Upper Endoscopy in Patients with Extra-Oesophageal Reflux Symptoms: A Multicentre Study

Background: There are no evidence-based recommendations for performing upper gastrointestinal endoscopy (UGIE) in patients with extra-oesophageal symptoms of gastro-oesophageal reflux disease (GORD). However, UGIEs are often performed in clinical practice in these patients. We aimed to assess the prevalence of gastro-oesophageal lesions in patients with atypical GORD symptoms. Methods: Patients complaining of at least one extra-oesophageal GORD symptom and undergoing UGIE in seven centres were prospectively enrolled. Clinically relevant lesions (Barrett's oesophagus, erosive oesophagitis, gastric precancerous conditions, peptic ulcer, cancer, and H. pylori infection) were statistically compared between groups regarding GORD symptoms (atypical vs. both typical and atypical), type of atypical symptoms, age, and presence of hiatal hernia. Results: Two hundred eleven patients were enrolled (male/female: 74/137; mean age: 55.5 ± 14.7 years). Barrett's oesophagus was detected in 4 (1.9%), erosive oesophagitis in 12 (5.7%), gastric precancerous conditions in 22 (10.4%), and H. pylori infection in 38 (18%) patients. Prevalence of clinically relevant lesions was lower in patients with only atypical GORD symptoms (28.6 vs. 42.5%; p = 0.046; χ2 test), in patients ≤50 years (20 vs. 44.8%; p = 0.004; χ2 test), and in those in ongoing proton pump inhibitor (PPI) therapy (21.1 vs. 40.2%; p = 0.01; χ2 test). No clinically relevant lesions were detected in patients ≤50 years, without alarm symptoms, and receiving PPI therapy. Hiatal hernia was diagnosed in only 6 patients with cardiologic and in 41 patients with ear-nose-throat symptoms (11.3 vs. 35.1%; p = 0.03; χ2 test). Conclusions: Clinically relevant lesions are uncommon among young (≤50 years) patients with extra-oesophageal GORD symptoms. Hiatal hernia is not more prevalent in patients with cardiologic symptoms and suspicion of GORD. The usefulness of UGIE in these patients is questionable

Clinical care pathway program versus open-access system: a study on appropriateness, quality, and efficiency in the delivery of colonoscopy in the colorectal cancer

Open-access colonoscopy (OAC), whereby the colonoscopy is performed without a prior office visit with a gastroenterologist, is affected by inappropriateness which leads to overprescription and reduced availability of the procedure in case of alarming symptoms. The clinical care pathway (CCP) is a healthcare management tool promoted by national health systems to organize work-up of various morbidities. Recently, we started a CCP dedicated to colorectal cancer (CRC), including a colonoscopy session for CRC diagnosis and prevention. We aimed to evaluate the appropriateness, the quality, and the efficiency in the delivery of colonoscopy with the open-access system and a CCP program in the CRC. Quality indicators for colonoscopy in subjects in the CCP were compared to referrals by general practitioners (OAC) or by non-gastroenterologist physicians (non-gastroenterologist physician colonoscopy, NGPC). Attendance rate to colonoscopy was greater in the CCP group and NGPC group than in the OAC group (99%, 99%, and 86%, respectively). Waiting time in the CCP group was shorter than in the OAC group (3.88 +/- 2.27 vs. 32 +/- 22.31 weeks, respectively). Appropriateness of colonoscopy prescription was better in the CCP group than in the OAC group (92 vs. 50%, respectively). OAC is affected by the lack of timeliness and low appropriateness of prescription. A CCP reduces the number of inappropriate colonoscopies, especially for post-polypectomy surveillance, and improves the delivery of colonoscopy in patients requiring a fast-track examination. The high rate of inappropriate OAC suggests that this modality of healthcare should be widely reviewed

Measuring the hadronic cross section via radiative return

Recently it has been demonstrated that particle factories, such as DAPHNE and PEP-II, operating at fixed center-of-mass energies, are able to measure hadronic cross sections as a function of the hadronic system energy using the raditive return. This paper is an experimental overview of the progress in this aera. Preliminary results from KLOE for the process e+e- -> \rho \gamma -> \pi+\pi-\gamma and a fit to the pion form factor are presented. Some first results from the BABAR collaboration are also shown.Comment: Invited talk presented at RADCOR/Loops and Legs 2002, Kloster Banz/Germany, September 8-13 2002, 6 pages, 2 Figures; v1: references added, typos correcte

Measurement of the branching fraction for the decay KS --> pi e nu

We present a measurement of the branching ratio BR(KS --> pi e nu) performed using the KLOE detector. KS mesons are produced in the reaction e+ e- --> phi --> KS KL at the DAFNE collider. In a sample of about 5 million KS-tagged events we find 624 +- 30 semileptonic KS decays. Normalizing to the KS --> pi+ pi- count in the same data sample, we obtain BR(KS --> pi e nu) = (6.91 +- 0.37) 10^-4, in agreement with the Standard Model expectation.Comment: 9 pages, 5 Encapsulated Postscript figures. Submitted to Phys. Lett.

Measurement of Gamma(phi -> eta' gamma)/Gamma(phi -> eta gamma) and the pseudoscalar mixing angle

We have measured the radiative decays phi -> eta gamma, phi ->etaprime gamma selecting pi+ pi- gamma gamma gamma final state in a sample of about 5 times 10^7 phi mesons produced at the Frascati phi factory DAFNE. We obtain Gamma(phi -> etaprime gamma)/Gamma(phi -> eta gamma)=(4.70 +- 0.47 +- 0.31) times 10^-3. From this result we derive new accurate values for the branching ratio BR(phi ->etaprime gamma) = (6.10 +- 0.61 +- 0.43) times 10^-5, and the mixing angle of pseudoscalar mesons in the flavour basis phi_P=(41.8 +1.9 -1.6) degrees.Comment: Submitted to Phys. Lett.

Study of the Decay phi --> eta pi0 gamma with the KLOE detector

In a sample of 5.3x10^7 phi-decays observed with the KLOE detector at the Frascati phi-factory Dafne we find 605 eta pi0 gamma events with eta --> gamma\gamma and 197 eta pi0 gamma events with eta --> pi+ pi- pi0. The decay phi --> eta pi0 gamma is dominated by the process phi --> a0 gamma. From a fit to the eta pi0 mass spectrum we find BR(phi --> ao(980) gamma)= (7.4 +- 0.7)x10^-5.Comment: 12 pages, 6 figures, submitted to Phys.Lett.

The full-length prototype of the KLOE drift chamber

The main goal of the KLOE experiment is the study of CP violation in the K mesons system, with an accuracy of 10(-4) in the measurement of Re(epsilon'/epsilon). This task imposes strong constraints on the design and operation of the drift chamber, which must reconstruct the charged decays of low momentum K-L's and K-S's with high efficiency and high resolution, full-length prototype of the chamber has been built and tested on a 50 GeV/c beam. The analysis of the large sample of data has allowed a detailed study of the time to distance relations as a function of the track parameters and of the peculiar geometry of the drift cell, The detector performance, in terms of efficiency, spatial resolutions and dE/dx resolution, is illustrated and discussed

Description and performance of MEA, The magnetic detector at adone

Abstract The experimental detector at Adone, MEA, which operates with its magnetic field perpendicular to the e + e − beams is described. Studies of the magnetic compensation for operation at Adone and resulting magnetic fields are presented. Particles are detected and analyzed using narrow-gap and wide-gap spark chambers which are triggered by scintillation and proportional counters. Momentum measurements for charged particles are made with Δ / p / p = ±0.07 at p = 1 Gev/ c ( B = 2.5 kG) and angles are measured to better than ± 1.5° over a solid angle of ∼0.3 × 4 π sr