Anxiety can significantly explain bolus perception in the context of hypotensive esophageal motility: Results of a large multicenter study in asymptomatic individuals.

BACKGROUND: Previous studies have not been able to correlate manometry findings with bolus perception. The aim of this study was to evaluate correlation of different variables, including traditional manometric variables (at diagnostic and extreme thresholds), esophageal shortening, bolus transit, automated impedance manometry (AIM) metrics and mood with bolus passage perception in a large cohort of asymptomatic individuals. METHODS: High resolution manometry (HRM) was performed in healthy individuals from nine centers. Perception was evaluated using a 5-point Likert scale. Anxiety was evaluated using Hospitalized Anxiety and Depression scale (HAD). Subgroup analysis was also performed classifying studies into normal, hypotensive, vigorous, and obstructive patterns. KEY RESULTS: One hundred fifteen studies were analyzed (69 using HRM and 46 using high resolution impedance manometry (HRIM); 3.5% swallows in 9.6% of volunteers were perceived. There was no correlation of any of the traditional HRM variables, esophageal shortening, AIM metrics nor bolus transit with perception scores. There was no HRM variable showing difference in perception when comparing normal vs extreme values (percentile 1 or 99). Anxiety but not depression was correlated with perception. Among hypotensive pattern, anxiety was a strong predictor of variance in perception (R2 up to .70). CONCLUSION AND INFERENCES: Bolus perception is less common than abnormal motility among healthy individuals. Neither esophageal motor function nor bolus dynamics evaluated with several techniques seems to explain differences in bolus perception. Different mechanisms seem to be relevant in different manometric patterns. Anxiety is a significant predictor of bolus perception in the context of hypotensive motility.

The Chicago Classification 3.0 Results in More Normal Findings and Fewer Hypotensive Findings With No Difference in Other Diagnoses.

OBJECTIVES: High-resolution manometry (HRM) is the preferred method for the evaluation of motility disorders. Recently, an update of the diagnostic criteria (Chicago 3.0) has been published. The aim of this study was to compare the performance criteria of Chicago version 2.0 (CC2.0) vs. 3.0 (CC3.0) in a cohort of healthy volunteers and symptomatic patients. METHODS: HRM studies of asymptomatic and symptomatic individuals from several centers of Spain and Latin America were analyzed using both CC2.0 and CC3.0. The final diagnosis was grouped into hierarchical categories: obstruction (achalasia and gastro-esophageal junction obstruction), major disorders (distal esophageal spasm, absent peristalsis, and jackhammer), minor disorders (failed frequent peristalsis, weak peristalsis with small or large defects, ineffective esophageal motility, fragmented peristalsis, rapid contractile with normal latency and hypertensive peristalsis) and normal. The results were compared using McNemar's and Kappa tests. RESULTS: HRM was analyzed in 107 healthy volunteers (53.3% female; 18-69 years) and 400 symptomatic patients (58.5% female; 18-90 years). In healthy volunteers, using CC2.0 and CC3.0, obstructive disorders were diagnosed in 7.5% and 5.6%, respectively, major disorders in 1% and 2.8%, respectively, minor disorders in 25.2% and 15%, respectively, and normal in 66.4% and 76.6%, respectively. In symptomatic individuals, using CC2.0 and CC3.0, obstructive disorders were diagnosed in 11% and 11.3%, respectively, major disorders in 14% and 14%, respectively, minor disorders in 33.3% and 24.5%, respectively, and normal in 41.8% and 50.3%, respectively. In both groups of individuals, only an increase in normal and a decrease in minor findings using CC3.0 were statistically significant using McNemar's test. DISCUSSIONS: CC3.0 increases the number of normal studies when compared with CC2.0, essentially at the expense of fewer minor disorders, with no significant differences in major or obstructive disorders. As the relevance of minor disorders is questionable, our data suggest that CC3.0 increases the relevance of abnormal results.

Normal values of esophageal pressure responses to a rapid drink challenge test in healthy subjects: results of a multicenter study.

BACKGROUND: Multiple water swallow is increasingly used as a complementary challenge test in patients undergoing high-resolution manometry (HRM). Our aim was to establish the range of normal pressure responses during the rapid drink challenge test in a large population of healthy subjects. METHODS: Pressure responses to a rapid drink challenge test (100 or 200 mL of water) were prospectively analyzed in 105 healthy subjects studied in nine different hospitals from different countries. Esophageal motility was assessed in all subjects by solid-state HRM. In 18 subjects, bolus transit was analyzed using concomitant intraluminal impedance monitoring. KEY RESULTS: A virtually complete inhibition of pressure activity was observed during multiple swallow: Esophageal body pressure was above 20 mm Hg during 1 (0-8) % and above 30 mm Hg during 1 (0-5) % of the swallow period, and the pressure gradient across the esophagogastric junction was low (-1 (-7 to 4) mm Hg). At the end of multiple swallow, a postswallow contraction was evidenced in only 50% of subjects, whereas the remaining 50% had non-transmitted contractions. Bolus clearance was completed after 7 (1-30) s after the last swallow, as evidenced by multichannel intraluminal impedance. CONCLUSIONS & INFERENCES: The range of normal pressure responses to a rapid drink challenge test in health has been established in a large multicenter study. Main responses are a virtually complete inhibition of esophageal pressures with a low-pressure gradient across esophagogastric junction. This data would allow the correct differentiation between normal and disease when using this test.

Rate of tree carbon accumulation increases continuously with tree size.

Forests are major components of the global carbon cycle, providing substantial feedback to atmospheric greenhouse gas concentrations. Our ability to understand and predict changes in the forest carbon cycle--particularly net primary productivity and carbon storage--increasingly relies on models that represent biological processes across several scales of biological organization, from tree leaves to forest stands. Yet, despite advances in our understanding of productivity at the scales of leaves and stands, no consensus exists about the nature of productivity at the scale of the individual tree, in part because we lack a broad empirical assessment of whether rates of absolute tree mass growth (and thus carbon accumulation) decrease, remain constant, or increase as trees increase in size and age. Here we present a global analysis of 403 tropical and temperate tree species, showing that for most species mass growth rate increases continuously with tree size. Thus, large, old trees do not act simply as senescent carbon reservoirs but actively fix large amounts of carbon compared to smaller trees; at the extreme, a single big tree can add the same amount of carbon to the forest within a year as is contained in an entire mid-sized tree. The apparent paradoxes of individual tree growth increasing with tree size despite declining leaf-level and stand-level productivity can be explained, respectively, by increases in a tree's total leaf area that outpace declines in productivity per unit of leaf area and, among other factors, age-related reductions in population density. Our results resolve conflicting assumptions about the nature of tree growth, inform efforts to undertand and model forest carbon dynamics, and have additional implications for theories of resource allocation and plant senescence.

Positive interactions, discontinuous transitions and species coexistence in plant communities.

The population and community level consequences of positive interactions between plants remain poorly explored. In this study we incorporate positive resource-mediated interactions in classic resource competition theory and investigate the main consequences for plant population dynamics and species coexistence. We focus on plant communities for which water infiltration rates exhibit positive dependency on plant biomass and where plant responses can be improved by shading, particularly under water limiting conditions. We show that the effects of these two resource-mediated positive interactions are similar and additive. We predict that positive interactions shift the transition points between different species compositions along environmental gradients and that realized niche widths will expand or shrink. Furthermore, continuous transitions between different community compositions can become discontinuous and bistability or tristability can occur. Moreover, increased infiltration rates may give rise to a new potential coexistence mechanism that we call controlled facilitation.

Antiprotozoal activity of (8-hydroxymethylen)-trieicosanyl acetate isolated from Senna villosa.

A white solid compound was isolated from the chloroform extract of the leaves of Senna villosa. The material was identified by (1)H-NMR, (13)C-NMR, IR and EM methods as (8-hydroxymethylen)-trieicosanyl acetate, a new compound with biological activity, which was tested in vitro at concentrations of 1.65, 3.3 and 6.6 microg/ml for inhibition of the growth of Trypanosoma cruzi epimastigotes and tripomastigotes. We observed inhibition of growth at all concentrations tested, and the effect at concentrations of 3.3 and 6.6 microg/ml was greater than that of gentian violet (positive control). At the concentration of 6.6 microg/ml, the compound showed the greatest inhibitory effect against the growth of both forms of the parasite.

Treatment of lower load graywater by using a controlled soil natural treatment system.

Experiences of treating graywater by soil natural treatment systems have not been widely reported. In general terms, graywater has a lower concentrations of organic matter; nutrients (e.g. nitrogen), and microorganisms than combined wastewater; therefore, the graywater treatment capacity of soil should be evaluated. In this study, the performance of a natural soil treatment system was evaluated when shower graywater from a house located at Sapporo City, Japan, was treated by a layer of 30 cm of soil from the Hokkaido University Campus. Results showed very high removal efficiencies of chemical oxygen demand (98%) and Kjeldahl nitrogen (95%) at high infiltration rates (214 cm/d), which denotes that natural soil treatment systems could be a good alternative to treat lower load graywater.

Design and operation of the bio-toilet system.

Criteria for the proper design and operation of the bio-toilet have not been established either by the manufacturers or by the authorities. Based on the results of experimental research already reported by us, criteria for the proper design and operation of the bio-toilet system were established. The establishment of operation criteria led to the formulation of an operation scheme where three main zones are distinguished: i) green zone, where the best composting performance is expected; ii) yellow zone, where biodegradation can be conducted but performance is not the most efficient; iii) other zones where operation of the bio-toilet is not recommended because odour problems and human health risks will develop, or in the worst case, biodegradation of faeces will not occur. In the design criteria, the surface area required for evaporating the water loads due to contributions of urine and faeces was determined by applying concepts of drying theory. This theory was also applied to estimate the mass and volume of dried sawdust required for dealing with the critical water loading. However, the accumulation of stabilised solids transpired to be more critical and, finally, mass and volume of dried sawdust were estimated based on this factor.

A study of the antidiarrheal properties of Loeselia mexicana on mice and rats.

Antidiarrheal properties of hexane, chloroform, methanol and aqueous extracts from Loeselia mexicana were studied using mice and rats as animal models. Flavones and sesquiterpenlactones were detected in the chemical screening of the aqueous extract. Diarrhea was induced by castor oil or MgSO4. The methanol extract diminished diarrhea in mice induced by MgSO4, while the aqueous extract showed an effect on castor-oil-induced. The aqueous extract also reduced castor-oil-enhanced intestinal transit and inhibited defecation of normal mice. The results obtained showed a symptomatic relief of diarrhea.

Anti-inflammatory activity of Lippia dulcis.

Lippia dulcis hexane and ethanol extracts were tested for its anti-inflammatory activity in several animal models. Hexane extract showed to be inactive, but the ethanol extract at doses of 400 mg/kg produced significant inhibition of carrageenan-induced paw oedema and reduced the weight of cotton pellet-induced granuloma, moreover, the topical application of 0.5 mg/ear of this extract inhibited the edema induced with TPA by 49.13%, an effect which is of less intensity than that produced by indomethacine at the same dose.

Biological activity in the composting reactor of the bio-toilet system.

The bio-toilet is becoming commercially available and it is actually used in Japan in public parks, sightseeing areas, and households; however, the biological activity in the system during degradation of toilet wastes, particularly faeces, is unknown. Thus, in this study activity of microorganisms in the bio-toilet system during degradation of faeces was assessed through the quantification of reductions in total solids (TS), volatile solids (VS), and chemical oxygen demand (COD) during batch tests in laboratory-scale composting reactors. Additionally, the fate of nitrogen and its transformation processes in such reactors were evaluated. TS, VS, and COD reductions were on the order of 56%, 70%, and 75%, respectively, irrespective of the organic loading regarded. Total nitrogen (T-N) reductions quantified 94%, regardless of the organic loading. Furthermore, all T-N reductions observed during composting were equivalent to the NH(3)-N released from the reactor, i.e., 94% of ammonia was lost.

Onsite wastewater differential treatment system: modeling approach.

In this paper, the Onsite Wastewater Differential Treatment System (OWDTS), a new approach for improving the traditional onsite wastewater treatment systems (OWTS), is proposed based on differential management and treatment of household wastewater effluents. Three fractions of household wastewater have been differentiated, reduced-volume blackwater, higher-load graywater and lower-load graywater. Based on this differentiation, different treatment processes required for each fraction are discussed. The procedure adopted for treatment of toilet wastes (reduced-volume blackwater) is shown. In the case of graywater, a sketch of treatment processes is provided. The OWDTS seems to be a new approach with higher potential for improvement of traditional OWTS, dry ecological sanitation, recycling of resources (toilet wastes and water), conservation of water resources, etc. Aerobic biodegradation of toilet wastes by using sawdust as a matrix is an essential treatment process of the OWDTS. Membrane technology seems to be the most effective process to treat higher-load gray water. Natural biodegradation of lower-load gray water by soil bacteria needs to be deeply studied.

Hypoglycemic effects of lactucin-8-O-methylacrylate of Parmentiera edulis fruit.

Hypoglycemic activity-guided fractionation together with chemical analysis led to the isolation of one guaianolide (lactucin-8-O-methylacrylate) from the chloroform extract of the dried fruits of Parmentiera edulis. Identification was based on spectroscopic methods. The compounds lowers blood sugar levels after administration to alloxan-diabetic mice.

Isolation and hypoglycemic activity of 5, 7,3'-trihydroxy-3,6,4'-trimethoxyflavone from Brickellia veronicaefolia.

Hypoglycemic activity-guided fractionation together with chemical analysis led to the isolation of one flavone (5, 7,3'-trihydroxy-3,6,4'-trimethoxyflavone) from the chloroform extract of the leaves of Brikkellia veronicaefolia. Identification was based on spectroscopic methods. The isolated flavone was tested for hypoglycemic activity in normal and alloxan-diabetic CD1 mice (25-30 g) were administered in doses of 10, 25 and 50 mg/kg body weight. The blood glucose levels were determined before and 1.5, 3, 4.5 and 24 hours after drug administration. The results showed that the flavone produces a significant hypoglycemic effect in normal as well as in diabetic mice. Comparison was made between the action of the flavone and a known hypoglycemic drug as tolbutamide (50 mg/kg). The flavone was found to be slow and less effective than tolbutamide.

Labeling peptides with rhenium-188.

A direct labeling technique via EHDP for the preparation of 188Re-somatostatin analogue peptide beta-(2-naphthyl)-D-Ala-Cys-Tyr-D-Trp-Lys-Val-Cys-Thr-amide complex was developed. The influence of reaction conditions such as pH, temperature, weak ligand concentration and stannous chloride concentration were investigated. Methods of analysis were also established permitting identification of radiochemical impurities which may be present in the radiopharmaceutical solution. Results showed that under the procedure reported herein 188Re-peptide complex can be prepared with a radiochemical purity of 90% and a specific activity up to 1.8 GBq mg-1 without radiolytic degradation of the product.

Preparation, biodistribution, and dosimetry of 188Re-labeled MoAb ior cea1 and its F(ab')2 fragments by avidin-biotin strategy.

The biotinylated monoclonal antibody (MoAb) ior cea1 and its F(ab')2 fragments were labeled with Re-188 by combination of avidin-biotin strategy. 188Re-MoAb, 188Re-MoAb-biotin, 188Re-F(ab')2, and 188Re-F(ab')2-biotin preparations were produced for these studies with specific activities of 1.30+/-0.18 GBq/mg and from instant freeze-dried kit formulations using ethane-1-hydroxy-1,1-diphosphonic acid (EHDP) as a weak competing ligand. There were no significant differences (p > 0.05) between the biodistribution in mice of biotinylated and unbiotinylated 188Re-labeled immunoconjugates. When avidin was injected as a chase after injection of 188Re-MoAb-biotin or 188Re-F(ab')2-biotin, the blood radioactivity level decreased approximately 75% (cumulated activity) and the effective dose decreased almost 25% with respect to that of the radioimmunoconjugates in which the chase effect was not used. Our results suggest that 188Re-labeled biotinylated MoAb ior ceal and its F(ab')2 fragments prepared by this method are stable complexes in vivo.

Antiurolithiatic activity of Raphanus sativus aqueous extract on rats.

The aqueous extract of the bark of Raphanus sativus was tested for its antiurolithiatic and diuretic activity. The urolithiasis was experimentally induced by implantation of zinc disc in the urinary bladder of rats. Significant decrease in the weight of stones was observed after treatment in animals which received aqueous extract in comparison with control groups. This extract showed an increase in the 24 h urine volume as compared to the control.

Antidiarrhoeal activity of Waltheria americana, Commelina coelestis and Alternanthera repens.

The antidiarrhoeal activity of the hexane, chloroform, methanol and aqueous extracts of Waltheria americana, Commelina coelestis and Alternathera repens, was tested on mice with diarrhoea induced by castor oil and MgSO4. The methanol extract of C. coelestis and A. repens and aqueous extract of A. repens, presented antidiarrhoeal effect, monitored by number of liquid feces defecated and intestinal transit of a suspension of graphite with castor oil in Wistar rats.

Coyolosa, a new hypoglycemic from Acrocomia mexicana.

From the methanol extract of the Arocomia mexicana root a new tetrahydropyrane compound was isolated. Its skeletal structure and relative stereochemistry were established by spectral analysis. Substituent effects have been determined with the hope of providing information about steric interactions and conformation of tetrahydropyran derivatives and carbohydrates. The extract showed a significant blood sugar lowering effect on normal and alloxan-diabetic mice when administered at 2.5 to 40 mg/kg i.p. doses, and exhibited a dose-dependent response in the mice models.

Anti-inflammatory activity of the bark of Hippocratea excelsa.

The ethanol extract of the plant Hippocratea excelsa was examined for its anti-inflammatory effects using several animal models. It produced significant inhibition of carrageenan-induced paw edema and reduced the weight of cotton pellet-induced granuloma at doses of 25-100 mg/kg. The extract was found to exert a protective effect on heat-induced erythrocyte lysis at concentrations of 25, 50 and 100 micrograms/ml. In chronic models of formaldehyde and adjuvant arthritis, its anti-arthritic activity was found to be less than that of phenylbutazone (PNB). It may be inferred that the ethanol extract is effective against both exudative-proliferative and chronic phases of inflammation.