potential as therapy for NSCLC, because of the biological rationale …

PS01.057: THYROIDECTOMY AND LARYNGO-PHARYNGEAL REFLUX: WHAT’S NEW

Abstract Background ‘Local neck symptoms’ may be related to goiter; a persistence of those symptoms after an uncomplicated total thyroidectomy (TT) might be referred to the laryngo-pharyngeal reflux (LPR). Our previous study found a correlation between goiter and LPR in selected patients with local neck symptoms; the purpose of our current study is to investigate the presence of a laringopharyngitis in patients with goiter, before and after TT, even in the absence of local neck symptoms, assessing whether the presence of LPR may play a role at the outset of the symptomatology. Methods Two groups of patients were considered and they differred for the presence or absence of local neck symptom…

Targeted Therapies in Hepatocellular Carcinoma

Abstract: The onset of hepatocellular carcinoma (HCC) is related to the development of non-neoplastic liver disease, such as viral infections and cirrhosis. Even though patients with chronic liver diseases undergo clinical surveillance for early diagnosis of HCC, this cancer is often diagnosed in advanced stage. In this case locoregional treatment is not possible and systemic therapies are the best way to control it. Until now sorafenib, a Raf and multi-kinase inhibitor has been the best, choice to treat HCC systemically. It showed a survival benefit in multicenter phase III trials. However the proper patient setting to treat is not well defined, since the results in Child-Pugh B patients a…

L'Esofago di Barrett: il dilemma della diagnosi e della sorveglianza

Dysphagia and dysphonia in patients with thyroid goiter before and after thyroidectomy: Possibly related to the pharyngo-esophageal reflux laryngitis? Videofluorographic evaluation

Dysphagia and dysphonia in patients with thyroid goiter before and after thyroidectomy: Possibly related to the pharyngo-esophageal reflux laryngitis? Videofluorographic evaluation

Local neck symptoms before and after thyroidectomy: a possible correlation with reflux laryngopharyngitis

Objective Local symptoms in the neck such as swallowing, voice disorders and throat discomfort might be related to a goiter if present, but are also reported by patients suffering from reflux laryngopharyngitis. The aim of our study was to investigate the presence of reflux laryngopharyngitis in patients with nodular goiter before and after uncomplicated total thyroidectomy (TT) in order to evaluate if its presence could have any role in the origin of swallowing and voice alterations and throat discomfort. Study Design case series prospective study Setting hospitalized care in University Hospital Patients and Methods We consider twenty-five patients, affected by non-toxic nodular goiter and…

Accuracy of the water-siphon test associated to barium study in a high prevalence gastro-oesophageal reflux disease population: a novel statistical approach

Summary Rationale, aims and objectives  Gastro-oesophageal reflux disease (GORD) is ‘a condition which develops when the reflux of gastric content causes troublesome symptoms or complications’. Instrumental diagnostic tests generally used for GORD are 24-hour pH-metry and upper gastrointestinal (GI) endoscopy but barium study associated with provocative manoeuvres such as the water-siphon test (WST), has also been used for GORD. The aim of this paper was to estimate the accuracy of several tests in patients with GORD in a tertiary care setting, focusing on WST, which is rapid and non-invasive, simple to perform and well-tolerated by patients. Method  A total of 172 consecutive patients, sym…

espressione della citocheratina 7 come marker precoce di danno da reflusso nella muocsa colonnare dell'esofago in assenza di metaplasia intestinale

IL REFLUSSO ACIDO

The role of microRNAs in cancer: diagnostic and prognostic biomarkers and targets of therapies

Introduction: miRNAs are noncoding RNAs that target specific mRNA with subsequent regulation of particular genes, implicated in various biological processes. In cancer, miRNAs could show a different expression from normal tissues. miRNAs have a role as oncogenes when they target tumor suppressor genes and similarly they are tumor suppressors when they target oncogenes. Areas covered: In this review, areas covered include the role of miRNAs in cancer diagnosis, prognosis and research for achievement of therapeutic strategies implicating miRNAs in oncology. As biogenesis of miRNAs is fundamental to understand their usefulness, this has also been discussed. Both miRNA expression profiles in ca…

Gastro-gastric fistula after Gastric by-pass: from a casual complication the answer to the problem of gastro-duodenal and bilio-pancreatic inexplorability ?

The molecular changes driving the carcinogenesis in Barrett's esophagus: which came first, the chicken or the egg?

Esophageal adenocarcinoma originates from columnar metaplastic epithelium of the distal esophagus. Various steps for this carcinogenetic process are known. Before the onset of high-grade dysplasia and adenocarcinoma, endoscopic surveillance is possible. However, because of the high cost of long-term surveillance, predictive factors for cancer are being evaluated to identify subjects with metaplasia who have a higher risk of developing malignancy. Molecular changes seem suitable for this purpose, but could require a high resource expenditure. While trying to identify the best predictive factors for cancer risk, molecular changes and differences in miRNA expression profile between the various…

The consumption of snacks and soft drinks between meals may contribute to the development and to persistence of gastro-esophageal reflux disease

Abstract The hypothesis The habit of snacking and drinking soft beverages between breakfast, lunch and dinner, which is very widespread in the western world, could be a primum movens, thereby contributing to the development and subsequent persistence of gastroesophageal reflux disease (GERD). What does the proposed hypothesis based on? The high prevalence of GERD suggests that it is very probably caused by factors, which are intrinsic and widespread in a western lifestyle. Ingesting snacks or imbibing soft drinks between breakfast, lunch and dinner causes additional gastric acid secretion, acid pocket formation, and additional transient lower esophageal sphincter relaxations (TLESRs) with a…

Immunohistochemical/histochemical double staining method in the study of the columnar metaplasia of the oesophagus

Intestinal metaplasia in Barrett’s oesophagus (BO) represents an important risk factor for oesophageal adenocarcinoma. Instead, few and controversial data are reported about the progression risk of columnar-lined oesophagus without intestinal metaplasia (CLO), posing an issue about its clinical management. The aim was to evaluate if some immunophenotypic changes were present in CLO independently of the presence of the goblet cells. We studied a series of oesophageal biopsies from patients with endoscopic finding of columnar metaplasia, by performing some immunohistochemical stainings (CK7, p53, AuroraA) combined with histochemistry (Alcian-blue and Alcian/PAS), with the aim of simultaneousl…

Monoclonal antibodies in gastrointestinal cancers

Introduction: Among gastrointestinal cancers, colorectal and gastric neoplasms are the most frequent. The development of new targeted drugs improved the efficacy of systemic therapy in advanced stages of those malignancies. Areas covered: This review highlights the main biological processes implicated in gastrointestinal cancer development and progression, such as angiogenesis and epidermal growth factor receptor (EGFR) signaling pathway. On these bases, anti-EGFR and anti-vascular endothelial growth factor (VEGF) monoclonal antibodies in colorectal and gastric cancer are discussed. Data about further monoclonal antibodies in development are also reported. Expert opinion: The use of monoclo…

Gastrooesophageal reflux and "Epileptic" attacks: casually associated or related? Efficiency of antireflux surgery, a case report

P02.30 GASTRO-OESOPHAGEAL REFLUX AND “EPILEPTIC” ATTACKS: CASUALLY ASSOCIATED OR RELATED? EFFICIENCY OF ANTIREFLUX SURGERY A CASE REPORT Achille Mastrosimone1, Alessia Cusimano2, Silvia Marino2, Gianni Pantuso2, Eugenio Fiorentino2 1Policlinico Of Palermo, Palermo/ITALY, 2University Of Palermo, Palermo/ITALY Background: Although a possible link between gastro-oesophageal reflux disease (GORD) and obstructive sleeping apnoea has already been reported in the literature, there has never been any suggestion of an association with epilepsy, and epileptic attacks have not so far been included among gastro- oesophageal reflux disease symptoms. Methods: We report the case of a patient with gastro-o…

Columnar-Lined Esophagus CK7 Positive is an Early Marker of Gastroesophageal Reflux Disease

LETTER TO EDITOR

TP53 mutations and microsatellite instability are prognostic factors in gastric cancer?

What can platinum offer yet in the treatment of PS2 NSCLC patients? A systematic review and meta-analysis

Abstract: Background: Randomized phase III trials showed interesting, but conflicting results, regarding the treatment of NSCLC, PS2 population. This meta-analysis aims to review all randomized trials comparing platinum-based doublets and single-agents in NSCLC PS2 patients. Materials and methods: Data from all published randomized trials, comparing efficacy and safety of platinum-based doublets to single agents in untreated NSCLC, PS2 patients, were collected. Pooled ORs were calculated for the 1-year Survival-Rate (ly-SR), Overall Response Rate (ORR), and grade 3-4 (G3-4) hematologic toxicities. Results: Six eligible trials (741 patients) were selected. Pooled analysis showed a significan…

The value of total thyroidectomy as the definitive treatment for Graves’ disease: A single centre experience of 594 cases

Highlights • Total thyroidectomy is a safe and effective treatment for Graves’ disease. • It is associated with a very low incidence rate of post-operative complications. • Total thyroidectomy offers a rapid and definitive control of hyperthyroidism and its related symptoms.

Water-siphon test associated to barium study in the diagnosis of Gastro-Esophageal Reflux: a novel statistical approach

Author's reply: Laryngopharyngeal reflux as a potential cause of persistent local neck symptoms after total thyroidectomy.