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.

Determinants of the omega-3 index in a Mediterranean population at increased risk for CHD.

The omega-3 index, defined as the sum of EPA and DHA in erythrocyte membranes expressed as a percentage of total fatty acids, has been proposed as both a risk marker and risk factor for CHD death. A major determinant of the omega-3 index is EPA þ DHA intake, but the impact of other dietary fatty acids has not been investigated. In a cross-sectional study on 198 subjects (102 men and 96 women, mean age 66 years) at high cardiovascular risk living in Spain, the country with low rates of cardiac death despite a high prevalence of cardiovascular risk factors, dietary data were acquired from FFQ and blood cell membrane fatty acid composition was measured by GC. The average consumption of EPA þ DHA was 0·9 g/d and the mean omega-3 index was 7·1%. In multivariate models, EPA þ DHA intake was the main predictor of the omega-3 index but explained only 12% of its variability (P,0·001). No associations with other dietary fatty acids were observed. Although the single most influential determinant of the omega-3 index measured here was the intake of EPA þ DHA, it explained little of the former"s variability; hence, the effects of other factors (genetic, dietary and lifestyle) remain to be determined. Nevertheless, the high omega-3 index could at least partially explain the paradox of low rates of fatal CHD in Spain despite a high background prevalence of cardiovascular risk factors.

Identification by Real-time PCR of 13 mature microRNAs differentially expressed in colorectal cancer and non-tumoral tissues

MicroRNAs (miRNAs) are short non-coding RNA molecules playing regulatory roles by repressing translation or cleaving RNA transcripts. Although the number of verified human miRNA is still expanding, only few have been functionally described. However, emerging evidences suggest the potential involvement of altered regulation of miRNA in pathogenesis of cancers and these genes are thought to function as both tumours suppressor and oncogenes. In our study, we examined by Real-Time PCR the expression of 156 mature miRNA in colorectal cancer. The analysis by several bioinformatics algorithms of colorectal tumours and adjacent non-neoplastic tissues from patients and colorectal cancer cell lines allowed identifying a group of 13 miRNA whose expression is significantly altered in this tumor. The most significantly deregulated miRNA being miR-31, miR-96, miR-133b, miR-135b, miR-145, and miR-183. In addition, the expression level of miR-31 was correlated with the stage of CRC tumor. Our results suggest that miRNA expression profile could have relevance to the biological and clinical behavior of colorectal neoplasia.

Spontaneous mirror symmetry breaking in the limited enantioselective autocatalysis model: abyssal hydrotermal vents as scenario for the emergence of chirality in prebiotic chemistry

The emergence of chirality in enantioselective autocatalysis for compounds unable to transform according to the Frank-like reaction network is discussed with respect to the controversial limited enantioselectivity (LES) model composed of coupled enantioselective and non-enantioselective autocatalyses. The LES model cannot lead to spontaneous mirror symmetry breaking (SMSB) either in closed systems with a homogeneous temperature distribution or in closed systems with a stationary non-uniform temperature distribution. However, simulations of chemical kinetics in a two-compartment model demonstrate that SMSB may occur if both autocatalytic reactions are spatially separated at different temperatures in different compartments but coupled under the action of a continuous internal flow. In such conditions, the system can evolve, for certain reaction and system parameters, toward a chiral stationary state; that is, the system is able to reach a bifurcation point leading to SMSB. Numerical simulations in which reasonable chemical parameters have been used suggest that an ade- quate scenario for such a SMSB would be that of abyssal hydrothermal vents, by virtue of the typical temper- ature gradients found there and the role of inorganic solids mediating chemical reactions in an enzyme-like role. Key Words: Homochirality Prebiotic chemistry.

Earliest known use of marine resources by neanderthals

Numerous studies along the northern Mediterranean borderland have documented the use of shellfish by Neanderthals but none of these finds are prior to Marine Isotopic Stage 3 (MIS 3). In this paper we present evidence that gathering and consumption of mollusks can now be traced back to the lowest level of the archaeological sequence at Bajondillo Cave (Málaga, Spain), dated during the MIS 6. The paper describes the taxonomical and taphonomical features of the mollusk assemblages from this level Bj19 and briefly touches upon those retrieved in levels Bj18 (MIS 5) and Bj17 (MIS 4), evidencing a continuity of the shellfishing activity that reaches to MIS 3. This evidence is substantiated on 29 datings through radiocarbon, thermoluminescence and U series methods. Obtained dates and paleoenvironmental records from the cave include isotopic, pollen, lithostratigraphic and sedimentological analyses and they are fully coherent with paleoclimate conditions expected for the different stages. We conclude that described use of shellfish resources by Neanderthals (H. neanderthalensis) in Southern Spain started ~150 ka and were almost contemporaneous to Pinnacle Point (South Africa), when shellfishing is first documented in archaic modern humans.

Determinants of the omega-3 index in a Mediterranean population at increased risk for CHD.

The omega-3 index, defined as the sum of EPA and DHA in erythrocyte membranes expressed as a percentage of total fatty acids, has been proposed as both a risk marker and risk factor for CHD death. A major determinant of the omega-3 index is EPA þ DHA intake, but the impact of other dietary fatty acids has not been investigated. In a cross-sectional study on 198 subjects (102 men and 96 women, mean age 66 years) at high cardiovascular risk living in Spain, the country with low rates of cardiac death despite a high prevalence of cardiovascular risk factors, dietary data were acquired from FFQ and blood cell membrane fatty acid composition was measured by GC. The average consumption of EPA þ DHA was 0·9 g/d and the mean omega-3 index was 7·1%. In multivariate models, EPA þ DHA intake was the main predictor of the omega-3 index but explained only 12% of its variability (P,0·001). No associations with other dietary fatty acids were observed. Although the single most influential determinant of the omega-3 index measured here was the intake of EPA þ DHA, it explained little of the former"s variability; hence, the effects of other factors (genetic, dietary and lifestyle) remain to be determined. Nevertheless, the high omega-3 index could at least partially explain the paradox of low rates of fatal CHD in Spain despite a high background prevalence of cardiovascular risk factors.

Determinação da composição mineral de subprodutos agroindustriais utilizados na alimentação animal, pela técnica de ativação neutrônica

O presente trabalho teve como objetivo analisar alguns subprodutos agroindustriais utilizados na alimentação animal e identificar os principais minerais presentes. Amostras de farelos de algodão, arroz, canola, soja e trigo; farinhas de peixe, carne e penas + vísceras; cascas de algodão, arroz, laranja; bagaços de tomate e de laranja foram coletadas em diferentes locais de produção. O método analítico empregado foi a análise por ativação com nêutrons seguida de espectrometria gama. Os níveis de minerais encontrados em todas as amostras, inclusive aqueles considerados tóxicos, tais como As, Cd e Hg, não excederam os limites máximos permitidos em dietas para animais domésticos. Os valores obtidos foram comparados com os comumente encontrados em forragens.

Cuidados Paliativos en oncología

Los cuidados paliativos atienden a personas afectadas de enfermedades avanzadas, sin posibilidad de tratamientos específicos y con expectativas de vida limitadas. La percepción vivida por estos enfermos está determinada por la presencia de síntomas múltiples y complejos, expresados en todas las dimensiones humanas (física, psicológica y social), y por la amenaza explícita o implícita de una muerte próxima. Los objetivos planteados por un equipo interdisciplinar son el control de síntornas, el soporte psicológico y la asesoría social.

Fosfato e micorriza na estabilidade de agregados em amostras de latossolos cultivados e não-cultivados

Nos trópicos, existe escassez de informação quanto à contribuição de espécies fúngicas do solo na formação e estabilização de agregados. Este estudo teve como objetivo avaliar o efeito do histórico de uso, níveis de P, de inoculação micorrízica e cultivo com braquiária e soja em casa de vegetação, sobre o diâmetro médio geométrico dos agregados (DMG), o índice de floculação das partículas, a matéria seca das raízes, a colonização micorrízica e o comprimento total de hifas, em amostras de Latossolo Vermelho distrófico e Latossolo Vermelho distroférrico. Amostras dos dois solos, previamente cultivados por longos períodos, e de solos não-cultivados, foram trazidas para casa de vegetação, submetidas a inoculação, e a dois níveis de P, e então cultivadas com braquiária e soja, em dois cultivos sucessivos. Os resultados mostraram que o solo previamente cultivado apresentou menor comprimento total de hifas, menor estabilidade de agregados (menor diâmetro médio de agregados) e menor índice de floculação. A inoculação propiciou maior estabilidade dos agregados, e este efeito é condicionado ao nível de P do solo e ao histórico de uso. A presença de P promoveu, indiretamente, maior agregação, por propiciar maior comprimento total das hifas e matéria seca de raízes.

Relações solo-superfície geomórfica e evolução da paisagem em uma área do Planalto Central Brasileiro

Com base em levantamento pedológico de reconhecimento de alta intensidade, foram investigadas relações pedogeomorfológicas em uma área do Planalto Central Brasileiro, com vistas à predição de atributos e distribuição dos solos em áreas vizinhas carentes de mapas pedológicos. Três superfícies geomórficas, com distintos padrões de espacialização de solos, foram identificadas. Na mais elevada, a distribuição dos solos é estreitamente relacionada à variação do regime hídrico ao longo das encostas. Ocorrem Latossolo Vermelho (LV), Latossolo Vermelho-Amarelo (LVA), Latossolo Amarelo (LA), Latossolo Amarelo plíntico, Latossolo Amarelo petroplíntico (concrecionário) e Plintossolo Háplico, todos muito argilosos, com teores de Fe2O3 e TiO2 relativamente homogêneos e índices Ki e Kr indicativos de mineralogia oxídica. Na segunda superfície, os solos apresentam maior variação quanto à textura e teores de Fe e Ti. Predominam LV e LV acriférrico, além de LVA e LA. Nos limites com as chapadas, observa-se a ocorrência de LVA e LA acriférricos endopetroplínticos. Na terceira superfície, que disseca as anteriores, predominam solos menos intemperizados, com atributos muito variáveis, como Cambissolo Háplico, Argissolos Vermelho e Vermelho-Amarelo, Nitossolo Vermelho eutroférrico, Neossolo Litólico e Neossolo Flúvico. O trabalho inclui a proposição de um modelo de evolução para a paisagem regional.

Polyphenol-rich foods in the Mediterranean diet are associated with better cognitive function in elderly subjects at high cardiovascular risk

Brain oxidative processes play a major role in age-related cognitive decline, thus consumption of antioxidant-rich foods might help preserve cognition. Our aim was to assess whether consumption of antioxidant-rich foods in the Mediterranean diet relates to cognitive function in the elderly. In asymptomatic subjects at high cardiovascular risk (n = 447; 52% women; age 5580 y) enrolled in the PREDIMED study, a primary prevention dietary-intervention trial, we assessed food intake and cardiovascular risk profile, determined apolipoprotein E genotype, and used neuropsychological tests to evaluate cognitive function.We also measured urinary polyphenols as an objective biomarker of intake. Associations between energy-adjusted food consumption, urinary polyphenols, and cognitive scores were assessed by multiple linear regression models adjusted for potential confounders. Consumption of some foods was independently related to better cognitive function. The specific associations [regression coefficients (95% confidence intervals)] were: total olive oil with immediate verbal memory [0.755 (0.1511.358)]; virgin olive oil and coffee with delayed verbal memory [0.163 (0.0100.316) and 0.294 (0.0550.534), respectively];walnuts with working memory [1.191 (0.0612.322)]; and wine with Mini-Mental State Examination scores [0.252 (0.0060.496)]. Urinary polyphenols were associated with better scores in immediate verbal memory [1.208 (0.2362.180)]. Increased consumption of antioxidant-rich foods in general and of polyphenols in particular is associated with better cognitive performance in elderly subjects at high cardiovascular risk. The results reinforce the notion that Mediterranean diet components might counteract age-related cognitive decline.

Empirics of the international inequality in CO2 emissions intensity: explanatory factors according to complementary decomposition methodologies

This paper analyses the international inequalities in CO2 emissions intensity for the period 1971–2009 and assesses explanatory factors. Multiplicative, group and additive methodologies of inequality decomposition are employed. The first allows us to clarify the separated role of the carbonisation index and the energy intensity in the pattern observed for inequalities in CO2 intensities; the second allows us to understand the role of regional groups; and the third allows us to investigate the role of different fossil energy sources (coal, oil and gas). The results show that, first, the reduction in global emissions intensity has coincided with a significant reduction in international inequality. Second, the bulk of this inequality and its reduction are attributed to differences between the groups of countries considered. Third, coal is the main energy source explaining these inequalities, although the growth in the relative contribution of gas is also remarkable. Fourth, the bulk of inequalities between countries and its decline are explained by differences in energy intensities, although there are significant differences in the patterns demonstrated by different groups of countries. JEL codes: D39; Q43; Q56. Key words: CO2 international distribution, inequality decomposition, CO2 emissions intensity

Frações de fósforo em Latossolos

O objetivo deste trabalho foi verificar se o histórico de uso, adubação fosfatada, inoculação micorrízica e cultivo com braquiária e soja, em casa de vegetação, alteram as frações de P em três Latossolos. Foi determinado o P ligado a Al (P-Al), Fe (P-Fe) e Ca (P-Ca) e as frações de P separadas com resina, NaHCO3, NaOH, HCl e digestão com H2SO4 e H2O2. As frações orgânicas e inorgânicas foram separadas por autoclavagem. No Latossolo Amarelo coeso (LAx) e Latossolo Vermelho ácrico (LVw), o P-Al, P-Fe e P-Ca foram maiores nos solos cultivados, e no Latossolo Vermelho distroférrico (LVdf) o PAl e PFe foram maiores nos solos não cultivados, tendências não alteradas pelo cultivo com braquiária e soja. A adição de P elevou principalmente as frações inorgânicas lábeis (Pi-resina e Pi-NaHCO3) e moderadamente lábil (Pi-NaOH). Solos anteriormente cultivados tiveram menos P nas frações orgânicas do que os não cultivados. Nos solos com braquiária, verificou-se menos P nas frações pouco lábeis e mais nas frações mais lábeis. O efeito da micorriza foi menor e menos consistente do que o cultivo e aplicação de fósforo.