Veteranness : Representations of Combat-related PTSD in U.S. Popular Visual Media

Posttraumatic stress and PTSD are becoming familiar terms to refer to what we often call the invisible wounds of war, yet these are recent additions to a popular discourse in which images of and ideas about combat-affected veterans have long circulated. A legacy of ideas about combat veterans and war trauma thus intersects with more recent clinical information about PTSD to become part of a discourse of visual media that has defined and continues to redefine veteran for popular audiences. In this dissertation I examine realist combat veteran representations in selected films and other visual media from three periods: during and after World Wars I and II (James Allen from I Am a Fugitive from a Chain Gang, Fred Derry and Al Stephenson from The Best Years of Our Lives); after the Vietnam War (Michael from The Deer Hunter, Eriksson from Casualties of War), and post 9/11 (Will James from The Hurt Locker, a collection of veterans from Wartorn: 1861-2010.) Employing a theoretical framework informed by visual media studies, Barthes’ concept of myth, and Foucault’s concept ofdiscursive unity, I analyze how these veteran representations are endowed with PTSD symptom-like behaviors and responses that seem reasonable and natural within the narrative arc. I contend that veteran myths appear through each veteran representation as the narrative develops and resolves. I argue that these veteran myths are many and varied but that they crystallize in a dominant veteran discourse, a discursive unity that I term veteranness. I further argue that veteranness entangles discrete categories such as veteran, combat veteran, and PTSD with veteran myths, often tying dominant discourse about combat-related PTSD to outdated or outmoded notions that significantly affect our attitudes about and treatment of veterans. A basic premise of my research is that unless and until we learn about the lasting effects of the trauma inherent to combat, we hinder our ability to fulfill our responsibilities to war veterans. A society that limits its understanding of posttraumatic stress, PTSD and post-war experiences of actual veterans affected by war trauma to veteranness or veteran myths risks normalizing or naturalizing an unexamined set of sociocultural expectations of all veterans, rendering them voice-less, invisible, and, ultimately disposable.

Geographical literacy, attitudes, and experiences of freshman students: A qualitative study at Florida International University

The purpose of the study was to explore the geography literacy, attitudes and experiences of Florida International University (FIU) freshman students scoring at the low and high ends of a geography literacy survey. The Geography Literacy and ABC Models formed the conceptual framework. Participants were freshman students enrolled in the Finite Math course at FIU. Since it is assumed that students who perform poorly on geography assessments do not have an interest in the subject, testing and interviewing students allowed the researcher to explore the assumption. ^ In Phase I, participants completed the Geography Literacy Survey (GLS) with items taken from the 2010 NAEP Geography Subject Area Assessment. The low 35% and high 20% performers were invited for Phase II, which consisted of semi-structured interviews. A total of 187 students participated in Phase I and 12 in Phase II. ^ The primary research question asked was what are the geography attitudes and experiences of freshman students scoring at the low and high ends of a geographical literacy survey? The students had positive attitudes regardless of how they performed on the GLS. ^ The study included a quantitative sub-question regarding the performance of the students on the GLS. The students’ performance on the GLS was equivalent to the performance of 12th grade students from the NAEP Assessment. There were three qualitative sub-questions from which the following themes were identified: the students’ definition of geography is limited, students recall more out of school experiences with geography, and students find geography valuable. In addition, there were five emergent themes: there is a concern regarding a lack of geographical knowledge, rote memorization of geographical content is overemphasized, geographical concepts are related to other subjects, taking the high school level AP Human Geography course is powerful, and there is a need for real-world applications of geographical knowledge. ^ The researcher offered as suggestions for practice to reposition geography in our schools to avoid misunderstandings, highlight its interconnectedness to other fields, connect the material to real world events/daily decision-making, make research projects meaningful, partner with local geographers, and offer a mandatory geography courses at all educational levels.^

Work creativity as a dimension of job performance

To stay competitive, many employers are looking for creative and innovative employees to add value to their organization. However, current models of job performance overlook creative performance as an important criterion to measure in the workplace. The purpose of this dissertation is to conduct two separate but related studies on creative performance that aim to provide support that creative performance should be included in models of job performance, and ultimately included in performance evaluations in organizations. Study 1 is a meta-analysis on the relationship between creative performance and task performance, and the relationship between creative performance and organizational citizenship behavior (OCB). Overall, I found support for a medium to large corrected correlation for both the creative performance-task performance (ρ = .51) and creative performance-OCB (ρ = .49) relationships. Further, I also found that both rating-source and study location were significant moderators. Study 2 is a process model that includes creative performance alongside task performance and OCB as the outcome variables. I test a model in which both individual differences (specifically: conscientiousness, extraversion, proactive personality, and self-efficacy) and job characteristics (autonomy, feedback, and supervisor support) predict creative performance, task performance, and OCB through engagement as a mediator. In a sample of 299 employed individuals, I found that all the individual differences and job characteristics were positively correlated with all three performance criteria. I also looked at these relationships in a multiple regression framework and most of the individual differences and job characteristics still predicted the performance criteria. In the mediation analyses, I found support for engagement as a significant mediator of the individual differences-performance and job characteristics-performance relationships. Taken together, Study 1 and Study 2 support the notion that creative performance should be included in models of job performance. Implications for both researchers and practitioners alike are discussed.^

The Relationship between Job Structure, Burnout, and Coping Methods among Public School county Bus Drivers, Bus Aides, Mechanics, and Clerical Workers

The purpose of this study was to examine the relationship between the structure of jobs and burnout, and to assess to what extent, if any this relationship was moderated by individual coping methods. This study was supported by the Karasek's (1998) Job Demand-Control-Support theory of work stress as well as Maslach and Leiter's (1993) theory of burnout. Coping was examined as a moderator based on the conceptualization of Lazarus and Folkman (1984). Two overall overarching questions framed this study: (a) what is the relationship between job structure, as operationalized by job title, and burnout across different occupations in support services in a large municipal school district? and (b) To what extent do individual differences in coping methods moderate this relationship? This study was a cross-sectional study of county public school bus drivers, bus aides, mechanics, and clerical workers (N = 253) at three bus depot locations within the same district using validated survey instruments for data collection. Hypotheses were tested using simultaneous regression analyses. Findings indicated that there were statistically significant and relevant relationships among the variables of interest; job demands, job control, burnout, and ways of coping. There was a relationship between job title and physical job demands. There was no evidence to support a relationship between job title and psychological demands. Furthermore, there was a relationship between physical demands, emotional exhaustion and personal accomplishment; key indicators of burnout. Results showed significant correlations between individual ways of coping as a moderator between job structure, operationalized by job title, and individual employee burnout adding empirical evidence to the occupational stress literature. Based on the findings, there are implications for theory, research, and practice. For theory and research, the findings suggest the importance of incorporating transactional models in the study of occupational stress. In the area of practice, the findings highlight the importance of enriching jobs, increasing job control, and providing individual-level training related to stress reduction.

An Examination of Psychological Meaningfulness, Safety, and Availability as the Underlying Mechanisms linking Job Features and Personal Characteristics to Work Engagement

The present study tested a nomological net of work engagement that was derived from its extant research. Two of the main work engagement models that have been presented and empirically tested in the literature, the JD-R model and Kahn’s model, were integrated to test the effects that job features and personal characteristics can have on work engagement through the psychological conditions of meaningfulness, safety, and availability. In this study, safety refers to psychological perceptions of safety and not workplace safety behaviors. The job features that were tested in this model included person-job fit, autonomy, co-worker relations, supervisor support, procedural justice, and interactional justice, while the personal characteristics consisted of self-consciousness, self-efficacy, extraversion, and neuroticism. Thirty-four hypotheses and a conceptual model were tested in order to establish the viability of this nomological net of work engagement in which it was expected that meaningfulness would mediate the relationships between job features and work engagement, safety would mediate the relationships that job features and personal characteristics have with work engagement, and availability (physical, emotional, and cognitive resources) would mediate the relationships that personal characteristics have with work engagement. Furthermore, analyses were run in order to determine the factor structure of work engagement, assess whether or not it exhibits differential validity from organizational commitment and job satisfaction, and confirm that it is positively related to the outcome variable of organizational citizenship behavior (OCB). The final sample consisted of 500 workers from an online labor market who responded to a questionnaire composed of measures of all constructs included in this study. Findings show that work engagement is best represented as a three-factor construct, composed of vigor, dedication and absorption. Furthermore, support was found for the distinction of work engagement from the related constructs of organizational commitment and job satisfaction. With regard to the proposed model, meaningfulness proved to be the strongest predictor of work engagement. Results show that it partially mediates the relationships that all job features have with work engagement. Safety proved to be a partial mediator of the relationships that autonomy, co-worker relations, supervisor support, procedural justice, interactional justice, and self-efficacy have with work engagement, and fully mediate the relationship between neuroticism and work engagement. Findings also show that availability partially mediates the positive relationships that extraversion and self-efficacy have with work engagement, and fully mediates the negative relationship that neuroticism has with work engagement. Finally, a positive relationship was found between work engagement and OCB. Research and organizational implications are discussed.

Knowledge and attitudes towards dietary fibers - romania vs other european countries

Aim: The aim of our study was to evaluate the Romanian’s knowledge and attitudes regarding dietary fibers compared with other European countries. Materials and methods: We made a cross-sectional survey (part of multinational project from CI&DETS Research Centre, Instituto Politecnico Viseu, Portugal, with reference PROJ/CI&DETS/2014/0001) based on a questionnaire applied in 2015, over 670 Romanian consumers, focused on the attitudes and knowledge towards ingestion of foods rich in fibers. We used the software SPSS for statistics. Results: Our results showed that the knowledge about dietary fibers and also the ingestion of food products rich in fibers were low. The female participants ate more whole grains and fruits than males and pay more attention to food labelling, the Romanian people prefer to stay and eat home than at restaurants especially in rural areas, and the knowledge about fiber’s benefits was significantly related to high education and urban location. Comparing to other European countries, Romania had the highest level of knowledge about dietary fibers definition followed by Portugal, Turkey and Hungary, but the lowest regarding the fibers importance for health after Macedonia, Turkey and Latvia. Conclusion: We sustain the needs for more efficient community interventions and proper information about the importance of dietary fibers for our health and also for the dissemination of the nutritional standards among Romanian population.

Romanian Knowledge and Attitudes regarding Dietary Fibers

Presently, the scientists recognize the health benefits of food fibers in the menu and also plant food sources are at high interest both for general population and food companies. The food companies are responsible for a clear nutrition labelling that will assist consumers to make informed and healthy choices and health providers has to inform the population about the benefits of fibers.The aim of our study was to evaluate the Romanian knowledge and attitudes regarding dietary fibers from food products. We made a qualitative survey based on a questionnaire applied in 2015, over a period of 6 months, over 670 Romanian consumers. It was focused on testing the attitudes and knowledge towards ingestion of foods rich in fibers. For all data analysis we used the software SPSS, from IBM Inc. Our results showed that the knowledge about dietary fibers and also the ingestion of food products rich in fibers were low, and most of the subjects didn’t have any interest to read the nutritional information from food labels. The female participants ate more whole grains and fruits than males and pay more attention to food labelling. Romanian people prefer to stay and eat home than at restaurants especially in rural areas, and the knowledge about fibers benefits was significantly related to education and urban location. We underline the needs for more efficient community interventions and proper information about the importance of dietary fibers for our health and also to improve and disseminate nutritional standards and diet recommendation among population.

The role of cancer related inflammation, Src family kinases and matrix metalloproteinase 9 in colorectal cancer

Colorectal cancer (CRC) is the third most common cancer in the UK with 41,000 new cases diagnosed in 2011. Despite undergoing potentially curative resection, a significant amount of patients develop recurrence. Biomarkers that aid prognostication or identify patients who are suitable for adjuvant treatments are needed. The TNM staging system does a reasonably good job at offering prognostic information to the treating clinician, but it could be better and identifying methods of improving its accuracy are needed. Tumour progression is based on a complex relationship between tumour behaviour and the hosts’ inflammatory responses. Sustained tumour cell proliferation, evading growth suppressors, resisting apoptosis, replicative immortality, sustained angiogenesis, invasion & metastasis, avoiding immune destruction, deregulated cellular energetics, tumour promoting inflammation and genomic instability & mutation have been identified as hallmarks. These hallmarks are malignant behaviors are what makes the cell cancerous and the more extreme the behaviour the more aggressive the cancer the more likely the risk of a poor outcome. There are two primary genomic instability pathways: Microsatellite Instability (MSI) and Chromosomal Instability (CI) also referred to as Microsatellite Stability (MSS). Tumours arising by these pathways have a predilection for specific anatomical, histological and molecular biological features. It is possible that aberrant molecular expression of genes/proteins that promote malignant behaviors may also act as prognostic and predictive biomarkers, which may offer superior prognostic information to classical prognostic features. Cancer related inflammation has been described as a 7th hallmark of cancer. Despite the systemic inflammatory response (SIR) being associated with more aggressive malignant disease, infiltration by immune cells, particularly CD8+ lymphocytes, at the advancing edge of the tumour have been associated with improved outcome and tumour MSI. It remains unknown if the SIR is associated with tumour MSI and this requires further study. The mechanisms by which colorectal cancer cells locally invade through the bowel remain uncertain, but connective tissue degradation by matrix metalloproteinases (MMPs) such as MMP-9 have been implicated. MMP-9 has been found in the cancer cells, stromal cells and patient circulation. Although tumoural MMP-9 has been associated with poor survival, reports are conflicting and contain relatively small sample sizes. Furthermore, the influence of high serum MMP-9 on survival remains unknown. Src family kinases (SFKs) have been implicated in many adverse cancer cell behaviors. SFKs comprise 9 family members BLK, C-SRC, FGR, FYN, HCK, LCK, LYN, YES, YRK. C-SRC has been the most investigated of all SFKs, but the role of other SFKs in cellular behaviors and their prognostic value remains largely unknown. The development of Src inhibitors, such as Dasatinib, has identified SFKs as a potential therapeutic target for patients at higher risk of poor survival. Unfortunately, clinical trials so far have not been promising but this may reflect inadequate patient selection and SFKs may act as useful prognostic and predictive biomarkers. In chapter 3, the association between cancer related inflammation, tumour MSI, clinicopathological factors and survival was tested in two independent cohorts. A training cohort consisting of n=182 patients and a validation cohort of n=677 patients. MSI tumours were associated with a raised CRP (p=0.003). Hypoalbuminaemia was independently associated with poor overall survival in TNM stage II cancer (HR 3.04 (95% CI 1.44 – 6.43);p=0.004), poor recurrence free survival in TNM stage III cancer (HR 1.86 (95% 1.03 – 3.36);p=0.040) and poor overall survival in CI colorectal cancer (HR 1.49 (95% CI 1.06 – 2.10);p=0.022). Interestingly, MSI tumours were associated with poor overall survival in TNM stage III cancer (HR 2.20 (95% CI 1.10 – 4.37);p=0.025). In chapter 4, the role of MMP-9 in colorectal cancer progression and survival was examined. MMP-9 in the tissue was assessed using IHC and serum expression quantified using ELISA. Serum MMP-9 was associated with cancer cell expression (Spearman’s Correlation Coefficient (SCC) 0.393, p<0.001)) and stromal expression (SCC 0.319, p=0.002). Serum MMP-9 was associated with poor recurrence-free (HR 3.37 (95% CI 1.20 – 9.48);p=0.021) and overall survival (HR 3.16 (95% CI 1.22 – 8.15);p=0.018), but tumour MMP-9 was not survival or MSI status. In chapter 5, the role of SFK expression and activation in colorectal cancer progression and survival was studied. On PCR analysis, although LYN, C-SRC and YES were the most highly expressed, FGR and HCK had higher expression profiles as tumours progressed. Using IHC, raised cytoplasmic FAK (tyr 861) was independently associated with poor recurrence free survival in all cancers (HR 1.48 (95% CI 1.02 – 2.16);p=0.040) and CI cancers (HR 1.50 (95% CI 1.02 – 2.21);p=0.040). However, raised cytoplasmic HCK (HR 2.04 (95% CI 1.11 – 3.76);p=0.022) was independently associated with poor recurrence-free survival in TNM stage II cancers. T84 and HT29 cell lines were used to examine the cellular effects of Dasatinib. Cell viability was assessed using WST-1 assay and apoptosis assessed using an ELISA cell death detection assay. Dasatinib increased T84 tumour cell apoptosis in a dose dependent manner and resulted in reduced expression of nuclear (p=0.008) and cytoplasmic (p=0.016) FAK (tyr 861) expression and increased nuclear FGR expression (p=0.004). The results of this thesis confirm that colorectal cancer is a complex disease that represents several subtypes of cancer based on molecular biological behaviors. This thesis concentrated on features of the disease related to inflammation in terms of genetic and molecular characterisation. MSI cancers are closely associated with systemic inflammation but despite this observation, they retain their relatively improved survival. MMP-9 is a feature of tissue remodeling during inflammation and is also associated with degradation of connective tissue, advanced T-stage and poor outcome when measured in the serum. The lack of stromal quantification due to TMA use rather than full sections makes the value of tumoural MMP-9 immunoreactivity in the prognostication and its association with MSI unknown and requires further study. Finally, SFK activation was also associated with SIR, however, only cytoplasmic HCK was independently associated with poor survival in patients with TNM stage II disease, the group of patients where identifying a novel biomarker is most needed. There is still some way to go before these biomarkers are translated into clinical practice and future work needs to focus on obtaining a reliable and robust scientific technique with validation in an adequately powered independent cohort.

Choques al hogar, trabajo Infantil y acumulación de capital humano : evidencia para Colombia

En este trabajo se estima el efecto que tienen distintos choques a los hogares sobre el logro académico de los niños. Mediante un modelo de regresión lineal, se encuentra un efecto adverso de la presencia de choques sobre el puntaje de la prueba Saber 11. Además, los resultados sugieren que el trabajo infantil es un mecanismo por el cual los choques afectan negativamente la acumulación de capital humano. Al explorar efectos heterogéneos por sexo y edad, las estimaciones indican que el efecto de los choques es guiado por los hombres y los adolescentes mayores a 14 años.

Reciclaje de residuos sólidos domésticos y conductas pro-ambientales en una comunidad residencial de Bogotá, Colombia

Introducción: La implicación social dentro de la problemática ambiental, establece una relación causal entre hábitos e impacto ambiental; aspectos del comportamiento humano tales como la conveniencia, familiaridad, presión social y actitud, nos permiten realizar un acercamiento acerca de la decisión de reciclar o no en un hogar. Objetivo: identificar los factores ambientales asociados con el manejo de residuos domésticos entre los miembros de una comunidad residencial en la ciudad de Bogotá. Materiales y métodos: Se realizó un estudio transversal realizado a 200 personas de una comunidad residencial. La evaluación de la conducta pro-ambiental se llevó a cabo por medio de la utilización de la Escala del Comportamiento Pro-ambiental desarrollada por Corral-Verdugo unida a la escala de Reciclaje de Sidique. Para el tratamiento estadístico se empleó el análisis de regresión lineal múltiple. Resultados: La mayoría de los encuestados fueron hombres (55%), con una mediana de edad de 37,5 años. Más de la mitad tenía por lo menos formación en pregrado (53%), el 55,5% contaban con un empleo al momento de la entrevista, cerca del 50% de las personas refirieron tener casa propia y la mediana del tamaño de las mismas fue de 80 m2. De los aspectos sociodemográficos, el tipo de vivienda, sexo y edad, estuvieron relacionados con los factores ambientales pro reciclaje. Mientras que las conductas proambientales relacionadas fueron: altruismo, frugalidad, conducta ecológica general, indignación y aprecio por la naturaleza. Conclusiones: Las conductas proambientales Altruismo, Frugalidad, Conducta Ecológica, Indignación y Aprecio por lo natural, están relacionadas con la intención de reciclar. Para futuras investigaciones es necesario constatar la realización del comportamiento proambiental, para aseverar de manera irrebatible que las dimensiones analizadas pueden soportar una acción real y no un auto reporte de una conducta.

Lung Age Is Related To Carotid Structural Alterations In Hypertensive Subjects.

Hypertensive patients exhibit higher cardiovascular risk and reduced lung function compared with the general population. Whether this association stems from the coexistence of two highly prevalent diseases or from direct or indirect links of pathophysiological mechanisms is presently unclear. This study investigated the association between lung function and carotid features in non-smoking hypertensive subjects with supposed normal lung function. Hypertensive patients (n = 67) were cross-sectionally evaluated by clinical, hemodynamic, laboratory, and carotid ultrasound analysis. Forced vital capacity, forced expired volume in 1 second and in 6 seconds, and lung age were estimated by spirometry. Subjects with ventilatory abnormalities according to current guidelines were excluded. Regression analysis adjusted for age and prior smoking history showed that lung age and the percentage of predicted spirometric parameters associated with common carotid intima-media thickness, diameter, and stiffness. Further analyses, adjusted for additional potential confounders, revealed that lung age was the spirometric parameter exhibiting the most significant regression coefficients with carotid features. Conversely, plasma C-reactive protein and matrix-metalloproteinases-2/9 levels did not influence this relationship. The present findings point toward lung age as a potential marker of vascular remodeling and indicate that lung and vascular remodeling might share common pathophysiological mechanisms in hypertensive subjects.

Diet Carotenoid Lutein Modulates The Expression Of Genes Related To Oxygen Transporters And Decreases Dna Damage And Oxidative Stress In Mice.

Lutein (LT) is a carotenoid obtained by diet and despite its antioxidant activity had been biochemically reported, few studies are available concerning its influence on the expression of antioxidant genes. The expression of 84 genes implicated in antioxidant defense was quantified using quantitative reverse transcription polymerase chain reaction array. DNA damage was measured by comet assay and glutathione (GSH) and thiobarbituric acid reactive substances (TBARS) were quantified as biochemical parameters of oxidative stress in mouse kidney and liver. cDDP treatment reduced concentration of GSH and increased TBARS, parameters that were ameliorated in treatment associated with LT. cDDP altered the expression of 32 genes, increasing the expression of GPx2, APC, Nqo1 and CCs. LT changed the expression of 37 genes with an induction of 13 mainly oxygen transporters. In treatments associating cDDP and LT, 30 genes had their expression changed with a increase of the same genes of the cDDP treatment alone. These results suggest that LT might act scavenging reactive species and also inducing the expression of genes related to a better antioxidant response, highlighting the improvement of oxygen transport. This improved redox state of the cell through LT treatment could be related to the antigenotoxic and antioxidant effects observed.

Bisphosphonate-related Osteonecrosis Of The Jaw: A Review Of The Literature.

Bisphosphonates (BPs) are a class of drugs used to treat osteoporosis and malignant bone metastasis. BPs show high binding capacity to the bone matrix, especially in sites of active bone metabolism. The American Society for Bone and Mineral Research defines BRONJ as an area of exposed bone in the maxillofacial region that has not healed within 8 weeks after identification by a healthcare provider in a patient who is receiving or has been exposed to a bisphosphonate and has not had radiation therapy to the craniofacial region. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) can adversely affect quality of life, as it may produce significant morbidity. The American Association of Oral and Maxillofacial Surgeons (AAOMS) considers as vitally important that information on BRONJ be disseminated to other dental and medical specialties. The purpose of this work is to offer a perspective on how dentists should manage patients on BPs, to show the benefits of accurately diagnosing BRONJ, and to present diagnostic aids and treatments strategies for the condition.

Delays In Receiving Obstetric Care And Poor Maternal Outcomes: Results From A National Multicentre Cross-sectional Study.

The vast majority of maternal deaths in low-and middle-income countries are preventable. Delay in obtaining access to appropriate health care is a fairly common problem which can be improved. The objective of this study was to explore the association between delay in providing obstetric health care and severe maternal morbidity/death. This was a multicentre cross-sectional study, involving 27 referral obstetric facilities in all Brazilian regions between 2009 and 2010. All women admitted to the hospital with a pregnancy-related cause were screened, searching for potentially life-threatening conditions (PLTC), maternal death (MD) and maternal near-miss (MNM) cases, according to the WHO criteria. Data on delays were collected by medical chart review and interview with the medical staff. The prevalence of the three different types of delays was estimated according to the level of care and outcome of the complication. For factors associated with any delay, the PR and 95%CI controlled for cluster design were estimated. A total of 82,144 live births were screened, with 9,555 PLTC, MNM or MD cases prospectively identified. Overall, any type of delay was observed in 53.8% of cases; delay related to user factors was observed in 10.2%, 34.6% of delays were related to health service accessibility and 25.7% were related to quality of medical care. The occurrence of any delay was associated with increasing severity of maternal outcome: 52% in PLTC, 68.4% in MNM and 84.1% in MD. Although this was not a population-based study and the results could not be generalized, there was a very clear and significant association between frequency of delay and severity of outcome, suggesting that timely and proper management are related to survival.

Laparoscopic Antireflux Surgery In Patients With Extra Esophageal Symptoms Related To Asthma.

Asthma, laryngitis and chronic cough are atypical symptoms of the gastroesophageal reflux disease. To analyze the efficacy of laparoscopic surgery in the remission of extra-esophageal symptoms in patients with gastroesophageal reflux, related to asthma. Were reviewed the medical records of 400 patients with gastroesophageal reflux disease submitted to laparoscopic Nissen fundoplication from 1994 to 2006, and identified 30 patients with extra-esophageal symptoms related to asthma. The variables considered were: gender, age, gastroesophageal symptoms (heartburn, acid reflux and dysphagia), time of reflux disease, treatment with proton pump inhibitor, use of specific medications, treatment and evolution, number of attacks and degree of esophagitis. Data were subjected to statistical analysis, comparing the pre- and post-surgical findings. The comparative analysis before surgery (T1) and six months after surgery (T2) showed a significant reduction on heartburn and reflux symptoms. Apart from that, there was a significant difference between the patients with daily crises of asthma (T1 versus T2, 45.83% to 16.67%, p=0.0002) and continuous crises (T1, 41.67% versus T2, 8.33%, p=0.0002). Laparoscopic Nissen fundoplication was effective in improving symptoms that are typical of reflux disease and clinical manifestations of asthma.