ABSTRACT
Although biofeedback has been used as a first-line therapy for fecal incontinence, it is known to be time consuming and demands attendance to a hospital during the whole period of treatment. In this study, we describe a new biofeedback device specifically developed for home treatment of fecal incontinence, which consists of a microprocessor controlled unit able to register and store the anal pressure waves corresponding to exercises performed by patients at home. In order to test the new device, a pilot study including ten patients with fecal incontinence was conducted. Evaluation of patients before and after the biofeedback training showed significant improvement in manometric and clinical parameters of anal continence. The new method may improve compliance of patients with the training program and reduce their need to be supervised during the treatment. It might represent a new alternative for the treatment of fecal incontinence.
Subject(s)
Biofeedback, Psychology/methods , Fecal Incontinence/therapy , Aged , Anal Canal/physiopathology , Fecal Incontinence/physiopathology , Female , Humans , Middle Aged , Pelvic Floor/physiopathology , Pilot Projects , Treatment OutcomeABSTRACT
Anti-reflux barrier (ARB) resistance may be useful to test new treatments for gastroesophageal reflux (GER). The ARB has been estimated by increasing gastric yield pressure (GYP) and gastric yield volume (GYV) in animal models but has not been validated. This study aimed to develop an experimental model suitable for assessing the ARB resistance to increasing intragastric pressure and volume and its reproducibility in a seven-day interval. Ten two-month-old female Large-White swine were studied. Intragastric pressure and volume were recorded using a digital system connected to a Foley catheter inserted through gastrostomy into the stomach. GYP and GYV were defined as the gastric pressure and volume able to yield gastric contents into the esophagus detected by esophageal pH. A sudden pH drop below 3 sustained during 5 min was considered diagnostic for gastric yield. Animals were studied again after seven days. On days 0 and 7, there were no significant differences for GYP (mean ± SD = 7.66 ± 3.02 mmHg vs. 7.07 ± 3.54 mmHg, p = .686) and GYV (636.70 ± 216.74 ml vs. 608.30 ± 276.66 ml; p = .299), respectively. Concordance correlation coefficient (ρc) was significant for GYP (ρc = 0.634, 95% CI = 0.141-0.829, p = .006), but not for GYV (ρc = 0.291, 95% CI = -0.118 to 0.774, p = .196). This study demonstrated an experimental model, assessing the ARB resistance. GYP seems to be a more reliable parameter than GYV for assessment of ARB resistance.
Subject(s)
Gastroesophageal Reflux/physiopathology , Pressure , Stomach/physiology , Animals , Esophagogastric Junction/physiology , Female , Gastroesophageal Reflux/prevention & control , Hydrogen-Ion Concentration , Manometry , Models, Animal , Reproducibility of Results , SwineABSTRACT
BACKGROUND AND AIMS: Endoscopic augmentation of the esophagogastric junction (EGJ) with polymethylmethacrylate (PMMA) has been reported in an experimental short-term study. We assessed whether endoscopic augmentation of the EGJ with PMMA is durable, safe, and efficacious after 6 months in mini-pigs. METHODS: Ten mini-pigs were studied under anesthesia. After a pilot study in two animals, eight mini-pigs underwent lower esophageal sphincter (LES) manometry and gastrostomy with measurement of gastric yield volume (GYV) and gastric yield pressure (GYP). Endoscopic implantation of PMMA was performed aiming for the submucosa of the EGJ. Six months later, LES manometry and GYV and GYP measurements were repeated and animals were sacrificed, followed by microscopic analyses of the EGJ. RESULTS: Out of 32 implants (four per animal), 29 (91%) were identified as submucosal nodules postmortem. PMMA deposits were found at microscopic analysis in all animals and located as follows [mean (range)]: submucosa 61.5% (37.5-91%), muscularis propria 21.5% (0-58%), mucosa 11% (0-25%), and subserosa 6% (0-17%). Neither esophageal perforation nor death was observed. A significant increase in GYV (1,404 versus 905 ml; p = 0.02) and a borderline increase in GYP (8.1 versus 6.5 mmHg; p = 0.057) were detected 6 months later. CONCLUSIONS: Endoscopic augmentation of the esophagogastric junction with PMMA was durable and had no complications after 6 months. However, the occurrence of implants in the subserosa requires technical refinement before use in clinical trials.
Subject(s)
Endoscopy, Gastrointestinal/methods , Esophagogastric Junction/surgery , Gastroesophageal Reflux/surgery , Plastic Surgery Procedures/methods , Polymethyl Methacrylate/pharmacology , Animals , Disease Models, Animal , Esophagoscopy/methods , Follow-Up Studies , Gastroscopy/methods , Manometry , Pilot Projects , Prosthesis Failure , Prosthesis Implantation , Swine , Swine, Miniature , Tensile Strength , Treatment OutcomeABSTRACT
Este artigo apresenta a descrição de um microcautério otológico com dispositivos de aspiração e descolamento para utilização em cirurgia otológica. O microcautério foi desenvolvido no Hospital de Clínicas de Porto Alegre, pelos setores de Engenharia Biomédica e Otorrinolaringologia
Subject(s)
Humans , Otologic Surgical Procedures/instrumentation , Cautery/instrumentation , Cautery/methodsABSTRACT
Objetivo: Descrever a avaliação em cirurgias do ouvido médio em seres humanos, do microcautério otológico Lavinsky/HCPA...
Subject(s)
Humans , Otologic Surgical Procedures/instrumentation , Cautery/instrumentation , Cautery/methods , Stapes Surgery , TympanoplastyABSTRACT
O equipamento de Biofeedback eletromiográfico utiliza circuitos eletrônicos para detetar e amplificar sinais biológicos associados às atividades musculares, fornecendo informações precisas sobre o estado de contração muscular do paciente e possibilitando que ele interaja no sentido de modificá-lo.
Abstract : The electromyographic Biofeedback detects and amplifies biological signals related to muscular activities using electronic circuits. It provides some information about the muscular aotivity of the patients helping them to modify wrong habits
Subject(s)
Electromyography/instrumentation , Muscle Contraction/radiation effects , Fractures, Stress , Cerebrovascular Disorders/therapy , Muscle Fatigue , Feedback , Electric Stimulation TherapyABSTRACT
O sistema proposto visa avaliar, qualitativa e quantitativamente, o comportamento de diferentes técnicas de síntese pós-osteotomia em metatarsos, mediante aplicação de esforços conhecidos em suas extremidades.
The equipment measures the deviation of the first metatarsal head as a result of forces applied through its plantar surface. Load displacement curves were obtained and the stiffness of severa! metatarsal osteotomy j!xation techniques were then compared
