-Background -The esophagus has a different response in relation to the characteristics of a swallowed bolus. Bolus viscosity and body position may affect esophageal contraction and transit. Objective -To investigate the effect of bolus viscosity and body position on esophageal contraction, transit and perception. Methods -Esophageal contraction, transit and perception of transit were evaluated in 26 asymptomatic volunteers, 13 men and 13 women aged 18-60 years, mean: 33.6 (12.2) years. Esophageal contraction (manometry) and transit (impedance) were measured with a solid state catheter with sensors located 5, 10, 15, and 20 cm from the lower esophageal sphincter. Each volunteer swallowed in duplicate and in random sequence a 5 mL low viscous (LV) liquid bolus of an isotonic drink with pH 3.3, and a 5 mL high viscous (HV) paste bolus, which was prepared with 7.5 g of instant food thickener diluted in 50 mL of water (pH: 6.4). Results -Total bolus transit time, in the sitting position, was longer with the HV bolus than with the LV bolus. Esophageal transit was longer in the supine position than in the sitting position. Bolus head advance time was longer with the HV bolus than with the LV bolus in both positions. Contraction esophageal amplitude was higher in the supine position than in the sitting position. The perception of bolus transit was more frequent with the HV bolus than with the LV bolus, without differences related to position. Conclusion -The viscosity of the swallowed bolus and body position during swallows has an influence on esophageal contractions, transit and perception of transit.

-Context -It has been demonstrated that the ageing process affects esophageal motility. Objectives -To evaluate the effect of the age on the proximal esophageal response to wet swallows. Method -We measured the proximal esophageal response to swallows of a 5 mL bolus of water in 69 healthy volunteers, 20 of them aged 18-30 years (group I), 27 aged 31-50 years (group II), and 22 aged 51-74 years (group III). We used the manometric method with continuous perfusion. The proximal esophageal contractions were recorded 5 cm from a pharyngeal recording site located 1 cm above the upper esophageal sphincter. The time between the onset of the pharyngeal and of the proximal esophageal recording (pharyngeal-esophageal time) and the amplitude, duration and area under the curve of the proximal esophageal contraction were measured. Results -The pharyngeal-esophageal time was shorter in group I subjects than in group II and III subjects (P<0.05). The duration of proximal esophageal contractions was longer in group I than in groups II and III (P<0.001). There was no differences between groups in the amplitude or area under the curve of contractions. There were no differences between groups II and III for any of the measurements. Conclusion -We conclude that the age may affects the response of the proximal esophagus to wet swallows.

OBJETIVO: Estudar a viabilidade de redução da dose de radiação em protocolos de aquisição de imagens de tomografia helicoidal em um hospital universitário. MATERIAIS E MÉTODOS: Foi realizado levantamento de dose de radiação de protocolos de tomografia com objetos simuladores e câmara de ionização. Foram propostas variações de kVp e mAs, determinando-se a média de ruído. Protocolos com valores de ruído menores ou iguais a 1% foram submetidos à avaliação qualitativa de contraste e resolução espacial por três observadores. RESULTADOS: Foram realizados 22 testes de variações para o protocolo de crânio pediátrico, 26 para crânio adulto, 28 para abdome e 18 para tórax. A redução da dose conseguida variou entre 7,4-13% para protocolo de crânio pediátrico, 3,8-25% para crânio adulto, 9,6-34,3% para abdome e 6,4-12% para tórax. Notou-se também que a utilização de ferramentas de janelamento e zoom favoreceu o aceite das imagens pelos observadores. CONCLUSÃO: É possível reduzir os níveis de dose de radiação em até 34,4%, comparativamente aos protocolos utilizados na rotina, mantendo-se o ruído em níveis aceitáveis. O uso de ferramentas de manipulação digital das imagens possibilitou a aceitação de imagens com níveis maiores de ruído, favorecendo o processo de redução de dose de radiação.

-Context -Esophageal dysphagia is the sensation that the ingested material has a slow transit or blockage in its normal passage to the stomach. It is not always associated with motility or transit alterations. Objectives -To evaluate in normal volunteers the possibility of perception of bolus transit through the esophagus after swallows of liquid and solid boluses, the differences in esophageal contraction and transit with these boluses, and the association of transit perception with alteration of esophageal contraction and/or transit. Methods -The investigation included 11 asymptomatic volunteers, 4 men and 7 women aged 19-58 years. The subjects were evaluated in the sitting position. They performed swallows of the same volume of liquid (isotonic drink) and solid (macaroni) boluses in a random order and in duplicate. After each swallow they were asked about the sensation of bolus passage through the esophagus. Contractions and transit were evaluated simultaneously by solid state manometry and impedance.Results -Perception of bolus transit occurred only with the solid bolus. The amplitude and area under the curve of contractions were higher with swallows of the solid bolus than with swallows of the liquid bolus. The difference was more evident in swallows with no perception of transit (n = 12) than in swallows with perception (n = 10). The total bolus transit time was longer for the solid bolus than for the liquid bolus only with swallows followed by no perception of transit. Conclusion -The results suggest that the perception of esophageal transit may be the consequence of inadequate adaptation of esophageal transit and contraction to the characteristics of the swallowed bolus.

BackgroundIn normal subjects the distal esophageal response to dry swallows differs from that of wet swallows. Our aim in this investigation was to compare the esophageal contractions of the proximal and distal esophageal body to wet and dry swallows.MethodsWe studied the esophageal contractions of eight patients with idiopathic achalasia, 37 patients with Chagas’ disease, 28 patients with esophagitis, and 31 normal volunteers using manometric examination with continuous perfusion. The esophageal contractions were measured at 2 cm (proximal) and 22 cm (distal) from the upper esophageal sphincter. Five swallows of a 5 ml bolus of water alternated with 5 dry swallows were performed.ResultsIn the proximal esophagus there was no difference between wet and dry swallows. In patients with esophagitis and volunteers the contractions in the distal esophagus had greater amplitude with wet swallows than with dry swallows. Contraction amplitude was lower than the amplitude of the other groups, in both the proximal and distal esophageal body in achalasia, and in distal esophageal body in Chagas’ disease. The interval between the upstroke of contractions in the proximal and distal esophageal body was longer in volunteers and patients with esophagitis than in patients with Chagas’ disease and achalasia.ConclusionsWet swallows cause higher amplitude of contraction in distal esophagus than dry swallows, which is not seen in diseases with impairment of esophageal innervation (achalasia and Chagas’ disease). In the proximal esophagus there is no difference in contractions caused by wet or dry swallows.

BackgroundThere have been results showing the influence of bolus viscosities and consistency on esophageal motility and transit. However, there is no description about the influence of two different viscous boluses on esophageal contractions, bolus transit and perception of transit. Our objective in this investigation was to evaluate the esophageal transit and contraction after swallows of two viscous boluses.MethodsBy impedance and manometric methods, we measured the esophageal transit and contraction after swallows of two viscous boluses of 5 mL volume, 100% barium sulfate and yogurt, swallowed in duplicate in the supine and upright positions. The bolus transit, esophageal contractions and the perception of bolus transit through the esophagus were evaluated in both positions. Impedance and contraction were measured at 5, 10, 15 and 20 cm from the lower esophageal sphincter. After each swallow, the volunteers were asked about the sensation of bolus transit through the esophagus.ResultsIn supine position, the yogurt had a less frequent complete bolus transit than barium. Also in the supine position, the esophageal transit was longer with yogurt than with barium. Esophageal contractions after swallows were similar between barium and yogurt boluses. There was no difference in perception of transit between the two boluses.ConclusionAlthough both 100% barium sulfate and yogurt are viscous boluses and have similar viscosities, the transit through the esophagus is slower with yogurt bolus than with barium bolus, which suggests that viscosity may be not the sole factor to determine transit.

RESUMOA unidade de tratamento intensivo (UTI) é uma área localizada dentro de uma unidade hospitalar destinada a pacientes que necessitam de uma monitoração de 24 horas por dia. Diariamente o técnico de radiologia realiza exames de raios x de tórax, o mais comum dos exames radiográficos em ambiente de UTI, para o monitoramento do paciente internado. Objetivo realizar a medição da quantidade de radiação espalhada que é gerada durante os exames de rotina de UTI, utilizando para as medidas um dosímetro TLD, e com o resultado registrado, fazer a comparação da dose efetiva (E) mensal permitida para o técnico de raios X. Materiais e Métodos: Os dados coletados foram adquiridos entre 15 de janeiro de 2019 a 14 de fevereiro de 2019, no período matutino na unidade de tratamento intensivo (UTI) do hospital Público de Várzea Grande-MT. Os materiais utilizados foram: dosímetro (TLD), trena, pedestal e equipamento de aparelho de raios x móvel marca SIEMENS POLIMOBIL PLUS, model No 10187800, Serial No 21339.Palavras-Chave: Medição de dose de ambiente; Radiação X; Raios X UTI.