Biomedical subjects

Priya Padmanabhan

Publications and source records attributed to Priya Padmanabhan.

4 recordsLinked to original sources

PubMed2006

Penile oxygen saturation in the flaccid and erect penis in men with and without erectile dysfunction.

It is believed that a chronic state of corporal oxygen desaturation or hypoxemia secondary to the loss of nocturnal erections is a fundamental pathophysiological cause of erectile dysfunction (ED). Limited invasive blood gas measurements in human models have shown decreased oxygen tension in vasculogenic impotence. Normative data on flaccid and erect oxygen saturation (StO(2)) levels are lacking due to the invasive nature of blood gas determinations. Our objective was to determine StO(2) in the flaccid and erect penis in men with and without ED using a tissue oximeter. This FDA-approved instrument provides instantaneous, noninvasive, painless local tissue StO(2) measurements, which highly correlate to blood gas data. The study population included 171 men (18-90 years) who presented to one andrologist. They completed the Sexual Health Inventory for Men (SHIM) based on pharmacologically unassisted erectile function and had penile StO(2) measurements taken. 64 of these men had repeat measurements after PGE-1 induced erections. There are significant differences (P<.001) in corporal and glanular StO(2) in the flaccid (right corpora, 45.23%; left corpora, 52.50%) and erect state (right corpora, 76.58; left corpora, 80.42). Men with ED (right corpora, 45.04% vs 53.58%; P=.02; and left corpora, 50.95% vs 58.78%; P=.03) have significantly lower corporal penile StO(2). Future prospective data collection can correlate penile StO(2) in specific populations, such as diabetics and RRP patients. This may help further elucidate the relationship between corporal hypoxia and the development and progression of ED and possibly its treatment and prevention.

Adolescent↗

PubMed2006

Female stress urinary incontinence: how do patient and physician perspectives correlate in assessment of outcomes?

PURPOSE OF REVIEW: This article discusses outcome assessment following surgery for incontinence, by correlating patient perspectives with that of the physician. RECENT FINDINGS: A review of the literature demonstrates a large variance in the 'success rates' published for different stress urinary incontinence procedures. We review the elements essential in formation of a universal and valid incontinence questionnaire. Studies have attempted to correlate common clinical measures (voiding diaries, pad testing, urodynamics) with quality-of-life questionnaires. Sentinel articles in incontinence outcome assessment are discussed. Studies with critical measures of outcome are examined using the recommendations made by the Female Stress Urinary Incontinence Guidelines Panel summary report. Through presentation of our data on tension-free vaginal tape procedures, we give insight into the future of stress urinary incontinence research and outcomes. SUMMARY: Early 'cure rates' were severely limited by their retrospective nature and focus on chart review and physician assessment. Symptom and quality-of-life questionnaires provide subjective outcome assessments. No direct correlation exists between universally accepted objective and subjective measures of improvement. Recent studies are getting closer to the female stress urinary incontinence guidelines. Yet, the pursuit for a universal definition of success continues, in order to bridge patient and physician perspectives on cure.

Female↗

PubMed2005

Patient perception of videourodynamic testing: a questionnaire based study.

PURPOSE: We determined the degree of anxiety, embarrassment and discomfort anticipated by patients before undergoing videourodynamics and compared the results to the actual degrees experienced by patients. In addition, we compared these variables between men and women, and younger and older patients. MATERIALS AND METHODS: All patients undergoing urodynamics for the first time were given a 2 part questionnaire. Patients with neurological disease or those requiring an indwelling or intermittent catheter were excluded. Part 1 given immediately prior to the test contained 5 questions regarding expected anxiety, pain, embarrassment, apprehension regarding x-ray exposure and preparedness. Part 2 given immediately after testing contained 5 questions comparing anticipated to actual overall experience, pain and embarrassment, preparation and whether the patient would undergo testing again. Each question had a 5 point scale. RESULTS: A total of 78 men and 88 women respondents completed the questionnaires. Most (greater than 95% per question) expected no to moderate anxiety, pain, embarrassment and apprehension. This did not vary with age, although more women anticipated greater embarrassment and more men expected little or no embarrassment (p <0.001). After testing most respondents (greater than 90% per question) thought that the test was the same or better than expected and it was associated with an expected or less than expected level of pain and embarrassment. This did not vary between the sexes but more younger individuals found that the test experience was worse than expected, while more older individuals found that it was better than expected. Of the patients 95% would undergo urodynamic testing again if medically indicated. CONCLUSIONS: Videourodynamics is well tolerated and is associated with only minimal to moderate degrees of anxiety, discomfort and embarrassment. A suspected lack of tolerance should not be a barrier to performing medically indicated urodynamic testing.

Adult↗

PubMed2004

Impact of fusion of indium-111 capromab pendetide volume data sets with those from MRI or CT in patients with recurrent prostate cancer.

OBJECTIVE: Our goal was to evaluate the impact of image fusion on the interpretation of indium-111 Prosta-Scint SPECT scans. MATERIALS AND METHODS: Sixty-seven consecutive patients referred for rising prostate-specific antigen (PSA) levels after initial therapy for primary prostate cancer underwent SPECT 96 hr after infusion of (111)In Prosta-Scint, with simultaneous technetium-99m blood pool imaging. Volume data sets from the SPECT scans were then fused with those from CT and MR images of the pelvis using a 3D landmark-based warping program. The SPECT scans were initially interpreted without benefit of MRI or CT fusion. The fused Prosta-Scint MRI-CT volumes were reevaluated by a nuclear radiologist and an MRI radiologist. Independent reviews before and after fusion were available in these patients. Validation of results after fusion was performed through correlation with PSA changes after radiation therapy. RESULTS: Six patients with sites that could not be evaluated and three without their original Prosta-Scint scanning reports were excluded; thus, 58 patients were studied clinically. Seventy-four of 161 prefusion-positive sites were found to be negative after fusion. These 74 sites subsequently were identified primarily as showing bowel, vessel, or marrow uptake after fusion. In two patients, nodal disease was identified although the review before perfusion indicated none. Twenty-five patients previously thought to have nodal disease appeared to have only local disease after fusion. After local radiation therapy, PSA levels decreased in 12 of 25 patients, increased in five, and were unavailable in eight. CONCLUSION: Although Prosta-Scint SPECT alone can help in the proper management of recurrent prostate cancer, fusion with MRI-CT of the pelvis can improve the specificity of the examination.

Aged↗