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Concept: Valsalva maneuver


Venipuncture is one of the most painful events for children in hospitals. Valsalva maneuver (VM) decreases the incidence and severity of pain on venipuncture pain in adults. This study was designed to evaluate VM as compared with Eutectic Mixture of Local Anesthetic (EMLA(®)) cream for venipuncture pain in children.

Concepts: Neurology, Anesthesia, Local anesthesia, Pain, Local anesthetic, Valsalva maneuver, Virtual machine


During neuronal activation, neurovascular coupling leads to a local decrease of deoxygenated hemoglobin concentration (deoxy-Hb) and thus forms the basis of many functional brain mapping methods. In animals, an elevated intracranial pressure (ICP) can attenuate or even reverse this deoxy-Hb signaling. To study the effect of an elevated ICP on functional brain imaging in humans, we used different breathing tasks to modify ICP and analyzed the resulting effect on neurovascular coupling in the motor cortex. Functional near-infrared spectroscopy (fNIRS) was performed on 45 subjects during alternating conditions of finger tapping and resting state combined with four different breathing maneuvers (normal breathing (NB), breath holding without Valsalva maneuver (BH), Valsalva maneuver with 15 mm Hg forced expiratory pressure against resistance (V15) and Valsalva maneuver with 35 mm Hg forced expiratory pressure against resistance (V35)) in randomized order. With escalation of breathing tasks the median amplitude of the functional deoxy-Hb decrease during finger tapping became smaller. In contrast, functional oxygenated hemoglobin concentration (oxy-Hb) and total hemoglobin concentration (total-Hb) responses did not show a significant alteration. The functional oxy-Hb map evoked by finger tapping withstood Valsalva challenges while the functional deoxy-Hb map identified the correct motor cortex in normal breathing conditions only and did not reveal a functional contrast during Valsalva maneuvers. In summary, we conclude that during ICP elevation, deoxy-Hb is not a reliable basis for functional brain imaging. This suggests that the validity of BOLD fMRI during increased ICP might be impaired.

Concepts: Oxygen, Brain, Intracranial pressure, Neuroimaging, Functional magnetic resonance imaging, Breathing, Valsalva maneuver, Brain mapping


To investigate the influence of the Valsalva maneuver (VM) on anterior lamina cribrosa surface depth (ALCSD), and to compare normal with treated glaucomatous eyes in terms of this effect.

Concepts: Comparison, Eye, Comparisons, Valsalva maneuver


Hiatal hernia (HH) can cause left atrial (LA) compression and impair LA filling. We evaluated the cardiac effects of preload reduction and abdominal strain induced by Valsalva maneuver (VM) in large HH patients.

Concepts: Heart, Valsalva maneuver


The aims of this prospective experimental study were to explore the influence of the Valsalva manoeuvre (VM) on retinal venous pressure (RVP) in human volunteers in a university setting and to establish correlations for RVP with the increase in airway pressure (∆AirP) and in intraocular pressure (∆IOP).

Concepts: Blood pressure, Intraocular pressure, Underwater diving, Valsalva maneuver


Eustachian tube dysfunction has been associated with most cases of middle-ear disease. We aimed to assess the effectiveness of dynamic slow motion video endoscopy (DSVE) as a test of eustachian tube dysfunction. Furthermore, we assessed the correlation of the test with the Valsalva maneuver, the seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7), and intraoperative findings of the eustachian tube.

Concepts: Middle ear, Eustachian tube, Otitis media, Ear, Pseudoephedrine, Patulous Eustachian tube, Valsalva maneuver, Ear clearing


To evaluate the effect of the Valsalva maneuver (VM) on anterior segment parameters and its association with refractive status.

Concepts: Valsalva maneuver, Virtual machine


To investigate the effects of Valsalva maneuver (VM) on retrobulbar blood flow parameters in healthy subjects.

Concepts: Hematology, Doppler effect, Valsalva maneuver


To determine if the anterior choroid is involved in ocular change during the Valsalva manoeuvre (VM).

Concepts: Change, Valsalva maneuver


Pneumatocele of the lacrimal sac is an uncommon entity and has been rarely reported in literature. The valvular function of the Hasner’s valve at the lower end of nasolacrimal duct is presumed to prevent the retrograde reflux of air into the lacrimal sac with increased intranasal pressure as in valsalva maneuver. Loss of this valvular function as noted with persistent positive airway pressure ventilation can cause retrograde air reflux into lacrimal sac. The authors report a case of lacrimal sac pneumatocele which developed following blunt nasal trauma involving the bony nasolacrimal duct.

Concepts: HVAC, Valve, Lacrimal sac, Lacrimal apparatus, Nasolacrimal duct, Nasolacrimal canal, Underwater diving, Valsalva maneuver