Grape harvest and yield responses to inter-annual changes in temperature and precipitation in an area of north-east Spain with a Mediterranean climate.

This study presents an analysis of temperature and precipitation trends and their impact on grape harvests in the Penedès region (NE Spain). It includes analyses of maximum, minimum and mean daily temperatures (for both the growing and ripening seasons) and daily rainfall (for the hydrological year, the growing season and each phenological stage) for three observatories in the immediate area. We analysed a series of factors: beginning and end harvest dates; the day on which a given potential alcoholic degree was reached; and yield for several varieties of grape grown in the area in relation to climatic variables. Maximum temperatures increased at all the observatories, with greater values being recorded in recent years (1996-2009) than in previous decades (1960s-2000s): we observed increases in average growing season temperatures of 0.11°C per year for the period 1996-2009 vs 0.04°C per year for the period 1960-2009 at Vilafranca del Penedès. These temperature changes were due mainly to increases in maximum temperatures and an increase in the incidence of extreme heat (number of days with T > 30°C). Crop evapotranspiration also increased significantly during the same period. The Winkler index also increased, so the study area would correspond to region IV according to that climatic classification. There were no significant trends in annual rainfall but rainfall recorded between bloom and veraison decreased significantly at the three observatories, with the greatest decrease corresponding to the period 1996-2009. The dates on which harvests started and ended showed a continuous advance (of between -0.7 and -1.1 days per year, depending on the variety), which was significantly correlated with the average mean and maximum daily growing season temperatures (up to -7.68 days for 1°C increase). Winegrape yield was influenced by the estimated water deficit (crop evapotranspiration minus precipitation) in the bloom-veraison period; this value increased due to a reduction in precipitation and an increase in evapotranspiration. Yield may have been reduced by up to 30 kg/ha for each millimetre increase in the estimated water deficit. Under these conditions, new strategies need to be followed in this area in order to maintain grape quality and yield.

Tratamiento laparoscópico de la acalasia. Análisis de resultados y reflexiones sobre la técnica / Laparoscopic treatment of achalasia: analysis of results and reflections on the technique

Introducción La miotomía de Heller por vía laparoscópica es el mejor tratamiento que podemos ofertar a los pacientes con acalasia. Al no actuar sobre la causa de la enfermedad sino que únicamente aliviamos la sintomatología la persistencia de los síntomas puede no desaparecer. Objetivo Analizar los resultados de nuestro grupo en el tratamiento de la acalasia por vía laparoscópica. Material y métodos Se revisan los resultados pre y postoperatorios de una serie de 20 pacientes intervenidos prospectivamente por vía laparoscópica de acalasia durante el período comprendido entre mayo de 2003 y abril de 2010. Para ello se ha utilizado una modificación de la escala de de gradación progresiva de los síntomas pre y postoperatorios descrita por Velanovich para el RGE (escala de 0-5). También se han recogido las complicaciones y estancia hospitalaria. Resultados Se ha practicado una miotomía de Heller amplia asociando un mecanismo anti-reflujo tipo Dor en todos los casos. No se han producido perforaciones esofágicas ni complicaciones intraoperatorias. Dos (10%) pacientes han presentado complicaciones postoperatorias. La estancia hospitalaria ha sido de 3,11±2,13 días. Tras un seguimiento medio de 55,8±14,1 meses los síntomas estudiados han disminuido significativamente tras la cirugía. Sólo 3 pacientes (15%) han presentado clínica postoperatoria de RGE. Diecinueve pacientes (95%) refirieron estar satisfechos con el resultado de la intervención. Conclusiones El tratamiento laparoscópico de la acalasia es una técnica segura, reproducible y efectiva, que consigue un control de los síntomas de la acalasia muy satisfactorio con una mínima morbilidad (AU)

Introduction Heller myotomy using the laparoscopic approach is the best treatment that we can offer to patients with achalasia. On not acting on the cause of the disease, we can only alleviate the persistence of the symptoms, but not make them disappear. Objective To analyse the results of our group in the treatment of achalasia by laparoscopy. Material and methods The pre- and post-operative results are analysed of a series of 20 patients intervened prospectively by laparoscopy of achalasia during a period from May 2003 to April 2010. For this we used a modification of the grading scale of pre- and post-operative symptoms described by Velanovich for GER (a scale from 0-5). Data on the complications and the hospital stay were also collected. Results A wide Heller myotomy was performed using a Dor type antireflux mechanism. There were no oesophageal perforations or complications during the surgery. Two (10%) patients had postoperative complications. The mean hospital stay was 3.11±2.13 days. After a mean follow up of 55.8±14.1 months, the symptoms studied had significantly decreased after the surgery. Only 3 (15%) patients had clinical symptoms of GER after surgery. Nineteen patients (95%) said they were satisfied with the operation. Conclusions The laparoscopic treatment of achalasia is a safe technique, reproducible and effective technique, which achieves very satisfactory control of the achalasia symptoms with a minimum of morbidity (AU)

[Laparoscopic treatment of achalasia: analysis of results and reflections on the technique]. / Tratamiento laparoscópico de la acalasia. Análisis de resultados y reflexiones sobre la técnica.

INTRODUCTION: Heller myotomy using the laparoscopic approach is the best treatment that we can offer to patients with achalasia. On not acting on the cause of the disease, we can only alleviate the persistence of the symptoms, but not make them disappear. OBJECTIVE: To analyse the results of our group in the treatment of achalasia by laparoscopy. MATERIAL AND METHODS: The pre- and post-operative results are analysed of a series of 20 patients intervened prospectively by laparoscopy of achalasia during a period from May 2003 to April 2010. For this we used a modification of the grading scale of pre- and post-operative symptoms described by Velanovich for GER (a scale from 0-5). Data on the complications and the hospital stay were also collected. RESULTS: A wide Heller myotomy was performed using a Dor type antireflux mechanism. There were no oesophageal perforations or complications during the surgery. Two (10%) patients had postoperative complications. The mean hospital stay was 3.11 ± 2.13 days. After a mean follow up of 55.8 ± 14.1 months, the symptoms studied had significantly decreased after the surgery. Only 3 (15%) patients had clinical symptoms of GER after surgery. Nineteen patients (95%) said they were satisfied with the operation. CONCLUSIONS: The laparoscopic treatment of achalasia is a safe technique, reproducible and effective technique, which achieves very satisfactory control of the achalasia symptoms with a minimum of morbidity.