No abstract

Background: Patients with severe developmental disabilities often have concurrent decreased neuromuscular tone of the gastrointestinal tract, which can lead to a weak gag reflex, esophageal reflux, aspiration, and severe intractable constipation. High doses of multiple laxatives are frequently needed to maintain bowel motility in these patients. Colchicine, a natural alkaloid that is primarily used for the treatment of acute attacks of gout, causes an increase in gastrointestinal motility by neurogenic stimulation. The purpose of this study was to determine whether daily colchicine administration can improve bowel function and reduce laxative use in profoundly disabled patients with severe, intractable constipation who currently require large doses of multiple laxatives.Methods: Twelve developmentally disabled patients who required three or more different laxatives to manage their chronic constipation were selected to participate in a double-blind, crossover study. Eleven patients who completed the study received placebo treatment for 8 weeks and colchicine treatment for 8 weeks. The total number of bowel movements and the total number of laxatives used during each of the two 8-week periods were compared.Results: Eight of 11 patients experienced an improved bowel pattern while on colchicine compared with placebo, as defined by an increase in total number of bowel movements or a decrease in total number of rectal laxatives used. No clinically important complications were related to use of colchicine.Conclusions: Colchicine appears to be a valuable adjunct in the management of severe intractable

Temperature-index modeling is used to determine the magnitude of temperature depression on the Blanca Massif, Colorado, required to maintain steady-state mass balances of nine reconstructed glaciers at their extent during the Last Glacial Maximum (LGM). The mean temperature depression thus determined is ~8.6 +0.7/−0.9 °C where the uncertainties account for those inherent in the glacier reconstructions, in model parameters (e.g., melt factors), and possible modest changes in LGM precipitation. Associated equilibrium-line altitudes (ELAs) exhibit a statistically significant directional dependency being lower toward the north and east. Under the assumption that regional temperature change was uniform, required changes in precipitation vary systematically—also exhibiting a directional dependency coinciding with that in ELAs—and indicate increases (over modern) occurred on the eastern side of the massif while decreases occurred on the western side. This disparity represents a strengthening of a precipitation asymmetry, particularly winter precipitation, which exists today. The modern precipitation asymmetry may be a consequence of snow being blown over to the eastern side of the massif (advective transport) by southwesterly flow. Intensification of this flow during the LGM would have enhanced advection, and augmented snow accumulation on glaciers, thus explaining the lower ELAs and increased precipitation on that side of the massif.

A review of the coals on the UK continental shelf as conventional dry gas source rocks and coalbed methane reservoirs has been undertaken using wireline log data from 1747 oil/gas wells. Coals ranging from Late Devonian to Pleistocene age were recorded, with important coal-bearing sequences in the Lower and Upper Carboniferous, Middle Jurassic and Palaeogene. The coals range from lignite to anthracite rank. Coal thicknesses were interpreted from a combination of gamma, sonic and density wireline logs. However, it is apparent that relatively large source/detector spacings and high logging speeds used in deep oil/gas wells fail to completely resolve thin coals. Frequency distributions of coal thickness for the offshore data set cover about 4720 observations in subsets based on geological age and indicate a high positive skewness with evidence of truncation at thicknesses less than approximately 2 ft (0.6 m). A sample of coal thicknesses based on 1227 observations from 66 cored boreholes in the onshore Westphalian displays similar frequency characteristics, but with the truncation confined to coals less than 1 in (0.03 m) thick. Data truncation seen in the offshore wells is attributed to incomplete wireline log resolution. At the maximum end of the distributions, the data generally display an asymptotic shape for larger thicknesses, normally somewhere in excess of 10 ft (3.0 m). To estimate the unresolved thin coals as well as test the statistical validity of the distributions, comparisons were made of the observed frequency distributions with a number of theoretical distributions of the exponential family, including the generalized Pareto distribution. In addition to this frequential approach, a series of thickness-weighted plots, indicative of coal volume, are introduced. Subsequently, conclusions are drawn regarding the estimation of the total coal resource base from this data. In particular, the effects of the truncation can be quantified and are of the order of 20–30%. These are important adjustments to the estimates of overall coal volumes which are used to assess gas-generating capacity.