Brazilian consensus on gastroesophageal reflux disease: Proposals for assessment, classification, and management

The Brazilian Consensus on Gastroesophageal Reflux Disease considers gastroesophageal reflux disease to be a chronic disorder related to the retrograde flow of gastroduodenal contents into the esophagus and/or adjacent organs, resulting in a variable spectrum of symptoms, with or without tissue damage. Considering the limitations of classifications currently in use, a new classification is proposed that combines three criteria - clinical, endoscopic, and pH-metric - providing a comprehensive and more complete characterization of the disease. The diagnosis begins with the presence of heartburn, acid regurgitation, and alarm manifestations (dysphagia, odynophagia, weight loss, GI bleeding, nausea and/or vomiting, and family history of cancer). Also, atypical esophageal, pulmonary, otorhinolaryngological, and oral symptoms may occur. Endoscopy is the first approach, particularly in patients over 40 yr of age and in those with alarm symptoms. Other exams are considered in particular cases, such as contrast radiological examination, scyntigraphy, manometry, and prolonged pH measurement. The clinical treatment encompasses behavioral modifications in lifestyle and pharmacological measures. Proton pump inhibitors in manufacturers' recommended doses are indicated, with doubling of the dose in more severe cases of esophagitis. The minimum time of administration is 6 wk. Patients who do not respond to medical treatment, including those with atypical manifestations, should be considered for surgical treatment. Of the complications of gastroesophageal reflux disease, Barrett's esophagus presents a potential development of adenocarcinoma; biopsies should be performed, independent of Barrett's esophagus extent or location. In this regard the designation short Barrett's is not important in terms of management and prognosis. © 2002 by Am. Coll. of Gastroenterology.

The application of distributed virtual machines for enterprise computer management: A two-tier network file system for image provisioning and management

In order to simplify computer management, several system administrators are adopting advanced techniques to manage software configuration of enterprise computer networks, but the tight coupling between hardware and software makes every PC an individual managed entity, lowering the scalability and increasing the costs to manage hundreds or thousands of PCs. Virtualization is an established technology, however its use is been more focused on server consolidation and virtual desktop infrastructure, not for managing distributed computers over a network. This paper discusses the feasibility of the Distributed Virtual Machine Environment, a new approach for enterprise computer management that combines virtualization and distributed system architecture as the basis of the management architecture. © 2008 IEEE.

Regulation, worker protection and active labour-market policies in Latin America

Includes bibliography

Flexibility, protection and active policies in Chile

Includes bibliography

Labour markets, worker protection and lifelong learning in a global economy: experiences and perspectives of Latin America and the Caribbean

Includes bibliography

Information society and public ICT policies in the Caribbean: a review of advances and challenges, policy instruments and country experiences

Includes bibliography

Flexible labour markets, workers' protection and the security of the wings": a Danish flexicurity solution to the unemployment and social problems in globalized economies"

Includes bibliography

Flexible labour markets, workers' protection and active labour market policies in the Caribbean

Includes bibliography