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At least 109 records · Page 6Linked to original sources
PubMed2006

Weight bearing radiographs are not necessary for measurement of polyethylene penetration in total hip prostheses: a radiostereometric study of 111 patients examined in weight-bearing and supine position.

BACKGROUND: Controversy exists as to whether polyethylene (PE) penetration of hip prostheses is underestimated when the measurements are made on radiographs obtained in supine position as compared to weight-bearing position. PATIENTS AND METHODS: We examined 111 patients by radiostereometric analysis (RSA) in the supine and weight-bearing positions. RESULTS: The mean 3-D penetration was 0.68 mm (SD 0.58, range 0.04-3.05) for the supine position and 0.70 mm (SD 0.57, range 0.08-3.01) for the weight-bearing position. The correlation between supine and weight-bearing examinations was 0.99 (p < 0.001). The degree of penetration made no difference. There was no statistically significant difference as to whether the first examination was performed early, i.e. after 3 months, or after 12 months (p = 0.7). INTERPRETATION: The small systematic difference in penetration values between the supine and the weight-bearing positions is of no clinical or methodological importance.

Arthroplasty, Replacement, Hip↗
PubMed2000

Changes in the excitability of the H-reflex in wrist flexors related to the prone or supine position of the forearm in man.

The effect of the forearm position, prone vs. supine, on the excitability of the H-reflex in flexor carpi radialis (FCR) muscle was tested in nine adult volunteers by comparing the recruitment profiles of the H and M waves. The H-reflex size, normalized to the maximal M response, was lower when the forearm was supine than when it was prone, with an average reduction of about 50% over most of the H-recruitment curve. In three wrist positions, intermediate between prone and supine, the amount of reflex attenuation was related to the prono-supination angle. Control experiments excluded that the changes in the H reflex excitability were due to displacements of the stimulating or recording electrodes.

Adult↗
PubMedDate not supplied

Does prone or supine position influence pain responses in preterm infants at 32 weeks gestational age?

OBJECTIVE: The purpose of this study was to examine the influence of prone and supine position in preterm infants during acute pain of blood collection. SETTING: Level III Neonatal Intensive Care Unit (NICU). STUDY DESIGN: Thirty-eight preterm infants (birthweight 1339 [590-2525] g, GA 29 [25- 32] wks) were in 2 groups depending on their position in the isolette prior to and during heel lance at 32 weeks post-conceptional age. The study design was a comparison between groups (Prone, Supine) during 2 events (Baseline, Heel lance). OUTCOME MEASURE: Pain measures were multidimensional, including behavioral (sleep-wake state and facial activity) and physiological (heart rate) responses measured continuously prior to (Baseline) and during blood collection (Lance). RESULTS: Both groups of infants displayed statistically significant shifts in sleep-wake state to greater arousal, and increased facial activity and heart rate, from Baseline to Lance. Prone position was associated with significantly more deep sleep during Baseline, compared with Supine position, but there were no differences in sleep-wake state during Lance. Minor increased facial activity was shown in some time segments of Baseline for infants in Supine compared with Prone, but did not differ overall between positions. Prone and Supine position did not affect heart rate significantly during Baseline or Lance events. CONCLUSIONS: Prone position promotes deep sleep in preterm neonates at 32 weeks post-conceptional age when they are undisturbed. However, placement in prone position is not a sufficient environmental comfort intervention for painful invasive procedures such as heel lance for blood sampling in the NICU. Neonates require other environmental supports to promote coping with this stressful event.

Facial Expression↗
PubMedDate not supplied

Dorsally angulated solitary metaphyseal greenstick fractures in the distal radius: results after immobilization in pronated, neutral, and supinated position.

In a prospective study, angular redisplacement has been correlated with immobilization in the pronated, neutral, or supinated position (20 children in each group). Those with greater than 20 degrees of dorsal angulation at day 1 and after 2 weeks were manipulated. Dorsal angulation after immobilization at day 1, 2 weeks, and 6 weeks was measured on accurate lateral views. Angular displacement during the first two weeks was (a) greater among reduced than unreduced cases in the pronation group (p less than 0.001), and (b) less in the supination group than in the other groups (p less than 0.05). Based on these findings, we believe that the fracture should be immobilized in the supinated position.

Child↗
PubMed2003

A single-stage video-assisted thoracoscopic surgery procedure for simultaneous bilateral spontaneous pneumothorax in a supine position.

We report on the case of a 23-year-old man with simultaneous bilateral spontaneous pneumothorax (SBSP), treated with bilateral video-assisted thoracoscopic surgery (VATS) in a supine position. SBSP is a very rare condition that can be life-threatening when therapeutic techniques fail. We performed a unique operative procedure for SBSP using one-stage bilateral VATS in a supine position. This procedure is less invasive, more effective, and safer for the treatment of SBSP.

Adult↗
PubMed1985

[Diagnosis of ischemic cardiopathy by 2-dimensional echocardiography carried out after the bicycle ergometry test in the supine position: feasibility, sensibility and specificity].

We performed two dimensional echocardiography (2D ECO) after bicycle exercise obtained in supine position in 80 patients undergoing coronary angiography for the evaluation of chest pain. Adequate 2D images after exercise were recorded in 64/80 (80%) patients (pts). Forty pts had significative coronary artery disease (CAD), 24 had no CAD. Twenty-three CAD pts had left ventricle wall motion abnormalities (WMA) at rest; 17 pts had 1-, 11 2- and 12 3-vessels disease. The test was considered positive if WMA were present after exercise. Thirty-two CAD pts and 1 pt without CAD had WMA after exercise, thus sensitivity and specificity were, respectively, 80% and 96%. In 1-, 2- and 3-vessels disease pts, sensitivity was, respectively, 71%, 91% and 83%. WMA were observed after exercise in 9/17 (53%) pts without WMA at rest. 2D Echo obtained after bicycle exercise performed in the supine position is a feasible, sensitive and specific technique to detect CAD.

Coronary Disease↗
PubMed2003

Tension pneumocephalus after craniotomy in supine position.

Tension pneumocephalus has been reported frequently after posterior fossa surgery, mostly in procedures done in the sitting position. Though uncommon, tension pneumocephalus is a life-threatening complication that requires urgent diagnosis and treatment. It is rare for this complication to occur after neurosurgical procedures done in the supine position. The authors report a case of an adult patient diagnosed with craniopharyngioma who developed tension pneumocephalus following craniotomy in the supine position.

Adult↗
PubMed1989

[Potentiating effect of a supine position on ischemia induced by exercise].

Though sitting bicycle and treadmill are the commonest devices used in exercise stress testing, supine ergometric test shows some advantages, especially in research investigations. The latter allows better ECG and blood pressure recordings during exercise. Recently, a greater frequency of ST-segment depression has been reported with supine vs upright exercise, but some doubt as to the ischemic significance of this result has been raised. Thus, we compare the ECG and hemodynamic pattern during upright and supine bicycle exercise in 50 subjects with chest pain, without prior myocardial infarction: 31 had documented coronary artery disease (CAD) and 19 had normal coronary vessels. In a subgroup (22 CAD patients and all subjects without CAD) a measurement of myocardial perfusion was performed during exercise using thallium-201 radionuclide ventriculography. Initial work-load and the further graded increases were identical for both postures. The frequency of ST-segment depression was higher during supine exercise (84% vs 74%). The increase in sensitivity (+7% vs CAD) was wider if a more direct measurement of myocardial ischemia was adopted as gold standard (+13% vs TI-201 responses) and was not associated with a decreased specificity (Tab. II). In the supine position the threshold of exercise-induced ST-segment depression was significantly lower. Chest pain appeared more frequently and at a lower work-load. Accentuation and precocity of exercise-induced ischemia in the supine-position could be attributed to an increased imbalance between supply and demand of MVO2 at equivalent work-load, heart rate changes, systolic blood pressure and double product were significantly higher.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Comparison of V'O2 kinetics in upright and supine position.

Oxygen uptake (V'O2) kinetics during exercise depends in particular on muscular aerobic capacity and cardio-vascular parameters. The objective of this study was to investigate the influence of body position on the V'O2 kinetics as determined by means of the PRBS technique. 9 healthy male volunteers performed bicycle ergometer exercise in both upright and supine position. No significant changes were seen in normalized gains and phase shifts of the power-V'O2-relationship. It is concluded that the differences in venous blood volume distribution and cardiac output associated with upright and supine position do not have major effects on power- V'O2-gains.

Cardiac Output↗
PubMed2006

[Pulmonary atelectasis in patients with neurological or muscular disease; gravity-related lung compression by the heart and intra-abdominal organs on persistent supine position].

We report 10 cases of pulmonary atelectasis diagnosed by chest computed tomography in patients with neurological or muscular disease. Atelectasis was frequently seen in hypotonic patients who could not roll over on their own. The atelectases located mostly in the dorsal bronchopulmonary segments, adjacent to the heart or diaphragm. Atelectasis diminished in two patients after they became able to roll themselves over. Gravity-related lung compression by the heart and intra-abdominal organs on persistent supine position can cause pulmonary atelectasis in patients with neurological or muscular disease who can not roll over by their own power. To confirm that the prone position reduces compression of the lungs, chest computed tomography was performed in both the supine and the prone position in three patients. Sagittal images with three-dimensional computed tomographic reconstruction revealed significant sternad displacements of the heart and caudal displacements of the dorsal portion of the diaphragm on prone position compared with supine position. The prone position, motor exercises for rolling over, and biphasic cuirass ventilation are effective in reducing gravity-related lung compression. Some patients with intellectual disabilities were also able to cooperate in chest physiotherapy. Chest physiotherapy is useful in preventing atelectasis in patients with neurological or muscular disease.

Abdomen↗
PubMed2004

Bilateral video-assisted thoracoscopic surgery in the supine position for primary spontaneous pneumothorax.

On the basis of the bilateral nature of bullous lesions of the lung, the authors have performed single-stage bilateral video-assisted thoracoscopic surgery (VATS) in the supine position for primary spontaneous pneumothorax in five patients since October 1999. All five patients were males with a mean age of 23 years (range 19 to 29 years). The presenting pneumothorax was ipsilateral (right-sided) in four patients and simultaneous bilateral in the one remaining patient. Apart from the one case of simultaneous bilateral spontaneous pneumothorax (SBSP), all patients had a history of at least one pneumothorax episode requiring tube thoracotomy. Bilateral bullae were confirmed in all patients on preoperative chest computed tomography (CT). Bilateral bullectomy was performed by endo-stapler with no difficulties. Mean operating time was 111 minutes (range 85 to 140 minutes). All patients were returned to the surgical ward in good condition from the operating room immediately after extubation. No complications were observed, and duration of postoperative hospital stay was two to four days. All patients were alive without recurrence of pneumothorax after a mean follow-up period of 25 months (range, 9 to 43 months). Single-stage bilateral VATS in the supine position has shown itself to be an excellent approach for the treatment of bilateral bullous lesions, combining both efficacy and low morbidity.

Adult↗
PubMed2002

Effects of prone and supine positions on sleep state and stress responses in mechanically ventilated preterm infants during the first postnatal week.

BACKGROUND/RATIONALE: Preterm infants in mechanical ventilation are vulnerable and may manifest physiological instability and a disorganized behavioural state when responding to external stimuli. Adequate positioning strategies may play an important role in protecting infants from environmental stressor and assisting quality of sleep. However, no study has examined effects of prone and supine positions on behavioural state and stress signs including startle, tremor, and twitch responses for ventilated preterm infants during the critical first week postbirth. AIM OF THE STUDY: The purpose of this study was to compare effects of prone and supine positions on behavioural state and stress responses in mechanically ventilated preterm infants. DESIGN/METHODS: The infants were aged 25-36 weeks of gestation, < or = 7 days of age, and without sedation or congenital abnormalities. Using a crossover design, 28 infants were randomly assigned to supine/prone or prone/supine position sequence. Infants were placed in each position for 2 hours. A stabilization period of 10 minutes before observation of each position was allowed. During the protocol, care procedures were kept minimal and ventilator settings remained unchanged. Behavioural state and frequencies of stress signs including startle, tremor, and twitch were systemically recorded and analysed with repeated measures analysis of variance. FINDINGS: Infants when prone compared with supine had (a) less crying, less active sleep, and more quiet sleep states, and (b) fewer stress responses of startle, tremor, and twitch. CONCLUSION: Results indicate that prone positioning improves the quality of sleep and decreases stress for ventilated preterm infants during the first week postbirth. These may conserve energy and assist infants' extrauterine adaptation.

Cross-Over Studies↗
PubMed1993

Intravertebral vacuum cleft: changes in content after supine positioning.

Sequential radiographic and magnetic resonance (MR) imaging examinations were performed in nine patients with an intravertebral vacuum cleft indicative of avascular necrosis. Progressive changes in the content of the cleft occurred within an hour after the patients were placed in a supine position. Initially, the cleft showed a gaslike pattern during extension of the spine, with a radiolucent band on radiographs and a signal void on MR images. Later, the vacuum phenomenon disappeared on radiographs, and a fluidlike high-signal-intensity pattern appeared on T2- or T2*-weighted MR images, suggestive of a slow fluid inflow within the intravertebral cleft. Because the recognition of a vacuum cleft in a collapsed vertebral body helps avoid confusion with malignancy or infection, it is important to search for this in examinations performed immediately after supine positioning.

Aged↗
PubMed2000

The incidence of transient neurologic symptoms (TNS) after spinal anaesthesia in patients undergoing surgery in the supine position. Hyperbaric lidocaine 5% versus hyperbaric bupivacaine 0.5%.

BACKGROUND: The incidence of TNS after spinal anaesthesia is a problem. Especially the use of hyperbaric lidocaine in patients placed in the lithotomy position during surgery has been associated with a high incidence of TNS. The present study was performed to investigate whether TNS is present more frequently in patients undergoing surgery in the supine position with use of hyperbaric lidocaine compared with hyperbaric bupivacaine. METHOD: Seventy patients were included and randomised to receive either hyperbaric lidocaine or hyperbaric bupivacaine. All patients were contacted on the first and third postoperative days by an anaesthesiologist blinded to the local anaesthetic used. The patients were asked about symptoms of TNS, pain not associated with the operation area, and asked to grade the complaints after a verbal analogue score from 0 to 10. RESULTS: We found a total of ten patients who showed signs of TNS. There were nine patients in the lidocaine group (26%) who showed signs of TNS compared to only one patient in the bupivacaine group (3%) (P<0.01). The average score of TNS complaints was 3.5. A total of 13 patients (19%) complained of back pain. There were no significant differences with regard to which local anaesthetic was used. The average score of back pain was 3.3. CONCLUSION: TNS is a significant problem in patients having spinal anaesthesia with hyperbaric lidocaine compared to hyperbaric bupivacaine, both in the supine position. For day-case surgery, TNS would start after dismissal from hospital. The use of hyperbaric lidocaine is therefore questionable, even though these problems are of an order that the majority of patients would still choose spinal anaesthesia for future operations.

Adult↗
PubMed2005

Head-body righting reflex from the supine position and preparatory eye movements.

CONCLUSION: Saccular and utricular maculae can provide information on the supine static position, considering that both have pronounced curved structures with hair cells having a variety of polarization vectors that enable them to sense an inverted position and thus direct the righting reflex. OBJECTIVE: The vestibular system is essential for the structuring of motor behaviour, senses linear and angular acceleration and has a strong influence on posture and balance at rest, during locomotion and in head body righting reflexes. MATERIAL AND METHODS: Using guinea pigs in the supine position with a symmetrical head and trunk position, the ocular position was analysed to ascertain whether any ocular movement that occurred would adopt a spatial deviation indicative of the subsequent head and body righting. The characteristics of the righting reflex (direction, latency, duration and velocity) were analysed in guinea pigs from position signals obtained from search coils implanted in the eye, head and pelvis. The animals were kept in a supine position for a few seconds or even minutes with the eyes in a stable primary position and the head and body symmetrical and immobile. RESULTS: The righting reflex took place either immediately or after a slow deviation of the eyes. In both cases the righting sequence (eyes, head, body) was stereotyped and consistent. The direction of head and body righting was along the longitudinal axis of the animal and was either clockwise or anticlockwise and the direction of righting was related to the direction of the eye deviation. The ocular deviation and the direction of deviation that initiated and determined the direction of the righting reflex could be explained by possible otolithic activation.

Animals↗
PubMed2005

Prone SPECT myocardial perfusion imaging is associated with less cardiac drift during the acquisition duration than imaging in the supine position.

BACKGROUND AND AIM: Cardiac cranial drift, a slow vertical upward displacement seen during the acquisition of myocardial single photon emission tomography (SPECT), is a source of image artefacts that may lead to erroneous interpretation. Changes in breathing pattern and depth throughout image acquisition are believed to cause cardiac cranial drift. As the physiology of respiration probably differs with postural changes, we hypothesized that cardiac drift may be different for supine vs. prone acquisitions. Our aim was to assess the magnitude of cardiac displacement for prone and supine SPECT acquisitions in patients undergoing stress myocardial perfusion imaging. METHODS: We enrolled prospectively 15 subjects undergoing exercise myocardial perfusion imaging. Subjects had post-stress images acquired in both the prone and supine positions. Motion was assessed in the horizontal (x) and vertical (y) axes for both camera heads at all 64 projections at which images were obtained. Pixel displacement (number of pixels from the baseline of zero) in either the cranial/caudal or left/right direction was quantified using the automated camera motion correction algorithm. RESULTS: Supine imaging was associated with more cranial drift than prone imaging (1.20+/-0.40 pixels vs. 0.92+/-0.24 pixels, P<0.05). There was no significant difference in cardiac displacement in the horizontal axis (1.03+/-0.5 pixels vs. 1.12+/-0.22 pixels, P=NS). CONCLUSIONS: Prone imaging is associated with less cardiac cranial drift than imaging in the supine position, suggesting that the former is associated with a more constant and reliable diaphragmatic breathing pattern. Acquisitions in the prone position may thus be associated with fewer motion artefacts than supine acquisitions for cardiac SPECT imaging.

Adult↗
PubMed1994

Hip arthroscopy utilizing the supine position.

The purpose of this article is to demonstrate the merits of the supine position in arthroscopic surgery about the hip. Twenty consecutive patients successfully underwent arthroscopy by this technique. The procedure is performed on a standard fracture table with fluoroscopy. Traction is used to distract the hip for introduction of the instruments. Three standard arthroscopic portals are routinely used. Two portals are placed laterally over the superior aspect of the greater trochanter, and one is placed anteriorly. The procedure is effective and reproducible. It is user friendly to both the surgeon and the operating room staff. Additionally, the procedure uses existing operating room equipment with only minor modifications.

Adolescent↗