Opening Pressure (opening + pressure)

Distribution by Scientific Domains

Selected Abstracts

Urodynamic effects of silodosin, a new ,1A -adrenoceptor selective antagonist, for the treatment of benign prostatic hyperplasia,,

Tomonori Yamanishi
Abstract Aims To investigate urodynamically the effects of silodosin, a new ,1A -adrenoceptor-selective antagonist, in the treatment of benign prostatic hyperplasia (BPH). Methods Thirty six male patients with BPH (69.9,,7.3 years), who were referred as candidates for surgery, were treated with silodosin (4,mg twice daily). The total International Prostate Symptom Score (IPSS) was 20.7,,7.4, maximum flow rate (Qmax) was 6.7,,3.0,ml/sec, and prostate volume was 45.6,,24.5,ml. Results Total IPSS, storage and voiding symptom subscores and QOL score decreased significantly, and Qmax increased significantly after 1,12 months of therapy (all P,<,0.05). In urodynamic study (n,=,29), maximum cystometric capacity increased significantly (P,=,0.0027), and detrusor overactivity disappeared in 8 of 20 patients (40%) and improved (bladder capacity increased more than 50%) in 7 (35%) after the therapy. In pressure/flow studies (n,=,27), the obstruction grade was improved in 15 patients (56%). Detrusor opening pressure, detrusor pressure at Qmax, bladder outlet obstruction index, and Schfer's obstruction class decreased significantly after therapy (all P,<,0.01). After 12 months, 16 patients (44%) are still on silodosin for 23.3,,7.0 (range 12,36) months, and the improvements in IPSS and Qmax were stable. Twenty patients withdrew because of insufficient effectiveness in 13 patients (12 patients underwent surgery), side effects in 3, and unknown reasons in 4. Conclusion Silodosin appears to improve detrusor overactivity and obstruction grade in patients with BPH. With silodosin treatment, LUTS could be managed effectively for more than a year in at least 44% of the patients. Neurourol. Urodynam. 29:558,562, 2010. 2009 Wiley-Liss, Inc. [source]

Comparative study of pressure-flow parameters

Lars M. Eri
Abstract Methods for quantification of bladder outlet obstruction (BOO) are still controversial. Parameters such as detrusor opening pressure (, maximum detrusor pressure (pdet.max), minimum voiding pressure (pdet.min.void), and detrusor pressure at maximum flow rate (Pdet.Qmax) separate obstructed from nonobstructed patients to some extent, but two nomograms, the Abrams-Griffiths nomogram and the linearized passive urethral resistance relation (LinPURR), are more accepted for this purpose, along with the urethral resistance algorithm. In this retrospective, methodologic study, we evaluated the properties of these parameters with regard to test-retest reproducibility and ability to detect a moderate (pharmacologic) and a pronounced (surgical) relief of bladder outlet obstruction. We studied the pressure-flow charts of 42 patients who underwent 24 weeks of androgen suppressive therapy, 42 corresponding patients who received placebo, and 30 patients who had prostate surgery. The patients performed repeat void pressure-flow examinations before and after treatment or placebo. The various parameters were compared. Among the bladder pressure parameters, Pdet.Qmax seemed to have some advantages, supporting the belief that it is the most relevant detrusor pressure parameter to include in nomograms to quantify BOO. In assessment of a large decrease in urethral resistance, such as after TURp, resistance parameters that are based on maximum flow rate as well as detrusor pressure are preferable. Neurourol. Urodynam. 21:186,193, 2002. 2002 Wiley-Liss, Inc. [source]

Variability of Eustachian Tube Function: Comparison of Ears With Retraction Disease and Normal Middle Ears ,

Marie Bunne MD
Abstract Objective To explore the short-term and long-term variability of tubal opening and closing in ears with advanced retractions and in healthy ears. Study Design/Methods Twenty ears with retraction type middle ear disease (R-MED) and 20 normal ears underwent direct recording of the middle ear pressure during repeated forced openings, equalization of +100 daPa and ,100 daPa by swallowing, Valsalva inflation, and forceful sniffing. Tests were performed twice (separated by 30 min) on each of 2 days separated by 3 to 4 months. Results There was considerable intraindividual variability of the forced opening pressure and the closing pressure in both groups, within as well as between sessions and test days. Although the variability was 1.5 to 2 times higher in ears with retraction than in the normal group, mean Po and Pc did not differ between the groups. Compared with normal ears, ears with retraction changed more frequently from a positive to negative test response, or vice versa, when re-tested after 30 minutes. Rates of positive response in the equalization and Valsalva tests were significantly lower in diseased ears compared with normal ears. Conclusions Eustachian tube opening and closing functions vary more in ears with retraction disease than in normal ears, which is consistent with the variable clinical course of R-MED and implies that single tubal function tests have little prognostic value on the individual level. [source]

Cerebrospinal fluid opening pressure measurements in acute headache patients and in patients with either chronic or no pain

S. H. B
B SH, Davidsen EM, Benth J,, Gulbrandsen P, Dietrichs E. Cerebrospinal fluid opening pressure measurements in acute headache patients and in patients with either chronic or no pain. Acta Neurol Scand: 2010: 122 (Suppl. 190): 6,11. 2010 John Wiley & Sons A/S. Objective,,, To observe cerebrospinal fluid opening pressure (CSFOP) in different clinical settings and in patients with acute, chronic and no pain and to observe possible differences because of age and sex. Method,,, In this prospective study, CSFOP was measured in lumbar puncture in three different settings of clinical investigations; patients with acute headache investigated for subarachnoidal haemorrhage (n = 222), patients with sciatica undergoing myelography (n = 61), and patients in an outpatient neurological clinic (n = 65). Results,,, The mean CSFOP in cm H2O was 17.3 for the myelography patients, 19.1 for the outpatients, 19.3 for the primary headache patients and 22.4 for the patients with secondary headache. Large proportions of patients in all groups had CSFOP above 20 cm H2O. The female patients in all groups had lower mean CSFOP than the male patients. Conclusion,,, The CSFOP levels found in clinical practice among patients without intracranial lesions or infectious conditions were broader than expected. Measurement of CSFOP is of limited value as diagnostic procedure if not closely linked to clinical symptoms and finds. [source]

A prospective retrieval study to determine how speaking valve failure is effected by colonization

S.R. Ell
Introduction. It has been suggested that Groningen Low Resistance (GLR) valve failure is associated with biofouling of the valve's oesophageal surface and hinge areas. However, the valve edges are responsible for efficient valve function. 1 Therefore, valve edge colonization should be the most important factor determining valve failure. The null hypothesis that valve edge colonization was not associated with failure was tested using 106 GLR valves retrieved, after failure, from 41 patients. Methods. The opening pressures, reverse opening pressures and forward resistances of the new valves were determined using apparatus validated previously. 2 The pressure/flow parameters were measured again after removal and the changes calculated. The degree of colonization of each valve edge, oesophageal surface, hinge area, tracheal surface and valve lumen was scored using 100-mm linear analogue scales. The changes, in pressure/flow parameters were examined for associated with colonization of the five areas described above. Results. The increase in the opening pressure and resistance, and decrease in reverse opening pressure, of the retrieved valves was significant compred with new valves. The increase in opening pressure was associated with colonization of the valve edge (rs = 0.262, P = 0.007). The decrease in reverse opening pressure was associated with colonization of the valve edge, hinge areas and oesophageal surface (rs = 0.266, P = 0.006; rs = 0.271, P = 0.005; rs = 0.271, P = 0.004, respectively). The increase in resistance was associated with colonization in all areas (rs , 0.367, P = 0.0005). Conclusion. This study demonstrated that colonization of the valve edge is associated significantly with the changes, in pressure/flow parameters of failed valves. [source]