Gastroesophageal reflux disease and vocal disturbances

CONTEXTO: A doença do refluxo gastroesofágico (DRGE) é uma doença crônica na qual o conteúdo gastroduodenal reflui para o esôfago. O quadro clínico da DRGE é usualmente referido como pirose e regurgitação (manifestações típicas). Manifestações atípicas (distúrbios da voz e asma) podem também ser referidas. OBJETIVO: Analisar os aspectos clínicos, endoscópicos, manométricos e pHmétricos de pacientes portadores da DRGE com distúrbios da voz. MÉTODO: Foram estudados 50 pacientes com a DRGE, sendo 25 com distúrbios da voz (grupo 1 - G1) e 25 sem estes sintomas (controles, grupo 2 - G2). Todos os pacientes foram submetidos a endoscopia, manometria e pHmetria esofágica (dois sensores). Os pacientes do G1 foram submetidos a videolaringoscopia. RESULTADOS: Achados endoscópicos: DRGE não-erosiva foi observada em 95% dos pacientes de G1 e em 88% de G2. Videolaringoscopia: congestão das pregas vocais, assimetria, nódulos e pólipos foram diagnosticados nos pacientes do G1. Manometria esofágica: pressão no esfíncter inferior do esôfago (mm Hg): 11,6 ± 5,2 em G1 e 14,0 ± 6,2 em G2 (P = 0,14); pressão no esfíncter superior do esôfago (mm Hg): 58,4 ± 15,9 em G1 e 69,5 ± 30,7 nos controles. Achados pHmétricos: índice de DeMeester: 34,0 ± 20,9 em G1 e 15,4 ± 9,4 em G2 (P<0,001); número de episódios de refluxo no sensor distal: 43,0 ± 20,4 em G1 e 26, 4 ± 17,2 em G2 (P<0,003); percentagem do tempo com pH esofágico menor que 4 unidades (sensor distal): 9,0% ± 6,4% em G1 e 3,4% ± 2,1% em G2 (P<0,001); número de episódios de refluxo no sensor proximal: 7,5 ± 10,9 em G1 e 5,3 ± 5,7 em G2 (P = 0,38); percentagem de tempo com pH esofágico menor que quatro unidades (sensor proximal): 1,2% ± 2,7% em G1 e 0,5% ± 0,7% em G2 (P = 0,210). CONCLUSÕES: Os aspectos clínicos, endoscópicos e manométricos em pacientes com a DRGE e distúrbios da voz não diferem dos pacientes sem estes sintomas. A intensidade do refluxo gastroesofágico é maior nos pacientes com distúrbios da voz. Os pacientes sem distúrbios da voz podem também apresentar episódios de refluxo gastroesofágico no sensor proximal.

Hq(4) symmetry: the linear q-harmonic oscillator based on generalized irreps of the q-deformed Heisenberg algebra

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Disturbances in beta-cell function in impaired fasting glycemia

In a cross-sectional study, we assessed beta-cell function and insulin sensitivity index (ISI) with hyperglycemic clamps (10 mmol/l) in 24 subjects with impaired fasting glycemia (IFG, fasting plasma glucose [FPG] between 6.1 and 7.0 mmol/l), 15 type 2 diabetic subjects (FPG >7.0 mmol/l), and 280 subjects with normal fasting glycemia (NFG, FPG <6.1 mmol/l). First-phase insulin release (0-10 min) was lower in IFG (geometric mean 541 pmol/l (.) 10 min; 95% confidence interval [CI] 416-702 pmol/l (.) 10 min) and in type 2 diabetes (geometric mean 376 pmol/l (.) 10 min; 95% CI 247-572 pmol/l (.) 10 min) than NFG (geometric mean 814 pmol/l (.) 10 min; 95% CI 759-873 pmol/l (.) 10 min) (P < 0.001). Second-phase insulin secretion (140-180 min) was also lower in IFG (geometric mean 251 pmol/l; 95% CI 198-318 pmol/l; P = 0.026) and type 2 diabetes (geometric mean 157 pmol/l; 95% CI 105-235 pmol/l; P < 0.001) than NFG (geometric mean 295 pmol/l; 95% CI 276-315 pmol/l): IFG and type 2 diabetic subjects had a lower ISI (0.15 +/- 0.02 and 0.16 +/- 0.02 mumol/kg fat-free mass [FFM]/min/ pmol/l, respectively) than NFG (0.24 +/- 0.01 mumol/kg FFM/min/pmol/l, P < 0.05). We found a stepwise decline in first-phase (and second-phase) secretion in NFG subjects with progressive decline in oral glucose tolerance (P < 0.05). IFG subjects with impaired glucose tolerance (IGT) had lower first-phase secretion than NFG subjects with IGT (P < 0.02), with comparable second-phase secretion and ISI. NFG and IFG subjects with a diabetic glucose tolerance (2-h glucose >11.1 mmol/l) had a lower ISI than their respective IGT counterparts (P < 0.05). We conclude that the early stages of glucose intolerance are associated with disturbances in beta-cell function, while insulin resistance is seen more markedly in later stages.

LARGE-ORDER PERTURBATION EXPANSIONS FOR THE CHARGED HARMONIC-OSCILLATOR

The charged oscillator, defined by the Hamiltonian H = -d2/dr2+ r2 + lambda/r in the domain [0, infinity], is a particular case of the family of spiked oscillators, which does not behave as a supersingular Hamiltonian. This problem is analysed around the three regions lambda --> infinity, lambda --> 0 and lambda --> -infinity by using Rayleigh-Ritz large-order perturbative expansions. A path is found to connect the large lambda regions with the small lambda region by means of the renormalization of the series expansions in lambda. Finally, the Riccati-Pade method is used to construct an implicit expansion around lambda --> 0 which extends to very large values of Absolute value of lambda.

Adaptive control charts: A Markovian approach for processes subject to independent disturbances

Recent studies have shown that adaptive X control charts are quicker than traditional X charts in detecting small to moderate shifts in a process. In this article, we propose a joint statistical design of adaptive X and R charts having all design parameters varying adaptively. The process is subjected to two independent assignable causes. One cause changes the process mean and the other changes the process variance. However, the occurrence of one kind of assignable cause does not preclude the occurrence of the other. It is assumed that the quality characteristic is normally distributed and the time that the process remains in control has exponential distribution. Performance measures of these adaptive control charts are obtained through a Markov chain approach. (c) 2005 Elsevier B.V. All rights reserved.

A new three-phase transformer modeling for three-phase harmonic analysis in distribution systems

This work presents a new three-phase transformer modeling suitable for simulations in Pspice environment, which until now represents the electrical characteristics of a real transformer. It is proposed the model comparison to a three-phase transformer modeling present in EMTP - ATP program, which includes the electrical and magnetic characteristics. In addition, a set including non-linear loads and a real three-phase transformer was prepared in order to compare and validate the results of this new proposed model. The three-phase Pspice transformer modeling, different from the conventional one using inductance coupling, is remarkable for its simplicity and ease in simulation process, since it uses available voltage and current sources present in Pspice program, enabling simulations of three-phase network system including the most common configuration, three wires in the primary side and four wires in the secondary side (three-phases and neutral). Finally, the proposed modeling becomes a powerful tool for three-phase network simulations due to its simplicity and accuracy, able to simulate and analyze harmonic flow in three-phase systems under balanced and unbalanced conditions.

On bifurcation and symmetry of solutions of symmetric nonlinear equations with odd-harmonic forcings

In this work we study existence, bifurcation, and symmetries of small solutions of the nonlinear equation Lx = N(x, p, epsilon) + mu f, which is supposed to be equivariant under the action of a group OHm, and where f is supposed to be OHm-invariant. We assume that L is a linear operator and N(., p, epsilon) is a nonlinear operator, both defined in a Banach space X, with values in a Banach space Z, and p, mu, and epsilon are small real parameters. Under certain conditions we show the existence of symmetric solutions and under additional conditions we prove that these are the only feasible solutions. Some examples of nonlinear ordinary and partial differential equations are analyzed. (C) 1995 Academic Press, Inc.

Perturbative breaking of the pseudospin symmetry in the relativistic harmonic oscillator

We show that relativistic mean fields theories with scalar S, and vector V, quadratic radial potentials can generate a harmonic oscillator with exact pseudospin symmetry and positive energy bound states when S = -V. The eigenenergies are quite different from those of the non-relativistic harmonic oscillator. We also discuss a mechanism for perturbatively breaking this, symmetry by introducing a tensor potential. Our results shed light into the intrinsic relativistic nature of the pseudospin symmetry, which might be important in high density systems such as neutron stars.

Alterations in pulmonary structure by elastase administration in a model of emphysema in mice is associated with functional disturbances

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Harmonic identification using parallel neural networks in single-phase systems

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Immunological disturbances in toxic multinodular goitre and active Graves' disease

Cell-mediated and humoral immunity were studied in seventeen patients with toxic multinodular goitre, ten with active Graves' disease and fourteen healthy controls. The study included determination of sheep erythrocyte and complement rosette-forming cells in peripheral blood, immunoglobulin levels, titres of microsomal antibodies and migration inhibition test using thyroid extract and phytohaemagglutinin. When compared with controls the patients showed a positive response to thyroid antigen in the leucocyte migration inhibition test. Microsomal antibodies were detected in seven out of ten active Graves' disease patients against two out of seventeen of those with toxic multinodular goitre. Significantly increased IgG and IgA and decreased IgM levels were found only in the toxic multinodular group. These data provide further evidence for immunological disturbances in toxic multinodular goitre.

Nonsingular spiked harmonic oscillator

A perturbative study of a class of nonsingular spiked harmonic oscillators defined by the Hamiltonian H= -d2/dr2 + r2 + λ/rα in the domain [0,∞] is carried out, in the two extremes of a weak coupling and a strong coupling regimes. A path has been found to connect both expansions for α near 2. © 1991 American Institute of Physics.

On the quantum mechanical propagator for driven coupled harmonic oscillators

The exact propagator beyond and at caustics for a pair of coupled and driven oscillators with different frequencies and masses is calculated using the path-integral approach. The exact wavefunctions and energies are also presented. Finally the propagator is re-calculated through an alternative method, using the δfunction. © 1992 IOP Publishing Ltd.

Exact solution for a three-dimensional three-body problem with harmonic interactions

The three-dimensional three-body problem with non-equal masses interacting through pairwise harmonic forces of non-equal strengths is analysed. It is shown that the Jacobi coordinates per se do not decouple this problem but lead to the problem of two coupled three-dimensional harmonic oscillators which becomes exactly soluble through the use of an additional coordinate set.