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Results for “Prone Position”

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At least 1,333 records · Page 74Linked to original sources

PubMed1993

Diagnosis of asbestosis by a time expanded wave form analysis, auscultation and high resolution computed tomography: a comparative study.

BACKGROUND: Crackles are a prominent clinical feature of asbestosis and may be an early sign of the condition. Auscultation, however, is subjective and interexaminer disagreement is a problem. Computerised lung sound analysis can visualise, store, and analyse lung sounds and disagreement on the presence of crackles is minimal. High resolution computed tomography (HRCT) is superior to chest radiography in detecting early signs of asbestosis. The aim of this study was to compare clinical auscultation, time expanded wave form analysis (TEW), chest radiography, and HRCT in detecting signs of asbestosis in asbestos workers. METHODS: Fifty three asbestos workers (51 men and two women) were investigated. Chest radiography and HRCT were assessed by two independent readers for detection of interstitial opacities. HRCT was performed in the supine position with additional sections at the bases in the prone position. Auscultation for persistent fine inspiratory crackles was performed by two independent examiners unacquainted with the diagnosis. TEW analysis was obtained from a 33 second recording of lung sounds over the lung bases. TEW and auscultation were performed in a control group of 13 subjects who had a normal chest radiograph. There were 10 current smokers and three previous smokers. In asbestos workers the extent of pulmonary opacities on the chest radiograph was scored according to the International Labour Office (ILO) scale. Patients were divided into two groups: 21 patients in whom the chest radiograph was > 1/0 (group 1) and 32 patients in whom the chest radiograph was scored < or = 1/0 (group 2) on the ILO scale. RESULTS: In patients with an ILO score of < or = 1/0 repetitive mid to late inspiratory crackles were detected by auscultation in seven (22%) patients and by TEW in 14 (44%). HRCT detected definite interstitial opacities in 11 (34%) and gravity dependent subpleural lines in two (6%) patients. All but two patients with evidence of interstitial disease or gravity dependent subpleural lines on HRCT had crackles detected by TEW. In patients with an ILO score of > 1/0 auscultation and TEW revealed mid to late inspiratory crackles in all patients, whereas HRCT revealed gravity dependent subpleural lines in one patient and signs of definite interstitial fibrosis in the rest. In normal subjects crackles different from those detected in asbestosis were detected by TEW in three subjects but only in one subject by auscultation. These were early, fine inspiratory crackles. CONCLUSION: Mid to late inspiratory crackles in asbestos workers are detected by TEW more frequently than by auscultation. Signs of early asbestosis not apparent on the plain radiograph are detected by TEW and HRCT with similar frequency. off

Asbestosis↗

PubMedDate not supplied

Clinical considerations concerning detection of venous air embolism.

Venous air embolism during neurosurgical procedures (detected by Doppler Ultrasound and aspiration via a right atrial catheter) was noted in 100 of 400 patients in the sitting position, 5 of 60 patients in the lateral position, 7 of 48 patients in the supine position, and 1 of 10 individuals monitored in the prone position. We confirmed venous air embolism in many of these cases by using serial technetium-macroaggregated albumin lung scans. Gravitational gradients from the venous portal of entrance to the right side of the heart were as small as 5.0 cm, with aspiration of 200 ml of air occurring. Doppler ultrasonic air bubble detection and aspiration through a previously inserted right atrial catheter are critical factors in the diagnosis and treatment of this condition.

Cardiac Catheterization↗

PubMed2005

Radiologic assessment of rectosigmoid cancer before and after neoadjuvant radiation therapy: comparison between quantitation techniques.

OBJECTIVE: Volumetric analysis was compared with conventional unidimensional measurements for follow-up of rectosigmoid cancer before and after radiation therapy. SUBJECTS AND METHODS: Fifteen patients with rectosigmoid cancer underwent helical CT before and after neoadjuvant radiation therapy. The helical CT examination was performed after colon distention with air and IV administration of an antiperistaltic drug. Two scans were obtained: one with the patient in the supine position and the other with the patient in the prone position after contrast medium injection. The maximal wall thickness and the volumetric analysis of the tumor were obtained through manual segmentation. RESULTS: The mean of the differences between the volumetric analysis of the scans obtained before and after radiation therapy was 8.3 +/- 10.3 (SD) mL (-22.7%) (p <0.05). The mean of the differences between the maximal wall thickness of the pre- and post-radiation therapy scans was 3.4 +/- 2.6 mm (-19.1%) (p <0.05). A significant difference was observed between the variation of the maximal wall thickness and the variation of volumetric analysis in pre- and post-radiation therapy scans (p <0.05). The patients could be classified in different response categories depending on the measurement method and on the response criteria. CONCLUSION: Volumetric analysis of rectosigmoid cancer is feasible. A long-term study is needed to correlate volumetric assessment with patient outcome.

Aged↗

PubMed1997

Effects of 20 days horizontal bed rest on kinesthesia during knee flexion and two-point discrimination in skin of young subjects.

Investigating the effect of 20 days bed rest (BR) on kinesthesia and two-point discrimination, 10 young volunteers participated in this study as subjects. Angle position sensation of right knee was measured in the prone position during flexion and extension monitored by a goniometer after two-point discrimination in skin was determined on the same lower leg. Flexed constant error was unchanged but directional constant error and absolute error were increased after BR (p<0.05). Two-point discrimination was unchanged after BR, which brought about a decline of the orientation of moving the joint indicated as over shooting of the angle during knee flexion, while it did not affect superficial sensation observed by two-point discrimination. Probably, an adjustment of deep sensation to the knee joint is lowered by the reduction in kinesthesia as well as the sensory disturbance during BR, which is independent on information from superficial sensation.

Adult↗

PubMed2005

Paraplegia by acute cervical disc protrusion after lumbar spine surgery.

Non-traumatic paraplegia caused by herniation of the cervical intervertebral disc is an uncommon postoperative complication. A patient with claudication and radiculopathy was scheduled for lumbar laminectomy due to spinal stenosis. Postoperatively, numbness below T6 was found in his both legs of the patient. MRI showed a protruded intervertebral disc between C6 and C7. Despite urgent disectomy, the patient's lower extremities remained paralyzed without significant improvement for 3 months. Loss of muscle support during general anesthesia, excessive neck extension during endotracheal intubation and positioning, as well as bucking and agitation are believed as triggering factors for the protrusion of the cervical disc. We suggest that a complete history taking and physical examination be accomplished in patients scheduled for lumbar spine surgery in order to exclude coexisting cervical spine disorders. In addition, skillful endotracheal intubation and careful neck positioning are mandatory for patients receiving surgery in the prone position.

Acute Disease↗

PubMed1984

The effect of drugs, position of the patient and filling of the stomach on pancreatic sonography.

Using 750 outpatients as our material, the effects of dimethicon , simethicon - pankreatin and lysin-vasopressin, of the position of the patient and of the filling of the stomach with soup on the success of pancreatic ultrasonography were studied. Dimethicon had no, simethicon - pankreatin an almost significant and lysin-vasopressin a highly significant positive effect. Lysin-vasopressin caused several mild adverse reactions. The filling of the stomach with soup combined with erect position was effective in about 3/4 of the cases. Prone position was not usefull.

Clinical Trials as Topic↗

PubMed1995

[The belly-board technic for the sparing of the small intestine. Studies on positioning accuracy taking into consideration conformational irradiation technics].

BACKGROUND: The immobilization error of patients positioned on the open table-top device in prone position as well as the movement of the small bowel out of the pelvis by this positioning technique was determined. The positioning error is of special importance for the 3-dimensional treatment planning for conformational radiotherapy. PATIENTS AND METHODS: The positioning error was determined by superpositioning 106 portal films with the corresponding simulator films from 21 patients with carcinoma of the rectum who-received 3D-planned conformational radiotherapy (3-field technique with irregular blocks). The movement of the small bowel out of the pelvis was studied by comparing simulator films after barium swallow in supine and open table-top position as well with 3D-treatment plans of the same patient in both positions in 3 cases. RESULTS: The positioning error along the medio-lateral, dorso-ventral and cranio-caudal axis was 1.4/0.6/1.8 mm and the standard deviation 4.4/6.8/6.3 mm, respectively. In comparison to the supine position more rotation errors in the sagittal view were observed (37% and 9% respectively) with a median of 5.1 degrees. Six out of 22 patients showed no adhesions of the small bowel and a complete movement out of the treatment field was achieved. 14 out of 16 Patients with adhesions revealed a partial movement of the small bowel out of the treatment field. Comparing 3D-treatment plans in both positions again demonstrated a marked reduction of the irradiated small bowel volume with the use of the open table-top device. CONCLUSIONS: The open table-top device positioning technique is a simple and cheap positioning support to reduce small bowel obstructions by radiation therapy of pelvic and retroperitoneal tumors. For the radiation treatment planning the data suggest a safety margin to compensate positioning errors of approximately 1.5 cm referring to the 95% confidence interval.

Administration, Oral↗

PubMed1996

[Echographic diagnosis of nephro-urological neoplasia in a pediatric nephrology center].

The use of ultrasound for the diagnosis of urologic neoplasms in simple and accurate. Nowadays nephrologists and urologists advocate the use of ultrasound and the procedure now plays a complementary role of the clinical examination. We present a retrospective study regarding our experience with ultrasonography in the diagnosis of urologic problems. In the period february 95-february 96 we performed 672 ultrasound examination on children ranging in age from 30 days to 16 years. All examinations were performed using a 3.5-5 MHz real time convex scanner. The patients were examined in the supine position for imaging of the bladder and in the prone position for imaging of the kidneys. We report 3 cases of neoplasm of the genito-urinary tract screened with the use of ultrasounds in a selected paediatric population.

Adolescent↗

PubMed1997

Effect of nursing in the head elevated tilt position (15 degrees) on the incidence of bradycardic and hypoxemic episodes in preterm infants.

OBJECTIVE: We investigated whether nursing in the head elevated tilt position (HETP), compared with the horizontal position, has any effect on the incidence of bradycardic and hypoxemic episodes in preterm infants. METHODS: Twelve spontaneously breathing preterm infants with idiopathic recurrent apnea were studied in a randomized controlled crossover trial. Nine infants were treated with aminophylline. Each spent a total of 24 hours in the horizontal prone position and a total of 24 hours in HETP (prone, 15 degrees). The position was changed in random order every 6 hours. Thoracic impedance, heart rate, and arterial oxygen saturation were recorded continuously. The frequency of isolated hypoxemia (arterial saturation <80%), of isolated bradycardia (heart rate <90 beats per minute), and of mixed events was analyzed and compared without knowledge of the allocated position. RESULTS: In total, there were significantly fewer bradycardic and/or hypoxemic episodes (28.2%) in HETP compared with the horizontal position (mean difference, 13.35 episodes/24 hours; 95% confidence interval [CI]: 5.9- 20.8). The decrease was largest for isolated hypoxemic episodes (48.5%; mean difference, 11.74 episodes/24 hours; 95% CI: 6.1-17.4). Isolated bradycardic episodes (mean difference, 2.27 episodes/24 hours; 95% CI: -0.78-5.31) and mixed events were not decreased significantly in HETP. CONCLUSIONS: Nursing in a moderately tilted position (15 degrees) reduces hypoxemic events in preterm infants. This intervention is easy to apply, quickly reversible, and can be combined with drugs such as aminophylline.

Apnea↗

PubMed2002

Seated transforaminal injection approach in severe lumbar stenosis.

The use of seated positioning for the performance of a fluoroscopically guided transforaminal lumbar epidural injection is presented. An 81 year old gentleman presented with a lumbar radiculopathy with radiographs demonstrating foraminal stenosis arising in the setting of offending disc pathology, multilevel and advanced central canal compromise, and a scoliotic deformity. He was unable to tolerate prone positioning secondary to radicular pain. A seated approach allowed for the patient to remain comfortable, and a satisfactory epidurogram was observed. Comparative images of the L4 transforaminal injection performed in the prone and seated position may be consistent with an increased foraminal cross sectional area in the seated and forward flexed posture.

Journal Article↗

PubMed1976

Positional shift of intraventricular blood clots demonstrated by computed tomography.

Computed tomography with the patient in the prone position was employed to obtain information in a case of intraventricular hematoma secondary to arteriovenous maliformation. A gravitational shift in the position of the intraventricular blood clots was demonstrated by a scan obtained with the patient in the brow-down position. Consideration is given to the possible use of the "prone EMI scan" for other intracranial problems of differential diagnosis.

Adolescent↗

PubMed2006

Spontaneous arousability in prone and supine position in healthy infants.

STUDY OBJECTIVE: Compared with control infants, those who will be future victims of sudden infant death syndrome (SIDS) show a decreased arousability during sleep, with fewer cortical arousals and more-frequent subcortical activations. These findings suggest an incomplete arousal process in victims of SIDS. Prone sleep position, a major risk factor for SIDS, has been reported to reduce arousal responses during sleep. The present study was undertaken to evaluate whether the prone sleep position impairs the arousal process in healthy infants. METHODS: Twenty-four healthy infants were studied polygraphically during 1 night; 12 infants regularly slept supine and 12 infants regularly slept prone. Infants were matched for sex, gestational age, and age at recording. Arousals were differentiated into subcortical activations or cortical arousals, according to the presence of autonomic and/or electroencephalographic changes. Frequencies of subcortical activations and cortical arousals were compared in the prone- and the supine-sleeping infants. RESULTS: Compared with supine sleepers, prone sleepers had significantly fewer cortical arousals during rapid eye movement (REM) sleep (p = .043). There were no significant differences in cortical arousals between the 2 groups during non-REM sleep. No significant differences were seen in the frequencies of subcortical activations during both REM and non-REM sleep between supine and prone sleepers. The ratio of cortical arousal to subcortical activation showed no significant differences between the prone and the supine sleepers. CONCLUSIONS: Prone sleep position decreased the frequency of cortical arousals but did not change the frequency of subcortical activations, as has been previously found in SIDS victims. These results suggest specific pathways for impairment of the arousal process in SIDS victims.

Arousal↗

PubMed1992

Effect of prone versus supine patient positioning on pelvic magnetic resonance image quality.

RATIONALE AND OBJECTIVES: Magnetic resonance imaging (MRI) of the pelvis in the prone position has been proposed as a means of reducing motion-related image blurring. The authors performed a randomized controlled trial to determine if patient positioning affects image quality. METHODS: All women undergoing pelvic MRI during a 7-month period, who could lie both prone and supine, were randomized to the supine or prone position. The quality of axial T2-weighted spin-echo images was rated by two radiologists using a 1-to-4 scale (1 = marked blurring to 4 = sharp definition of pelvic structures). RESULTS: Of 78 eligible women, 61 were randomized. Two patients could not complete the examination. The mean image quality rating of 2.8 for the 32 patients imaged prone was not significantly different from the mean rating of 2.9 for the 27 patients imaged supine (P = .5, Mann-Whitney U test). CONCLUSION: Patient positioning did not significantly affect pelvic MRI quality. The choice of patient position should be based on other considerations, such as patient comfort or ease of patient positioning.

Adult↗

PubMed2006

Alveolar recruitment assessed by positron emission tomography during experimental acute lung injury.

OBJECTIVES: To compare changes in aerated lung volumes measured by positron emission tomography (PET) and inflation volume-pressure curve (V-P) of the respiratory system, and to evaluate the reliability of PET to assess alveolar recruitment. DESIGN AND SETTING: Experimental study in six anesthetized and mechanically ventilated pigs in a PET facility in an experimental university laboratory. INTERVENTIONS: Lung injury was induced by oleic acid. Animals were randomly studied in four conditions: PEEP 0cmH(2)O (ZEEP) in supine position (SP), PEEP 10cmH(2)O in SP, ZEEP in prone position (PP) and PEEP in PP, each applied for 30min. MEASUREMENTS AND RESULTS: With PET aerated lung volume was obtained from pulmonary density analysis using transmission scan (VA(trans)) and from nitrogen-13 kinetics on emission scan (VA(em)). Changes in VA(trans) and VA(em) were computed as the difference in aerated volume between conditions. VA(trans) and VA(em) did not differ between SP and PP, on either ZEEP or PEEP, suggesting no modification in relaxation volume of the respiratory system induced by posture. Changes in VA(trans) or VA(em) were significantly correlated with changes in aerated volume assessed from superimposed V-P curves (R (2)=0.74 and 0.75, respectively). Alveolar recruitment assessed by PET was significantly correlated with both PaO(2) (R (2)=0.61) and PaCO(2) (R (2)=0.40) variations induced by PEEP. CONCLUSIONS: PET is a new reliable tool of scientific interest to image lung volume and alveolar recruitment during acute lung injury.

Animals↗

PubMed2006

Effective radiation doses in CT colonography: results of an inventory among research institutions.

The purpose of this study was to estimate the effective dose that is currently used in CT colonography using scan parameters that were collected for this purpose, and to investigate trends in time. PubMed was systematically searched from 1996 until January 2004 for studies investigating CT colonography. Research institutions were contacted and asked for their current scan protocol. Thirty-six institutions published 74 studies. Twenty-eight of the 36 institutions provided their current protocol. The median effective dose in 2004 was 5.1 mSv (range 1.2-11.7 mSv) per position. Most institutions (93%) scan in both the supine and prone positions. The median mAs value was 67 mAs (range 20-200), median collimation was 2.5 mm (range 0.75-5). From 1996 until 2004 a significant decrease in mAs and collimation (P=0.006, P<0.0001, respectively) was observed, while institutions that used a multislice scanner increased (P<0.0001). The effective dose remained constant (P=0.76). In 2004 the median effective dose for a complete CT colonography was 10.2 mSv. Despite the increasing use of multislice scanners, which are slightly less dose-efficient, the median effective dose remained approximately constant between 1996 and 2004. This is mainly caused by the use of lower mAs settings.

Academies and Institutes↗

PubMed2002

Surgical strategy in adrenal masses.

OBJECTIVE: Endoscopic adrenalectomy represents the "New Golden Standard" in the surgical treatment of benign adrenal lesions up to 6 cm. Open adrenalectomy is recommended for patients with suspected malignant disease and tumors larger than 6 cm. METHODS AND MATERIAL: The surgical technique of trans- and retroperitoneal adrenalectomy is described. Reviewing literature the importance of the endoscopic approach and its role in the surgical treatment of adrenal lesions is analyzed. RESULTS: As in open adrenalectomy different endoscopic approaches to the adrenals were developed: adrenal tumors can be removed endoscopically using a transperitoneal (patient in a supine or lateral decubitus position) or extraperitoneal route (patient in a lateral decubitus or prone position). Reviewing literature the endoscopic transperitoneal adrenalectomy is documented in 1425 patients. 4.6% (66 patients) had to be converted to an open procedure. Five hundred and forty-four tumors were removed by an extraperitoneal access. The conversion rate was 4.4% (24 patients). CONCLUSION: The basis of excellent results are careful patient selection, evaluation and preoperative preparation in a center with experience in the open techniques and at least 20 endoscopic adrenalectomies per year.

Adrenal Gland Neoplasms↗

PubMed1996

Thrombin in the management of full thickness macular holes.

PURPOSE: As thrombin is a known stimulator of retinal glial and pigment epithelial cells, we performed a pilot study to evaluate the use of thrombin as adjunctive mitogen therapy in vitreous surgery for full-thickness macular holes. METHODS: Macular hole surgery was performed on 25 eyes of 24 consecutive patients with stage II, III, or IV macular holes. After removal of the posterior hyaloid, peeling of epiretinal membranes, and fluid-air exchange, 0.05 mL or 0.1 mL of thrombin (100 units/ mL) was placed over the macular hole. After infusion of a gas tamponade, the patient's head was kept in a supine position for 1 hour, and then was kept in a prone position for approximately 2 weeks. RESULTS: Closure of the macular hole with one procedure was achieved in 80% of the eyes. Sixty-five percent of the eyes with a closed macular hole achieved a visual acuity of 20/40 or better. Postoperative inflammation was present in all eyes, and a small hypopyon developed in 28% of the eyes. CONCLUSION: Thrombin therapy failed to markedly increase the success rate of macular hole surgery.

Aged↗

PubMed1982

Evaluation of laser iridectomy in angle-closure glaucoma: provocative tests.

An argon laser iridectomy was performed on 18 eyes of 14 patients with closed-angle glaucoma. The intraocular pressure (IOP) was controlled in all but one eye within normal limits. Variable amounts of pigment were found on gonioscopy in all cases. The mydriasis test was positive in one eye (5.5%) after homatropine and in 5 eyes (28%) after tropicamide drops. 80% of the positive results occurred in lightly pigmented irides. The dark-prone position test was positive in 7 eyes (38%), 71% of the positive results occurring in heavily pigmented irides. Tomography was also performed; the possibility of trabecular damage is discussed.

Eye Color↗