ABSTRACT
Despite the aging of our population, there remains a paucity of information about gastroesophageal reflux (GER) in the elderly. To assess the prevalence and characteristics of GER within this patient population, questionnaires evaluating symptoms associated with GER were administered to 313 consecutive patients 62 yr old or older from a primary care setting. Fourteen percent of these patients reported having at least weekly heartburn. Ambulatory 24-h esophageal pH monitoring was accomplished in 54 of the 313 patients surveyed. Twenty percent (11/54) of this subgroup exhibited increased acid contact time (pH less than 4 for more than 6% of the monitoring period). Twenty-two percent (12/54) complained of heartburn, yet only six individuals (11%) exhibited both symptomatic and objective indications of acid reflux. Surprisingly, 31% (17/54) of the patients studied exhibited significant alkalinity within the distal esophagus (pH greater than 8 for greater than 1.5% of the monitoring period). Whereas 29% of these patients (5/17) reported heartburn, 40% of those reporting heartburn (2/5) had acid GER as well as excessive alkalinity. In contrast to patients with acid GER--none of whom reported pulmonary symptoms--24% (4/17) of these patients with esophageal alkalinity reported wheezing, nocturnal cough, or paroxysmal nocturnal dyspnea. Of the four patients with significant distal esophageal exposure to both acid and alkali, two reported heartburn and a third reported dysphagia. In addition to the somewhat higher prevalence of acid reflux than anticipated, a surprisingly high prevalence of esophageal alkalinity was observed.
Subject(s)
Gastroesophageal Reflux/epidemiology , Aged , Aged, 80 and over , Ambulatory Care , Esophagus/physiopathology , Female , Gastroesophageal Reflux/complications , Gastroesophageal Reflux/physiopathology , Heartburn/etiology , Humans , Hydrogen-Ion Concentration , Male , Middle Aged , Monitoring, Physiologic , Oklahoma , Prevalence , Primary Health Care , Surveys and QuestionnairesSubject(s)
Attention , Auditory Perception , Eye Movements , Pursuit, Smooth , Adult , Humans , MaleABSTRACT
A conceptual means of obtaining improved bonding between filler particles and the polymeric binders of composites is presented. It involves preparing glass particles that separate into two interconnected vitreous phases when heated to an appropriate temperature, and then etching these to produce a porous surface layer. Candidate glass compositions were prepared and subjected to heat treatment in a gradient furnace. Compositions susceptible to phase separations were delineated.
