scholarly journals Inverse correlation between urethral length and continence before and after native tissue pelvic floor reconstruction

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
A. R. Mothes ◽  
H. K. Mothes ◽  
A. Kather ◽  
A. Altendorf-Hofmann ◽  
M. P. Radosa ◽  
...  
Keyword(s):  
Stress Test ◽  
Stage Iv ◽  
Inverse Correlation ◽  
Native Tissue Repair ◽  
Pelvic Floor Reconstruction ◽  
Native Tissue ◽  
Before And After ◽  
Defect Pattern ◽  
Tissue Aging ◽  
Tvt Surgery

AbstractUrethral length was evaluated retrospectively in patients with prolapse undergoing anterior native-tissue repair. Effects of age, prolapse stage, defect pattern, urodynamic and clinical stress test findings, and tension-free vaginal tape (TVT) surgery indication were analyzed using Mann–Whitney and Wilcoxon tests and linear and logistic regression. Of 394 patients, 61% had stage II/III and 39% had stage IV prolapse; 90% of defects were central (10% were lateral). Median pre- and postoperative urethral lengths were 14 and 22 mm (p < 0.01). Preoperative urethral length was greater with lateral defects [p < 0.01, B 6.38, 95% confidence interval (CI) 4.67–8.08] and increased stress incontinence risk (p < 0.01, odds ratio 1.07, 95% CI 1.03–1.12). Postoperative urethral length depended on prolapse stage (p < 0.01, B 1.61, 95% CI 0.85–2.38) and defect type (p = 0.02, B – 1.42, 95% CI – 2.65 to – 0.2). Postoperatively, TVT surgery was indicated in 5.1% of patients (median 9 months), who had longer urethras than those without this indication (p = 0.043). Native-tissue prolapse repair including Kelly plication increased urethral length, reflecting re-urethralization, particularly with central defects. The functional impact of urethral length in the context of connective tissue aging should be examined further.

scholarly journals Cardiac Rehabilitation and Physical Performance in Patients after Myocardial Infarction: Preliminary Research

2021 ◽  
Vol 10 (11) ◽  
pp. 2253
Author(s):  
Agnieszka Grochulska ◽  
Sebastian Glowinski ◽  
Aleksandra Bryndal
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Rehabilitation ◽  
Physical Performance ◽  
Stress Test ◽  
Maximal Oxygen Consumption ◽  
Exercise Stress Test ◽  
Health Condition ◽  
Exercise Stress ◽  
Test Time ◽  
Before And After

(1) Background: Cardiovascular diseases, in particular, myocardial infarction (MI), are the main threats to human health in modern times. Cardiac rehabilitation (CR), and especially increased physical activity, significantly prevent the consequences of MI. The aim of this study was to assess physical performance in patients after MI before and after CR. (2) Methods: 126 patients after MI were examined. They were admitted to the cardiac rehabilitation ward twice: in the 3rd month after MI, and then in the 6th month after the last rehabilitation session. CR lasted 20 treatment days (4 weeks with 5 treatment days and 2 days’ break). The exercise stress test on the treadmill and a 6-minute walk test (6MWT) were used to assess physical performance. Patients were assigned to an appropriate rehabilitation model due to their health condition. (3) Results: In the studied group, the exercise stress test time and the metabolic equivalent of task (MET), the maximal oxygen consumption (VO2max), and 6MWT score increased significantly (p = 0.0001) at two time-points of observation. (4) Conclusion: CR significantly improves physical performance in patients after MI.

Inverse response of global longitudinal strain after dipyridamole stress echocardiography in patients with microvascular coronary dysfunction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Tagliamonte ◽  
C Montuori ◽  
L Riegler ◽  
A Forni ◽  
R Scarafile ◽  
...  
Keyword(s):  
Coronary Flow ◽  
Stress Echocardiography ◽  
Stress Test ◽  
Global Longitudinal Strain ◽  
Inverse Correlation ◽  
Left Ventricular ◽  
Peak Dose ◽  
Different Response ◽  
Dipyridamole Stress Echocardiography ◽  
Dipyridamole Stress

Abstract Background Coronary microvascular dysfunction (CMD) is a potential cause of myocardial ischemia and may affect myocardial function at rest and during stress. CMD can be identified, in patients with non-obstructive coronary artery disease (CAD), by a reduced transthoracic Doppler-derived coronary flow reserve (CFR), which is an index of coronary arterial reactivity, and can be impaired in both obstructive CAD and CMD. The aim of this study was to investigate the dipyridamole-induced changes of global longitudinal strain (GLS) in patients with CMD. Methods 43 patients (29M, 14F; mean age 68±7 years) without obstructive CAD, assessed by invasive coronary angiogram, underwent dipyridamole stress echocardiography. Coronary flow was assessed in the left anterior descending coronary artery (LAD) and was identified as the colour signal directed from the base to the apex of the left ventricle, containing the characteristic biphasic pulsed-Doppler flow signals. CFR were determined as the ratio of hyperaemic to baseline diastolic coronary flow velocity. CMD was defined as CFR &lt;2. GLS was measured using automated function imaging, through the positioning of three endocardial markers (two markers at the mitral annulus and one at the apex) in each apical view. Subsequently, the obtained segmental values of GLS were visualized as a bull's-eye map in a quick and feasible manner. We had optimal left ventricular endocardial tracking in the overall population. In each patient, we used a frame rate of 70 frames/sec for adequate 2D strain analysis. We analyzed GLS at each step of stress test and compared peak-dose values with baseline. Results Thirteen patients (30%) among the overall population showed CMD. There were no significant differences in baseline characteristics between patients with or without CMD. GLS, at baseline, was significantly lower in patients with CMD (−16.9±3.78 vs. −17.8±3.77 – p&lt;0.01). We observed a different response to dipyridamole stress echocardiography, between the two groups: GLS significantly increased up to peak dose in patients without CMD (from −17.8±3.77 to −19.3±4.09 – p&lt;0.01), whereas on the other hand, a significant decrease from rest to peak dose was observed in patients with CMD (from −16.9±3.78 to −15.5±4.18 – p&lt;0.01). There was a significant inverse correlation between CFR and delta GLS measured at rest and after dipyridamole peak dose (r=−0.82 – p&lt;0.01). Conclusions GLS analysis, particularly performed by comparing dipyridamole peak-dose with baseline values, shows that in patients with CMD there is a different response of left ventricular myocardiim to stress test. It could be assumed that the inverse correlation between CFR and delta GLS reflects a progressive subclinical worsening of left ventricular myocardial function in these patients. Larger studies could confirm our data. Funding Acknowledgement Type of funding source: None

The effect of mask use on maternal oxygen saturation in term pregnancies during the COVID-19 process

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Erzat Toprak ◽  
Ayça Nazlı Bulut
Keyword(s):  
Oxygen Saturation ◽  
Pregnant Women ◽  
Stress Test ◽  
Statistical Significance ◽  
Categorical Variables ◽  
Fisher Exact Test ◽  
Coin Toss ◽  
Arterial Blood ◽  
Surgical Masks ◽  
Before And After

AbstractObjectivesOur aim was to evaluate the effect of standard surgical and N-95 respiratory mask use on maternal oxygen saturation, vital signs and result on non-stress tests in term pregnancies.MethodsIt is a prospective observational study. The study included healthy, not in labor, singleton pregnant women of 370/7–410/7 weeks who were applied to our hospital for routine obstetric control examination between March 1, 2020, and August 31, 2020. Patients were randomised by coin toss method. Oxygen saturation, systolic, and diastolic arterial blood pressure, pulse, respiratory rate, and temperature of pregnant women using surgical masks and respiratory masks were measured before and after the non-stress test. The tolerance of the masks was also evaluated. Student’s t-test was used for variables showing parametric distribution and the Mann Whitney U-test was used for non-parametric tests. The categorical variables between the groups was analyzed by using the Chi square test or Fisher Exact test. The statistical significance level was taken as p<0.05 in all tests.ResultsA total of 297 pregnant women using masks were included in the study. The effect of mask type on oxygen saturation before and after the non-stress test was found to be significant (97.1±1.8 corresponds to 95.3±2.6 for the surgical mask, p=0.0001; 97.8±1.7 corresponds to 93.7±2.0 for the respiratory mask, p=0.0001). Mask tolerance of patients using respiratory masks was significantly higher than those using surgical masks (mean 8, 1–10, p=0.0001).ConclusionsSurgical mask and respiratory mask usage decreased significantly in oxygen saturation in term pregnancies.

scholarly journals Comparison of treatment outcomes for native tissue repair and sacrocolpopexy as apical suspension procedures at the time of hysterectomy for uterine prolapse

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sumin Oh ◽  
E. Kyung Shin ◽  
Sowoon Hyun ◽  
Myung Jae Jeon
Keyword(s):  
Treatment Outcomes ◽  
Tissue Repair ◽  
Uterine Prolapse ◽  
Reoperation Rate ◽  
Complication Rates ◽  
Native Tissue Repair ◽  
Apical Suspension ◽  
Native Tissue ◽  
Surgical Failure

AbstractConcomitant apical suspension should be performed at the time of hysterectomy for uterine prolapse to reduce the risk of recurrent prolapse. Native tissue repair (NTR) and sacrocolpopexy (SCP) are commonly used apical suspension procedures; however, it remains unclear which one is preferred. This study aimed to compare the treatment outcomes of NTR and SCP in terms of surgical failure, complication and reoperation rates. Surgical failure was defined as the presence of vaginal bulge symptoms, any prolapse beyond the hymen, or retreatment for prolapse. This retrospective cohort study included 523 patients who had undergone NTR (n = 272) or SCP (n = 251) along with hysterectomy for uterine prolapse and who had at least 4-month follow-up visits. During the median 3-year follow-up period, the surgical failure rate was higher in the NTR group (21.3% vs 6.4%, P < 0.01), with a low rate of retreatment in both groups. Overall complication rates were similar, but complications requiring surgical correction under anesthesia were more common in the SCP group (7.2% vs 0.4%, P < 0.01). As a result, the total reoperation rate was significantly higher in the SCP group (8.0% vs 2.6%, P = 0.02). Taken together, NTR may be a preferred option for apical suspension when hysterectomy is performed for uterine prolapse.

scholarly journals Effects of Open-Label Placebos on State Anxiety and Glucocorticoid Stress Responses

2021 ◽  
Vol 11 (4) ◽  
pp. 508
Author(s):  
Michael Schaefer ◽  
Julian Hellmann-Regen ◽  
Sören Enge
Keyword(s):  
Stress Responses ◽  
Acute Stress ◽  
Stress Test ◽  
Self Report ◽  
Control Group ◽  
Relaxation Techniques ◽  
Open Label ◽  
Before And After ◽  
Cortisol Responses ◽  
Negative Feelings

Stress belongs to the most frequent negative feelings people are confronted with in daily life. Strategies against acute stress include, e.g., relaxation techniques or medications, but it is also known that placebos can successfully reduce negative emotional stress. While it is widely held that placebos require deception to provoke a response, recent studies demonstrate intriguing evidence that placebos may work even without concealment (e.g., against anxiety or pain). Most of these studies are based on self-report questionnaires and do not include physiological measures. Here we report results of a study examining whether placebos without deception reduce acute stress. A total of 53 healthy individuals received either placebos without deception or no pills before participating in a laboratory stress test (Maastricht Acute Stress Test, MAST). We recorded self-report stress measures and cortisol responses before and after the MAST. Results showed no significant differences between the placebo and the control group, but when comparing participants with high relative to low beliefs in the power of placebos we found significant lower anxiety and cortisol responses for the placebo believers. These results show that non-deceptive placebos may successfully reduce acute anxiety and stress, but only in participants who had a strong belief in placebos. We discuss the results by suggesting that open-label placebos might be a possible treatment to reduce stress at least for some individuals.

Sexual Function Following Trocar‐guided Mesh or Vaginal Native Tissue Repair in Recurrent Prolapse: A Randomized Controlled Trial

2011 ◽  
Vol 8 (10) ◽  
pp. 2944-2953 ◽  
Author(s):  
Alfredo L. Milani ◽  
Mariella I.J. Withagen ◽  
Hok S. The ◽  
Ileana Nedelcu‐van der Wijk ◽  
Mark E. Vierhout
Keyword(s):  
Randomized Controlled Trial ◽  
Sexual Function ◽  
Tissue Repair ◽  
Controlled Trial ◽  
Recurrent Prolapse ◽  
Native Tissue Repair ◽  
Randomized Controlled ◽  
Native Tissue

scholarly journals Inverse correlation between baseline inhibin B and FSH after stimulation with GnRH: a study of serum levels of inhibin A and B, pro alpha-C and activin A in women with ovulatory disturbances before and after stimulation with GnRH

2000 ◽  
pp. 77-84 ◽  
Author(s):  
FW Casper ◽  
RJ Seufert ◽  
K Pollow
Keyword(s):  
Inverse Correlation ◽  
Strong Relationship ◽  
Serum Levels ◽  
Activin A ◽  
Inhibin B ◽  
Inhibin A ◽  
Before And After ◽  
Pituitary Secretion ◽  
Objective Interest ◽  
A Minor

OBJECTIVE: Interest has focused recently on the influences of the polypeptide factors inhibin and activin on the selective regulation of the pituitary secretion of gonadotropins. DESIGN: Measurement of the concentrations of inhibin-related proteins in relation to the changes in pituitary gonadotropin (FSH, LH) parameters, after GnRH stimulation with a bolus injection of 100 microg gonadorelin, in 19 women with ovulatory disturbances. METHODS: Serum levels of inhibin A and B, activin A, and pro alpha-C were measured using sensitive ELISA kits. RESULTS: Within 60 min after GnRH stimulation, FSH values doubled from 5 to 10 mU/ml (P < 0.001). LH increased 12-fold from 2 to 24 mU/ml (P < 0.001). Activin A showed a significant decrease from 0.47 to 0.36 ng/ml (P < 0.001), whereas pro alpha-C increased from 127 to 156 pg/ml (P = 0.039). The median inhibin A concentration did not show a significant change between baseline and the 60 min value, whereas inhibin B was characterized by a minor, but not significant, increase in the median from 168 to 179 pg/ml (P = 0.408). A significant inverse correlation (P = 0.014) with a mean coefficient of correlation of 0.5516 was found, demonstrating a strong relationship between high inhibin B baseline levels and a small increase of FSH after 60 min. CONCLUSION: Our results show an interesting correlation between the baseline inhibin B and the change in FSH before and after GnRH stimulation. A high baseline inhibin B implies only a minor increase of FSH after 60 min.

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