Palatopharyngeal surgery. A study of its effectiveness in the treatment of obstructive apnea syndrome during sleep

Palatopharyngeal surgery is a therapeutic option for obstructive Sleep Apnea Syndrome (OSAS). This operation is based on the assumption that the soft palate is the principal apneogenic area of the upper airways. The effectiveness of palatopharyngeal surgery and of correcting nasal obstruction (co-adjuvant factor of SAOS), when present, was evaluated. Thirty patients were selected by cephalometry for surgery (3 women, 27 men; age 45.3 +/- 7.5 years). The success rate was 60%, which justifies the inclusion of surgery as a useful option for treating SAOS.     

Organizational determinants of IT adoption in the pharmaceutical distribution sector

The aim of this paper is to propose new organizational factors that might explain the differences in the extent and the speed of IT adoption. With this in mind, we carried out an analysis of 16 cases in the pharmaceutical distribution sector in Spain. The results indicate that there are certain intangible assets that favour the introduction and development of IT. Among these are a frank and fluid communication between departments and members of the organization, low levels of conflict, the explicit support of top management towards IT adoption and learning and creative skills of IT-staff. In addition to these factors, we found others that we propose as catalysts of IT adoption. Among these we might mention the special relationship between the member-clients and the company in the case of cooperative firms.     

Optimal Locations of Groundwater Extractions in Coastal Aquifers

A regional water supply management model for coastal aquifers was developed. One of its outcomes is the definition of the optimized locations for groundwater withdrawal. Such a tool permits the analysis of alternative plans for groundwater extraction and the sustainable use of water resources in a coastal aquifer subject to saltwater intrusion. The principal components are the evolutionary optimization and the analytical/numerical simulation models. The optimization technique looks for the best well locations taking into consideration the economic results and the satisfaction of the societal water demand. However these two concerns are conditioned by trying to control the saltwater intrusion, i.e., preserving the environmental equilibrium. The simulation model uses the governing mathematical equations for groundwater movement to find the interface between freshwater and saltwater. Because of the non-linearity in the system and the possibility of a jumping interface, a security distance was defined. This is a controlling variable which can be set by the decision makers. The model was applied to a typical case with interesting results. For example, diagrams showing the relationship between the location of the wells and the security distance(s) are of importance to the managers. It was also crucial to have an understanding of the tradeoffs between groundwater withdrawals, positions of the wells from the coast line, and the security distance. The model was also applied to a real case in order to relate the extractions, distances and artificial recharge (not presented in this paper).     

Sublethal effects of an organophosphate insecticide on the European eel, Anguilla anguilla

Recent research has found that family caregivers do not discuss their caregiving in terms of tasks but instead describe their care as shaped by concerns, commitments and goals. The purpose of this paper is to challenge the ways in which nurses approach the family caregiving process and to explore possibilities for evolving nursing knowledge by questioning existing practice in the light of developing insight into the ways in which being a family caregiver is meaningful. A critique of the philosophical orientations of rationalism and empiricism provides a platform to discuss the merits of a Heideggerian phenomenological approach in assisting nurses to better understand family caring experience. Such critique serves to support the notion of displacing the traditional scientific view as the prime means of disclosing truth, acknowledging alternative ways of knowing.     

Spreading Codes Generator for Wireless CDMA Networks

The prime characteristic of spread spectrum modulated signals is that their bandwidth is greater than the information rate. In this way a redundancy is introduced that allows the severe levels of inteference inherent in the transmission of digital information over radio and satellite links to be overcome. Current spread spectrum applications are primarily in military communications; nevertheless, there is growing interest in this technique for third generation mobile radio networks (UMTS, FPLTS, etc.) with open discussion regarding the practicality of using a multiple access system based on spread spectrum techniques (CDMA). However, in order to support as many users in the same bandwidth as other multiple access techniques such as TDMA or FDMA, it is important how to generate large families of sequences that present low cross-correlation. The aim of this paper is to describe a spreading codes generator that can produce a large number of PN sequences with good properties of auto- and cross-correlation. Moreover, the codes generated shows high unpredictability and good statistical behaviour. This also allows the implementation of some features that are common on military networks such as message privacy (increasingly important in commercial networks) without additional cost. The structure presented shows itself to be advantageous for high speed generation of codes at a low cost, low power consumption (allowing longer life for batteries), small size and simplicity of implementation, essential ingredients for commercial equipment. Another attractive feature is its structural parallelism, useful in VLSI implementations. All of these features render it potentially suitable for the implementation of channel bandwidth sharing systems in future wireless personal communications networks.     

Bone marrow biopsy in the diagnosis of fever of unknown origin in patients with acquired immunodeficiency syndrome

BACKGROUND: Fever is commonly observed in patients with human immunodeficiency virus (HIV) disease and frequently eludes diagnosis. The role of bone marrow biopsy in the diagnosis of fever of unknown origin in patients infected with HIV remains controversial. PATIENTS AND METHODS: One hundred twenty-three consecutive patients with 137 episodes of fever lasting 10 or more days without diagnosis after 1 week of hospitalization were evaluated by bone marrow biopsy. RESULTS: Overall, a specific diagnosis was achieved in 52 episodes by means of culture and histopathological examination (diagnostic yield, 37.9%). Three types of disease were found: mycobacterial infections (n = 36, 69% of documented episodes), including 18 patients with disseminated tuberculosis and 14 with Mycobacterium avium-intracellulare complex infections; non-Hodgkin lymphomas (n = 12, 23%); and visceral leishmaniasis (n = 4, 8%). Although bone marrow cultures were more sensitive than microscopic examination with special stains for the diagnosis of mycobacterial infections, the pathological examination of bone marrow led to a more rapid diagnosis of disease. In addition, the histopathological examination of bone marrow alone led to the diagnosis of a specific condition in 43 episodes (31.3% of all episodes). CONCLUSIONS: Bone marrow biopsy is a useful procedure for the diagnosis of fever in patients with advanced HIV disease, particularly in areas where tuberculosis and leishmaniasis are prevalent. Involvement of the marrow may be the first indication of the existence of extranodal non-Hodgkin lymphoma. For Mycobacterium avium-intracellulare complex infection, blood cultures were more sensitive than bone marrow biopsy.     

Expression of smooth-muscle actin in cultured cells from human plasmacytoid myoepithelioma

BACKGROUND: Endoscopic sclerotherapy (ST), widely used as treatment of bleeding esophageal varices, might cause motility disturbances of the esophagus as well as mucosal damage. We performed this study to evaluate the long-term effects of repeated sclerotherapy on esophageal motility and mucosa. METHODS: Ten patients with liver cirrhosis and bleeding esophageal varices treated with repeated ST were evaluated after the last ST, median 52 months, by esophageal manometry and gastroscopy where forceps biopsies were taken. RESULTS: We found a significant difference in the distal esophageal sphincter intraabdominal length. The distal esophageal sphincter pressure was somewhat lower in the ST group although the difference did not reach statistical significance. There was infiltration of neutrophil leukocytes in biopsies from four patients and normal findings in the rest. CONCLUSIONS: Long-term follow-up evaluation showed statistically longer distal esophageal intraabdominal length in the ST group. No mucosal alterations were found at the histopathological investigation.     

Development of an octocalcium phosphate cement

From previous studies it is known that alpha-tertiary calcium phosphate and dicalcium phosphate form a cement upon mixing with water. In this study this cement was optimized in terms of the milling of the constituents, their molar ratio, the amount of hydroxyapatite added and the water/powder ratio. The optimum Ca/P molar ratio of the cement mixture was 1.36±0.03. X-ray diffraction showed the reaction product to be octocalcium phosphate. Addition of precipitated hydroxypatite of over 3% diminished the final strength of the cement significantly. However, admixtures of only 2% of precipitated hydroxyapatite (a) kept the final compressive strength at 30±5 MPa after soaking in Ringers solution at 37°C, (b) diminished the initial setting time from 27.5 to 10 min and the final setting time from 65 to 40 min, (c) diminished the time in which the final strength was reached from 36 to less than 14 h. The tensile strength of this cement is 19±1% of its compressive strength. The optimum water/powder ratio as found in this study was 0.30 g/g.