[Predictive factors of eosinophilic esophagitis in esophageal food bolus impaction]. / Factores predictores de esofagitis eosinofílica en impactación esofágica por bolo alimenticio.

BACKGROUND: Food bolus esophageal impaction is often the first symptom in patients diagnosed with eosinophilic esophagitis, representing a change in the epidemiology and management of this urgency. AIM: To detect eosinophilic esophagitis predictive factors in patients with esophageal impaction due to food bolus. METHODS: Patients seen for foreign body impaction were retrospectively analyzed. Epidemiologic characteristics, endoscopic findings, and impaction history were studied. The statistical analysis was carried out using the Student's t test and the chi square test and a logistic regression model. RESULTS: Of the 131 patients, 65% were men and the mean age was 56 years. The endoscopic suspicion of eosinophilic esophagitis was the most frequent finding in patients with food bolus impaction (n=89); those patients that did not have histologic confirmation were excluded (n=7). The remaining patients (n=82) were divided into two groups: confirmed eosinophilic esophagitis (Group A) (n=18) and other endoscopic findings (Group B) (n=64). Group A presented with a lower mean age (36.47 vs. 64.45, P=.001) and a more frequent past history of impaction (38% vs. 6%, OR=15.70, 95% CI (3.60-62.50), P=.001) than Group B. Age and impaction history acted as predictors for eosinophilic esophagitis with 82% sensitivity, 80% specificity, and 84% diagnostic accuracy (P<.001). CONCLUSIONS: Age and a history of impaction predict the presence of eosinophilic esophagitis in patients with food bolus impaction.

Determination of absolute threshold and just noticeable difference in the sensory perception of pungency.

Absolute threshold and just noticeable difference (JND) were determined for the perception of pungency using chili pepper in aqueous solutions. Absolute threshold and JND were determined using 2 alternative forced-choice sensory tests tests. High-performance liquid chromatography technique was used to determine capsaicinoids concentration in samples used for sensory analysis. Sensory absolute threshold was 0.050 mg capsaicinoids/kg sample. Five JND values were determined using 5 reference solutions with different capsaicinoids concentration. JND values changed proportionally as capsaicinoids concentration of the reference sample solutions changed. Weber fraction remained stable for the first 4 reference capsaicinoid solutions (0.05, 0.11, 0.13, and 0.17 mg/kg) but changed when the most concentrated reference capsaicinoids solution was used (0.23 mg/kg). Quantification limit for instrumental analysis was 1.512 mg/kg capsaicinoids. Sensory methods employed in this study proved to be more sensitive than instrumental methods. Practical Application: A better understanding of the process involved in the sensory perception of pungency is currently required because "hot" foods are becoming more popular in western cuisine. Absolute thresholds and differential thresholds are useful tools in the formulation and development of new food products. These parameters may help in defining how much chili pepper is required in a formulated product to ensure a perceptible level of pungency, as well as in deciding how much more chili pepper is required in a product to produce a perceptible increase in its pungency.

Long-term secular trends in initiation of cigarette smoking among Hispanics in the United States.

Preventing the initiation of cigarette smoking plays a vital role in reducing rates of cigarette smoking. The authors investigated trends in cigarette smoking initiation among Mexican Americans, Cuban Americans, Puerto Rican Americans, compared with whites, by examining the cigarette smoking histories of adults from the 1982-83 Hispanic Health and Nutrition Examination Survey and the 1987 National Health Interview Survey. To evaluate these trends, they calculated the prevalence of cigarette smoking among 20-24-year-olds, an indicator of the rate of smoking initiation, in successive 5-year birth cohorts from 1908-12 to 1958-62 among Hispanics and from 1908-12 to 1963-67 among whites. Recently, rates of smoking initiation among Mexican American and Cuban American men have declined and converged with rates of initiation among white men. However, rates of initiation among Puerto Rican American men appeared to have remained unchanged since the 1950s. During the 1970s rates of smoking initiation among Cuban American and Puerto Rican American women surpassed those of white women. In the early 1980s, however, rates of initiation among these groups of Hispanic women have declined to levels comparable to or perhaps lower than the rates among white women. Although recently the rates among Mexican American women have been the lowest of all groups of women, they have not experienced appreciable declines. In general, rates of smoking initiation either declined or leveled off later for Hispanics than for whites. These results suggest that Hispanics tended to follow the smoking trends observed among whites and that special efforts are needed to prevent cigarette smoking among Hispanics.

Long-term age-specific prevalence of cigarette smoking among Hispanics in the United States.

To investigate trends in the prevalence of cigarette smoking among different age groups of Mexican-Americans, Cuban-Americans, and Puerto Rican-Americans, the smoking histories of 8,286 adults and adolescents from the 1982-83 Hispanic Health and Nutrition Examination Survey (HHANES) were evaluated. Age-specific prevalence rate curves were constructed by using the estimated smoking rates among 8-, 18-, 28-, 38-, 48-, and 58-year-olds from 1923 to 1983. Age-specific rates were higher for men than for women. However, rates declined over time among all age groups of Mexican-American men, and among Cuban-American and Puerto Rican-American men older than 18 years. In contrast, rates for Mexican-American women did not change appreciably over time, but they increased markedly for 28- and 38-year-old Cuban-American women and most age groups of Puerto Rican-American women. These results suggest that rates of cigarette smoking among Hispanic women are beginning to converge with those of Hispanic men, and that rates of smoking initiation among Cuban-American boys and Puerto Rican-American boys and girls have either remained unchanged or increased markedly over time.

Birth cohort analysis of prevalence of cigarette smoking among Hispanics in the United States.

To investigate historical trends of cigarette smoking among Mexican-Americans, Cuban-Americans, and Puerto Rican-Americans, we conducted a birth cohort analysis of smoking prevalence by using smoking histories of 8286 adults and adolescents from the 1982-1983 Hispanic Health and Nutrition Examination Survey. We constructed smoking prevalence curves for men and women among successive ten-year birth cohorts. Birth cohort-specific prevalence rates were higher for men than for women. Rates, however, decreased among successive cohorts of men. Conversely, rates increased among successive cohorts of Cuban-American and Puerto Rican-American women. For example, peak rates among the 1911 through 1920 cohorts were 26% (Cuban-American women) and 25% (Puerto Rican-American women) compared with peak rates of 43% and 52%, respectively, among comparable groups from 1951 through 1960. These results demonstrate that despite a reduction of cigarette smoking among successive cohorts of Hispanic men, Hispanic women have made little progress or have actually increased their cigarette smoking.