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PubMed1996

Exogenous stimuli and circadian peak expiratory flow variation in allergic asthmatic children.

The influence of exogenous factors in the home on the circadian variation of airway obstruction has not been fully assessed in children with asthma. The aim of the present study was to investigate the contribution of exogenous stimuli to the degree of peak expiratory flow (PEF) variability during 24 h. Fifty-five children (33 boys and 22 girls; mean age, 9.3 +/- 1.7 yr) with symptoms of asthma, increased bronchial responsiveness, and a solitary allergy to house dust mite (HDM) participated. Their asthma symptoms were well-controlled for at least 4 mo with daily inhaled corticosteroids (ICS) and beta 2-adrenergic drugs if needed. Symptoms, peripheral blood eosinophils, total IgE, and specific IgE to HDM were assessed. Spirometry and PC20 histamine were performed. PEF amplitudes during 24 h (highest minus lowest as a percentage of the day's mean value) were obtained at home during and 6 d after withdrawal of ICS. Dust samples were collected from the total area of the living rooms, bedrooms, mattresses (n = 25), and classrooms to obtain the HDM allergen (HDMA) exposure to Der p I and Der p II. Family smoking habits, presence of pets, and types of floor-covering were recorded on a checklist. Mean PEF amplitude did not increase after withdrawal of ICS, but absolute PEF values were significantly lower (p = 0.05) at midnight and 4:00 A.M. Twenty-six children (47%) were exposed to environmental tobacco smoke (ETS), and 23 (42%) kept pets. Mattresses contained significantly higher amounts of HDMA compared with other locations. PEF amplitude after withdrawal of ICS was significantly higher in children exposed to ETS, a pet, or a high HDMA level in their mattress than in children who were not exposed (ETS: 29.7% [3.9 to 56.6] versus 19.4% [0.0 to 56.6], p < 0.05; pets: 31.4% [9.7 to 52.5] versus 21.9% [0.0 to 56.6], p < 0.05; high HDMA level in the mattress: 35.5% [10.2 to 56.6] versus 21.4% [3.9 to 56.6], p < 0.05). These factors combined with age and PC20 histamine and its interaction with ETS, especially in mild to moderate asthma, explained 48.4% of the variance of the PEF amplitude after withdrawal of ICS. Exogenous stimuli such as exposure to ETS, pets, and high HDMA levels in mattresses contribute to an increased circadian PEF amplitude after withdrawal of ICS and therefore to nocturnal worsening of asthma in HDM-allergic asthmatic children. Moreover, ETS exposure seems to especially worsen PEF variability in children with mild to moderately severe bronchial responsiveness.

Age Factors↗

PubMedDate not supplied

Introducing the pressure support surfaces from Kaymed.

The range of support surfaces available is quite varied. It is important that both the purchaser and the users are satisfied with the quality, comfort and the pressure-reducing properties of the mattress. The mattress needs to be versatile, in that it can be used both in a patient's home or in a hospital or nursing home and also on profiling beds. The Kaymed range of mattresses offers increased comfort with low interface pressures for patients up to and including high risk. This product focus examines the Kaymed mattress and looks at the design and results of tests performed on the visco-elastic foam used in the manufacturing of the mattresses.

Beds↗

PubMed2003

Pressure-relieving properties of a intra-operative warming device.

OBJECTIVES: The primary objective of this study was to determine differences in interface pressure between four mattress combinations: a standard operating table mattress, a pressure-relieving gel pad and an under-patient warming device set at 38 degrees C (Pegasus Inditherm System) and at ambient temperature. The secondary objective was to determine whether the warming device remains stable in extreme surgical positions. METHOD: Interface pressures obtained with all four combinations were measured in 10 healthy volunteers using force sensing array technology. RESULTS: The warming device demonstrated better or equivalent pressure relief when compared with the standard gel pad. There was no significant difference in subject position 'shift' between the mattress, the gel pad and the warming device for either the Trendelenberg or reverse Trendelenberg positions. CONCLUSION: Both pressure-relieving mattresses and warming reduce intra-operative pressure damage. A mattress with both properties may further reduce pressure damage postoperatively. The warming device used in this study appears stable--subject 'slippage' was minimal in extreme positions. Research needs to be conducted among real anaesthetised patients to support these conclusions.

Adult↗

PubMed2000

A bacteriological study of hospital beds before and after disinfection with phenolic disinfectant.

In hospitals, one of the ways to control microbial contamination is by disinfecting the furniture used by patients. This study's main objective was to evaluate the microbiological condition of hospital mattresses before and after such disinfection, in order to identify bacteria that are epidemiologically important in nosocomial infection, such as Staphylococcus aureus and Pseudomonas aeruginosa. RODAC plates with two different culture media were used to collect specimens. Patient beds were selected according to previously established criteria, and surface areas on the mattresses were chosen at random. From the total of 1,040 plate cultures from 52 mattresses, positive results were obtained from 500 of them (48.1%), 263 before disinfection and 237 after disinfection. Considering the selectivity of the culture media, the positivity rate was high. There were high prevalences of S. aureus both before and after mattress disinfection. The study results suggest that the usual disinfection procedures, instead of diminishing the number of microbes, merely displace them from one part of the mattress to another, and the number of microorganisms remains the same.

Bacteria↗

PubMed2004

Use of impact testing to predict softness, cow preference, and hardening over time of stall bases.

The objective of this study was to assess the softness and durability of commercially available free-stall bases, and to determine the relationship of stall base softness to cow preference. Clegg impact values were recorded at the University of Wisconsin-Madison Arlington Agricultural Research Station on June 19, 2002, and again on July 24, 2003. The Clegg Impact Soil Tester (model 95051, Lafayette Instruments, Lafayette, IN) with a 20-kg hammer was used in this study. The impact of the hammer on the free-stall base results in a digital display based on peak deceleration of the hammer's impact with the free-stall base in tens of gravities (CIV/H). The CIV/H value, as measured by the Clegg Impact hammer, is based on peak deceleration of the 20-kg hammer's impact with the surface, from a height of 30 cm. Clegg impact measures were highly correlated with cow preference measurements. This relationship suggests that Clegg impact measures of compressibility were good indicators for predicting stall-base acceptance. A cork mattress, 4 foam mattresses, 4 rubber mattresses, 4 rubber mats, and a waterbed were evaluated in this study. Foam-based mattresses lost cushioning ability faster than rubber mattresses or rubber mats. Clegg impact values increased over the 13-mo time period for most stall base types, which indicated a tendency of stall bases to harden.

Animals↗

PubMed2004

House dust mite allergen levels in Chiang Mai homes.

The quantitative assays for house dust mite (HDM) allergens provide a valid index of exposure and can be used for risk evaluation. We assessed group I HDM allergen levels in mattress and living room floor dust from 35 Chiang Mai homes and identified factors associated with high allergen levels. One-third of mattress and living room floor dust had group I HDM allergen levels of between 2-10 microg/g. Two-thirds of mattress dust and a small amount of living room floor dust had group I HDM allergen levels of over 10 microg/g. The geometric means of Der p I, Der f I and total group I allergens in mattress and living room floor dust were 8.61, 2.88, and 15.81 microg/g and 1.61, 0.27 and 2.43 microg/g, respectively. Mattresses made of kapok and rugs kept in the living room were associated with high group I allergen levels.

Allergens↗

PubMed2005

Reducing pressure ulcer incidence in a long-term setting.

Selection of appropriate pressure prevention equipment relies on risk assessment and clinical assessment of the resident/patient. Decisions are then made in combination with manufacturer's recommendations, such as interface pressure testing. However, risk assessments can over-predict and laboratory investigations do not necessarily provide an accurate picture of how individual patients will react to pressures from support surfaces. There are few studies on visco-elastic mattresses and their benefits in reducing pressure ulcer incidence. Therefore, a small study was undertaken to review the efficacy of a pressure-reducing visco-elastic foam mattress. For the benefit of the study, a 20-bedded nursing home was provided with 20 visco-elastic mattresses (Pressurease) and 20 pressure-reducing cushions (Mediform Visco). The study aimed to demonstrate a reduction in pressure ulcer prevalence. The study involved 21 residents over a 6-month period. There was a 53.8% prevalence (of Stirling grade 1-2 pressure damage) at trial initiation. The results showed an 85.7% decrease of pressure ulcers within 4 weeks, and an overall decrease of 82.5% over the 6-month period. Comfort levels, scored by residents on a visual analogue scale, demonstrated the Pressurease mattress to be superior to the nursing home standard mattress.

Journal Article↗

PubMedDate not supplied

Reducing pressure ulcer incidence in a long-term setting.

Selection of appropriate pressure prevention equipment relies on risk assessment and clinical assessment of the resident/patient. Decisions are then made in combination with manufacturer's recommendations, such as interface pressure testing. However, risk assessments can over-predict and laboratory investigations do not necessarily provide an accurate picture of how individual patients will react to pressures from support services. There are few studies on visco-elastic mattresses and their benefits in reducing pressure ulcer incidence. Therefore, a small study was undertaken to review the efficacy of a pressure-reducing visco-elastic foam mattress. For the benefit of the study, a 20-bedded nursing home was provided with 20 visco-elastic mattresses (Pressurease) and 20 pressure-reducing cushions (Mediform Visco). The study aimed to demonstrate a reduction in pressure ulcer prevalence. The study involved 21 residents over a 6-month period. There was a 58.3% prevalence (of Stirling grade 1-2 pressure damage) at trial initiation. The results showed an 85.7% decrease of pressure ulcers within 4 weeks, and an overall decrease of 82.5% over the 6-month period. Comfort levels, scored by residents on a visual analogue scale, demonstrated the Pressurease mattress to be superior to the nursing home standard mattress.

Aged↗

PubMed1992

[Revision consensus prevention and treatment decubitus].

The text of the Consensus Meetings Prevention and Treatment of Decubitus (pressure sores; 1985 and 1986 respectively) was adapted to current insights into pathogenesis and treatment. This adaptation was important since the costs of the prevention and treatment of decubitus are enormous and decubitus tends to occur more often since the population is growing older. The so called anti-decubitus devices were grouped in 3 categories: 1. polyether foam mattresses, placed on top of the standard hospital mattresses (merely in prevention and in treatment of patients less than 85 kg), 2. polyether foam mattresses with or without special surface layout or simple alternating pressure air mattresses, replacing the standard hospital mattress (especially in patients greater than 85 kg) and 3. special beds and bed systems as low-air-loss beds and air-fluidized beds (only on strict indications such as thoracic operations and intensive treatments). The clinical manifestations of decubitus were classified in 4 stages: non-blanching erythema (1), blister (2), superficial decubitus (3) and deep decubitus (4). The existence of another form of pressure sores was identified: decubitus originating from operation or angiography tables, on which a deep necrosis develops, extending to form an abscess, erupting through the skin after 7-14 days. These ulcers are characterised by an impressive depth, usually to the underlying bones, but with vivid edges. The development of these sores is prevented in most cases by using a category 1 device on the tables mentioned.(ABSTRACT TRUNCATED AT 250 WORDS)

Bedding and Linens↗

PubMed1985

Mechanical properties of three orthopedic wire configurations.

An 18-gauge stainless steel wire was applied to a transverse fracture model to determine the antirotational effectiveness of cruciate, horizontal mattress, and simple interrupted interfragmentary wire configurations. The number of twists used to tighten the configuration and the distance from the fracture were compared in the cruciate and horizontal mattress patterns. In a 2nd experiment, the compressive forces generated at the fracture by cruciate and horizontal mattress configurations tightened with 1 and 2 twists were determined. The cruciate configuration was better than the horizontal mattress and simple interrupted configurations in preventing rotation (P less than 0.001). Increasing the distance from the fracture line to the wire holes decreased antirotational effectiveness. Tightening the cruciate and horizontal mattress configurations with 2 twists produced significantly greater compressions across the fracture line than did tightening with 1 twist (P less than 0.0001).

Animals↗

PubMedDate not supplied

Sequential determinations of Dermatophagoides spp. allergens in a tropical city.

The purpose of this study was to establish seasonal levels of Der p 1, Der f 1 and D. pteronyssinus allergens in mattress and floor dust samples in the homes of 20 mite-allergic asthmatic patients in Cartagena, Colombia. Dust samples were collected using a portable vacuum cleaner once monthly for the same 12 months in all houses. The highest Der p 1 levels in mattress samples were detected in August (geometric mean = 109.49 ng/g) and represented a 2.2-times increase from the lowest level observed in November. Der f 1 was detected in only 3 mattresses, ranging from 90 ng to 1.6 micrograms per gram of dust. The highest levels were detected in February and March. The highest level of D. pteronyssinus allergens in mattress dust samples, quantitated by RAST-inhibition, was 8, 994 AU/g (80% inhibition); the lowest level detected was 150 AU/g (5% inhibition). Allergen levels were significantly higher in mattresses than in floor samples (p < 0.001). Overall, a Spearman rank correlation coefficient of 0.48, p < 0.001, was obtained between Der p 1 and D. pteronyssinus allergens. There was a good correlation between mite allergens and absolute humidity (r = 0.8, p = 0.007). Der p 1, Der f 1 and D. pteronyssinus allergen levels show minimal variations in this tropical environment. Allergens derived from various mite species must be considered when assessing mite allergen exposure in these environments.

Allergens↗

PubMed1996

Comparison of anastomotic suturing techniques in the rat trachea.

BACKGROUND: Tracheal resection is the preferred treatment for primary tracheal tumors. Anastomotic tension can be a problem, even when various tension-relieving release maneuvers are employed. Excessive tension can cause anastomotic sutures to pull through the tracheal tissue, with resultant early tracheal anastomotic dehiscence. To test the hypothesis that interrupted horizontal mattress sutures would withstand the forces of tension better than interrupted simple sutures, an experimental study of rat tracheal anastomoses was done. METHODS: Twenty rats were killed and their tracheas excised. The tracheas were divided in the mid portion and end to end anastomoses were done using interrupted 7-0 polypropylene sutures. Ten tracheas had anastomoses done with interrupted simple sutures, and 10 had interrupted horizontal mattress suturing. RESULTS: Anastomotic breaking strength was 2.30 +/- 0.57 N for the interrupted simple sutured anastomoses and 2.15 +/- 0.48 N for the interrupted horizontal mattress group (P = 0.54). The difference was not significant. CONCLUSIONS: In this animal study, interrupted simple and horizontal mattress suturing withstood the disruptive forces of anastomotic tension equally well.

Anastomosis, Surgical↗

PubMed2000

Kinesthetic stimulation for preventing apnea in preterm infants.

BACKGROUND: Recurrent apnea is common in preterm infants, particularly at very early gestational ages. These episodes of loss of effective breathing can lead to hypoxemia and bradycardia, which may be severe enough to require resuscitation including use of positive pressure ventilation or other treatments. Physical stimulation is often used to restart breathing and it is possible that repeated stimulation, such as with an oscillating mattress (kinesthetic stimulation), might prevent apnea and its consequences. OBJECTIVES: In preterm infants at risk for apnea, does prophylactic use of kinesthetic stimulation lead to a clinically important reduction in apnea and bradycardia, and use of intemittent positive preswsure ventilation (IPPV). SEARCH STRATEGY: The standard search strategy of the Neonatal Review Group was used. This included searches of the Oxford Database of Perinatal trials, Cochrane Controlled Trials Register, MEDLINE, previous reviews including cross references, abstracts, conferences and symposia proceedings, expert informants, journal handsearching mainly in the English language. SELECTION CRITERIA: All trials in preterm infants at risk of developing clinical apnea which utilised random or quasi-random allocation to treatment with an oscillating mattress or control, were eligible. DATA COLLECTION AND ANALYSIS: Standard methods of the Cochrane Collaboration and its Neonatal Review Group were used with separate evaluation of trial quality and data extraction by each author and synthesis of the data using relative risk. MAIN RESULTS: There were no differences in short term effects (apnea /bradycardia, IVH, use of IPPV, sleep/wake cycles and neurological status at discharge) or longterm effects (in one trial - growth and development to one year). REVIEWER'S CONCLUSIONS: Implications for practice. Prophylactic use of kinesthetic stimulation cannot be recommended to reduce apnea/bradycardia in preterm infants. Implications for research. There are currently no clear research questions regarding prophylactic use of kinesthetic stimulation to prevent apnea in preterm infants.

Apnea↗

PubMed1997

Strength of different meniscus suturing techniques.

We measured and compared the primary stabilities of five different meniscal suturing techniques. The techniques tested were horizontal mattress, vertical mattress, knot-end, vertical, and vertical loop. Twenty bovine medial menisci were cut to simulate peripheral longitudinal tears and repaired with one of the five suture techniques. Then the two parts of the meniscus were pulled using the Instron Tensometer until failure occurred. Knot-end techniques gave inferior results (mean ultimate failure strength 64 +/- 5 N) compared with the other techniques. Vertical mattress failed at 130 +/- 3 N, vertical loop at 128 +/- 4.5 N, horizontal mattress at 98 +/- 5 N and vertical suturing at 136 +/- 2.7 N. This study shows the superior mechanical characteristic of the vertical suturing technique.

Animals↗

PubMed2004

Assessment of the efficiency of warming devices during neonatal surgery.

This study assessed the relative efficiency of different warming devices (surgical sheets covering the body and a tubegauze on the head, forced-air warming, warming mattress) commonly used to prevent body hypothermia during neonatal surgery. Dry heat losses were measured from a thermal manikin, which simulated a low-birth-weight neonate of 1,800 g. The manikin's surface temperatures (35.8 degrees C) corresponded to those of neonates nursed in closed incubators. Experiments were performed in a climatic chamber at an ambient temperature of 30 degrees C, as commonly found in operating theatres. The supine manikin was naked or covered with operative sheets with a 5x5 cm aperture over the abdomen. Its head could be covered by a tube-gauze. Additional warming was provided by conduction through a warming mattress (surface temperature, 39 degrees C) and/or by convection (Bair Hugger, forced-air temperature 38 degrees C). Covering the manikin with surgical sheets decreased the dry heat loss by 10.4 W. Additional forced-air warming was more efficient than the warming mattress to reduce the total dry heat loss (6.8 W vs 2.1 W). Heat losses were reduced by 7.9 W when combining the warming mattress and Bair Hugger. The heat loss from the head of the covered manikin was reduced from 4.5 W to 3.9 W when the head was covered with the tubegauze. Our data indicate that forced-air warming is more effective than conductive warming in preventing neonatal hypothermia during abdominal operations.

Abdomen↗

PubMed1998

The combined influence of immunotherapy and mite allergen reduction on bronchial hyperresponsiveness in mite-sensitive asthmatic children.

UNLABELLED: Encasings for mattresses, blankets and pillows in combination with mite allergen reduction on the floor have proved effective in reducing bronchial hyperreactivity of mite-allergic children. We studied the effect of combining the use of encasings with specific immunotherapy in comparison to the use of encasings alone (control group). Twenty mite-allergic children (Skin Prick Test, RAST, mean age 10 years) with asthma and high domestic mite allergen exposure ( > 2 microg Der p 1 + f 1/g mattress dust) were included in our study. The concentration of these major allergens as well as specific and nonspecific bronchial hyperreactivity (PC20 FEV1 histamine) were assessed before, 6 months after and 1 year after start of treatment. All children received elongated polytetrafluorethylene (ePTFE; Goretex/Intervent Allergy Bedding System) encasings. A subgroup of eight children were treated additionally by specific immunotherapy with a partially purified mite extract (ALK Scherax) and a maximum dose of 100000 SQ-U Der p + f. Initially both groups were comparable with respect to the parameters assessed. In 80% of children, encasings reduced Der p 1 and Der f 1 concentrations on the mattress to below 3% of the initial values (P < 0.01). The median reduction was 99%. PC20 FEV1 histamine increased from 0.4 to 1.4 mg/dl (median) in the combined group with immunotherapy and encasings (P < 0.05) and remained essentially unchanged in the control group. PC20 FEV1 Der p did not increase significantly in either group. CONCLUSION: Specific immunotherapy with allergen extracts is an effective adjunct to encasings. Encasings, a key factor for reducing Der p 1 and Der f 1 on the mattress, should be used in combination with other avoidance measures (e.g. removal of carpets) in order to improve allergen-induced bronchial hyperreactivity.

Adolescent↗

PubMed1991

Short-term effect of solidified benzyl benzoate on mite-allergen concentrations in house dust.

The effect of solidified benzyl benzoate (bb) foam and powder on concentrations of the major allergens of Dermatophagoides pteronyssinus (Der p I) and D. farinae (Der f I) in dust samples from mattresses and carpets in 22 households was investigated in a randomized, double-blind, placebo-controlled trial. All houses had been demonstrated to have significant (greater than or equal to 2000 ng/gm of dust) mite-allergen concentrations on mattresses. Dust samples were collected from mattresses and carpets before treatment and on days 10, 30, and 60 after the first treatment. There was a second application on day 10. Der p I and Der f I were determined by a sandwich-type ELISA with monoclonal noncross-reacting antibodies to Der p I and polyclonal monospecific antibodies to Der f I. There was a significant reduction of mite allergens in mattresses and carpets within both bb-treated and control groups, but only the results on carpets of the bb-treated group were significantly different from results of the control group on days 30 and 60 (p less than 0.05).

Allergens↗

PubMed2006

Prevention and early detection of pressure ulcers in patients undergoing cardiac surgery.

Absence of pressure ulcers is increasingly being used as an indicator of quality nursing care, based on the premise that pressure ulcers are preventable. This retrospective study examined the occurrence, presentation, and timing of pressure ulcer development in 150 patients undergoing cardiac surgery. Pressure ulcer incidents were recorded in groups of patients who underwent surgery with use of a standard foam OR bed mattress; use of a fluid, pressure-reducing OR bed mattress; or use of a fluid, pressuring-reducing mattress after a comprehensive educational program on pressure ulcer prevention was presented to RNs. Tcers decreased when the fluid, pressure-reducing OR bed mattresses were used in conjunction with the comprehensive RN education program.

Adult↗