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Aim: To evaluate the effect of the Valsalva maneuver on ease of the endometrial sampling procedure in cases where the cervix cannot be passed spontaneously.
Methods: A randomized prospective trial was conducted in 84 patients whose cervix could not pass spontaneously with pipelle, and they were randomized for the Valsalva maneuver or tenaculum groups. In 43 of a total of 84 patients, we requested Valsalva maneuver throughout the process to pass the cervical canal, and in 41 patients, we performed tenaculum to pass the cervix.
Results: Valsalva and tenaculum groups did not differ in success rates (P = 0.314). There was no difference between the two groups in the history of the disease, past surgery and education (P > 0.05).
Conclusion: In endometrial sampling procedure with pipelle, when the cervix cannot be passed spontaneously, the transition with the Valsalva maneuver should be tried before using the tenaculum. Thus, a more painful procedure can be avoided and patient satisfaction may increase.
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http://dx.doi.org/10.1111/jog.14546 | DOI Listing |
Clin Auton Res
September 2025
Faculty of Medicine, Department of Medicine, Ageing and Age-Associated Disorders Research Group, Division of Geriatric Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
Background: Orthostatic hypotension (OH) is prevalent in older adults and is often associated with falls. However, the presence or absence of symptoms in OH may be mediated by cerebral autoregulation, which helps maintain cerebral perfusion during blood pressure fluctuations.
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N Engl J Med
August 2025
Massachusetts General Hospital, Harvard Medical School, Boston.
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August 2025
Nephrology Division, Universidade Federal de São Paulo, São Paulo, Brazil.
Background: Autosomal Dominant Polycystic Kidney Disease (ADPKD) is the most common monogenic kidney disease, leading to progressive renal function loss. Systemic arterial hypertension is a frequent early onset extrarenal manifestation with an incompletely understood pathogenesis. Therefore, this study investigated cardiovascular autonomic control at rest and during physiological sympathetic stimulation, along with humoral and urinary molecules involved in blood pressure (BP) regulation, in young ADPKD patients before hypertension and renal dysfunction onset.
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January 2025
Division of Cardiology, Department of Internal Medicine, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.
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Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou City, China.
Background: Hypertrophic obstructive cardiomyopathy (HOCM) is a hereditary myocardial disease. Percutaneous endocardial septal radiofrequency ablation (PESA) is an innovative approach for treating HOCM. Consequently, we present the outcomes of the PESA for HOCM.
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