High amplitude contractions in the middle third of the esophagus: a manometric marker of chronic alcoholism?

BACKGROUND--Oesophageal motor abnormalities have been reported in alcoholism. AIM--To investigate the effects of chronic alcoholism and its withdrawal on oesophageal disease. PATIENTS--23 chronic alcoholic patients (20 men and three women; mean age 43, range 23 to 54). METHODS--Endoscopy, manometry, and 24 hour pH monitoring 7-10 days and six months after ethanol withdrawal. Tests for autonomic and peripheral neuropathy were also performed. Motility and pH tracings were compared with those of age and sex matched control groups: healthy volunteers, nutcracker oesophagus, and gastro-oesophageal reflux disease. RESULTS--14 (61%) alcoholic patients had reflux symptoms, and endoscopy with biopsy showed oesophageal inflammation in 10 patients. One patient had an asymptomatic squamous cell carcinoma. Oesophageal motility studies in the alcoholic patients showed that peristaltic amplitude in the middle third was > 150 mm Hg (95th percentile (P95) of healthy controls) in 13 (57%), the ratio lower/ middle amplitude was < 0.9 in 15 (65%) (> 0.9 in all control groups), and the lower oesophageal sphincter was hypertensive (> 23.4 mm Hg, P95 of healthy controls) in 13 (57%). All three abnormalities were present in five (22%). Abnormal reflux (per cent reflux time > 2.9, P95 of healthy controls) was shown in 12 (52%) alcoholic patients, and was unrelated to peristaltic dysfunction. Subclinical neuropathy in 10 patients did not effect oesophageal abnormalities. Oesophageal motility abnormalities persisted at six months in six patients with ongoing alcoholism, whereas they reverted towards normal in 13 who remained abstinent; reflux, however, was unaffected. CONCLUSIONS--Oesophageal peristaltic dysfunction and reflux are frequent in alcoholism. High amplitude contractions in the middle third of the oesophagus seem to be a marker of excessive alcohol consumption, and tend to improve with abstinence.

Predictive factors in the long term outcome in gastro-oesophageal reflux disease: six years follow up of 107 patients

There is little information concerning the long term outcome of patients with gastro-oesophageal reflux disease (GORD). Thus 109 patients with reflux symptoms (33 with erosive oesophagitis) with a diagnosis of GORD after clinical evaluation and oesophageal testing were studied. All patients were treated with a stepwise approach: (a) lifestyle changes were suggested aimed at reducing reflux and antacids and the prokinetic agent domperidone were prescribed; (b) H2 blockers were added after two months when symptoms persisted; (c) anti-reflux surgery was indicated when there was no response to (b). Treatment was adjusted to maintain clinical remission during follow up. Long term treatment need was defined as minor when conservative measures sufficed for proper control, and as major if daily H2 blockers or surgery were required. The results showed that one third of the patients each had initial therapeutic need (a), (b), and (c). Of 103 patients available for follow up at three years and 89 at six years, respective therapeutic needs were minor in 52% and 55% and major in 48% and 45%. Eighty per cent of patients in (a), 67% in (b), and 17% in (c) required only conservative measures at six years. A decreasing lower oesophageal sphincter pressure (p < 0.001), radiological reflux (p = 0.028), and erosive oesophagitis (p = 0.031), but not initial clinical scores, were independent predictors of major therapeutic need as shown by multivariate analysis. The long term outcome of GORD is better than previously perceived.

El país del dos y el país del tres. Cuento didáctico

Cuento didáctico para explicar las figuras musicales y las relaciones entre ellas, así como los compases simples y compuestos y los grupos artificiales.

Sintesis por implantacion ionica de nanocristales semiconductores para dispositivos en tecnologia de Si

En este artículo se estudia la síntesis de nanocristales semiconductores elementales y compuestos elaborados por implantación iónica en SiO2. En el caso de los nanocristales de Si, se ha desarrollado un estudio sistemático que correlaciona las características de los precipitados y sus propiedades de luminiscencia. Nanopartículas de Ge, que presentan menor emisión pero mayor contraste en Microscopía Electrónica de Transmisión, han sido fabricadas para desarrollar un nuevo método de medida de la densidad de nanocristales en matrices amorfas. Por otro lado, nanopartículas de ZnS dopadas con Mn han sido elaboradas por primera vez con esta técnica, observando la emisión de un pico de luminescencia característico de una transición intra-Mn. Finalmente, se presentan los primeros resultados ópticos de capas coimplantadas con Si+ y C+, que muestran la presencia de tres picos intensos de luminescencia en las regiones roja, verde y azul del espectro visible, que ha sido relacionada con la presencia de diferentes tipos de nanopartículas. Cabe destacar que la emisión simultánea de los tres picos ha permitido la observación de una intensa emisión de luz blanca.

Billy Budd: de H. Melville a E. M. Forster, o la via Plutarquea vers Plató

L'objectiu d'aquest article és proposar i fonamentar una via plutarquea -no només Les Vides Paral·leles, sinó també L'Eròtic- vers el contingut platònic de Billy Budd de B. Britten amb libretto d'E. M. Fosrter en col·laboració amb Eric Crozier. H. Melville no cita pas Plutarc en la seva novel·la, però l'excel·lent coneixement dels textos de l'escriptor i filòsof grec per part d'E. M. Foster fa que aquesta hipòtesi sigui altament versemblant.

Billy Budd: de H. Melville a E. M. Forster, o la via Plutarquea hacia Platón

El objetivo de este artículo es proponer y fundamentar una vía plutarquea -no sólo Las Vidas Parelelas, sino tambén El Eròtico- al contenido platónico de Billy Budd de B. Britten con libreto de E. M. Foster en colaboración con Eric Crozier. H. Melville no cita a Plutarco en su novela, pero el excelente conocimiento de los textos del escritor y filósofo griego por parte de E. M. Forster hace que esta hipótesis sea altamente verosímil.

Billy Budd: from H. Melville to E. M. Forster, or Plutarch's way to Plató

The aim of this article is to propose and lay the foundations of a Plutarch's way ¿not only his Lives but also his Eroticus- to the Platonic content of Billy Budd by B. Britten with a libretto by E. M. Forster in association with Eric Crozier. Plutarch is not quoted in H. Melville¿s novel, but E. M. Forster¿s good knowledge of the texts by the Greek writer and philosopher makes this hypothesis quite credible

High amplitude contractions in the middle third of the esophagus: a manometric marker of chronic alcoholism?

BACKGROUND--Oesophageal motor abnormalities have been reported in alcoholism. AIM--To investigate the effects of chronic alcoholism and its withdrawal on oesophageal disease. PATIENTS--23 chronic alcoholic patients (20 men and three women; mean age 43, range 23 to 54). METHODS--Endoscopy, manometry, and 24 hour pH monitoring 7-10 days and six months after ethanol withdrawal. Tests for autonomic and peripheral neuropathy were also performed. Motility and pH tracings were compared with those of age and sex matched control groups: healthy volunteers, nutcracker oesophagus, and gastro-oesophageal reflux disease. RESULTS--14 (61%) alcoholic patients had reflux symptoms, and endoscopy with biopsy showed oesophageal inflammation in 10 patients. One patient had an asymptomatic squamous cell carcinoma. Oesophageal motility studies in the alcoholic patients showed that peristaltic amplitude in the middle third was > 150 mm Hg (95th percentile (P95) of healthy controls) in 13 (57%), the ratio lower/ middle amplitude was < 0.9 in 15 (65%) (> 0.9 in all control groups), and the lower oesophageal sphincter was hypertensive (> 23.4 mm Hg, P95 of healthy controls) in 13 (57%). All three abnormalities were present in five (22%). Abnormal reflux (per cent reflux time > 2.9, P95 of healthy controls) was shown in 12 (52%) alcoholic patients, and was unrelated to peristaltic dysfunction. Subclinical neuropathy in 10 patients did not effect oesophageal abnormalities. Oesophageal motility abnormalities persisted at six months in six patients with ongoing alcoholism, whereas they reverted towards normal in 13 who remained abstinent; reflux, however, was unaffected. CONCLUSIONS--Oesophageal peristaltic dysfunction and reflux are frequent in alcoholism. High amplitude contractions in the middle third of the oesophagus seem to be a marker of excessive alcohol consumption, and tend to improve with abstinence.

Predictive factors in the long term outcome in gastro-oesophageal reflux disease: six years follow up of 107 patients

There is little information concerning the long term outcome of patients with gastro-oesophageal reflux disease (GORD). Thus 109 patients with reflux symptoms (33 with erosive oesophagitis) with a diagnosis of GORD after clinical evaluation and oesophageal testing were studied. All patients were treated with a stepwise approach: (a) lifestyle changes were suggested aimed at reducing reflux and antacids and the prokinetic agent domperidone were prescribed; (b) H2 blockers were added after two months when symptoms persisted; (c) anti-reflux surgery was indicated when there was no response to (b). Treatment was adjusted to maintain clinical remission during follow up. Long term treatment need was defined as minor when conservative measures sufficed for proper control, and as major if daily H2 blockers or surgery were required. The results showed that one third of the patients each had initial therapeutic need (a), (b), and (c). Of 103 patients available for follow up at three years and 89 at six years, respective therapeutic needs were minor in 52% and 55% and major in 48% and 45%. Eighty per cent of patients in (a), 67% in (b), and 17% in (c) required only conservative measures at six years. A decreasing lower oesophageal sphincter pressure (p < 0.001), radiological reflux (p = 0.028), and erosive oesophagitis (p = 0.031), but not initial clinical scores, were independent predictors of major therapeutic need as shown by multivariate analysis. The long term outcome of GORD is better than previously perceived.

Oxiesteroles: efectos biologicos, formacion, contenido y determinacion en alimentos

Se realiza una revisión bibliográfica de los aspectos nutricionales y bromatológicos de los llamados oxiesteroles. Se recogen los efectos biológicos descritos para estos compuestos, su presencia y formación en alimentos y la metodología analítica para su determinación.

Formacion de derivados oxidados de colesterol en alimentos

Este trabajo constituye una revisión bibliográfica en donde se recogen los mecanismos de formación de los diferentes oxiesteroles, los factores que influyen en la formación de estos compuestos en alimentos y su contenido en los mismos. Aspectos de creciente interés debido a la gran cantidad de efectos biológicos descritos para estos derivados.

Una nova eina per a l’estudi del paper i les filigranes. Anà lisi i desenvolupament d’una base de dades per a l’estudi del paper i de les filigranes: font per a l’elaboració de la història del paper a Espanya

L’aspiració de trobar una eina que pugui ajudar a identifi car els papers atenent les sevescaracterístiques sorgeix a fi nal segle XVIII amb les primeres descripcions de les filigranespapereres i va prenent cos al segle XIX com a ciència auxiliar de la codicologia.Des de les últimes dècades del segle XX, les filigranes han anat adquirint un interès creixententre els restauradors de document gràfi c —com una eina més per a la presa de decisions i pera la valoració del procés de restauració— i entre els documentalistes, historiadors, museòlegsi bibliòfils —per a la datació i autenticació de les obres— i, fins i tot, en investigacionspolicials i jurídiques per aclarir algun fet delictiu. No obstant això, durant aquests 150 anys, l’estudi del paper a través de les filigranes papereres a Espanya no ha experimentat cap avenç significatiu pel que fa als mètodes i procediments seguits per a l’obtenció i gestió deles dades. En l’àmbit europeu, encara que a partir dels anys 90 sorgeixen noves propostesd’estudi, aquestes limiten la investigació a l’anàlisi de la filigrana sense assolir una visió global del plec sortit de la forma.

Phytolith and spherulite studies of herbivores dung from the African Savannah as a tool for palaeocological reconstruction.

Los restos fecales están compuestos mayoritariamente por materia orgánica, la cual se degrada con el tiempo despareciendo finalmente del registro arqueológico. Sin embargo, estos restos fecales también contienen ciertos elementos resistentes al paso del tiempo y a los efectos postdeposicionales. Las esferulitas son cristales de carbonato cálcico formadas en los intestinos de ciertos animales herbívoros, principalmente rumiantes y que posteriormente son depositados en los restos fecales. Los fitolitos de sílice, aunque se forman en las plantas, son también comúnmente identificados en los restos fecales de animales herbívoros. Su número y morfología dependerá de la dieta vegetal de estos animales. El estudio que aquí se presenta se centra en el análisis microscópico de ambos elementos, fitolitos y esferulitas, identificados en restos fecales, de varios animales herbívoros, recolectados durante la estación seca en la Garganta de Olduvai en Tanzania. Los fitolitos y las esferulitas fueron identificados y analizados siguiendo un método morfológico y cuantitativo. Los fitolitos fueron luego comparados con una colección de referencia de plantas modernas de la misma zona geográfica con el propósito de estudiar la dieta de cada uno de los animales analizados. Finalmente los resultados fueron relacionados con los obtenidos del estudio de esferulitas, con el propósito de analizar la relación entre morfología y número de fitolitos y morfología y número de esferulitas para cada uno de los restos fecales analizados. El objetivo de este trabajo consiste en evaluar la utilidad de combinar ambas técnicas para identificar restos fecales en el registro arqueológico y, consecuentemente, responder a cuestiones relacionadas con el animal productor de estos restos, su dieta y movimientos migratorios y, paralelamente, la paleovegetación y el paleopaisaje en una región determinada.

Perceptions of diabetes obtained through drawing in childhood and adolescence

Objective: To examine whether drawing is useful in the detection of problems of psychosocial adaptation in children and adolescents with type 1 diabetes (T1D) and in improving communication with health professionals. Methods: We performed an exploratory descriptive study in 199 children and adolescents with T1D aged 413 years. The participants were asked to render a drawing on a suggested topic. The variables analyzed were related to the drawing and to clinical and sociodemographic data. Results: Most participants showed evidence of having a well-balanced personality, but there were also signs of affective or psychosocial difficulties. Conclusion: Drawing is a useful technique by which to identify children"s and adolescents" feelings and possible problems in adapting to T1D, as well as to gain information directly from the children themselves. Future studies should delimit the possibilities of this technique in clinical practice in greater detail.

Living with diabetes: quality of care and quality of life

Background: The aim of this research was to characterize the experience of living with diabetes mellitus (DM) and identify patients" opinions of the quality of care received and the results of interventions. Methods: A descriptive, exploratory evaluation study using qualitative methodology was performed. Participants consisted of 40 adult patients diagnosed with DM and followed up in a public hospital in Barcelona, Spain. A semistructured interview and a focus group were used and a thematic content analysis was performed. Results: Patients described DM as a disease that is difficult to control and that provokes lifestyle changes requiring effort and sacrifice. Insulin treatment increased the perception of disease severity. The most frequent and dreaded complication was hypoglycemia. The main problems perceived by patients affecting the quality of care were related to a disease-centered medical approach, lack of information, limited participation in decision-making, and the administrative and bureaucratic problems of the health care system. Conclusion: The bureaucratic circuits of the health care system impair patients" quality of life and perceived quality of care. Health professionals should foster patient participation in decision-making. However, this requires not only training and appropriate attitudes, but also adequate staffing and materials.