Search

Background: Stress urinary incontinence (SUI), a common disorder of the pelvic floor, often results in anxiety, poor quality of life, and psychological issues among its sufferers. The relationship between lipid accumulation products (LAP) and stress-related urine incontinence remains unclear. This research aimed to investigate any possible correlation between the risk of SUI and the level of lipid accumulation products. Methods: For this cross-sectional research, people with SUI who were 20 years of age or older were recruited using information from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. A weighted multivariate logistic regression model was used to evaluate the findings. As a potential biomarker, lipid accumulation product levels were sorted among individuals in ascending order and subjected to a trend test (P for trend). Additionally, a nonlinear analysis was conducted using smooth curve-fitting methods. Lipid accumulation products' effectiveness in predicting SUI was evaluated using receiver operating characteristic (ROC) curves. Finally, a subgroup analysis was performed to confirm that the connection between SUI and lipid accumulation products was consistent across all demographic groups. Results: A thorough survey performed on 14,945 participants indicated that 23.61% of the respondents had SUI. A noteworthy association was observed between higher lipid accumulation product values and a greater probability of SUI in multivariate logistic regression analysis. Specifically, the stratification of lipid accumulation products into quartiles demonstrated a substantial positive correlation between the upper and lower quartiles, as evidenced by an elevated odds ratio for SUI (OR = 1.92; 95%CI 1.51–2.44; P < 0.0001). The subgroup analysis supported link consistency across all cohorts under investigation. Finally, the ROC curve indicated that lipid accumulation products (AUC = 0.67, 95%CI 0.654–0.690) had a superior predictive effect on the likelihood of SUI. Conclusions: Increased lipid accumulation product values are associated with a higher chance of SUI in adult participants. This suggests that lipid accumulation products could be a valuable marker for detecting SUI, offering new perspectives for its evaluation and treatment. [ABSTRACT FROM AUTHOR]

Abstract Background Stress urinary incontinence (SUI), a common disorder of the pelvic floor, often results in anxiety, poor quality of life, and psychological issues among its sufferers. The relationship between lipid accumulation products (LAP) and stress-related urine incontinence remains unclear. This research aimed to investigate any possible correlation between the risk of SUI and the level of lipid accumulation products. Methods For this cross-sectional research, people with SUI who were 20 years of age or older were recruited using information from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. A weighted multivariate logistic regression model was used to evaluate the findings. As a potential biomarker, lipid accumulation product levels were sorted among individuals in ascending order and subjected to a trend test (P for trend). Additionally, a nonlinear analysis was conducted using smooth curve-fitting methods. Lipid accumulation products' effectiveness in predicting SUI was evaluated using receiver operating characteristic (ROC) curves. Finally, a subgroup analysis was performed to confirm that the connection between SUI and lipid accumulation products was consistent across all demographic groups. Results A thorough survey performed on 14,945 participants indicated that 23.61% of the respondents had SUI. A noteworthy association was observed between higher lipid accumulation product values and a greater probability of SUI in multivariate logistic regression analysis. Specifically, the stratification of lipid accumulation products into quartiles demonstrated a substantial positive correlation between the upper and lower quartiles, as evidenced by an elevated odds ratio for SUI (OR = 1.92; 95%CI 1.51–2.44; P

Muscle strength and mass strongly influence performance. The role of the trunk, upper limbs, and lower limbs in a specific performance is important but unclear in terms of muscle strength, muscle mass, and the degree of influence of each part. Standing long jump is a performance that produces results by not only the muscles of the lower limbs working together but also the entire body, including the trunk and upper limbs. To determine the influence of muscle strength and the mass of each body part on standing long jump, 31 healthy young adults (18 males and 13 females) participated in this study. Abdominal trunk muscle strength, grip strength, and knee extension muscle strength were measured, each of which was defined as trunk, upper limb, and lower limb muscle strength. The trunk, upper limb, and lower limb muscle masses were measured using a body composition analyzer. Performance was measured using the standing long jump test (jumping power). Factors influencing standing long jump were examined. A multiple regression analysis revealed that trunk (β = 0.367, p = 0.006) and upper limb (β = 0.608, p < 0.001) muscle strength values were extracted for standing long jump (adjusted R2 = 0.574, p < 0.01). Trunk and upper limb muscle strength influence standing long jumps.

Muscle strength and mass strongly influence performance. The role of the trunk, upper limbs, and lower limbs in a specific performance is important but unclear in terms of muscle strength, muscle mass, and the degree of influence of each part. Standing long jump is a performance that produces results by not only the muscles of the lower limbs working together but also the entire body, including the trunk and upper limbs. To determine the influence of muscle strength and the mass of each body part on standing long jump, 31 healthy young adults (18 males and 13 females) participated in this study. Abdominal trunk muscle strength, grip strength, and knee extension muscle strength were measured, each of which was defined as trunk, upper limb, and lower limb muscle strength. The trunk, upper limb, and lower limb muscle masses were measured using a body composition analyzer. Performance was measured using the standing long jump test (jumping power). Factors influencing standing long jump were examined. A multiple regression analysis revealed that trunk (β = 0.367, p = 0.006) and upper limb (β = 0.608, p < 0.001) muscle strength values were extracted for standing long jump (adjusted R2 = 0.574, p < 0.01). Trunk and upper limb muscle strength influence standing long jumps. [ABSTRACT FROM AUTHOR]

Abstract Background We have previously reported a simple correction method for estimating pleural pressure (Ppl) using central venous pressure (CVP). However, it remains unclear whether this method is applicable to patients with varying levels of intravascular volumes and/or chest wall compliance. This study aimed to investigate the accuracy of our method under different conditions of intravascular volume and chest wall compliance. Results Ten anesthetized and paralyzed pigs (43.2 ± 1.8 kg) were mechanically ventilated and subjected to lung injury by saline lung lavage. Each pig was subjected to three different intravascular volumes and two different intraabdominal pressures. For each condition, the changes in the esophageal pressure (ΔPes) and the estimated ΔPpl using ΔCVP (cΔCVP-derived ΔPpl) were compared to the directly measured change in pleural pressure (Δd-Ppl), which was the gold standard estimate in this study. The cΔCVP-derived ΔPpl was calculated as κ × ΔCVP, where “κ” was the ratio of the change in airway pressure to the change in CVP during the occlusion test. The means and standard deviations of the Δd-Ppl, ΔPes, and cΔCVP-derived ΔPpl for all pigs under all conditions were 7.6 ± 4.5, 7.2 ± 3.6, and 8.0 ± 4.8 cmH2O, respectively. The repeated measures correlations showed that both the ΔPes and cΔCVP-derived ΔPpl showed a strong correlation with the Δd-Ppl (ΔPes: r = 0.95, p

Background: We have previously reported a simple correction method for estimating pleural pressure (Ppl) using central venous pressure (CVP). However, it remains unclear whether this method is applicable to patients with varying levels of intravascular volumes and/or chest wall compliance. This study aimed to investigate the accuracy of our method under different conditions of intravascular volume and chest wall compliance. Results: Ten anesthetized and paralyzed pigs (43.2 ± 1.8 kg) were mechanically ventilated and subjected to lung injury by saline lung lavage. Each pig was subjected to three different intravascular volumes and two different intraabdominal pressures. For each condition, the changes in the esophageal pressure (ΔPes) and the estimated ΔPpl using ΔCVP (cΔCVP-derived ΔPpl) were compared to the directly measured change in pleural pressure (Δd-Ppl), which was the gold standard estimate in this study. The cΔCVP-derived ΔPpl was calculated as κ × ΔCVP, where "κ" was the ratio of the change in airway pressure to the change in CVP during the occlusion test. The means and standard deviations of the Δd-Ppl, ΔPes, and cΔCVP-derived ΔPpl for all pigs under all conditions were 7.6 ± 4.5, 7.2 ± 3.6, and 8.0 ± 4.8 cmH2O, respectively. The repeated measures correlations showed that both the ΔPes and cΔCVP-derived ΔPpl showed a strong correlation with the Δd-Ppl (ΔPes: r = 0.95, p < 0.0001; cΔCVP-derived ΔPpl: r = 0.97, p < 0.0001, respectively). In the Bland–Altman analysis to test the performance of the cΔCVP-derived ΔPpl to predict the Δd-Ppl, the ΔPes and cΔCVP-derived ΔPpl showed almost the same bias and precision (ΔPes: 0.5 and 1.7 cmH2O; cΔCVP-derived ΔPpl: − 0.3 and 1.9 cmH2O, respectively). No significant difference was found in the bias and precision depending on the intravascular volume and intraabdominal pressure in both comparisons between the ΔPes and Δd-Ppl, and cΔCVP-derived ΔPpl and Δd-Ppl. Conclusions: The CVP method can estimate the ΔPpl with reasonable accuracy, similar to Pes measurement. The accuracy was not affected by the intravascular volume or chest wall compliance. [ABSTRACT FROM AUTHOR]

Objective: To compare bioelectrical impedance analysis (BIA)-derived parameters in healthy volunteers and critically ill patients and to assess its prognostic value in an ICU patient cohort. Design: Retrospective, observational data analysis. Setting: Single centre, tertiary-level ICU (Ziekenhuis Netwerk Antwerpen, ZNA Stuivenberg Hospital). Patients: 101 patients and 101 healthy subjects, participants of International Fluid Academy Days. Measurements and main results: Compared to healthy volunteers, both male and female ICU patients had significantly higher values for total body water (TBW), extracellular water (ECW), extracellular fluid (ECF), plasma, and interstitial fluid volumes. The phase angle was significantly lower and the malnutrition index was significantly higher in ICU patients, regardless of gender. Non-survivors in the ICU had significantly higher extracellular water content (ECW, 50.7 ± 5.1 vs. 48.9 ± 4.3%, p = 0.047) and accordingly significantly lower intracellular water (ICW, 49.2 ± 5.1 vs. 51.1 ± 4.3%, p = 0.047). The malnutrition index was also significantly higher in non-survivors compared to survivors (0.94 ± 0.17 vs. 0.87 ± 0.16, p = 0.048), as was the capillary leak index (ECW/ICW). Conclusions: Compared to healthy volunteers, this study observed a higher malnutrition index and TBW in ICU patients with an accumulation of fluids in the extracellular compartment. ICU non-survivors showed similar results, indicating that ICU patients and a fortiori non-survivors are generally overhydrated, with increased TBW and ECW, and more undernourished, as indicated by a higher malnutrition index. [ABSTRACT FROM AUTHOR]

Patients with severe acute pancreatitis (SAP) present complications and organ failure, which require treatment in critical care units. These extrapancreatic complications determine the clinical outcome of the disease. Intra-abdominal hypertension (IAH) deteriorates the prognosis of SAP. In this paper, relevant recent literature was reviewed, as well as the authors' own experiences, concerning the clinical importance of IAH and its treatment in SAP. The principal observations confirmed that IAH is a frequent consequence of SAP but is practically absent in mild disease. Common manifestations of AP such as pain, abdominal distension, and paralytic ileus contribute to increased abdominal pressure, as well as fluid loss in third space and aggressive fluid replacement therapy. A severe increase in IAP can evolve to abdominal compartment syndrome and new onset organ failure. Conservative measures are useful, but invasive interventions are necessary in several cases. Percutaneous drainage of major collections is preferred when possible, but open decompressive laparotomy is the final possibility in some cases in order to definitively reduce abdominal pressure. Intra-abdominal pressure should be measured in all SAP cases that worsen despite adequate treatment in critical care units. Conservative measures must be introduced to treat IAH, including negative fluid balance, digestive decompression by gastric–rectal tube, and prokinetics, including neostigmine. In the case of insufficient responses to these measures, minimally invasive interventions should be preferred. [ABSTRACT FROM AUTHOR]

Abstract As exemplified by prone positioning, regional variations of lung and chest wall properties provide possibilities for modifying transpulmonary pressures and suggest that clinical interventions related to the judicious application of external pressure may yield benefit. Recent observations made in late-phase patients with severe ARDS caused by COVID-19 (C-ARDS) have revealed unexpected mechanical responses to local chest wall compressions over the sternum and abdomen in the supine position that challenge the clinician’s assumptions and conventional bedside approaches to lung protection. These findings appear to open avenues for mechanism-defining research investigation with possible therapeutic implications for all forms and stages of ARDS.

As exemplified by prone positioning, regional variations of lung and chest wall properties provide possibilities for modifying transpulmonary pressures and suggest that clinical interventions related to the judicious application of external pressure may yield benefit. Recent observations made in late-phase patients with severe ARDS caused by COVID-19 (C-ARDS) have revealed unexpected mechanical responses to local chest wall compressions over the sternum and abdomen in the supine position that challenge the clinician's assumptions and conventional bedside approaches to lung protection. These findings appear to open avenues for mechanism-defining research investigation with possible therapeutic implications for all forms and stages of ARDS. [ABSTRACT FROM AUTHOR]

Abstract Background This study examined the feasibility of transabdominal intestinal ultrasonography in evaluating acute gastrointestinal injury (AGI). Methods A total of 116 patients were included. Intestinal ultrasonography was conducted daily within 1 week after admission to the intensive care unit. Ultrasonography indicators including intestinal diameter, changes in the intestinal folds, thickness of the intestinal wall, stratification of the intestinal wall, and intestinal peristalsis (movement of the intestinal contents) were observed to determine the acute gastrointestinal injury ultrasonography (AGIUS) score. The gastrointestinal and urinary tract sonography ultrasound (GUTS) protocol score was also calculated. During the first week of the study, the gastrointestinal failure (GIF) score was determined daily. The correlations between transabdominal intestinal scores (AGIUS and GUTS) and the GIF score were analyzed to clarify the feasibility of evaluating AGI through observation of the intestine. The utility of intestinal ultrasonography indicators in predicting feeding intolerance was investigated to improve the ability of clinicians to manage AGI. Results A total of 751 ultrasonic examinations were performed with 511 images (68%) considered to be of “good quality.” AGIUS and GUTS scores differed significantly between AGI patients (GIF score 0–2) and non-AGI patients (GIF score 3–4) (p 10/min) have increased risk for feeding intolerance (16/83 vs. 25/33, p

Patients with severe acute pancreatitis (SAP) present complications and organ failure, which require treatment in critical care units. These extrapancreatic complications determine the clinical outcome of the disease. Intra-abdominal hypertension (IAH) deteriorates the prognosis of SAP. In this paper, relevant recent literature was reviewed, as well as the authors’ own experiences, concerning the clinical importance of IAH and its treatment in SAP. The principal observations confirmed that IAH is a frequent consequence of SAP but is practically absent in mild disease. Common manifestations of AP such as pain, abdominal distension, and paralytic ileus contribute to increased abdominal pressure, as well as fluid loss in third space and aggressive fluid replacement therapy. A severe increase in IAP can evolve to abdominal compartment syndrome and new onset organ failure. Conservative measures are useful, but invasive interventions are necessary in several cases. Percutaneous drainage of major collections is preferred when possible, but open decompressive laparotomy is the final possibility in some cases in order to definitively reduce abdominal pressure. Intra-abdominal pressure should be measured in all SAP cases that worsen despite adequate treatment in critical care units. Conservative measures must be introduced to treat IAH, including negative fluid balance, digestive decompression by gastric–rectal tube, and prokinetics, including neostigmine. In the case of insufficient responses to these measures, minimally invasive interventions should be preferred.

During pneumoperitoneum, intra-abdominal pressure (IAP) is usually kept at 12-14 mmHg. There is no clinical benefit in IAP increments if they do not increase intra-abdominal volume IAV. We aimed to estimate IAV (DIAV) and respiratory driving pressure changes (DPRS) in relation to changes in IAP (DIAP). We carried out a patient-level meta-analysis of 204 adult patients with available data on IAV and DPRS during pneumoperitoneum from three trials assessing the effect of IAP on postoperative recovery and airway pressure during laparoscopic surgery under general anesthesia. The primary endpoint was DIAV, and the secondary endpoint was DPRS. The endpoints' response to DIAP was modeled using mixed multivariable Bayesian regression to estimate which mathematical function best fitted it. IAP values on the pressure-volume (PV) curve where the endpoint rate of change according to IAP decreased were identified. Abdomino-thoracic transmission (ATT) rate, that is, the rate DPRS change to DIAP was also estimated. The best-fitting function was sigmoid logistic and linear for IAV and DPRS response, respectively. Increments in IAV reached a plateau at 6.0 [95%CI 5.9-6.2] L. DIAV for each DIAP decreased at IAP ranging from 9.8 [95%CI 9.7-9.9] to 12.2 [12.0-12.3] mmHg. ATT rate was 0.65 [95%CI 0.62-0.68]. One mmHg of IAP raised DPRS 0.88 cmH2O. During pneumoperitoneum, IAP has a nonlinear relationship with IAV and a linear one with DPRS. IAP should be set below the point where IAV gains diminish. [ABSTRACT FROM AUTHOR]

Background: The shape and cross-sectional area (CSA) of internal jugular vein (IJV) are easily affected by external factors. That causes venous collapsibility. We tried to distend IJV by increasing the pressure on patients' abdomen in order to improve the success rate of internal jugular vein catheterization (IJVC).Materials and Methods: Patients undergoing IJVC were randomly allocated to two groups: Group 1 and Group 2. For patients in Group 1, the pressure on abdomen was increased by placing a 3000 ml bag of normal saline (NS). No special treatment was arranged for patients in Group 2. Transverse images of right IJV were captured at the outer edge which was parallel to the cricoid by ultrasonography. CSA, circumference (CF), transverse diameter (TD) and anteroposterior diameter (APD) of right IJV were measured and compared. All patients underwent ultrasound-guided short-axis puncturing. The success rates of one-off puncturing in two groups were recorded and compared.Results: The results under ultrasonography assessments show that CF, CSA, APD and success rate of puncturing in Group 1 were significantly higher than that of Group 2 (P < 0.05), while TD was not significantly increased (P > 0.05). There was no significant difference in complications between two groups (P > 0.05).Conclusion: Pressure on the abdomen could significantly increase CSA of IJV. That helps improving the success rate of one-off puncturing. [ABSTRACT FROM AUTHOR]

Introduction: Elevated intraabdominal pressure (IAP) it is known to have an impact on renal function trough the pressure transmitted from the abdominal cavity to the vasculature responsible for the renal blood flow. Intraabdominal pressure is found to be frequent in intensive care patients and also to be a predictor of mortality. Intra-abdominal high pressure is an entity that can have serious impact on intensive care admitted patients, studies concluding that if this condition progresses to abdominal compartment syndrome mortality is as high as 80%.

Objective: To compare bioelectrical impedance analysis (BIA)-derived parameters in healthy volunteers and critically ill patients and to assess its prognostic value in an ICU patient cohort., Design: Retrospective, observational data analysis., Setting: Single centre, tertiary-level ICU (Ziekenhuis Netwerk Antwerpen, ZNA Stuivenberg Hospital)., Patients: 101 patients and 101 healthy subjects, participants of International Fluid Academy Days., Measurements and Main Results: Compared to healthy volunteers, both male and female ICU patients had significantly higher values for total body water (TBW), extracellular water (ECW), extracellular fluid (ECF), plasma, and interstitial fluid volumes. The phase angle was significantly lower and the malnutrition index was significantly higher in ICU patients, regardless of gender. Non-survivors in the ICU had significantly higher extracellular water content (ECW, 50.7 ± 5.1 vs. 48.9 ± 4.3%, p = 0.047) and accordingly significantly lower intracellular water (ICW, 49.2 ± 5.1 vs. 51.1 ± 4.3%, p = 0.047). The malnutrition index was also significantly higher in non-survivors compared to survivors (0.94 ± 0.17 vs. 0.87 ± 0.16, p = 0.048), as was the capillary leak index (ECW/ICW)., Conclusions: Compared to healthy volunteers, this study observed a higher malnutrition index and TBW in ICU patients with an accumulation of fluids in the extracellular compartment. ICU non-survivors showed similar results, indicating that ICU patients and a fortiori non-survivors are generally overhydrated, with increased TBW and ECW, and more undernourished, as indicated by a higher malnutrition index.

The aim of this study was to explore the possibility of using rabbit bladder as a model for experimental detrusor electrostimulation research. In a study of urinary bladder activity induced through electrostimulation of the ventral roots, the functional and morphological parameters of the rabbit detrusor were investigated. Under general anaesthesia, open electrostimulation of ventral spinal roots leading towards the detrusor (usually S2, S3) was performed in 20 rabbits. Detrusor response was recorded by repeated electromyography and cystometry in two groups: animals with naturally concentrated urine content (Group A, eight rabbits) and animals after flushing and filling the bladder with saline (Group B, 12 rabbits). Histological examination of bladder wall was performed in both groups. The measured values were compared to one another as well as with data from the veterinary and human literature. The histological specimens were compared with histological specimens of human bladder. The reaction of detrusor fibres was detectable by electromyography in all cases. Elevation of intravesical pressure as a consequence of detrusor contraction was more difficult to detect, as this depends more on the density of the intravesical content. The pressure rise in Group B had a higher amplitude - up to 15 cm H2O versus 5 cm H2O in the first group (P = 0.00046). Histological examination of bladder wall from the two groups of rabbits showed no differences. In comparison with the bladder wall in humans, the only differences found were significantly thinner detrusor layers relative to the overall thickness of bladder wall. It is possible to use rabbit bladder for research into experimentally electrostimulation-induced activity of the detrusor or for experimental detrusor reinnervation research. It is necessary, however, to take into account certain limits - the lower contractility of the bladder wall and the need for qualitative control of bladder content. The present results also suggest that the physiological micturition of rabbits is probably more dependent on abdominal pressure than in humans.

Neurogenic lower urinary tract dysfunction is a common symptom after spinal cord injury. Here, the case of a 45-year-old male patient who was treated with indwelling urinary catheter during spinal surgery for a fall fracture injury of the T12 thoracic vertebra, associated with decreased muscle strength of both lower extremities, is described. During hospitalization in the rehabilitation department, conventional anticoagulation therapy was administered, and the urinary catheter was removed with the patient urinating by increasing abdominal pressure. At 8 days following urinary catheter removal, the patient was found to have a slight subconjunctival haemorrhage of the left eye, which gradually developed into massive subconjunctival haemorrhage in both eyes. After re-indwelling the urinary catheter, the bilateral subconjunctival haemorrhage gradually improved. No abnormal indicators were found during re-examination of coagulation function and platelet count, and the results of ophthalmological examination were normal. For patients with neurogenic bladder dysfunction associated with spinal cord injury, the risk of bleeding during the anticoagulation period should be carefully assessed to eliminate possible underlying bleeding risk factors (including past medical history and appropriate use of anticoagulant drugs) when considering spontaneous urination through the mode of abdominal pressure.

The purpose of this study is to propose a lying location on a gatch bed for bedridden elderly people or patients, in order to decrease pressures around the abdominal region during backrest lifting. A proposed lying location is defined as the location where an ischial tuberosity of the patient is positioned right above the rotational axis of the backrest. A patient dummy has been developed to directly measure the abdominal pressures. Experiments were carried out to verify the effects of the proposed lying location during the backrest lifting and lowering. The pressures and slipping displacements were measured using the developed patient dummy in the conventional and proposed lying location. As a result the pressures and slipping displacements were decreased in the proposed lying location.

No abstract available. Article truncated after 150 words. A 29 year old woman with history of a Whipple procedure for pancreatic cancer and nonalcoholic steatohepatitis cirrhosis presented with a massive upper gastrointestinal bleeding (UGIB) likely from esophageal varices and developed hemorrhagic shock. Emergent upper endoscopy could not be performed due to hemodynamic instability. Therefore, a Minnesota Tube was placed emergently for balloon tamponade of the bleeding. A transjugular intrahepatic portosystemic shunt was also placed emergently to decrease bleeding by reducing portal pressure. By this time, the patient had received 4 liters of normal saline, 14 units of packed red blood cells, 6 units of platelets, and 4 units of fresh frozen plasma. The Minnesota tube did control the bleeding somewhat, however, there was continued bloody drainage from the stomach port of the Minnesota tube. The patient’s abdomen became remarkably distended and was dull to percussion throughout. A CT scan of the abdomen and pelvis revealed severe dilatation of ...

The article examines the pathophysiological mechanisms of kidney damage during intra-abdominal hypertension. It states that increased intra-abdominal pressure may cause organ dysfunction in the abdomen which include acute kidney injury and abdominal compartment syndrome. It concludes that the pathophysiological mechanisms of is unclear, however decreased renal perfusion is a causative factor.

In order to assess and diagnose lower urinary tract dysfunction in patients and help patients with lower urinary tract rehabilitation training, an accurate and reliable urodynamic monitoring and automatic voiding system was designed. The system realizes the signal acquisition circuit of bladder pressure, abdominal pressure and urine volume based on the pressure sensor of urinary catheter and the load sensor. Meanwhile, the dynamic waveforms of urinary flow rate, bladder pressure and abdominal pressure are drawn in real time on the software of urodynamic monitoring. Signal processing and analysis of each signal are carried out, and the system performance is verified by building a simulation experiment. The experimental results show that the system is stable, reliable, accurate and meets the expected design goals, which can provide support for subsequent engineering design and clinical applications.

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Mechanical Engineering the National Technical University of Ukraine 'Kyiv Polytechnic Institute' is the property of National Technical University of Ukraine KPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this study was to explore the possibility of using rabbit bladder as a model for experimental detrusor electrostimulation research. In a study of urinary bladder activity induced through electrostimulation of the ventral roots, the functional and morphological parameters of the rabbit detrusor were investigated. Under general anaesthesia, open electrostimulation of ventral spinal roots leading towards the detrusor (usually S2, S3) was performed in 20 rabbits. Detrusor response was recorded by repeated electromyography and cystometry in two groups: animals with naturally concentrated urine content (Group A, eight rabbits) and animals after flushing and filling the bladder with saline (Group B, 12 rabbits). Histological examination of bladder wall was performed in both groups. The measured values were compared to one another as well as with data from the veterinary and human literature. The histological specimens were compared with histological specimens of human bladder. The reaction of detrusor fibres was detectable by electromyography in all cases. Elevation of intravesical pressure as a consequence of detrusor contraction was more difficult to detect, as this depends more on the density of the intravesical content. The pressure rise in Group B had a higher amplitude -- up to 15 cm H2O versus 5 cm H2O in the first group (P = 0.00046). Histological examination of bladder wall from the two groups of rabbits showed no differences. In comparison with the bladder wall in humans, the only differences found were significantly thinner detrusor layers relative to the overall thickness of bladder wall. It is possible to use rabbit bladder for research into experimentally electrostimulation-induced activity of the detrusor or for experimental detrusor reinnervation research. It is necessary, however, to take into account certain limits -- the lower contractility of the bladder wall and the need for qualitative control of bladder content. The present results also suggest that the physiological micturition of rabbits is probably more dependent on abdominal pressure than in humans. [ABSTRACT FROM AUTHOR]

BACKGROUND: Intrathoracic pressure in patients undergoing laparoscopic surgery may be affected by intra-abdominal pressure during surgery. We investigated the relationship between intra-abdominal pressure (Pabd) and esophageal pressure (Pes) in mechanically ventilated patients undergoing laparoscopic surgery. METHODS: We prospectively studied 43 consenting patients over 18 y of age who were scheduled for elective laparoscopic surgery with plans for intra-operative intubation and paralysis. After establishing a good level of inter-observer agreement on Pes measurements, Pes was measured by one observer for each patient using an esophageal catheter. Pabd and Pes were recorded before and after abdominal insufflation. We used regression analysis to model the relationship between Pabd and Pes. RESULTS: Patients' ages varied from 22 to 78 y, with a mean of 53.2 ± 14.6 y. Body mass index (BMI) varied from 13.7 to 60.5 kg/m2, with a mean of 33.7 ± 10.5. PEEP was 5-7 cm H2O for 19 patients and 0 cm H2O for the remainder. Most patients underwent gastric bypass surgery (n = 11); others underwent hernia repair (n = 9), colon resection (n = 7), cholecystectomy (n = 6), and various other surgeries (n = 10). Using univariate analyses, baseline Pabd was significantly correlated with baseline Pes (estimate of model coefficient [95% CI]: 0.79 [0.36 -1.21], R2 = 0.24, P = .001), as was BMI (0.29 [0.19-0.40], R2 = 0.41, P < .001). However, a multivariable analysis showed no significant correlation with baseline Pabd (0.10 [-0.46 to 0.65], P = .73), whereas BMI remained highly significant (0.27 [0.11- 00.43], P = .001) with R2 = 0.40. Due to unexpected uniformity of abdominal inflation pressures (generally 20.4 cm H2O) during surgery, data were not amenable to assessment of correlation between changes in abdominal and esophageal pressures after inflation. CONCLUSION: There was a limited correlation between baseline Pes and Pabd in patients undergoing elective laparoscopic surgery, suggesting a limited value of Pabd measurements in the management of mechanically ventilated patients. [ABSTRACT FROM AUTHOR]