Persulfate activated with calcium peroxide to remediate RAFT soil contaminated with diesel in Arctic northern villages: on-site pilot scale study.

A pilot field study was conducted in a Canadian northern village (NV) to assess the remediation efficiency of sodium persulphate (SPS) alkali activated with calcium peroxide (CP) to degrade diesel from Arctic raft soil. A minimum temperature increase in the subsurface due to overall process reactions was required. The projected context of application was imperative to preserve the integrity of the remaining permafrost. The test was performed with two soil columns of 370 L buried in the ground. The columns were contaminated with 7500 mg diesel/kg representative raft soil that was matured for a period of 11 months. The continuous delivery by gravity and the static presence of the oxidizing solution was made over 33 days. During that period, SPS concentration, pH and temperatures, were monitored. SPS was activated prior to its distribution and activation by-products were confined in a surficial tank and under a sludge form. The maturation period resulted in the important natural attenuation of diesel (47%) that occurred in the shallower horizons of the soil profile. About 35% of the diesel remaining after the maturation period was removed by chemical oxidation during the operation period on site. The temperature increase measured during the SPS activation process was not significant while the temperature increase due to diesel degradation by oxidation in the subsurface was evaluated to be below 3°C. The soil columns were not clogged by the by-products as indicated by hydraulic testing before and after oxidizing treatment.

Carbon dioxide sequestration by mineral carbonation via iron complexation using bipyridine chelating ligands.

An innovative mineral carbonation method was developed to synthesize iron(II) carbonate (FeCO3) by cation complexation using 2,2'-bipyridine as ligand. First, complexes of iron(II) and different ligands were theoretically analyzed and discounted in terms of their temperature and pH-dependent stabilities, iron-ligand interactions, possible by-products and difficulty of analysis, choosing 2,2'-bipyridine as the most suitable ligand. Then, the Job plot was used to verify the complex formula. The stability of [Fe(bipy)3]2+ at pH 1-12 was further monitored for 7 days using UV-Vis and IR spectroscopy. Good stability was observed between pH 3 and 8, decreasing within pH 9-12 where the carbonation reaction occurs. Finally, the reaction between Na2CO3 and [Fe(bipy)3]2+ was performed at 21, 60, and 80 °C and pH 9-12. The total inorganic carbon measured after 2 h shows that the best carbonate conversion (50%) occurred at 80 °C and pH 11, being the most suitable conditions for carbon sequestration. SEM-EDS and XRD were used to examine the effect of synthesis parameters on the morphology and composition of FeCO3. The FeCO3 particle size increased from 10 µm at 21 °C to 26 and 170 µm at 60 and 80 °C respectively with no pH dependence. In addition, EDS analysis supported the carbonate identity, whose amorphous nature was confirmed by XRD. These results would help prevent the iron hydroxide precipitation problem during mineral carbonation using iron-rich silicates. These results are promising for its application as a carbon sequestration method with a CO2 uptake of around 50% obtaining Fe-rich carbonate.

Physical process to sort construction and demolition waste (C&DW) fines components using process water.

Modern societies are generating considerable volume of Construction and Demolition Wastes (C&DW) annually. Most recycling facilities offers viable sorting and recycling options for the coarser particles of the different materials found in those wastes. However, usual dry mechanical sorting and human sorting are not efficient on C&DW fines particles (C&DF, <10 mm) representing the third of the C&DW produced and being composed of similar materials. Recent environmental issues related to the landfilling of C&DF have pointed out the need to develop innovative alternative and adapted recycling paths for the C&DF. This study presents an efficient sorting process train based on physical separation steps used in the mining and the soil treatment industries. The use and recirculation of process water allowed to segregate and concentrate the gypsum from the 2-12 mm C&DF into a specific fraction (55-65% gypsum content) representing 40% of the total mass. Other constituents were sorted based on their relative density, size and shapes; thanks to hydraulic classification and physical sorting forming four more fractions with high recycling potential: coarse aggregates (15%), fine aggregates (9.4%), organic and inorganic fibers (10.8%) and light organic compounds (24.8%). The process has been designed to be integrated in existing sorting facilities and the process costs were evaluated to 38 CAN$/t.

Effect of pCO2 on direct flue gas mineral carbonation at pilot scale.

Concerns about global warming phenomena induced the development of research about the control of anthropogenic greenhouse gases emissions. The current work studies on the scaling up of aqueous mineral carbonation route to reduce the CO2 emissions at the chimney of industrial emitters. The reactivity of serpentinite in a stirred tank reactor was studied for several partial pressures of CO2 (pCO2) (0.4, 0.7, 1.3 and 1.6 bar). Prior to carbonation, the feedstock was finely grinded and dehydroxyled at 650 °C by a thermal treatment. The major content of magnetite was removed (7.5 wt% · total weight-1). Experiments were carried out under batch mode at room temperature using real cement plant flue gas (14-18 vol% CO2) and open pit drainage water. The effect of the raw water and the pCO2 on the carbonation efficiency was measured. First, the main results showed a positive effect of the quarry water as a slight enhancement of the Mg leaching in comparison with distilled water. Secondly, a pCO2 of 1.3 bar was the optimal working pressure which provided the highest efficiency of the carbonation reaction (0.8 gCO2 · g residue-1). Precipitation rates of dissolved CO2 ranged from 7% to 33%. Pure precipitate was obtained and essentially composed of Nesquehonite. At a pCO2 of 1.3 bar, additional physical retreatment of the solid material after being contacted with 6 batches of gas enhanced considerably mineral carbonation efficiency (0.17 gCO2 · g residue-1.).

Reflujo faringolaringeo y su relación con la ausencia de porción intra abdominal del esfínter esofágico inferior / Pharyngolaryngeal reflux and its relationship with no portion of intra abdominal lower esophageal sphincter

Objetivo: Determinar la relación entre el reflujo faríngolaríngeo y la ausencia de porción intra-abdominal del esfínter esofágico inferior. Materiales y métodos: Estudio analítico, prospectivo y de corte transversal evaluando 65 pacientes referidos a la consulta de Gastroenterología por la Consulta de Otorrinolaringología con el diagnóstico de reflujo faríngolaríngeo, del Centro Medico Docente La Trinidad en el período Enero 2013 a Noviembre 2014. Se les realizo interrogatorio evaluando síntomas típicos (regurgitación y pirosis) y síntomas atípicos (tos, carraspeo y disfonía), manometría y monitoreo del pH esofágico de 24 horas. Posteriormente se seleccionaron dos grupos a comparar: Grupo A con ausencia de porción intra-abdominal del esfínter esofágico inferior y grupo B con presencia de porción intra-abdominal del esfínter esofágico inferior. Resultados: Las variables: edad, sexo, síntomas típicos (pirosis, regurgitación), atípicos (tos, carraspeo, ronquera), presión del esfínter esofágico inferior y la motilidad del cuerpo esofágico no fueron significativas al compararse los grupos Grupo A N=17, y grupo B N=48. El monitoreo de pH esofágico de 24 horas fue estadísticamente significativo al compararse los grupos, evidenciándose que el grupo A tenía mayor porcentaje de resultados positivos para reflujos patológicos. Conclusión: La ausencia de porción intra-abdominal determinada por manometría esofágica se relaciona con la presencia de reflujos patológicos determinados por el monitoreo de pH esofágico de 24 horas, demostrando que esta puede ser un factor desencadenante de ERGE y por consiguiente de reflujo faríngolaríngeo.

Objetive: To determine the relationship between pharyngolaryngeal reflux and the absence of intra-abdominal portion of the lower esophageal sphincter. Materials and methods: Analitical, prospective study. Evaluating 65 patients referred to the consultation of the Gastroenterology from Consultation of the Otorhinolaryngology diagnosed with reflux pharyngolaryngeal of Medical Teaching Center La Trinidad period January 2013 to November 2014. They were interviewed to assess typical symptoms (heartburn and regurgitation) and atypical symptoms (cough, hawking and hoarseness), esophageal manometry and ambulatory 24 hour esophageal pH monitoring. Two groups were selected to compare: group A with no intra-abdominal portion of the lower esophageal sphincter and group B with presence of intra-abdominal portion of the sphincter upper esophageal. Results: The variables: age, gender, typical symptoms (heartburn and regurgitation) and atypical symptoms (cough, hawking and hoarseness), pressure of the lower esophageal sphinter and the motility of the esophagic body, they were not significant when compared groups. The ambulatory 24 hours esophageal pH monitoring was significant statistically when compared groups, demostrating that the group A had the highest percentage of positive results for pathological reflux. Conclusion: the absence of intra-abdominal portion determined by esophageal manometry is related to the presence of pathological reflux determined by ambulatory 24 hour esophageal pH monitoring, demonstrating that this can be a trigger factor of Gastroesophageal reflux disease and therefore pharyngolaryngeal reflux.

Ictericia obstructiva benigna y maligna: utilidad clínica del CA 19-9 / Benign and malignant obstructive jaundice: clinical ultility of CA 19-9

Introducción: Se estableció como objetivo determinar la utilidad clínica del marcador tumoral CA 19-9 en ictericia obstructiva de origen benigno y maligno en pacientes adultos que acuden al servicio de gastroenterología del Hospital Universitario de Caracas. Pacientes y métodos: se estableció como muestra a todos los pacientes que fueron hospitalizados en el Servicio de Gastroenterología del Hospital Universitario de Caracas con ictericia obstructiva, a los cuales se les realizó la determinación del CA 19-9 antes y siete días después del drenaje de la vía biliar a través de una colangiopancreatografía retrógrada endoscópica y se determinó la variación de los valores de CA 19-9 y si este valor permitió diferenciar entre ambas etiologías. Resultados: Los valores de CA 19-9 no se modificaron de forma significativa después del drenaje biliar en la patología benigna ni en la maligna. Se obtuvo un nuevo punto de corte para el CA 19-9 (47U/L), manteniendo la sensibilidad, pero aumentando la especificidad. Conclusiones:No se puede utilizar la variación del CA 19-9 después del drenaje biliar como elemento diagnóstico para diferenciar entre enfermedad benigna o maligna biliopancreática.

Aim: to determinate the clinical utility of the tumor marker CA 19-9 in obstructive jaundice of benign and malignant origin in adult patients who comes to the service of gastroenterology of the Caracas University Hospital.Patients and methods: was stablish as sample every patient who undergo hospitalization in the service of gastroenterology Caracas University Hospital with obstructive jaundice in which was determinate the CA 19-9 before and seven days after the drainage of the biliary pathway with endoscopic retrograde colangiopancreatography and was determinate the variation of the results of the CA 19-9 and if this result can differentiate between both etiologies. Results: the values of CA19-9 did not modified in significant way after the biliary drainage in the benign and malignant pathology. It was obtained a new cohort point of the CA 19-9 (47U/L), keeping the sensitivity, but increasing the specificity. Conclusions: it can’t be used the variation of the CA 19-9 after the biliary drainage as diagnostic element to differentiate between benign and malignant pathology..

CO2 sequestration by mineral carbonation of steel slags under ambient temperature: parameters influence, and optimization.

This work focuses on the influence of different parameters on the efficiency of steel slag carbonation in slurry phase under ambient temperature. In the first part, a response surface methodology was used to identify the effect and the interactions of the gas pressure, liquid/solid (L/S) ratio, gas/liquid ratio (G/L), and reaction time on the CO2 removed/sample and to optimize the parameters. In the second part, the parameters' effect on the dissolution of CO2 and its conversion into carbonates were studied more in detail. The results show that the pressure and the G/L ratio have a positive effect on both the dissolution and the conversion of CO2. These results have been correlated with the higher CO2 mass introduced in the reactor. On the other hand, an important effect of the L/S ratio on the overall CO2 removal and more specifically on the carbonate precipitation has been identified. The best results were obtained L/S ratios of 4:1 and 10:1 with respectively 0.046 and 0.052 gCO2 carbonated/g sample. These yields were achieved after 10 min reaction, at ambient temperature, and 10.68 bar of total gas pressure following direct gas treatment.

Variantes anatómicas de las vías biliares: diagnóstico por cpre y su relación con enfermedades biliares / Anatomical variations of biliary tract: diagnosis by ERCP and their relationship with biliary diseases

Introducción: las variantes anatómicas de las vías biliares son frecuentes, por eso su conocimiento es de suma importancia durante la realización de procedimientos quirúrgicos de las vías biliares como la colecistectomía laparoscópica, con la finalidad de evitar lesiones incidentales de las mismas; en el presente estudio, se deter-minaron éstas variantes por colangiografía retrógrada endoscópica (CPRE), así como también su asociación con enfermedades de las vías biliares. Pacientes y métodos: Se evaluaron todos los pacientes que acudieron al Servicio de Gastroenterología del Hospital Universitario de Caracas, con indicación de realización de CPRE y se incluyeron 232 sujetos divididos en dos grupos, uno conformado por sujetos con presencia de variantes anatómicas de las vías biliares y el otro por sujetos sin varian-tes anatómicas de las vías biliares, luego se relacionaron ambos grupos con las en-fermedades coexistentes. Resultados: Se encontraron 168 casos con variantes del cístico, que corresponde a 72,4%, y 56 casos con variantes anatómicas de las vías biliares intrahepáticas, correspondiente a 24,1%. La variante anatómica del cístico más común correspondió a la inserción posterior (n= 32; 19,1%), encontrándose combinaciones con otras variantes del cístico (espiral posterior en 5 casos, posterior alta en 1 caso, posterior baja en 1 caso y espiral posterior baja en 1 caso). La segun-da variante del cístico más frecuente fue la inserción baja (n = 18; 10,7%). La variante anatómica de las vías biliares intrahepáticas más común fue la tipo B (n= 25; 44,6%), seguida de la tipo C1 (n= 18; 32,1%). La coledocolitiasis fue el diagnóstico más frecuente tanto en los pacientes con variantes anatómicas, como en los sin variantes anatómicas, correspondiendo respectivamente a 33,3% vs 34,8%; p = 0,40. De los pacientes con coledocolitiasis, la variante anatómica del cístico más frecuente fue la inserción posterior (17,5%). Conclusiones: Las variantes anatómicas de las vías biliares son frecuentes. La variante anatómica del cístico más frecuente fue la inserción posterior, mientras que variante anatómica de vías biliares la intrahepáticas fue la tipo B. La patología más frecuente, tanto en pacientes con variante anatómica como los pacientes sin variante anatómica, fue la coledocolitiasis. Sin embargo, no se encontró asociación entre las variantes anatómicas de las vías biliares y las enfermedades biliares.

Introduction: anatomic variants of the biliary tract are frequent, so his knowledge is of utmost importance for performing surgical procedures of the bile ducts as laparo-scopic cholecystectomy to prevent incidental injury of the biliar tree; in this study these variants were determined by retrograde cholangiopancreatography (ERCP) and its relationship with diseases of the biliary tract. Patient and Method: All patients who attended in the Gastroenterology Service of the University Hospital of Caracas with indicating ERCP, were evaluated, and 232 subjects were included, divided into two groups, one composed of subjects with presence of anatomic variants of the biliary tract, another for patients without anatomic variants of the biliary tract, then both groups coexisting illnesses related. Results: 168 cases with cystic duct variants, corresponding to 72.4%, and 56 cases with anatomical variations of intrahepatic bile ducts, corresponding to 24.1% were found. The most common anatomic variant cystic duct corresponded to the posterior insertion (n = 32; 19.1%), finding combinations with other variants of the cystic duct (posterior/spiral in 5 cases, posterior/high in 1 case, 1 case posterior/low and posterior/low/spiral in 1 case). The second variant more common was low insertion (n = 18; 10.7%). Most common variant of intrahepatic bile duct was the type B (n= 25; 44.6%), followed by type C1 (n= 18; 32.1%). Choledocholithiasis was the most frequent diagnosis in both patients with anatomical variants, as in no anatomical variants, corresponding respectively to 33.3% vs 34.8%; p= 0.40. Of patients with choledocholithiasis, the more common anatomical variant of cystic duct was low insertion (17.5%). Conclusions: The anatomic variants of the biliary tract are common. The more common anatomical variant of cystic duct was low insertion, while anatomical variant of the intrahepatic bile ducts was the type B. The most common pathology, both in patients with anatomical variant and in patients without anatomic variant, was choledocholithiasis. However, no association between the anatomic variants of the biliary tract and biliary diseases was found.

CO2 sequestration using waste concrete and anorthosite tailings by direct mineral carbonation in gas-solid-liquid and gas-solid routes.

Mineral carbonation (MC) represents a promising alternative for sequestering CO2. In this work, the CO2 sequestration capacity of the available calcium-bearing materials waste concrete and anorthosite tailings is assessed in gas-solid-liquid and gas-solid routes using 18.2% flue CO2 gas. The objective is to screen for a better potential residue and phase route and as the ultimate purpose to develop a cost-effective process. The results indicate the possibility of removing 66% from inlet CO2 using waste concrete for the aqueous route. However, the results that were obtained with the carbonation of anorthosite were less significant, with 34% as the maximal percentage of CO2 removal. The difference in terms of reactivity could be explained by the accessibility to calcium. In fact, anorthosite presents a framework structure wherein the calcium is trapped, which could slow the calcium dissolution into the aqueous phase compared to the concrete sample, where calcium can more easily leach. In the other part of the study concerning gas-solid carbonation, the results of CO2 removal did not exceed 15%, which is not economically interesting for scaling up the process. The results obtained with waste concrete samples in aqueous phase are interesting. In fact, 34.6% of the introduced CO2 is converted into carbonate after 15 min of contact with the gas without chemical additives and at a relatively low gas pressure. Research on the optimization of the aqueous process using waste concrete should be performed to enhance the reaction rate and to develop a cost-effective process.

Direct gas-solid carbonation of serpentinite residues in the absence and presence of water vapor: a feasibility study for carbon dioxide sequestration.

Mineral carbonation of serpentinite mining residue offers an environmentally secure and permanent storage of carbon dioxide. The strategy of using readily available mining residue for the direct treatment of flue gas could improve the energy demand and economics of CO2 sequestration by avoiding the mineral extraction and separate CO2 capture steps. The present is a laboratory scale study to assess the possibility of CO2 fixation in serpentinite mining residues via direct gas-solid reaction. The degree of carbonation is measured both in the absence and presence of water vapor in a batch reactor. The gas used is a simulated gas mixture reproducing an average cement flue gas CO2 composition of 18 vol.% CO2. The reaction parameters considered are temperature, total gas pressure, time, and concentration of water vapor. In the absence of water vapor, the gas-solid carbonation of serpentinite mining residues is negligible, but the residues removed CO2 from the feed gas possibly due to reversible adsorption. The presence of small amount of water vapor enhances the gas-solid carbonation, but the measured rates are too low for practical application. The maximum CO2 fixation obtained is 0.07 g CO2 when reacting 1 g of residue at 200 °C and 25 barg (pCO2 ≈ 4.7) in a gas mixture containing 18 vol.% CO2 and 10 vol.% water vapor in 1 h. The fixation is likely surface limited and restricted due to poor gas-solid interaction. It was identified that both the relative humidity and carbon dioxide-water vapor ratio have a role in CO2 fixation regardless of the percentage of water vapor.

Reaction mechanism for the aqueous-phase mineral carbonation of heat-activated serpentine at low temperatures and pressures in flue gas conditions.

Mineral carbonation is known as one of the safest ways to sequester CO2. Nevertheless, the slow kinetics and low carbonation rates constitute a major barrier for any possible industrial application. To date, no studies have focused on reacting serpentinite with a relatively low partial pressure of CO2 (pCO2) close to flue gas conditions. In this work, finely ground and heat-treated serpentinite [Mg3Si2O5(OH)4] extracted from mining residues was reacted with a 18.2 vol % CO2 gas stream at moderate global pressures to investigate the effect on CO2 solubility and Mg leaching. Serpentinite dissolution rates were also measured to define the rate-limiting step. Successive batches of gas were contacted with the same serpentinite to identify surface-limiting factors using scanning electron microscopy (SEM) analysis. Investigation of the serpentinite carbonation reaction mechanisms under conditions close to a direct flue gas treatment showed that increased dissolution rates could be achieved relative to prior work, with an average Mg dissolution rate of 3.55 × 10(-11) mol cm(-2) s(-1). This study provides another perspective of the feasibility of applying a mineral carbonation process to reduce industrial greenhouse gas (GHG) emissions from large emission sources.

Miotomía de heller asistida por robot Vs. Miotomía de heller laparoscópica Para el tratamiento de la acalasia / Heller's myotomy assisted by robot Vs laparoscopic heller's myotomy For the treatment of achalasia

La cirugía mínimamente invasiva se ha convertido en el tratamiento estándar para la acalasia. La incorporación de la tecnología robótica permite superar limitaciones de la cirugía laparoscópica aportando una óptima visión tridimensional, aumentando los grados de libertad de los movimientos a la vez que evita el efecto fulcrum e incrementa la ergonomía. Objetivo: determinar las ventajas de la miotomía de Heller asistida por robot sobre la miotomía de Heller laparoscópica en el tratamiento de la acalasia. Métodos: fueron incluidos cuarenta y ocho (48) pacientes con diagnóstico de acalasia confirmado con esofagograma y manometría. Las molestias principales en ambos grupos eran disfagia y pérdida de peso. Resultados: veinticinco (25) pacientes fueron tratados con miotomía de Heller laparoscópica y veintitrés (23) pacientes fueron tratados con miotomía de Heller asistida por robot. No hubo diferencia en el promedio de tiempo quirúrgico (73 ±13 vs 77 ± 18 min, p:0,39). Los eventos intraoperatorios adversos fueron menos frecuentes en los procedimientos asistidos por robot (8% vs. 0%), sin embargo, ésta no representa una diferencia estadísticamente significativa (p: 0.17). La efectividad de la cirugía es comparable en ambos abordajes Conclusión: la miotomía de Heller asistida por robot es un procedimiento seguro y eficaz. El tiempo operatorio no es mayor que la miotomía de Heller laparoscópica, pero es necesario evaluar la técnica en ensayos clínicos aleatorios para determinar sus ventajas en términos de eventos intraoperatorios adversos(AU)

Minimally invasive surgery has become the gold standard for the treatment of achalasia. The incorporation of robotic technology overcomes the limitations of laparoscopic surgery, providing optimum three-dimensional vision, increasing the degrees of freedom of movement while preventing the fulcrum effect and increases ergonomics. Objective: the aim of this study was to compare robotic-assisted laparoscopic Heller myotomy with laparoscopic Heller myotomy in terms of efficacy and safety. Methods: forty-eight (48) patients with diagnosis of achalasia confirmed by esophagogram and manometry were included. Dysphagia and weight loss were the main complaints in both groups. Results: twenty-five (25) patients were treated with laparoscopic Heller myotomy and twenty-three (23) patients were treated with robotic-assisted Heller myotomy. There was no difference in mean operative time (73 ± 13 vs 77 ± 18 min, p:0.39). Intraoperative adverse events were less frequent in the robotassisted procedures (8% vs. 0%), however, this was a nonsignificant difference (p:0.17). The effectiveness of the surgery is comparable in both approaches. Conclusion: Heller myotomy robot assisted is safe and effective. The operating time is not longer than laparoscopic Heller myotomy, but is necessary to evaluate the technique in randomized clinical trials to determine its advantages in terms of intraoperative adverse events(AU)

Tránsito colónico en individuos sanos / Colonic transit in healthy individuals

El tránsito colónico es la medición objetiva del tiempo en el que trascurre el contenido intestinal a través del colon y representa un adelanto muy importante en la evaluación de pacientes con trastornos en el hábito intestinal. Valores normales de tránsito colónico (TC). Determinar valores normales de TC en voluntarios sanos en la ciudad de Caracas. En el Hospital Universitario de Caracas (HUC). Estudio descriptivo, transversal; se empleó anillos metálicos de 8Fr (2.7mm), como marcadores radioopacos, introducidos en capsulas de gelatina tamaño 00 largo (24 anillos/cápsula), se tomaron al azar 30 voluntarios sanos, personal médico y de enfermería del HUC, con edades entre 18 y 50 años, agrupados por género: 15 masculino y 15 femenino. Se realizó radiografías de abdomen simple en posición decúbito dorsal a las 72, 96 y 120 horas posteriores a la ingesta de la cápsula, cuantificando la cantidad de marcadores eliminados. Para el análisis de los resultados se aplicó la prueba no paramétrica U de Mann-Whitney; con un nivel de significación del 95%. No se realizó modificaciones en la dieta durante el estudio. 21 voluntarios (70%) evacuaron más del 80% de los marcadores radiopacos a las 96 horas. 20% (6 voluntarios) registraron la eliminación total de los marcadores antes de las 96 horas. 70% presentó la eliminación de más del 80% de los marcadores de TC a las 96 horas. No se evidenció diferencias estadísticas significativas entre los grupos etarios ni género. Los valores obtenidos son inferiores a los aceptados como normales, reportados en la literatura mundial (eliminación del 80% de los marcadores antes de las 120 horas), y superiores en comparación con un estudio mexicano semejante (eliminación del 80% de los marcadores a las 48 horas)...

The colonic transit is the objective measurement of the time lag in the intestinal contents through the colon and represents an important advancement in the evaluation of patients with intestinal disorders of habit. Normal colonic transit (CT). To determine normal values of CT in healthy volunteers in the city of Caracas. Hospital Universitario de Caracas (HUC). A descriptive cross-functional study; 8Fr (2.7mm) metal rings were used as radiopaque markers, placed into gelatin capsules of 00 long (24 rings / capsule), 30 healthy volunteers, medical and nursing staff of HCU, aged between 18 and 50 years, matched by gender were randomly taken: 15 male and 15 female. A simple abdominal radiography was performed on dorsal decubitus position at 72, 96 and 120 hours after ingesting the capsule, quantifying the amount of markers removed. For the analysis of the results we used the nonparametric Mann-Whitney U test, with a significance level of 95%. No changes were made in the diet during the study. 21 volunteers (70%) evacuated more than 80% of the radiopaque markers at 96 hours. 20% (6 volunteers) reported the total elimination of the markers prior to 96 hours. 70% eliminated over 80% of the markers of the CT at 96 hours. No statistically significant differences were found between age groups or gender. The values obtained are below the ones accepted as normal, reported in the literature (80% elimination of the markers before the 120 hours) and higher compared to a similar Mexican study (80% elimination of the markers at 48 hours)...

Longitud esofágica: estudio prospectivo en pacientes adultos con enfermedad por reflujo gastroesofágico / Esophagus length: Prospective study in adult patients with gastroesophageal reflux disease

Objetivos: Correlacionar la longitud esofágica y de sus esfínteres, en pacientes adultos con enfermedad por reflujo gastroesofágico (ERGE) con síntomas típicos y atípicos. Métodos: Se realizó estudio prospectivo, de corte transversal. Se incluyeron un total de 80 pacientes con diagnóstico clínico, endoscópico y/o pHmétrico de enfermedad por reflujo gastroesofágico referidos al Laboratorio de Motilidad Digestiva del Centro Médico Docente La Trinidad en 2006-7. Se seleccionaron dos grupos: El "A" de pacientes con ERGE y síntomas típicos y el "B" con ERGE y síntomas atípicos. Se les realizó manometría esofágica, determinándose: longitud total y cuerpo esofágico; longitud y presión de los esfínteres esofágicos y presencia de hernia hiatal. Resultados: Del total de pacientes (n=80) que se incluyeron, 58 (72,5%) en el grupo A y 22 (27,5%) en el grupo B. Se encontró un EES de menor longitud en los pacientes del grupo B comparado con el del grupo A con una longitud promedio de 1,91 cm vs 2,71 cm (p= 0,0003). No se encontraron diferencias significativas en cuanto a la longitud del EEI, longitud del cuerpo esofágico. En cuanto a la longitud total esofágica, se encontró que era más corta en el grupo B que en el A, (25,32 cm. vs. 27,34 cm. p= 0,01). La presión del EEI del grupo B fue menor que la presión del mismo en el grupo A. Conclusión: La longitud del esófago total, del EES es menor en pacientes con ERGE y síntomas atípicos que en pacientes con síntomas típicos. Los pacientes con síntomas atípicos presentan una presión disminuida del EEI y una mayor frecuencia de hernia hiatal con respecto a los pacientes con ERGE y síntomas típicos.

Objective: To correlate the length of their esophageal sphincter and, in adult patients with gastroesophageal reflux disease (GERD) with symptoms typical and atypical. Methods: We conducted prospective study, cross-sectional. We included a total of 80 patients with clinical diagnosis, endoscopic and / or pHmétrico of gastroesophageal reflux disease related to laboratory Motility Digestive Centro Medico Docente La Trinidad in 2006-7. Were selected two groups: The "A" and GERD patients with typical symptoms and the "B" with atypical symptoms and GERD. They were conducted esophageal manometry, determined: total length and esophageal body; pressure and length of the esophagus and sphincters presence of hiatal hernia. Results: Of the total patients (n = 80) that were included, 58 (72.5%) in group A and 22 (27.5%) in group B. There was a minor ESS length of patients in group B compared with Group A with an average length of 1.91 cm vs. 2.71 cm (p = 0.0003) No significant differences were found on the length ERA, esophageal body length. As for the total length esophageal, was found to be shorter in group B compared with A (25.32 cm. Vs. 27.34 cms. P = 0.01). The pressure of the ERA group B was lower than the same pressure in group A. Conclusion: The total length of the esophagus, the ESS is lower in patients with atypical symptoms and GERD in patients with typical symptoms. Patients with atypical symptoms have diminished pressure ERA and a higher frequency of hiatal hernia regarding patients with typical symptoms and GERD.

Mesotelioma peritoneal maligno: Presentación de un caso clínico

El mesotelioma peritoneal maligno es una rara enfermedad que representa la neoplasia más común de la serosa peritoneal. Ocupa el segundo lugar de localización mas frecuente para el desarrollo de mesoteliomas después de la serosa pleural. Su incidencia anual es de 1 a 2 casos por millón en la población general. Desafortunadamente su presentación poco específica, retrasa el diagnóstico haciendo su pronóstico sombrío. Presentamos el caso de un paciente masculino de 34 años de edad, cuya única manifestación clínica fue la presencia de ascitis de 3 meses de evolución, a quien posterior a múltiples estudios negativos para malignidad, se le realizó Biopsia peritoneal guiada por laparoscopia. Mencionamos clínica, diagnóstico y tratamiento.

Mesothelioma of the peritoneum is a rare malignant disease that represents the most common neoplasia of the peritoneal serous. After the pleura, it occupies the second most common site for development of mesothelioma. The annual incidence of the tumor in the general population is 1-2 cases per million. Unfortunately, slightly specific presentation, delays the diagnosis, making a poor prognosis of the disease. We report a case of a 34 years old man which the only clinical manifestation was ascites of 3 months of evolution. A peritoneal biopsy was performed after multiple studies of negative results for malignancy. Symptoms, diagnosis and treatment are described.

Melanoma primario de esófago: Presentación de un caso

El melanoma primario de esófago es una neoplasia poco frecuente, reportándose menos de 300 casos en la literatura mundial. El síntoma cardinal de esta patología es disfagia progresiva, generalmente de corta evolución; lo cual refleja agresividad del tumor, del cual se reporta una sobrevida de 30% en un año posterior al diagnóstico. El tratamiento de elección es quirúrgico y no se cuenta con evidencias sólidas para recomendar radioterapia o quimioterapia de forma rutinaria. Describiremos la clínica, el diagnóstico y el tratamiento de un paciente masculino de 66 años con melanoma primario de esófago.

Primary esophageal melanoma is an uncommon neoplasia, with less than 300 cases documented worldwide. The disease main symptom is quick-onset dysphagia, which shows the highly aggressive behavior of these tumors; with a 1-year survival of only 30% after diagnosis. Surgical resection remains the first-line of treatment and radiotherapy and chemotherapy are generally not recommended. We will describe the symptoms, diagnosis and treatment of a 66 years-old male patient with primary esophageal melanoma.

Papilomatosis esofágica y respiratoria: Reporte de un caso y revisión de la literatura

La papilomatosis esofágica es una enfermedad de baja incidencia, en su mayoría presentándose como lesiones aisladas de tercio distal de esófago, en pacientes asintomáticos que son sometidos a endoscopia digestiva superior por estudio de dispepsia o, evidenciadas al momento de realización de autopsias. Existen sólo 5 casos de papilomatosis esofágica diseminada reportados en la literatura. El tratamiento de estas lesiones no se encuentra estandarizado debido a su baja frecuencia, lo que no ha permitido la realización de estudios clínicos controlados. Existen reportes de remisión espontánea; se suele sugerir la observación de las lesiones en pacientes asintomáticos. En los pacientes sintomáticos, se recomienda el uso de terapias ablativas endoscópicas (con la desventaja de una elevada tasa de recurrencia de las lesiones), y el tratamiento quirúrgico es generalmente reservado para aquellos pacientes que no responden sintomáticamente al tratamiento endoscópico.

The esophageal papillomatosis is a low incidence disease, mostly appearing as isolated lesions of the esophagus distal third, in asymptomatic patients who are undergoing upper endoscopy for the study of dyspepsia, evidenced when conducting autopsies. There are only 5 cases of disseminated esophageal papillomatosis reported in the literature. Treatment of these lesions is not standardized because of their low frequency, which has not allowed the conduct of controlled clinical trials, however, there are reports of spontaneous remission. In asymptomatic patients observation of the injury is often suggested. In symptomatic patients, we recommend the use of endoscopic ablative therapies (with the disadvantage of a high rate of recurrence of the injury), and surgical treatment is usually reserved to those patients who do not respond symptomatically to endoscopic therapy.