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Results for “Prone Position”

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At least 1,243 records · Page 69Linked to original sources

PubMed2001

[The development of the multifunctional cephalostat and its applications in anesthesia].

The multifunctional cephalostat is able to hold the patients' head better and firmly at prone position after tracheal intubation under general anesthesia According to the size of patients head, the anesthetist can properly adjust the distance of the malor holder and the distance between the superciliary ridge and the lower jaw, and fix the two tempora to prevent the head swaying. So this instrument greatly facilitates the anesthesia managements.

Anesthesia, General↗

PubMed2000

Venous oxygen embolism due to hydrogen peroxide irrigation during posterior fossa surgery.

Hazards of application of hydrogen peroxide to semiclosed space are well known. We present a case of suspected gas embolism following hydrogen peroxide irrigation of the surgical field during posterior fossa surgery in the prone position. Severe cardiovascular collapse occurred when the wound was irrigated with hydrogen peroxide solution. Generation of pressure gradient leads to absorption of a considerable amount of oxygen giving rise to features of venous gas embolism. Although the case was associated with an uneventful recovery, use of hydrogen peroxide for securing hemostasis should be avoided.

Absorption↗

PubMed2001

Distribution of prenatal and postnatal risk factors for sudden infant death in Budapest.

OBJECTIVE: To study the distribution of prenatal and postnatal risk factors for sudden infant death syndrome (SIDS). DESIGN: A questionnaire-based survey for SIDS risk factors; family interviews were performed among the parents of SIDS victims and symptom-free infants. SETTING: The survey was conducted in paediatric primary health care units in Budapest, Hungary in the period 1996 to 1998. SUBJECT: Eighteen SIDS cases and 74 symptom-free healthy infants aged 7-365 days were investigated. MAIN OUTCOME MEASURES: Occurrence of risk factors and impact of social environment were analysed using conditional logistic regression. RESULTS: In this study, the classic risk factors of small birth weight, maternal smoking, bottle-feeding did not reflect differences between the investigated groups. The prone position did not demonstrate a difference between SIDS cases and controls (p = 0.86). Short intervals between pregnancies (OR = 4.8, CI = 1.2-19.9, p = 0.025) and social disadvantage (OR = 6.7, CI = 1.3-35.7, p = 0.015) indicated significant differences between SIDS cases and controls. CONCLUSION: The outcome of our survey shows that infants from a lower social and economic environment may be at higher risk for SIDS.

Birth Intervals↗

PubMed2003

Infant care practices related to cot death in Turkish and Moroccan families in the Netherlands.

From 1979 to 1993 Turkish infants had a significantly higher cot death risk compared to Dutch infants. In contrast Moroccan infants had a risk of cot death that was approximately three times lower compared to Dutch infants during the same period. This study shows that these differences have disappeared, while differences still exist in infant care practices between these ethnic groups. At 28 well-baby clinics, questionnaires were distributed for this sample selection. The response was 82%. Data were collected on 55 Turkish, 54 Moroccan, and 210 Dutch families. Less than 7% of these three ethnic groups still placed infants in the prone position. Moroccan mothers hardly smoked. Turkish people used pillows and Moroccan people used soft mattresses more often. Moroccan families practised swaddling more widely. Length of maternal residence influenced some care giving practices. As a result of this study, subgroup specific intervention campaigns for safe sleeping can be developed for Turkish and Moroccan families.

Bedding and Linens↗

PubMedDate not supplied

Total cranial vault reconstruction for the older child with scaphocephaly.

A technique is described for the surgical correction of primary of secondary sagittal synostosis in the older child. This involves placing the patient in the modified prone position, reshaping the supraorbital bar, and reconstructing virtually the entire cranial vault with microplates. This technique of total cranial vault reconstruction has been performed successfully on 5 patients without mortality or significant morbidity, although blood loss is significant, averaging 1.8 blood volumes. Further experience will be needed to establish the proper indications for the procedure, the best method of fixation, and the optimal timing.

Child, Preschool↗

PubMed2000

Prone breast radiotherapy in early-stage breast cancer: a preliminary analysis.

PURPOSE: Women with large breasts have marked dose inhomogeneity and often an inferior cosmetic outcome when treated with breast conservation compared to smaller-sized patients. We designed a prone breast board, which both minimizes breast separation and irradiated lung or heart volume. We report feasibility, cosmesis, and preliminary local control and survival for selected women with Stage 0-II breast cancer. MATERIALS AND METHODS: Fifty-six patients with clinical Stage 0-II breast cancer were treated with lumpectomy and breast irradiation utilizing a prototype prone breast board. A total of 59 breasts were treated. Indications for treatment in the prone position were large or pendulous breast size (n = 57), or a history of cardiopulmonary disease (n = 2). The median bra size was 41D (range, 34D-44EE). Cosmesis was evaluated on a 1-10 (worst-to-best) scale. RESULTS: Acute toxicity included skin erythema (80% of patients experienced Grade I or Grade II erythema), breast edema (72% of patients experienced mild edema), pruritus (20% of patients), and fatigue (20% of patients reported mild fatigue). One patient required a treatment break. The only late toxicity was related to long-term cosmesis. The mean overall cosmesis score for 53 patients was 9.37 (range, 8-10). Actuarial 3- and 5-year local control rates are 98%. Actuarial overall survival at 3 and 5 years are 98% and 94%. CONCLUSION: Our data indicate that treating selected women with prone breast radiotherapy is feasible and tolerated. The approach results in excellent cosmesis, and short-term outcome is comparable to traditional treatment techniques. This technique offers an innovative alternative to women who might not otherwise be considered candidates for breast conservation.

Adult↗

PubMed2003

Contact dermatitis after the use of the PronePositioner.

UNLABELLED: The PronePositioner is used to support the head during prone position procedures. We present the first case report of allergic contact dermatitis from the PronePositioner. The patient was sensitized to the urethane in the PronePositioner during his many previous surgeries. We caution its repeated use in a single patient secondary to concerns of sensitization. IMPLICATIONS: We present the first case report of allergic contact dermatitis from the PronePositioner. We caution its repeated use in a single patient secondary to concerns of sensitization to the urethane in the PronePositioner.

Adult↗

PubMed2000

Tissue plasminogen activator and gas for diabetic premacular hemorrhage.

PURPOSE: To report the effect of intravitreal injection of tissue plasminogen activator and gas for the treatment of diabetic premacular hemorrhage. METHODS: Five eyes of five consecutive patients with fresh diabetic premacular hemorrhage and previous panretinal photocoagulation were treated with intravitreal injection of 50 microg of tissue plasminogen activator, and 0.3 ml of sulfur hexafluoride. After intravitreal injection, patients maintained a prone position for 3 days and were followed for an average of 7 months (range, 6 to 8 months). RESULTS: All eyes had clearing of the premacular hemorrhage with improved visual acuity. Three eyes with no visible fibrovascular proliferation required 3 weeks to resorb the hemorrhage, and two eyes with active fibrovascular proliferation needed 2 months to resorb the intravitreal hemorrhage. CONCLUSION: Intravitreal injection of tissue plasminogen activator and gas may be an effective way to treat fresh diabetic premacular hemorrhage.

Adult↗

PubMed2003

Avascular necrosis of the femoral head after surgery for lumbar spinal stenosis.

STUDY DESIGN: Case report. OBJECTIVE: To report a previously undescribed complication of lumbar spinal surgery under prolonged hypotensive anesthesia. BACKGROUND DATA: Avascular necrosis of bone most commonly affects the femoral head. The etiology of the condition is understood in only 75% of cases. There have been no prior reports of this condition following lumbar spine surgery carried out under hypotensive anesthetic. METHODS: Notes review, clinical examination, plain radiographs, and magnetic resonance imaging diagnosed three patients who developed avascular necrosis of the femoral heads (five joints in total) after surgery for lumbar spinal stenosis. All three were treated with total hip replacement (five joints), and the diagnosis of avascular necrosis was confirmed in two by histopathological examination. RESULTS: All three patients have recovered full mobility following hip replacement surgery. None had any residual symptoms of lumbar spinal stenosis or hip disease, and none of them had shown any clinical evidence of avascular necrosis in any other bone. CONCLUSIONS: The development of avascular necrosis of the femoral heads following surgery for spinal stenosis may be due to hypotensive anesthesia, prone positioning on a Montreal mattress, or a combination of the two. Careful intraoperative positioning may reduce the risk of this occurring after spinal surgery. However, close postoperative surveillance and a high index of suspicion of worsening hip pathology in patients who appear to mobilize poorly after lumbar spinal surgery may be the only method of early detection and treatment for this condition.

Aged↗

PubMed1996

Prevalence of modifiable risk factors for sudden infant death syndrome in British Forces Germany.

A questionnaire survey was conducted amongst parents in the military community in British Forces Germany to investigate the prevalence of known and suspected risk factors for Sudden Infant Death Syndrome. Over a thousand questionnaires were returned (response rate 58%) and these showed that the prevalence of babies being placed in the prone position to sleep is now extremely low and the use of room thermometers to help control ambient temperature is widespread. However 29% of the mothers had smoked in pregnancy and 44% of households with a new-born baby had at least one parent who smoked. Additional health promotion activity aimed at reducing the prevalence of smoking in pregnancy and amongst the parents of new-born babies is recommended.

Age Distribution↗

PubMed1997

Arthroscopic reduction and fixation of bony avulsion of the posterior cruciate ligament of the tibia.

Bony avulsion fractures of the posterior cruciate ligament of the tibia have commonly been treated by open reduction and internal fixation using the posterior approach. However, this approach, using the prone position, makes it difficult to investigate and treat other combined injuries of the knee joint. We report a case of posterior cruciate ligament avulsion of the tibia that was arthroscopically reduced and firmly fixed with two cannulated screws. The posterior sag was absent after the operation and the result was excellent. By arthroscopy, we got rigid fixation of the avulsed fragment for early rehabilitation, and detection of a concomitant injury was also possible.

Arthroscopy↗

PubMed2000

[Magnetic resonance imaging diagnosis of craniobasal cerebrospinal fluid fistulas by 3D-CISS sequence].

Recently, a Magnetic Resonance Imaging (MRI)-technique has been developed to diagnose the exact anatomical location of fistulas of the cerebrospinal fluid (CSF). This method is called 3D-constructive interference steady state-sequence (CISS) but it is not well known in clinical practice. Aim of the study was the evaluation of specificity and sensitivity of CISS-MRI. 12 patients with rhinoliquorrhea after head injury (n = 7) or skull base tumours (n = 5) were examined by CISS-MRI. The examinations were performed with a 1.5 T whole body MRI scanner in prone position and coronal plane sections. In cases of CSF leckage the sensitivity for detection of a CSF fistula was 100%. In comparison with intraoperative findings, specificity was 100%: in all cases, a dural lesion in anatomical correlation to MRI was detected. Further advantages of this method are its non-invasive character, no need for contrast application, no radiation exposure, and exact localisation of additional anatomical findings (brain herniation, brain contusions).

Adolescent↗

PubMed2001

Bag-mask ventilation as a temporizing measure in acute infectious upper-airway obstruction: does it really work?

Jaw-thrust and bag-mask ventilation usually provide adequate oxygenation in patients with acute infectious upper-airway obstruction (AIUAO). It is the treatment of choice for patients on the way to hospital or in an emergency department until definitive stabilization is achieved with available resources. We report three fatal case studies showing ineffective bag-mask ventilation in AIUAO that raise concerns over this treatment. Case 1 is a 4-year-old patient with epiglottitis who suffered complete obstruction during transport to the hospital. Case 2 is a 3-year-old patient with epiglottitis who suffered complete obstruction during transport to the hospital. Case 3 is a 3-year-old child with viral laryngotracheitis and respiratory arrest just after the admission. Should the approach of bag-mask ventilation in AIUAO change to ventilate patients in the prone position? This approach offers two advantages. First, gravity helps the epiglottis fall forward, reducing the airway obstructions. Second, if the patient vomits during ventilation, the vomit will fall to the floor. During bag-mask ventilation in patients with severe partial airway obstruction, ventilation pressure is high. Gastric inflation may occur and rapidly distend the stomach. This gastric distension interferes with ventilation by elevating the diaphragm, resulting in a decreased lung volume. Cricoid pressure could prevent gastric distension in these instances and should be recommended.

Airway Obstruction↗

PubMed1995

[Single dose toxicity studies of metabolite, degradation product and impurity of montirelin hydrate (NS-3) in mice].

Montirelin hydrate (NS-3) is a new drug for the treatment of disturbance of consciousness. The single dose toxicity studies of its degradation product and impurity (CNK-603) and its metabolite (CNK-6004) were conducted in Slc: ddY mice. The compounds were administered intravenously to male and female mice. Deaths occurred in both sexes of mice receiving more than 125 mg/kg of CNK-603. There were no treatment-related effects on survival in both sexes of mice receiving doses up to 2,000 mg/kg of CNK-6004. Approximate lethal dose of CNK-603 was 125 mg/kg and lethal dose of CNK-6004 was more than 2,000 mg/kg. Decrease in locomotor activity was observed in mice receiving the two compounds. Tremor, prone position and dyspnea were seen in mice receiving CNK-603. The body weight showed no changes attributable to the dosing of the two compounds in mice. In autopsies, congestion and hemorrhage in the lung were observed in dead mice given CNK-603. There were no remarkable changes in mice given CNK-6004. These results show that the lethal dose of CNK-603 is over 4 times lower than that of montirelin hydrate, and that CNK-6004 is less toxic than montirelin hydrate.

Animals↗

PubMed2001

Traumatic macular hole: observations, pathogenesis, and results of vitrectomy surgery.

PURPOSE: To review our experience with vitrectomy surgery techniques for the treatment of traumatic macular holes and the biomicroscopic and surgical findings. DESIGN: Retrospective noncomparative, multicenter, case series. PARTICIPANTS AND INTERVENTION: Twenty-five patients with traumatic macular hole underwent surgical repair. INTERVENTION: Vitrectomy with membrane peeling and gas injection followed by prone positioning for 7 to 14 days. MAIN OUTCOME MEASURES: Postoperative evaluation included visual acuity testing, closure of the macular hole, and ocular complications. RESULTS: The macular hole was successfully closed in 24 of 25 cases (96%). The visual acuity improved two or more lines in 21 (84%) cases, and 16 (64%) achieved 20/50 or better vision. CONCLUSIONS: Vitrectomy surgery can successfully close macular holes associated with trauma and improve vision.

Adolescent↗

PubMed1995

[Evaluation of compression radiotherapy in pelvic treatment].

In pelvic irradiation, the volume of irradiated small intestine is one of the major factors responsible for both acute and late gastrointestinal complications. In this study, exclusion of the small intestine from the pelvic radiation field was attempted with lower abdominal wall compression and bladder distention in the prone position. The mobility of intrapelvic and several problems associated with this technique were investigated. In our results, the small intestine was effectively moved outside of the whole pelvic radiation field in all but two patients. Treatment interruption of 2 days was observed in only two patients. With the AP/PA opposing field method the abdominal skin dose near the compression pillow was revealed to be higher and the dose at the isocenter was inhomogeneous; thus, a three- or four-field technique is recommended if abdominal wall compression is used.

Adult↗

PubMed2003

[Computerized tomography in evaluation of decreased acetabular and femoral anteversion].

Computerized tomography has received a new importance. It has been shown that decreased anteversion of femur and acetabulum, when both have decreased angles, are causing pain and osteoarthritis of the hip joint. Operative treatment should be performed before osteoarthritis develops. Exact measurements therefore are necessary. The investigation should be performed in prone position to have the pelvis lying in a defined and normal position. Femoral torsion is measured between the transverse axis of the knee and the femoral neck. The transverse axis for measurement of the femoral anteversion is defined by a rectangular line to the sagittal plane. For evaluation of the femoral anteversion in total the angle of the condyles has to be added to the femoral neck angle when the knee is found in internal rotation. Acetabular anteversion should be measured at the level where the femoral head is still in full contact and congruence with the anterior margin of the acetabulum.

Acetabulum↗

PubMed1999

New therapies for acute respiratory distress syndrome (ARDS):--a review.

Acute respiratory distress syndrome (ARDS) has been associated with high mortality. Improved understanding of the pathophysiology, recognition of precipitating events and improved management has decreased the mortality over the years. Mechanical ventilation is still the corner stone of the management of the disease. It is well recognised that high tidal volumes and airway pressures increase the morbidity, hence the need to use alternative modes of ventilation like pressure control with or without inverse ratio ventilation. Extracorporeal membrane oxygenation is still experimental and not easily available, whereas prone position to improve oxygenation is simple and inexpensive. The concept of pathological oxygen dependency and therapy aimed at supranormal values has failed to improve survival. Restricting the fluids to prevent further oedema formation in an already wet lung has improved the survival rate. Nitric oxide and surfactant have failed to produce desirable effect in large studies. Pharmacological support to inhibit inflammation with non steroidal anti-inflammatory drugs, antifungal agents, prostaglandin and corticosteroids have all failed. Interestingly corticosteroid rescue treatment in the late phase of ARDS has shown promise. Antiendotoxin and anticytokine studies which began with much enthusiasm is yet to produce desirable results.

Acute Disease↗