Unlabelled: Sleep apnea-hypopnea syndrome was described twenty years ago, and since then there have been doubts and controversies regarding it. Fiberoptic nasopharyngoscopy with Muller's maneuver, first described by Borowieck and Sassin (1983), is among them.
Aim: Careful literature review on Muller's maneuver, regarding whether it can predict the sucess of uvulopalatopharyngoplasty, location of upper airway obstruction and severity of the disorder.
Discussion And Literature Review: Literature has shown that there isn't a consensus about the use of Muller's maneuver. In spite of being technically easy, inexpensive and widely used, it is very unspecific and subjective.
Conclusion: The importance of Muller's maneuver in evaluating apneic patients has been questioned, because there are controversies whether it can predict the success of uvulopalatopharyngoplasty, location of upper airway obstruction and severity of the disease.
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http://dx.doi.org/10.1016/S1808-8694(15)30667-4 | DOI Listing |
Am J Ophthalmol
January 2025
Department of biomedical sciences, Humanitas University, Pieve Emanuele, Milan, Italy.; Ophthalmology Department, Humanitas Gavazzeni, Bergamo, Italy.
Purpose: To investigate the incidence, clinical spectrum and pathophysiology of microcystoid macular edema (MME) in two cohorts of patients with epiretinal membrane (ERM) and idiopathic full thickness macular hole (FTMH).
Design: Single-center, Retrospective, interventional, cohort study.
Methods: Review of clinical charts, structural and en-face optical coherence tomographty (OCT) and fluorescein angiography (FA) imaging of ERM and FTMH eyes which underwent surgery with pars plana vitrectomy and internal limiting membrane (ILM) peel, with a minimum follow-up of 6 months.
Anesthesiology
January 2025
Ary Serpa Neto M.D., M.Sc., Ph.D.; Department of Critical Care Medicine and Cardio-Pulmonary Department, Pulmonary Division, São Paulo, Brasil; Department of Intensive Care, Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Monash University, Melbourne, Australia; and Department of Critical Care, Melbourne Medical School, University of Melbourne, Austin Hospital, Melbourne, Australia.
Background: The influence of high positive end-expiratory pressure (PEEP) with recruitment maneuvers on the occurrence of postoperative pulmonary complications after surgery is still not definitively established. Bayesian analysis can help to gain further insights from the available data and provide a probabilistic framework that is easier to interpret. The objective was to estimate the posterior probability that the use of high PEEP with recruitment maneuvers is associated with reduced postoperative pulmonary complications in patients with intermediate-to-high risk under neutral, pessimistic, and optimistic expectations regarding the treatment effect.
View Article and Find Full Text PDFPneumologie
November 2024
Pneumologie, Philipps-Universität Marburg, Marburg, Deutschland.
The original Valsalva manoeuvre (VM) was described in detail by the Italian anatomist, physician and surgeon Antonio Maria Valsalva (1666-1723). The VM consists of a voluntary forced expiratory effort against a closed upper airway. It was used tradionally in otolaryngology for testing the openess of the eustachian tubes and expelling pus/fluid from the middle to the external ear.
View Article and Find Full Text PDFBMJ Case Rep
May 2024
Drishti Eye Institute, Dehradun, India.
J Anesth Analg Crit Care
May 2024
Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.
Objectives: To investigate the following: (a) effects of intercostal muscle contraction on sonographic assessment of lung sliding and (b) inter-rater and intra-observer agreement on sonographic detection of lung sliding and lung pulse.
Methods: We used Valsalva and Muller maneuvers as experimental models in which closed glottis and clipped nose prevent air from entering the lungs, despite sustained intercostal muscles contraction. Twenty-one healthy volunteers underwent bilateral lung ultrasound during tidal breathing, apnea, hyperventilation, and Muller and Valsalva maneuvers.
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