789 HIGH RESOLUTION ESOPHAGEAL MOTILITY: VARIABLE GEOGRAPHIC DISTRIBUTION IN A LARGE MEXICAN COHORT

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Genaro Vazquez-Elizondo ◽  
José María Remes-Troche ◽  
Enrique Coss-Adame ◽  
Edgardo Suárez-Morán ◽  
Miguel Ángel Valdovinos-Díaz ◽  
...  
Keyword(s):  
High Resolution ◽  
Data Base ◽  
Regional Differences ◽  
Outlet Obstruction ◽  
Central Mexico ◽  
Diverse Population ◽  
Chi Square ◽  
The North ◽  
Available Information ◽  
Diagnostic Outcome

Abstract   High resolution esophageal manometry (HREM) has been in use for about a decade. However, there is no available information regarding geographical or regional differences in diagnostic outcome. Aim Characterize the indications, demographics and diagnostic outcome of HREM in a diverse population of Mexico. Methods Data was collected from four major referral centers representing diverse geographical areas of Mexico: central—Mexico City (two centers, years 2016-2020), south (Veracruz, years 2015-2020) and north (Monterrey, years 2013—2020). All consecutive cases referred for HREM were entered into a data base and analyzed using Chicago 3 classification. Data was evaluated using chi-square to compare frequencies among groups. Results 2,932 patients included: Central n = 877(29.9), North n = 1003(34.2), South n = 1052(35.9). Mean age 47.9(11-93), women 1,795(61.2), men 1,137(38.8). Nationwide, the most common indications for testing were: GERD n = 1677(57.2), followed by dysphagia 587(20), atypical GERD 244(8.3), post-operative GERD 230(7.9), chest pain 114(3.9), and post-operative dysphagia 78(2.8). HREM was normal in 1,468(49.9) patients. Table shows the diagnostic distribution among centers: Central-Mexico had more abnormal cases 531(60.5) (p < 0.0.001) vs 407(40.6) North and 532(50.6) South. Achalasia was more commonly diagnosed in the South n = 104(19.5) whereas outlet obstruction 39(967) p < 0.001 and spastic disorders were more common in the North 47(11.8) p = 0.002. Weak peristaltic disorders were more common in Central-Mexico 369(78.8) p < 0.001. Conclusion This study represents the first large comparative multicenter HREM data base project in Mexico. In this cohort, most patients receiving HREM are women and those whose indication was GERD. These findings indicate variable regional geographical distribution of HERM diagnosis. Our study suggests that further investigation into the causes and epidemiological distribution of motility disorders is warranted.

788 VARIABLE GEOGRAPHICAL DIFFERENCES OF AMBULATORY ESOPHAGEAL REFLUX MONITORING IN MEXICO

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Genaro Vazquez-Elizondo ◽  
José María Remes-Troche ◽  
Enrique Coss-Adame ◽  
Edgardo Suárez-Morán ◽  
Miguel Ángel Valdovinos-Díaz ◽  
...  
Keyword(s):  
Data Base ◽  
Positive Symptom ◽  
Central Mexico ◽  
Limited Information ◽  
Esophageal Reflux ◽  
Erosive Disease ◽  
Functional Heartburn ◽  
Symptom Association Probability ◽  
Common Diagnosis ◽  
Diagnostic Outcome

Abstract   Ambulatory esophageal reflux monitoring (AEpH) is useful in evaluating persistent or refractory esophageal symptoms despite adequate pharmacologic and/or surgical therapy. There is limited information whether there are geographical or regional differences in the diagnostic outcome of this test. Aim Characterize the diagnostic outcome of AEpH in a diverse population of Mexico. Analyze whether there is regional geographical diagnostic variability. Methods Data was collected from four major referral centers representing diverse geographical areas of Mexico: Mexico City-Central (two centers, years 2016-2020), Veracruz-South (years 2015-2020) and Monterrey-North (years 2013-2020). Consecutive patients undergoing AEpH with persistent GERD symptoms despite PPI therapy and negative upper endoscopy (no erosive disease >C or D LA classification) were entered into a data base and analyzed. Patients were classified as: NERD (acid exposure time (AET > 6.0%); hypersensitive esophagus (normal AET and positive symptom index (SI) or positive symptom association probability [SAP]); functional heartburn (NL AET, neg SI/SAP). Statistics: ANOVA, Chi-square and descriptive methods were used to compare variables among groups. Results 969 cases met inclusion criteria: 311 (32.1%) Central, 430 (44.3%) South, and 228 (23.5%) North. The results are summarized in the table. There were more women 618(63.8%) than men 351(36.2%); p < 0.001 with a mean age 47.7 ± 14.3. Patients were older in Central-Mexico 49.3 ± 13.6 years vs South 47.5 ± 15 and North 46.1 ± 13.6; p = 0.033. Functional heartburn was the most common diagnosis overall and more prevalent in Central-Mexico 171(55%) vs North 97(42.5%) and South 160(37.2%); p < 0.001. NERD was more predominant in the South 171(39.8%) vs North 72(31.6%) and Central-Mexico 98(31.5%); p = 0.029. Hypersensitive esophagus was more frequent in the North 59(25.9%) vs South 99(23%), and Central 42(13.5%); p < 0.001. Conclusion This is the first large data base study to evaluate the outcome of ambulatory esophageal reflux pH testing in Mexico. Our findings indicate a geographical variability of GERD phenotypes and suggest that further investigations are warranted to determine the causes of this distribution.

scholarly journals A high-resolution solar spectrum 2000 Å–2200 Å

1970 ◽  
Vol 36 ◽  
pp. 271-273
Author(s):  
B. B. Jones ◽  
B. C. Boland ◽  
R. Wilson ◽  
S. T. F. Engstrom
Keyword(s):  
High Resolution ◽  
Solar Spectrum ◽  
Solar Image ◽  
Roll Control ◽  
North East ◽  
The North ◽  
Alignment System ◽  
Optical Alignment ◽  
South Axis ◽  
System Operating

A high-resolution solar spectrum in the range 2000–2200 Å was obtained in a recent flight of a sunpointing Skylark rocket. This was launched at 04.21 hr UT on April 22, 1969 from Woomera and reached an apogee of 178 km. An optical alignment system operating on the main vehicle pointing system gave a net stabilisation of ±3 arc sec in the position of the solar image relative to the spectrograph slit. The slit, of length 1.0 mm, was set in the north-east quadrant parallel to and 5 arc min from the north/south axis, its lower edge being 1 arc min from the equator. The roll control of ±2.5° was provided entirely by the standard Elliott Bros. type of vehicle stabilisation.

scholarly journals A tale of two parts of Switzerland: regional differences in the impact of the COVID-19 pandemic on parents

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michelle Seiler ◽  
Georg Staubli ◽  
Julia Hoeffe ◽  
Gianluca Gualco ◽  
Sergio Manzano ◽  
...  
Keyword(s):  
Public Health ◽  
Regional Differences ◽  
Online Survey ◽  
Pediatric Emergency ◽  
The South ◽  
Public Health Agencies ◽  
The North ◽  
Regional Strategies ◽  
Health Agencies ◽  
The Impact

Abstract Background We aimed to document the impact of the coronavirus disease 2019 (COVID-19) pandemic on regions within a European country. Methods Parents arriving at two pediatric emergency departments (EDs) in North of Switzerland and two in South of Switzerland completed an online survey during the first peak of the pandemic (April–June 2020). They were asked to rate their concern about their children or themselves having COVID-19. Results A total of 662 respondents completed the survey. Parents in the South were significantly more exposed to someone tested positive for COVID-19 than in the North (13.9 and 4.7%, respectively; P <  0.001). Parents in the South were much more concerned than in the North that they (mean 4.61 and 3.32, respectively; P <  0.001) or their child (mean 4.79 and 3.17, respectively; P <  0.001) had COVID-19. Parents reported their children wore facemasks significantly more often in the South than in the North (71.5 and 23.5%, respectively; P <  0.001). Conclusion The COVID-19 pandemic resulted in significant regional differences among families arriving at EDs in Switzerland. Public health agencies should consider regional strategies, rather than country-wide guidelines, in future pandemics and for vaccination against COVID-19 for children.

X-ray computed microtomography for the structural analysis of jewelry from the Museum “Royal Tombs of Sipán”

2020 ◽  
Vol 35 (S1) ◽  
pp. S38-S42
Author(s):  
Soraia Rodrigues de Azeredo ◽  
Roberto Cesareo ◽  
Angel Guillermo Bustamante Dominguez ◽  
Ricardo Tadeu Lopes
Keyword(s):  
Structural Analysis ◽  
High Resolution ◽  
Copper Alloys ◽  
North Coast ◽  
Flat Panel ◽  
X Ray ◽  
The North ◽  
Gold Silver ◽  
Computed Microtomography ◽  
X Ray Computed

Precious ornaments from the Museum Royal Tombs of Sipán were analyzed by X-ray computed microtomography (microCT). The ornaments analyzed were golden earrings produced by the Moche culture that flourished along the north coast of present-day Peru between approximately 100 and 600 AD. Sipán, also known as Huava Rajada, is a mochica archaeological complex in the north of Peru. In particular, the spectacular jewelry, mainly composed of gold, silver, and copper alloys, gilded copper, and tumbaga, from the Museum “Royal Tombs of Sipán,” in Lambayeque, north of Peru, are some of the most sophisticated metalworking ever produced of pre-Columbian America. A portable microCT system consisting of a high-resolution flat panel detector and a mini X-ray tube were used for the structural analysis of these ornaments. The microCT images show parts of the internal structure, highlighting the manufacturing technique and gold sheets joining techniques of the Moche artisans. Furthermore, the advantage of using the portable microCT system for nondestructive testing is clear when the sample cannot be taken to the laboratory.

Field Implementation of RBI for Jacket Structures

2003 ◽  
Author(s):  
Michael H. Faber ◽  
Daniel Straub ◽  
John D. So̸rensen ◽  
Jesper Tychsen
Keyword(s):  
Sensitivity Analysis ◽  
Data Base ◽  
Stress Ratio ◽  
Oil And Gas ◽  
Inspection Planning ◽  
The North ◽  
Large Numbers ◽  
Structural Details ◽  
Jacket Structures ◽  
The North Sea

The present paper first gives a brief outline of the simplified and generic approach to reliability and risk based inspection planning and thereafter sets focus on a recent application of the methodology for planning of in-service NDT inspections of the fixed offshore steel jacket structures in the DUC concession area in the Danish part of the North-Sea. The platforms are operated by Maersk Oil and Gas on behalf of DUC partners A.P. Mo̸ller, Shell and Texaco. The study includes a sensitivity analysis performed for the identification of relevant generic parameters such as the bending to membrane stress ratio, the design fatigue life and the material thickness. Based on the results of the sensitivity analysis a significant number of inspection plans were computed for fixed generic parameters (pre-defined generic plans) and a data-base named iPlan was developed from which inspection plans may be obtained by interpolation between the pre-defined generic plans. The iPlan data-base facilitates the straightforward production of large numbers of inspection plans for structural details subject to fatigue deterioration. In the paper the application of the generic inspection plan database iPlan is finally illustrated on an example.

New Evidence of the Late Neopleistocene Peopling of the Lower Ob Valley

2021 ◽  
Vol 49 (1) ◽  
pp. 9-20
Author(s):  
I. D. Zolnikov ◽  
A. A. Anoikin ◽  
E. A. Filatov ◽  
A. V. Vybornov ◽  
A. V. Vasiliev ◽  
...  
Keyword(s):  
Upper Paleolithic ◽  
The Arctic ◽  
Northern Eurasia ◽  
West Siberian Plain ◽  
Faunal Remains ◽  
Human Occupation ◽  
Large Area ◽  
Paleolithic Site ◽  
The North ◽  
Available Information

This study focuses on the early human occupation of the arctic part of the West Siberian Plain and introduces the finds at the Paleolithic site Kushevat (Shuryshkarsky District, Yamal-Nenets Autonomous Okrug), discovered in 2020. Geological and geomorphological characteristics of the Lower Ob region are provided, the chronology of the key Middle and Late Neopleistocene sequences is assessed, and criteria underlying the search for Paleolithic sites in the area are outlined. We describe the discovery and excavations at Kushevat, its stratigraphy and its faunal remains. On the basis of correlation with neighboring key Late Neopleistocene sections with a representative series of absolute dates, the age of the site is estimated at cal 50–35 ka BP. Results of a traceological study of a possibly human-modified reindeer antler are provided. Findings at Kushevat and the available information on the early peopling of northern Eurasia suggest that the boundary of the inhabited part of that region must be shifted ~200 km to the north. The Ob, therefore, is one of the last major Siberian rivers where traces of the Early Upper Paleolithic culture have been found. The discovery of a stratified site in its lower stretch is a milestone in the Paleolithic studies in the region. A large area over which faunal remains are distributed, and the presence of lithics among the surface finds, suggest that Kushevat is a highly prospective site for future archaeological studies of the early stages in the human peopling of the region.

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