Systemic hemodynamic changes in elderly hypertensive patients after ingesting foods with lipid, protein, and carbohydrate contents.

Aging is associated with changes in cardiovascular structure and function, which predisposes elderly people to reduced blood pressure levels after meals. The authors studied cardiac systolic function in elderly hypertensive patients after eating meals with different contents of lipids, proteins, and carbohydrates. Ten elderly male hypertensive patients were studied (mean age, 69 years; range 60-80 years). No patients had a previous history of orthostatic or postprandial hypotension. Patients ate 1 of 3 pre-prepared meals: lipid meal (LM), protein meal (PM), or carbohydrate meal (CM), on different days. Mean arterial pressure, total peripheral resistance index (TPRi), cardiac index (CI), and stroke index were recorded at the end of the fasting period and then at 5, 15, 30, 45, and 60 minutes after food ingestion. After ingestion of a CM, the CI increased from 2.30 +/- 0.21 L/ min /m(2) to 2.61 +/- 0.24 L/ min /m(2) and the TPRi decreased from 3212 +/- 226 dynes / sec(2) to 2793 +/- 255 dynes / sec(2) at 45 minutes (P<.05). After the LM, the CI increased from 2.15 +/- 0.15 to 2.84 +/- 0.27 L/ min /m(2) and the TPRi decreased from 3630 +/- 274 L/ min /m(2) to 2666 +/- 282 dynes / sec(2) at 45 minutes (P<.05). After the PM, no systemic hemodynamic changes were observed. When all 3 meals were compared, the highest values of CI and the lowest values of TPRi were observed for the LM and CM. The authors' results show that fat- and carbohydrate-rich foods cause changes in the systemic hemodynamic of the elderly hypertensive patients.

Pubovaginal sling with a low-cost polypropylene mesh.

OBJECTIVE: The aim of this study was to present the results of pubovaginal sling with a low-cost polypropylene mesh in the treatment of stress urinary incontinence. MATERIALS AND METHODS: 118 women diagnosed with stress urinary incontinence (SUI) due to urethral hypermobility or intrinsic sphincteric deficiency, treated with pubovaginal sling (PVS) with a low-cost polypropylene mesh confectioned by the surgeon, were analyzed. All patients had a basic evaluation that included a medical history, physical examination, stress tests and urodynamic investigation. RESULTS: The average follow up was of 42 months. Urethral hypermobility was observed in 67% of the cases. The process was carried out on an outpatient basis on 67 patients. Intra-operative complications included 4 vesical injuries, treated with catheterization for 3 days. There were 13 early complications, of which 8 were urinary retentions treated with vesical drainage for 1 to 3 weeks and 3 vaginal extrusions of the mesh treated with covering of the sections with mucous membrane. There was a need for 6 urethrolysis in patients who presented irritative and postoperative obstructive symptoms; 81.3% of the patients were considered cured, while 9.3% had significant improvement. Three initially unsuccessful cases required sling reconfiguration. All cases were eventually cured. CONCLUSION: The construction of a pubovaginal sling using a low-cost polypropylene mesh is a safe and effective technique for the relief of SUI. It should be considered an alternative, especially for patients in public health systems with low financial resources.

Pubovaginal sling with a low-cost polypropylene mesh

OBJECTIVE: The aim of this study was to present the results of pubovaginal sling with a low-cost polypropylene mesh in the treatment of stress urinary incontinence MATERIALS AND METHODS: 118 women diagnosed with stress urinary incontinence (SUI) due to urethral hypermobility or intrinsic sphincteric deficiency, treated with pubovaginal sling (PVS) with a low-cost polypropylene mesh confectioned by the surgeon, were analyzed. All patients had a basic evaluation that included a medical history, physical examination, stress tests and urodynamic investigation RESULTS: The average follow up was of 42 months. Urethral hypermobility was observed in 67 percent of the cases. The process was carried out on an outpatient basis on 67 patients. Intra-operative complications included 4 vesical injuries, treated with catheterization for 3 days. There were 13 early complications, of which 8 were urinary retentions treated with vesical drainage for 1 to 3 weeks and 3 vaginal extrusions of the mesh treated with covering of the sections with mucous membrane. There was a need for 6 urethrolysis in patients who presented irritative and postoperative obstructive symptoms; 81.3 percent of the patients were considered cured, while 9.3 percent had significant improvement. Three initially unsuccessful cases required sling reconfiguration. All cases were eventually cured CONCLUSION: The construction of a pubovaginal sling using a low-cost polypropylene mesh is a safe and effective technique for the relief of SUI. It should be considered an alternative, especially for patients in public health systems with low financial resources.