Objective: To present the results after balloon eustachian tuboplasty (BET) in patients with obstructive Eustachian tube dysfunction (OETD) grouped up into: baro-challenge, chronic serous otitis media and adhaesive otitis media.
Methods: A retrospective study was carried out on patients who underwent BET surgery. As outcome measures, otoscopy, tympanometry, Eustachian tube dysfunction questionnaire-7 (ETDQ-7) and ability to perform the Valsalva manoeuvre were recorded at baseline and at 3, 12 and 24 months after BET. A p value of 0.05 was used to indicate a statistically significant difference for all statistical tests.
Results: Three hundred and nineteen ears (248 patients) were included with a 3-month follow-up, 272 ears had a 12-month follow-up, and 171 ears had 24-month follow-up. Globally, a statistical significance improvement in all groups in all outcome measures was found. According to BET indication, in the baro-challenge group, there was no improvement in otoscopy, but ETDQ-7, Valsalva manoeuvre and tympanogram improved significantly. In the chronic serous otitis media group, otoscopy, ETDQ-7 and Valsalva manoeuvre were significantly improved in all the three timelines, including the avoidance of a new transtympanic tube after the BET in over 80% of cases. In the adhaesive otitis media group, Valsalva manoeuvre improved significantly, ETDQ-7 decreased and tympanogram improved but not significantly. Few mild complications were reported.
Conclusions: BET is an effective method for the treatment of OETD in all etiologic groups. The greatest benefit was observed in patients with baro-challenge. A long-term follow-up is recommended since the benefit seems to increase over time.
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http://dx.doi.org/10.1007/s00405-023-07906-0 | DOI Listing |
Hypertension
December 2024
Vanderbilt Autonomic Dysfunction Center, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN. (L.E.O., A.D., C.A.S., A.G., B.K.B., S.P., I.B.).
Background: The cholinesterase inhibitor pyridostigmine is used to treat orthostatic hypotension by facilitating cholinergic neurotransmission in autonomic ganglia, thereby harnessing residual sympathetic tone to increase blood pressure (BP) preferentially in the upright posture. We hypothesized that less severe autonomic impairment was associated with greater pressor responses to pyridostigmine.
Methods: To identify predictors of pressor response, linear regression analyses between the effect of pyridostigmine on upright BP and markers of autonomic impairment were retrospectively conducted on 38 patients who had a medication trial with pyridostigmine (60 mg single dose).
Int Urogynecol J
December 2024
Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, Guangdong, China.
Introduction And Hypothesis: This study examines the effectiveness of yoga intervention on the early postpartum recovery of pelvic organ positions.
Methods: A prospective study was conducted from May to November 2020, involving women who had vaginal deliveries and underwent pelvic floor ultrasound examinations. The control group received no intervention, whereas the experimental group participated in weekly 60-min yoga sessions from 1 week to 3 months postpartum.
Eur J Obstet Gynecol Reprod Biol
December 2024
Direttore UOC Ostetricia e Ginecologia, Azienda Ospedaliera Universitaria di Parma, Professore Ordinario di Ginecologia e Ostetricia, Direttore della Scuola di Specializzazione in Ostetricia e Ginecologia, Presidente del CdS OstetriciaUniversità di Parma, Italy. Electronic address:
Second stage of labor is considered to be associated with an increased risk of intrapartum fetal hypoxic injury. This is due to a combination of several risk factors such as -the increased frequency, strength and duration of uterine contractions due to higher number and affinity of myometrial oxytocin receptors; -the Ferguson's reflex which leads to a reflex release of endogenous oxytocin in response of the distension of the cervix by descending fetal head in late stages of labor; maternal expulsive efforts with the Valsalva manoeuvre that may reduce maternal oxygenation, as well as reduce the venous return and maternal cardiac output due to increased intrathoracic pressure, winch may lead to reduced placental oxygenation; - and increased fetal intracranial pressure due to head compression leading to a potential decrease in fetal cerebral oxygenation. In addition, the umbilical cord often forms one or more loops around the fetal neck, which may get tightened as the head descends leading to an acute and intermittent cessation of fetal oxygenation.
View Article and Find Full Text PDFBr J Sports Med
December 2024
Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
Objective: To examine maternal and fetal cardiovascular responses to high-intensity resistance exercise in pregnancy.
Methods: 10 healthy pregnant (26.4±3.
J Sex Med
December 2024
School of Psychology, Faculty of Arts and Sciences, Queen's University, Kingston, Ontario, K7L 3N6, Canada.
Background: The neuromuscular contribution to increased tone of the pelvic floor muscles (PFMs) observed among those with provoked vestibulodynia (PVD) is unclear.
Aim: To determine if PFM activity differs between those with provoked PVD and pain free controls, and if the extent of PFM activation at rest or during activities is associated with pain sensitivity at the vulvar vestibule, psychological, and/or psychosexual outcomes.
Methods: This observational case-control study included forty-two volunteers with PVD and 43 controls with no history of vulvar pain.
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