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Valsalva movement

Matthew E Smith, Andrew J C Blythe, Charlotte Baker, Charlie C Zou, Peter J A Hutchinson, James R Tysome
OBJECTIVE: There is no agreement on the best clinical test for Eustachian tube (ET) dysfunction. Numerous tests have been developed to detect ET opening, and all require a patient to perform a Valsalva, Toynbee or sniff maneuver, or to swallow on demand. We aimed to characterize existing tests of ET function in healthy ears, and identify the optimal method and patient maneuver for each test. Our own normative data is presented alongside published comparisons. STUDY DESIGN: Diagnostic test cohort study...
March 16, 2017: Otology & Neurotology
Matthew E Smith, Charlie C Zou, Charlotte Baker, Andrew J C Blythe, Peter J A Hutchinson, James R Tysome
OBJECTIVES/HYPOTHESIS: Many objective tests of eustachian tube (ET) function have been devised for clinical and research use but they have not been directly compared or characterized. As a first step to identifying tests to incorporate into an outcome set for ET dysfunction, we assessed repeatability of a panel of eight of these tests in healthy ears. STUDY DESIGN: Comparison of eight tests of ET function. METHODS: The following tests were investigated in combination with Valsalva, Toynbee, swallow, or sniff maneuvers: 1) patient-reported ET opening, 2) observed tympanic membrane movement, 3) continuous impedance, 4) canal manometry, 5) sonotubometry, 6) nine-step test, 7) tubomanometry, and 8) tympanometry at rest...
February 22, 2017: Laryngoscope
Kaven Baessler, Melanie Metz, Baerbel Junginger
AIMS: To assess the effects of the Valsalva manoeuvre versus straining on bladder neck (BN) and puborectalis muscle (PR) position, BN stiffness and pelvic floor muscle (PFM) activation in urinary incontinent women and healthy continent controls. METHODS: We recruited 17 continent and 85 incontinent women. A Microtip transducer measured urethral and vesical/abdominal pressures. A surface EMG electrode attached to a sponge was placed vaginally at the pelvic floor level...
January 31, 2017: Neurourology and Urodynamics
Aparna Hegde, Mayte Nogueiras, Vivian C Aguilar, G Willy Davila
INTRODUCTION AND HYPOTHESIS: To correlate dynamic assessment of sling function using 2D and 3D transperineal ultrasound with outcomes following transobturator sling surgery. METHODS: This is an unmatched case-control study of 100 patients who underwent transobturator sling surgery at our center between 2009 and 2012. Group A (n = 50) patients had successful outcomes and group B (n = 50) patients had suboptimal outcomes 1 year following surgery. The patients underwent 2D dynamic and 3D transperineal ultrasound...
December 26, 2016: International Urogynecology Journal
A Kuiper, M E van Egmond, M P M Harms, M D Oosterhoff, B van Harten, D A Sival, T J de Koning, M A J Tijssen
BACKGROUND: Compulsive movements, complex tics and stereotypies are frequent, especially among patients with autism or psychomotor retardation. These movements can be difficult to characterize and can mimic other conditions like epileptic seizures or paroxysmal dystonia, particularly when abnormal breathing and cerebral hypoxia are induced. CASE PRESENTATION: We describe an 18-year-old patient with Asperger syndrome who presented with attacks of tonic posturing of the trunk and neck...
2016: Journal of Clinical Movement Disorders
N Jufas, N Deveau, M Bance
BACKGROUND: Imaging the Eustachian tube has proven difficult as it has an anatomical orientation that is not aligned with standard planes. In addition, the Eustachian tube is a dynamic structure, opening briefly during a variety of physiological manoeuvres. CASE REPORT: A 54-year-old healthy and asymptomatic man underwent computed tomography utilising an area detector scanner. Multiplanar reconstruction was performed at 1 mm intervals. In addition, dynamic clips were constructed to demonstrate air and its movement in the field...
December 2016: Journal of Laryngology and Otology
Xu Sheng Cao, Xiao Yan Peng, Qi Sheng You, Li Bin Jiang, Jost B Jonas
PURPOSE: To describe the occurrence of a congenital contractile peripapillary staphyloma in association with a rhegmatogenous retinal detachment. METHODS: The clinical course of a 17-year-old patient with a contractile peripapillary staphyloma and undergoing pars plana vitrectomy for repair of an associated retinal detachment was studied. RESULTS: The left eye showed a peripapillary staphyloma which during the ophthalmoscopical examination revealed contractile movements after the presentation of a light stimulus to either eye...
September 23, 2016: Retinal Cases & Brief Reports
Jenny Kurz, Diane Borello-France
BACKGROUND AND PURPOSE: Women with postpartum pelvic organ prolapse (POP) and urinary incontinence are often treated by physical therapists specializing in women's health. Movement system impairments often coexist in this patient population. The purpose of this case report is to describe the physical therapist treatment of a woman with postpartum POP complicated by additional pelvic symptoms. CASE DESCRIPTION: A 31-year-old woman presented with postpartum POP, diastasis recti, urinary incontinence, and constipation...
September 1, 2016: Physical Therapy
Daphné Lizee, Giuseppe Campagna, Andrea Morciano, Giovanni Panico, Alfredo Ercoli, Pierre Gadonneix
AIMS: Laparoscopic sacral colpopexy (LSC) for pelvic prolapse is a complex procedure, characterized by an anterior mesh suspension to the sacral promontory and a posterior tension-free mesh fixation. METHODS: Totals of 150 age-BMI and parity matched consecutive POP patients were selected from our Diaconesses Hospital database among women who underwent a laparoscopic supracervical hysterectomy (LSH) plus sacral colpopexy (LSC) from June 2005 to March 2010. We analyzed two group of LSC populations, according to different tension-free apical fixation of the posterior mesh: Promontory (P) group and Utero-Sacral (US) group...
August 26, 2016: Neurourology and Urodynamics
Kawryshanker Rajaratnam, Chaitanya Tak, Sweeka Alexander, Jurgen Passage
A 69-year-old man underwent minimal incision mitral valve repair for severe symptomatic mitral regurgitation. The echocardiography showed that he had normal left ventricular function with a moderately to severely dilated left atrium, a mildly dilated right atrium, and a large patent foramen ovale. The multistage venous cannulation was very challenging because we could not negotiate the guide wire from the inferior vena cava via the right atrium into the superior vena cava. Despite several attempts, the guide wire would pass into the patent foramen ovale...
May 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
André Viveiros Monteiro, António Fiarresga, Duarte Cacela, Lídia de Sousa, Ruben Ramos, Ana Galrinho, Luísa Branco, Rui Cruz Ferreira
Acromegaly is a rare disease, mostly caused by a growth hormone (GH)-secreting benign pituitary tumor, with an increased production of GH and insulin-like growth factor 1 (IGF-1). Cardiovascular complications are common and are associated with cardiomyocyte apoptosis and concentric cardiac hypertrophy. Suppression of GH and IGF-1 appears to improve cardiac function only in the short term, with little or no decrease in left ventricular mass or improvement in cardiac function after prolonged treatment. Alcohol septal ablation (ASA) has emerged as a minimally invasive alternative to septal myectomy, with significant improvement in symptoms, gradients and left ventricular remodeling...
September 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
W J Zhang, Y L Yang, M X Xie, X F Wang, Q Lyu, L He, J Wang, L Li, J Zhang, Y Wang, J F Liu
OBJECTIVE: To observe image features of sinus of Valsalva aneurysm (SVA) extending into left ventricle by echocardiography. METHODS: Echocardiographic features of 5 cases of SVA extending into left ventricle and underwent surgery at Union Hospital from July 1995 to September 2015 were reviewed retrospectively and image and surgical findings were compared. A total of 4 patients were diagnosed by conventional and 3D echocardiography before surgery, and 1 patient was diagnosed by conventional echocardiography...
June 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
S De Sio, S Mandolesi, T Niglio, Aldo D'Alessandro, Alessandro D'Alessandro, A Vitarelli, S Ricci
BACKGROUND: The working posture affects the peripheral venous circulation, although the current literature does not report any correlation between working posture and the abnormalities of the jugular veins flow. The purpose of this preliminary research is to study, in female workers, the prevalence of Venous Compressive Syndrome (VCS) caused by total block of the internal jugular veins flow, so-called "White Compression". Due to complete compression by postural, muscular, fascial, anatomical or bone anomalies, White Compression is not visible by EchoColorDoppler (ECD) and its flow can only be detected by the rotational movements of the head or by Valsalva's maneuver...
May 2016: Annali di Igiene: Medicina Preventiva e di Comunità
Michael Henein, Sandra Arvidsson, Björn Pilebro, Christer Backman, Stellan Mörner, Per Lindqvist
BACKGROUND: Development of left ventricular outflow tract obstruction (LVOTO) in patients with hypertrophic cardiomyopathy (HCM) is important for explaining symptoms and designing management. LVOTO is mostly caused by a combination of septal hypertrophy and systolic anterior movement of the mitral valve (SAM). The aim of the present study was to determine predictors of exercise induced LVOTO in a group of HCM patients. METHODS: We performed supine exercise Doppler echocardiography, including measurements of LV morphology and function and anterior mitral leaflet length, in 51 mildly symptomatic HCM (septal thickness≥15mm) and compared them with 50 healthy controls...
June 1, 2016: International Journal of Cardiology
Fatemeh Heydari, Zahra Motaghed, Fatemeh Abbaszadeh
BACKGROUND: Stress urinary incontinence (SUI), the most common type of urinary incontinence (UI), is usually defined as leakage of urine during movement or activity which puts pressure on the bladder, such as coughing, sneezing, running or heavy lifting. It is reported in most countries that 15% to 40% of women struggle with SUI and its severe implications for daily life, including social interactions, sexuality, and psychological wellbeing. OBJECTIVES: The aim of our study was to assess the relationship between urinary tract infection and the severity of stress urinary incontinence (SUI)...
January 2016: Nephro-urology Monthly
Carolyn W Swenson, Jiajia Luo, Luyun Chen, James A Ashton-Miller, John O L DeLancey
INTRODUCTION AND HYPOTHESIS: This study aimed to describe a novel strategy to determine the traction forces needed to reproduce physiologic uterine displacement in women with and without prolapse. METHODS: Participants underwent dynamic stress magnetic resonance imaging (MRI) testing as part of a study examining apical uterine support. Physiologic uterine displacement was determined by analyzing uterine location in images taken at rest and at maximal Valsalva. Force-displacement curves were calculated based on intraoperative cervical traction testing...
August 2016: International Urogynecology Journal
George R Kasyan, Nataliya V Tupikina, Dmitry Yu Pushkar
INTRODUCTION AND HYPOTHESIS: Modern classifications of pelvic floor movements are based on pelvic floor assessment in a static midsagittal plane. This study presents a new and potentially useful 3D noninvasive tool for studying pelvic floor mobility in women with pelvic organ prolapse (POP). MATERIALS AND METHODS: Thirty-four patients with POP [grade ≥3 using the Pelvic Organ Prolapse Quantification (POP-Q) system] and 30 healthy volunteers (controls) at rest and during Valsalva maneuver were scanned using an Artec™ 3D optic portable scanner and 3D pelvic floor models were generated...
July 2016: International Urogynecology Journal
Vannessa Leung, John S Magnussen, Marcus A Stoodley, Lynne E Bilston
OBJECTIVE: The pathogenesis of syringomyelia associated with Chiari malformation type I (CM-I) is unclear. Theories of pathogenesis suggest the cerebellar tonsils may obstruct CSF flow or alter pressure gradients, or their motion might act as a piston to increase CSF pressure in the spinal subarachnoid space. This study was performed to measure cerebellar tonsillar and hindbrain motion in CM-I and assess the potential contributions to syrinx formation. METHODS: Sixty-four CM-I patients and 25 controls were retrospectively selected from a clinical database, and all subjects had undergone cardiac-gated cine balanced fast-field echo MRI...
April 2016: Journal of Neurosurgery. Spine
David W Brandel, Gandikota Girish, Catherine J Brandon, Qian Dong, Corrie Yablon, David A Jamadar
OBJECTIVES: The purpose of this article is to evaluate the diagnostic accuracy of sonography in clinically occult femoral hernias and to describe our sonographic technique. METHODS: The clinical and imaging data for 93 outpatients referred by general surgeons, all of whom underwent sonographic evaluation and surgery, were reviewed retrospectively. Of these, 55 patients who underwent surgical exploration for groin hernias within 3 months of sonography and met all inclusion criteria were included in the study...
January 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
P Alam, R Guzman Rojas, I Kamisan Atan, K Mann, H P Dietz
OBJECTIVE: To examine the relationship of visual analog scale (VAS) 'bother' scores for obstructed defecation (OD) with demographic data, physical examination and sonographic findings of the posterior compartment. METHODS: All patients seen at a urogynecology clinic between January and October 2013 were included. Patients were diagnosed with OD if they had any of the following: incomplete bowel emptying, straining with bowel movement or need for digitation. Patients used a VAS to rate OD bother on a scale of 0-10 (0, no bother; 10, worst imaginable bother)...
November 27, 2015: Ultrasound in Obstetrics & Gynecology
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