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Hamad AA, Amer BE, Al Mawla AM, Goufa E, Abdelwahab MM, Serag I. Clinical characteristics, course, and outcomes of amyotrophic lateral sclerosis overlapping with pregnancy: a systematic review of 38 published cases. Neurol Sci 2023; 44:4219-4231. [PMID: 37587387 PMCID: PMC10641051 DOI: 10.1007/s10072-023-06994-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 07/28/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVES Amyotrophic lateral sclerosis (ALS) is a rare and fatal neurodegenerative disease that can overlap with pregnancy, but little is known about its clinical characteristics, course, and outcomes in this context. This systematic review aimed to synthesize the current evidence on ALS overlapping with pregnancy. METHODS We comprehensively searched four databases on February 2, 2023, to identify case studies reporting cases of ALS overlapping with pregnancy. Joanna Brigs Institute tool was followed to assess the quality of the included studies. RESULTS Twenty-six articles reporting 38 cases were identified and included in our study. Out of the 38 cases, 18 were aged < 30 years. The onset of ALS was before pregnancy in 18 cases, during pregnancy in 16 cases, and directly after pregnancy in 4 cases. ALS progression course was rapid or severe in 55% of the cases during pregnancy, and this percentage reached 61% in cases with an onset of ALS before pregnancy. While ALS progression course after pregnancy was rapid or severe in 63% and stable in 37% of the cases. Most cases (95%) were able to complete the pregnancy and gave live birth. However, preterm delivery was common. For neonates, 86% were healthy without any complications. CONCLUSION While pregnancy with ALS is likely to survive and result in giving birth to healthy infants, it could be associated with rapid or severe progression of ALS and result in a worse prognosis, highlighting the importance of close monitoring and counselling for patients and healthcare providers.
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Affiliation(s)
| | - Basma Ehab Amer
- Medical Research Group of Egypt, Negida Academy, Arlington, MA, USA
- Faculty of Medicine, Benha University, Benha, Egypt
| | - Aya Mustafa Al Mawla
- Medical Research Group of Egypt, Negida Academy, Arlington, MA, USA
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Elarbi Goufa
- Medical Research Group of Egypt, Negida Academy, Arlington, MA, USA
- Faculty of Medicine, University of Oran 1 - Ahmed Ben Bella, Oran, Algeria
| | - Maya Magdy Abdelwahab
- Medical Research Group of Egypt, Negida Academy, Arlington, MA, USA
- Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Ibrahim Serag
- Medical Research Group of Egypt, Negida Academy, Arlington, MA, USA
- Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Pickkers P. The Obesity Paradox in Patients in Need of Extracorporeal Membrane Oxygenation. Am J Respir Crit Care Med 2023; 208:649-650. [PMID: 37638784 PMCID: PMC10515566 DOI: 10.1164/rccm.202307-1261ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 08/07/2023] [Indexed: 08/29/2023] Open
Affiliation(s)
- Peter Pickkers
- Department of Intensive Care Medicine Radboud University Medical Center Nijmegen Nijmegen, The Netherlands
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LoMauro A, Aliverti A. Respiratory physiology in pregnancy and assessment of pulmonary function. Best Pract Res Clin Obstet Gynaecol 2022; 85:3-16. [PMID: 35868980 DOI: 10.1016/j.bpobgyn.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/18/2022] [Accepted: 05/31/2022] [Indexed: 12/14/2022]
Abstract
A progressive chest wall adaptation occurs during pregnancy driven by the hormones and the expanding uterus. The effect of the former is more prevalent in the first weeks of pregnancy, while the latter is more evident in the last trimester. The combination of the hormonal-induced joint loosening together with the progressively enlarging uterus produces changes in the whole chest wall geometry, with the thoracic alterations being the most fundamental. The ribcage changes in size, but not in volume, secondary to an upward bucket handle shift centred in the xiphoidal process so that the lung is not restricted. A virtuous cycle of stretching and muscle conditioning seems to be established between the enlarging uterus, the diaphragm, and the abdominal muscles to prepare these muscles for the expulsive phase. From the respiratory point of view, the supine position seems to hinder the action of the abdominal muscles during forced expiration at the end of pregnancy.
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Affiliation(s)
- Antonella LoMauro
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy.
| | - Andrea Aliverti
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
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Cao Y, Li P, Wang Y, Liu X, Wu W. Diaphragm Dysfunction and Rehabilitation Strategy in Patients With Chronic Obstructive Pulmonary Disease. Front Physiol 2022; 13:872277. [PMID: 35586711 PMCID: PMC9108326 DOI: 10.3389/fphys.2022.872277] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/18/2022] [Indexed: 12/03/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) affects the whole body and causes many extrapulmonary adverse effects, amongst which diaphragm dysfunction is one of the prominent manifestations. Diaphragm dysfunction in patients with COPD is manifested as structural changes, such as diaphragm atrophy, single-fibre dysfunction, sarcomere injury and fibre type transformation, and functional changes such as muscle strength decline, endurance change, diaphragm fatigue, decreased diaphragm mobility, etc. Diaphragm dysfunction directly affects the respiratory efficiency of patients and is one of the important pathological mechanisms leading to progressive exacerbation of COPD and respiratory failure, which is closely related to disease mortality. At present, the possible mechanisms of diaphragm dysfunction in patients with COPD include systemic inflammation, oxidative stress, hyperinflation, chronic hypoxia and malnutrition. However, the specific mechanism of diaphragm dysfunction in COPD is still unclear, which, to some extent, increases the difficulty of treatment and rehabilitation. Therefore, on the basis of the review of changes in the structure and function of COPD diaphragm, the potential mechanism of diaphragm dysfunction in COPD was discussed, the current effective rehabilitation methods were also summarised in this paper. In order to provide direction reference and new ideas for the mechanism research and rehabilitation treatment of diaphragm dysfunction in COPD.
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Affiliation(s)
- Yuanyuan Cao
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Peijun Li
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yingqi Wang
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Xiaodan Liu
- School of Rehabilitation Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Xiaodan Liu, ; Weibing Wu,
| | - Weibing Wu
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai, China
- *Correspondence: Xiaodan Liu, ; Weibing Wu,
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Felton M, Hundley VA, Grigsby S, McConnell AK. Effects of slow and deep breathing on reducing obstetric intervention in women with pregnancy-induced hypertension: a feasibility study protocol. Hypertens Pregnancy 2021; 40:81-87. [PMID: 33463384 DOI: 10.1080/10641955.2020.1869250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/21/2020] [Indexed: 10/22/2022]
Abstract
Objective: To evaluate whether a slow and deep breathing (SDB) intervention is acceptable to pregnant women. Methods: The trial aims to recruit 67 pregnant women who have developed pregnancy-induced hypertension (clinicaltrials.gov: NCT04059822). SDB will be undertaken daily for 10 min using a video aid and women will self-monitor blood pressure (BP) daily. At 36-weeks gestation women will complete an online questionnaire. Adherence, recruitment rates, and acceptance of the intervention will be evaluated. Conclusion: The findings from this trial will evaluate if women accept SDB as a treatment method. Initial analysis will evaluate if BP and/or obstetric interventions reduce following SDB intervention.
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Affiliation(s)
- M Felton
- Department of Midwifery & Health Sciences, Bournemouth University , Bournemouth, UK
| | - V A Hundley
- Department of Midwifery & Health Sciences, Bournemouth University , Bournemouth, UK
| | - S Grigsby
- Department of Midwifery & Health Sciences, Bournemouth University , Bournemouth, UK
- St Mary's Maternity Unit, University Hospitals Dorset NHS Foundation Trust , Poole, UK
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Chorti A, AbuFarha S, Michalopoulos A, Papavramidis TS. Richter's hernia in a 5-mm trocar site. SAGE Open Med Case Rep 2019; 7:2050313X18823413. [PMID: 30719305 PMCID: PMC6349989 DOI: 10.1177/2050313x18823413] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 12/13/2018] [Indexed: 11/15/2022] Open
Abstract
We present an unusual case of a trocar site incision hernia at a 5-mm trocar port occurring approximately 2 weeks post-operatively after a laparoscopic cholecystectomy. The patient, in her mid-60s, reported diffuse abdominal pain, constipation, nausea and vomiting. An abdominal X-ray demonstrated dilated small bowel loops with gas-fluid levels. Abdominal computed tomography revealed the small bowel herniation through the 5-mm port site. Laparotomy confirmed a Richter’s hernia of the small bowel in the fascia defect. This case highlights the necessity to examine and investigate any complaint post-operatively and deliberate its possible significance. Furthermore, it demonstrates that, even during a normal recovery period for a patient without any underlying disease or risk factors, a rare complication could still develop in a delayed fashion multiple days post-operatively from a laparoscopic procedure. High clinical suspicion is essential in order to avoid further deterioration of the patient condition and optimal treatment.
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Affiliation(s)
- Angeliki Chorti
- 1st Propedeutic Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Samer AbuFarha
- 1st Propedeutic Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Antonios Michalopoulos
- 1st Propedeutic Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodosios S Papavramidis
- 1st Propedeutic Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Pouwels S, Kools-Aarts M, Said M, Teijink JAW, Smeenk FWJM, Nienhuijs SW. Effects of bariatric surgery on inspiratory muscle strength. SPRINGERPLUS 2015; 4:322. [PMID: 26180742 PMCID: PMC4493261 DOI: 10.1186/s40064-015-1088-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 06/08/2015] [Indexed: 11/25/2022]
Abstract
Background The respiratory function is affected by obesity due to an increased deposition of fat on the chest wall. The objective of this study was to investigate the strength of the inspiratory respiratory muscles of obese individuals and the possible influence of bariatric surgery on it by measuring the maximum inspiratory pressure (MIP). Methods Patients referred to a bariatric centre between the 3rd of October 2011 and the 3rd of May 2012 were screened preoperatively by a multidisciplinary team. Their MIP was measured at screening and 3, 6 and 9 months postoperative. In case of a preoperative MIP lower than 70% of predicted pressure training was provided supervised by a physiotherapist. Results The mean age of 124 included patients was 42.9 ± 11.0 years and mean BMI was 43.1 ± 5.2 kg/m2. The mean predicted MIP preoperatively was 127 ± 31 in cm H2O and the mean measured MIP was 102 ± 24 in cm H2O. Three patients (2.4%) received training. Three months after surgery the MIP was 76 ± 26 cm H2O, after 6 months 82 ± 28 cm H2O and after 9 months 86 ± 28 cm H2O. All postoperative measurements were significant lower than preoperatively (P < 0.05). The only influencing factor for the preoperative MIP was age (p = 0.014). Conclusion The preoperative MIP values were significantly lower than the predicted MIP values, probably due to altered respiratory mechanics.
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Affiliation(s)
- Sjaak Pouwels
- Department of Surgery, Catharina Hospital, Michelangelolaan 2, P.O. Box 1350, 5602 ZA Eindhoven, The Netherlands ; Department of Epidemiology, CAPHRI Research School, Maastricht University, Maastricht, The Netherlands
| | - Marieke Kools-Aarts
- Department of Surgery, Catharina Hospital, Michelangelolaan 2, P.O. Box 1350, 5602 ZA Eindhoven, The Netherlands
| | - Mohammed Said
- Department of Surgery, Catharina Hospital, Michelangelolaan 2, P.O. Box 1350, 5602 ZA Eindhoven, The Netherlands
| | - Joep A W Teijink
- Department of Surgery, Catharina Hospital, Michelangelolaan 2, P.O. Box 1350, 5602 ZA Eindhoven, The Netherlands ; Department of Epidemiology, CAPHRI Research School, Maastricht University, Maastricht, The Netherlands
| | - Frank W J M Smeenk
- Department of Respiratory Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | - Simon W Nienhuijs
- Department of Surgery, Catharina Hospital, Michelangelolaan 2, P.O. Box 1350, 5602 ZA Eindhoven, The Netherlands
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Miranda J, Palacio B, Rojas-Suarez JA, Bourjeily G. Long-term mechanical ventilation in a pregnant woman with amyotrophic lateral sclerosis: a successful outcome. CASE REPORTS IN PERINATAL MEDICINE 2014. [DOI: 10.1515/crpm-2013-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Introduction: Amyotrophic lateral sclerosis (ALS) is a progressive degenerative motor neuron disease that is rarely encountered in the obstetric population. This report describes the successful use of long-term mechanical ventilation in a pregnant woman with ALS.
Case presentation: A 37-year-old G3P2 woman with ALS was admitted to the emergency room with shortness of breath, tachypnea, and evidence of hypoxic and hypercapnic respiratory failure at 24 weeks of gestation, precipitated by bacterial pneumonia. Antibiotic therapy, intubation, and mechanical ventilatory support were initiated, followed by an early tracheostomy as soon as the need for prolonged airway access was identified. The mother remained with prolonged mechanical ventilation until spontaneous preterm birth occurred at 32 weeks of gestation, with the vaginal delivery of a healthy infant. The mother was discharged from the intensive care unit during puerperium to continue mechanical ventilation support in a home care facility.
Conclusion: Long-term mechanical ventilation can be successfully performed during pregnancy. Goals of oxygenation and ventilation need to be modified and customized based on the underlying condition and the status of the mother.
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Affiliation(s)
- Jezid Miranda
- Grupo de Investigación en Cuidado Intensivo y Obstetricia (GRICIO), Cartagena de Indias, Colombia
- Universidad de Cartagena, Cartagena de Indias, Colombia
| | - Betty Palacio
- Grupo de Investigación en Cuidado Intensivo y Obstetricia (GRICIO), Cartagena de Indias, Colombia
- Universidad de Cartagena, Cartagena de Indias, Colombia
| | - Jose Antonio Rojas-Suarez
- Grupo de Investigación en Cuidado Intensivo y Obstetricia (GRICIO), Cartagena de Indias, Colombia
- Universidad de Cartagena, Cartagena de Indias, Colombia
- Clínica Maternidad Rafael Calvo, Cartagena de Indias, Colombia
| | - Ghada Bourjeily
- Department of Medicine, Pulmonary and Critical Care Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
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Body mass index is associated with hospital mortality in critically ill patients: an observational cohort study. Crit Care Med 2013; 41:1878-83. [PMID: 23685638 DOI: 10.1097/ccm.0b013e31828a2aa1] [Citation(s) in RCA: 140] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Obesity is associated with a variety of diseases, which results in a decreased overall life expectancy. Nevertheless, some studies suggest that being overweight may reduce hospital mortality of certain patient groups, referred to as obesity paradox. Conflicting results for critically ill patients are reported. Therefore, we wished to investigate the association of body mass index and hospital mortality in critically ill patients. DESIGN Observational cohort study in Dutch critically ill patients. SETTING A dataset from the Dutch National Intensive Care Evaluation registry that includes patients admitted to Dutch ICUs was used. PATIENTS One hundred fifty-four thousand three hundred and eight ICU patients of teaching and nonteaching units in urban and nonurban hospitals. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS We used logistic regression analysis, correcting for case mix (Simplified Acute Physiology Score II, age, gender, admission type, neoplasm, AIDS, hematologic malignancy, immunologic insufficiency, mechanical ventilation, and calendar year), to determine the relationship between body mass index and hospital mortality. Body mass index was included in the model as a continuous nonlinear covariate in a restricted regression spline transformation. To facilitate interpretation, adjusted odds ratios were calculated for the World Health Organization-based body mass index classes. Body mass index was found to be significantly associated with hospital mortality, with risks quickly increasing for underweight patients (body mass index < 18.5 kg/m). Obese and seriously obese patients, with a body mass index of 30-39.9 kg/m, had the lowest risk of death with an adjusted odds ratio of 0.86 (0.83-0.90). CONCLUSIONS This large observational database shows an inverse association between obesity and hospital mortality in critically ill patients that could not be explained by a variety of known confounders.
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van Eijk LT, van der Pluijm RW, Ramakers BPC, Dorresteijn MJ, van der Hoeven JG, Kox M, Pickkers P. Body mass index is not associated with cytokine induction during experimental human endotoxemia. Innate Immun 2013; 20:61-7. [DOI: 10.1177/1753425913481821] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
A higher body mass index (BMI) appears to be associated with lower mortality in critically ill patients, possibly explained by an altered innate immune response. However, the precise relationship between BMI and the innate immune response in humans in vivo is unknown. We investigated the relationship between BMI and the systemic cytokine response during experimental human endotoxemia. Endotoxemia was induced in 112 healthy male volunteers by intravenous administration of 2 ng/kg Escherichia coli endotoxin. Plasma concentrations of TNF-α, IL-6, IL-10 and IL-1RA were serially determined. The relationship between BMI and the cytokine response, as well as body temperature, was investigated. The BMIs of the participants ranged from 18.3 to 33.6 kg/m2, (median: 22.7 kg/m2). All participants showed a marked increase in plasma cytokine levels [median (interquartile range)] peak levels: TNF-α 509 (353–673) pg/ml; IL-6 757 (522–1098) pg/ml; IL-10 271 (159–401) pg/ml; IL-1RA 4882 (3927–6025) pg/ml; and an increase in body temperature [1.8(1.4–2.2)℃] during endotoxemia. No significant correlations were found between BMI and levels of any of the cytokines or body temperature. No relationship between BMI and the cytokine response was found in healthy volunteers subjected to experimental endotoxemia. These data question the relationship between BMI and cytokine responses in critical illness.
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Affiliation(s)
- Lucas T van Eijk
- Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre, the Netherlands
| | - Rob W van der Pluijm
- Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre, the Netherlands
| | - Bart PC Ramakers
- Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre, the Netherlands
| | - Mirrin J Dorresteijn
- Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre, the Netherlands
| | | | - Matthijs Kox
- Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre, the Netherlands
| | - Peter Pickkers
- Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre, the Netherlands
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Abstract
BACKGROUND Intragastric balloons (BIB) are routinely used for weight reduction. They should be placed to the gastric fundus, as this place is believed more effective for achievement of satiety and thus weight reduction. The aim of the present study was to evaluate whether the balloon position may affect 6-month weight loss as well as first-month side-effects, i.e. nausea, vomiting, and gastroesophageal reflux. METHODS From a total of 158 BIB-treated obese individuals, 105 females were found eligible, since the balloon in the stomach was found upon removal in the same position (fundus or antrum) placed at the time of insertion. These subjects were divided into fundus and antral groups. Data related to obesity were recorded on day 0 and upon BIB removal, 6 months thereafter. Data related to transient side-effects (nausea, vomiting, gastroesophageal reflux) were recorded on days 0-3, 7, and weekly thereafter, for 1 month. RESULTS BIB placed in the antrum was found to have significantly better results on weight loss parameters, while nausea, vomiting (p = 0.02) as well as gastroesophageal reflux still remained up to the fourth week in a relation to the fundus group. Similarly, the rate of gastric distension was found significantly increased (p = 0.001) during the days 1-3 in fundus group in relation to antrum, followed by a progressive decrease in both groups. CONCLUSIONS Intragastric balloon placed in the antrum lead to better results in weight reduction but to longer duration of tolerability-related side-effects, i.e., nausea, vomiting, and gastroesophageal reflux.
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Effects of breathing maneuver and sitting posture on muscle activity in inspiratory accessory muscles in patients with chronic obstructive pulmonary disease. Multidiscip Respir Med 2012; 7:9. [PMID: 22958459 PMCID: PMC3436653 DOI: 10.1186/2049-6958-7-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 06/20/2012] [Indexed: 11/10/2022] Open
Abstract
Background To determine the influence of breathing maneuver and sitting posture on tidal volume (TV), respiratory rate (RR), and muscle activity of the inspiratory accessory muscles in patients with chronic obstructive pulmonary disease (COPD). Methods Twelve men with COPD participated in the study. Inductive respiratory plethysmography and surface electromyography were used to simultaneously measure TV, RR, and muscle activity of the inspiratory accessory muscles [the scalenus (SM), sternocleidomastoid (SCM), and pectoralis major (PM) muscles] during quiet natural breathing (QB) and pursed-lips breathing (PLB) in three sitting postures: neutral position (NP), with armm support (WAS), and with arm and head support (WAHS). Results Two-way repeated-measures analysis of variance was employed. In a comparison of breathing patterns, PLB significantly increased TV and decreased RR compared to QB. Muscle activity in the SM and SCM increased significantly in PLB compared to QB. In a comparison of sitting postures, the muscle activity of the SM, SCM, and PM increased in the forward-leaning position. Conclusions The results suggest that in COPD, PLB induced a favorable breathing pattern (increased TV and reduced RR) compared to QB. Additionally, WAS and WAHS positions increased muscle activity of the inspiratory accessory muscles during inspiration versus NP. Differential involvement of accessory respiratory muscles can be readily studied in COPD patients, allowing monitoring of respiratory load during pulmonary rehabilitation.
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The Effects of Chronically Increased Intra-abdominal Pressure on the Rabbit Diaphragm. Obes Surg 2012; 22:487-92. [DOI: 10.1007/s11695-012-0587-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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