Normal Values and Associated Factors in High-resolution Anorectal Manometry in Healthy Vietnamese Adults

Introduction The present study aims to identify normal high-resolution anorectal manometry (HRAM) values and related factors in healthy Vietnamese adults. Methods The present cross-sectional study was conducted at the Viet Duc hospital, Hanoi, Vietnam, during April and May 2019. Healthy volunteers were recruited to participate in the study. Anorectal measurement values from the digestive tract, including pressure, were recorded. Results A total of 76 healthy volunteers were recruited. The mean functional anal canal length was 4.2 ± 0.5 cm, while the mean anal high-pressure zone length was 3.4 ± 0.5 cm. The mean defecation index was 1.4 ± 0.8, with values ranging from 0.3 to 5.0. The mean threshold volume to elicit the rectoanal inhibitory reflex (RAIR) was 18.1 mL. The mean rectal sensation values were 32.4 mL, 81.6 mL, and 159 mL for first sensation, desire to defecate, and urge to defecate, respectively. Dyssynergic patterns occurred in ∼ 50% of the study participants and included mainly types I (27.6%) and III (14.6%). There were significant differences between male and female patients in terms of maximum anal squeeze pressure, maximum anal cough pressure, maximum anal strain pressure, maximum rectal cough pressure, and maximum rectal strain pressure (all p < 0.01). Conclusions The present study establishes normal HRAM values in healthy Vietnamese adults, particularly regarding normal values of anorectal pressure and rectal sensation. Further studies that include larger sample sizes should be conducted to further confirm the constants and their relationships.

Normal values and associated factors in high-resolution anorectal manometry in healthy Vietnamese adults

Background This study aims to identify normal HRAM values and related factors in healthy Vietnamese adults. Methods This cross-sectional study was conducted at Viet Duc hospital, Hanoi, Vietnam, during April and May, 2019. Healthy volunteers were recruited to participate in the study. Anorectal measurement values including pressure and an electromyographical signal from the digestive tract were recorded. Differences between groups were analyzed using paired t-tests, and linear regression models was used to compare anorectal values between men and women. Results A total of the 76 healthy volunteers was recruited. The mean functional anal canal length was 4.2 ± 0.5 cm while the mean anal high-pressure zone (HPZ) length was 3.4 ± 0.5 cm. The mean defecation index was 1.4 ± 0.8, with values ranging from 0.3 to 5.0. The mean threshold volume to elicit RAIR was 18.1 mL. Mean rectal sensation values were 32.4 mL, 81.6 mL, and 159 mL at the first sensation, the desire to defecate, and the urge to defecate, respectively. Dyssynergic patterns occurred in approximately 50% of study participants and included mainly types I (27.6%) and III (14.6%). There were significant differences between males and females in maximum anal squeeze pressure, maximum anal cough pressure, maximum anal strain pressure, maximum rectal cough pressure, and maximum rectal strain pressure (all p < 0.01). Conclusions This study establishes normal HRAM values in healthy Vietnamese adults, particularly with regards to normal values of anorectal pressure and rectal sensation. Further studies that include larger sample sizes should be conducted in order to further confirm the constants and their relationships.

Measurement of Cough Aerodynamics in Healthy Adults

Importance: Cough is a critical human reflex and also among the most frequent symptoms in medicine. Despite the prevalence of disordered cough in laryngeal pathologies, comprehensive and quantitative evaluation of cough in these patients is lacking. Objective: Herein we seek to establish normative values for cough aerodynamics to provide a population standard for reference in future studies. Design, Setting, and Participants: Healthy subjects were recruited from an outpatient clinic to perform voluntary cough. Subjects were instructed on the technique for maximal voluntary cough production with measurements recorded on pneumotachograph. Fifty-two subjects were studied, including 29 women and 23 men with a mean age of 51.6 and 52.3 years, respectively. Main Outcomes and Measures: Cough peak airflow, peak pressure, and expiratory rise time. Results were stratified by age, gender, and height. Results: Peak airflow demonstrated significant differences across age, gender, and height, with flow increasing according to increasing height. Peak cough pressure also increased with height and was significantly greater in males versus females. Expiratory rise time, the time from glottal opening to peak airflow, did not vary with age or height but was statistically significantly longer in women. Conclusions: Cough aerodynamics can be readily measured objectively in the outpatient setting. Expiratory rise time, peak flow, and peak pressure are important aspects of each cough epoch. Normative data provided herein can be used for future studies of patients with laryngotracheal disorders, and these cough parameters may prove to be simple, accessible, and repeatable outcome measures.