[Global systems for monitoring cerebral hemodynamics in the neurocritical patient: basic concepts, controversies and recent advances in measuring jugular bulb oxygenation].

Because of the importance of hypoxic/ischemic phenomena in head-injured patients, brain monitoring in these patients should be complemented by systems providing information on cerebral blood flow and metabolism. Indirect estimations of cerebral blood flow have been obtained from blood extracted from the jugular bulb, as a special bedside application of the Fick's principle to the brain. In the last few years, the use of jugular oximetry techniques has become routine in centers treating head-injured and other neurocritical patients such as those presenting subarachnoid hemorrhage or malignant middle cerebral artery infarction.

High amplitude contractions in the middle third of the oesophagus: a manometric marker of chronic alcoholism?

Background: Oesophageal motor abnormalities have been reported in alcoholism.

Aim: To investigate the effects of chronic alcoholism and its withdrawal on oesophageal disease.

Patients: 23 chronic alcoholic patients (20 men and three women; mean age 43, range 23 to 54).

High alcohol intake as a risk and prognostic factor for community-acquired pneumonia.

Objective: To evaluate whether high alcohol intake is an independent risk factor for community-acquired pneumonia in middle-aged people and whether it confers a poor prognosis.

Methods: A two-phase study was performed. Risk factors for community-acquired pneumonia were evaluated in a case-control study of 50 patients and 50 controls.

Autonomic and peripheral neuropathies in patients with chronic alcoholism. A dose-related toxic effect of alcohol.

Objective: To assess autonomic and peripheral nervous system function in patients with chronic alcoholism.

Design: A cross-sectional study.

Patients: A consecutive sample of 107 alcoholic patients and 61 controls.

Regional cerebral blood flow-SPECT in chronic alcoholism: relation to neuropsychological testing.

To determine the prevalence of central nervous system damage due to ethanol, we evaluated 40 asymptomatic chronic alcoholics and 20 age-matched controls. Studies included neuropsychological testing, brain 99mTc-HMPAO SPECT, and morphometric analysis by CT scan. In the qualitative analysis, 30 of the 40 alcoholics showed hypoperfused areas on SPECT scan.