Navegando por Palavras-chave "valsalva maneuver"

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    Does valsalva leak point pressure predict outcome after the distal urethral polypropylene sling? Role of urodynamics in the sling era
    (Lippincott Williams & Wilkins, 2004-07-01) Rodriguez, Larissa V.; Almeida, Fernando Gonçalves de [UNIFESP]; Dorey, Frederick; Raz, Shlomo; Univ Calif Los Angeles; Universidade Federal de São Paulo (UNIFESP)
    Purpose: Recently sling procedures have been shown to be effective in the treatment of all types of incontinence. in this study we evaluated the role of preoperative Valsalva leak point pressure (VLPP) in predicting the outcome of sling surgery.Materials and Methods: We prospectively evaluated 174 consecutive patients who underwent a distal polypropylene sling procedure for the treatment of stress urinary incontinence (SUI). Using SEAPI scores patients were divided by VLPP into group 1-60 patients who did not leak on urodynamics, group 2-27 patients with VLPP greater than 80 cm H2O, group 3-71 patients with VLPP 30 to 80 cm H2O and group 4-16 patients with VLPP less than 30 cm H2O. Surgical outcomes were determined by symptom, bother and quality of life questionnaires filled out by patients. the physicians were blinded to patient response.Results: Mean followup was 14.7 months (range 12 to 30) and mean patient age was 62 years (range 32 to 88). the groups were well matched before surgery with respect to age, number of previous surgeries, and severity of SUI symptoms and urge incontinence. the percentage of patients who were cured or improved was similar among groups. After surgery there was no statistical difference among patient mean self-reported symptoms of or bother from SUI or urge incontinence.Conclusions: the distal urethral polypropylene sling provides similar symptom improvement in all patients regardless of preoperative VLPP. VLPP is helpful in the diagnosis of SUI but appears to be of minimal benefit in predicting the outcome of the distal urethral polypropylene sling procedure.
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    Função da tuba auditiva em adultos com membrana timpânica íntegra
    (Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2010-06-01) Makibara, Renata Rumy; Fukunaga, Jackeline Yumi [UNIFESP]; Gil, Daniela [UNIFESP]; Universidade de São Paulo (USP); Irmandade da Santa Casa de Misericórdia de São Paulo; Universidade Federal de São Paulo (UNIFESP)
    The Eustachian tube has the function of equilibrating the environmental pressure with inner pressure, protecting the middle ear from abrupt pressure changes. AIM: To compare the Eustachian tube function in adults with and without history of otitis media and/or respiratory tract inflammation without tympanic membrane perforation. MATERIALS AND METHODS: The Eustachian tube function was evaluated in forty-two females and males of 18 to 55 years of age with intact tympanic membrane, tympanometric A curves and without historic of otological surgery. The patients (study group with past otological disease) were matched by a control group. The data was analyzed to compare the Eustachian tube function in both groups. RESULTS: In the study group, 21.4% of the persons presented dysfunction of the tube against 0% in the control group. There was no statistically significant difference considering the affected ear. We observed a higher percentage of men (90.9%) with normal functioning Eustachian tube in relation to women (65%). CONCLUSION: Middle ear infections, rhinitis and/or sinusitis influenced the Eustachian tube functioning. Therefore it is important to test its function in such individuals. Other studies are important to establish a standard of normality in each condition of the test and for a better understanding of these people's complaints.