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Titolo:
Continuous negative abdominal pressure device to treat pseudotumor cerebri
Autore:
Sugerman, HJ; Felton, WL; Sismanis, A; Saggi, BH; Doty, JM; Blocher, C; Marmarou, A; Makhoul, RG;
Indirizzi:
Virginia Commonwealth Univ, Med Coll Virginia, Dept Surg, Richmond, VA 23298 USA Virginia Commonwealth Univ Richmond VA USA 23298 , Richmond, VA 23298 USA Virginia Commonwealth Univ, Med Coll Virginia, Dept Oral Maxillofacial Surg, Richmond, VA 23298 USA Virginia Commonwealth Univ Richmond VA USA 23298, Richmond, VA 23298 USA
Titolo Testata:
INTERNATIONAL JOURNAL OF OBESITY
fascicolo: 4, volume: 25, anno: 2001,
pagine: 486 - 490
SICI:
0307-0565(200104)25:4<486:CNAPDT>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
INDUCED WEIGHT-LOSS; INTRACRANIAL HYPERTENSION; INTRAABDOMINAL PRESSURE; OBESITY; MECHANISM;
Keywords:
abdominal pressure; negative pressure device; pulsatile tinnitus; headache;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
15
Recensione:
Indirizzi per estratti:
Indirizzo: Sugerman, HJ Box 980519, Richmond, VA 23298 USA Box 980519 Richmond VA USA 23298 519, Richmond, VA 23298 USA
Citazione:
H.J. Sugerman et al., "Continuous negative abdominal pressure device to treat pseudotumor cerebri", INT J OBES, 25(4), 2001, pp. 486-490

Abstract

OBJECTIVE: To study the effects of an externally applied negative abdominal pressure device designed to lower the effects of intra-abdominal pressure(IAP) on headaches and pulsatile tinnitus in severely obese women with pseudotumor cerebri (PTC). DESIGN: Short-term clinical intervention trial in the Clinical Research Center. Days 1 and 3 were 'control' days; on days 2 and 4-6 patients were in the device from 8:00 am to noon and from 1:00 to 5:00 pm, and on nights 7-11 they were in the device from 10:00 pm to 8:00 am. The last four patients were treated in a device with a counter-traction mechanism. SUBJECTS: Seven centrally obese women with PTC. MEASUREMENTS: Headache and pulsatile tinnitus severity were graded by the patient using visual analog scale (1-10) and averaged for the time that thedevice was in use or not in use. IAP was estimated from urinary bladder pressure (UBP) before and during device use. The internal jugular vein (IJV) elliptical cross-sectional area was measured with B-mode ultrasonography; the timed average velocity was measured by Doppler. RESULTS: There was a decrease in both headache (6.8 +/- 0.8 to 4.2 +/- 0.8, P < 0.05) and pulsatile tinnitus (4.2 <plus/minus> 0.5 to 1.8 +/- 0.5, P < 0.02) within 5 min, and in headache (to 2.2 <plus/minus> 0.8, P < 0.01) and tinnitus (to 1.7 <plus/minus> 0.5, P < 0.01) within 1 h of device activation. UBP decreased (P < 0.001) from 19.1 +/- 3 to 12.5 +/- 2.8 cmH(2)O. Headache remained improved throughout time that the device was used. During the second week, five of seven patients slept in the device without difficulty and four awoke without headache. There was a progressive decrease (P < 0.01) in headache during the day after sleeping in the device at night as compared with days 1 and 3 when it was not used (6.5 <plus/minus> 0.5, day 1;4.1 +/- 0.7, day 3; 3.1 +/- 0.8, day 8; 2.3 +/-0.8, day 10). Headaches returned late in the afternoon in two patients; the device was reactivated andheadache again improved. Five patients underwent IJV sonography; the IJV area decreased (129 +/- 53 to 100 +/- 44 mm(2), P = 0.06) without a change in IJV flow (1004 +/- 802 to 1000 +/- 589 ml/min) with the device. When activated, the device was pulled into the patient, creating discomfort that wasalleviated with the counter-traction mechanism in the last four patients. One patient developed a 5 cm area of blisters that resolved when the devicewas worn over a hospital gown. CONCLUSIONS: Decreasing IAP relieved headaches and pulsatile tinnitus in PTC. When patients slept in the device, they awoke without headache or tinnitus, which remained markedly improved throughout most of the following day. This study supports the hypothesis that PTC in obese women is secondary toan increased IAP.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/12/20 alle ore 09:35:53