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At least 343 records · Page 19Linked to original sources
PubMed1987

Supine versus upright anterior images: comparison in T1-201 myocardial scintigraphy.

In patients undergoing exercise thallium-201 myocardial scintigraphy, activity in the inferior wall on anterior images may appear diminished when the standard supine view is used, but normal when the view is acquired with the patient upright. To determine the clinical significance of this observation, the distribution of thallium-201 activity was semiquantitatively assessed in supine and upright anterior images obtained immediately after exercise in 93 patients (65 men, 28 women). The presence of inferior wall and coronary artery disease was established with coronary angiography or from documentation of previous myocardial infarction. Supine and upright images were compared with use of receiver operating characteristic curves. In male patients diagnostic accuracy for identification of both inferior wall and coronary artery disease was improved through the use of the upright anterior image. In women, there was no significant difference in reader performance with upright and supine images. Upright anterior images should be routinely obtained in men in order to reduce the frequency of false-positive identification of inferior wall defects.

Adult↗
PubMed1989

Plasma atrial natriuretic peptide during brief upright and supine exercise in humans.

The factors associated with the exercise-induced increase in plasma atrial natriuretic peptide (ANP) have not been clearly established. Thus the purpose of the study was to further document the stimulus for the exercise-induced release of ANP and to examine the role of ANP in the control of hydromineral balance during exercise. Eight healthy male volunteers (25.1 +/- 4.5 yr) were submitted to a graded cycling exercise in both the upright and supine positions. Venous blood was sampled at rest and at the end of each 5-min work load at 40, 60, and 80% maximal oxygen uptake (Vo2max), at maximal exercise, and during recovery through an indwelling catheter for the determination of plasma vasopressin, aldosterone, catecholamines, plasma renin activity, and ANP concentrations. Results indicate a significant increase in ANP (pg/ml) from rest to maximal exercise in the upright position [rest, 21.9 +/- 10.2; 40%, 24.7 +/- 12.6; 60%, 32.4 +/- 17*; 80%, 47.8 +/- 27.7*; 100% Vo2max, 65.9 +/- 34.5* (*P less than or equal to 0.05)]. Supine concentrations were significantly higher than upright at 40 (37.9 +/- 15.2), 60 (54.0 +/- 18.8), and 80% Vo2max (68.9 +/- 16.6). Plasma ANP during maximal exercise was similar in both positions. Plasma vasopressin, aldosterone, renin activity, and catecholamines increased with increasing exercise intensity in both positions, although lower values were systematically observed in the supine position. The association of higher plasma ANP and blunted plasma vasopressin, plasma renin activity, and norepinephrine concentrations during supine exercise suggests that ANP may exert modulatory effects on the control of the hydromineral hormonal system during exercise.

Adult↗
PubMed1990

Shape of the chest wall in the prone and supine anesthetized dog.

The shape of the passive chest wall of six anesthetized dogs was determined at total lung capacity (TLC) and functional residual capacity (FRC) in the prone and supine body positions by use of volumetric-computed tomographic images. The transverse cross-sectional areas of the rib cage, mediastinum, and diaphragm were calculated every 1.6 mm along the length of the thorax. The changes in the volume and the axial distribution of transverse area of the three chest wall components with lung volume and body position were evaluated. The decrease of the transverse area within the rib cage between TLC and FRC, as a fraction of the area at TLC, was uniform from the apex of the thorax to the base. The volume of the mediastinum increased slightly between TLC and FRC (14% of its TLC volume supine and 20% prone), squeezing the lung between it and the rib cage. In the transverse plane, the heart was positioned in the midthorax and moved little between TLC and FRC. The shape, position, and displacement of the diaphragm were described by contour plots. In both postures, the diaphragm was flatter at FRC than at TLC, because of larger displacements in the dorsal than in the ventral region of the diaphragm. Rotation from the prone to supine body position produced a lever motion of the diaphragm, displacing the dorsal portion of the diaphragm cephalad and the ventral portion caudad. In five of the six dogs, bilateral isovolume pneumothorax was induced in the supine body position while intrathoracic gas volume was held constant.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia↗
PubMed2000

Supine lower body negative pressure exercise during bed rest maintains upright exercise capacity.

Bed rest and spaceflight reduce exercise fitness. Supine lower body negative pressure (LBNP) treadmill exercise provides integrated cardiovascular and musculoskeletal stimulation similar to that imposed by upright exercise in Earth gravity. We hypothesized that 40 min of supine exercise per day in a LBNP chamber at 1.0-1.2 body wt (58 +/- 2 mmHg LBNP) maintains aerobic fitness and sprint speed during 15 days of 6 degrees head-down bed rest (simulated microgravity). Seven male subjects underwent two such bed-rest studies in random order: one as a control study (no exercise) and one with daily supine LBNP treadmill exercise. After controlled bed-rest, time to exhaustion during an upright treadmill exercise test decreased 10%, peak oxygen consumption during the test decreased 14%, and sprint speed decreased 16% (all P < 0.05). Supine LBNP exercise during bed rest maintained all the above variables at pre-bed-rest levels. Our findings support further evaluation of LBNP exercise as a countermeasure against long-term microgravity-induced deconditioning.

Adult↗
PubMed2006

Effects of "priming" exercise on pulmonary O2 uptake and muscle deoxygenation kinetics during heavy-intensity cycle exercise in the supine and upright positions.

We hypothesized that the performance of prior heavy exercise would speed the phase 2 oxygen consumption (VO2) kinetics during subsequent heavy exercise in the supine position (where perfusion pressure might limit muscle O2 supply) but not in the upright position. Eight healthy men (mean +/- SD age 24 +/- 7 yr; body mass 75.0 +/- 5.8 kg) completed a double-step test protocol involving two bouts of 6 min of heavy cycle exercise, separated by a 10-min recovery period, on two occasions in each of the upright and supine positions. Pulmonary O2 uptake was measured breath by breath and muscle oxygenation was assessed using near-infrared spectroscopy (NIRS). The NIRS data indicated that the performance of prior exercise resulted in hyperemia in both body positions. In the upright position, prior exercise had no significant effect on the time constant tau of the VO2 response in phase 2 (bout 1: 29 +/- 10 vs. bout 2: 28 +/- 4 s; P = 0.91) but reduced the amplitude of the VO2 slow component (bout 1: 0.45 +/- 0.16 vs. bout 2: 0.22 +/- 0.14 l/min; P = 0.006) during subsequent heavy exercise. In contrast, in the supine position, prior exercise resulted in a significant reduction in the phase 2 tau (bout 1: 38 +/- 18 vs. bout 2: 24 +/- 9 s; P = 0.03) but did not alter the amplitude of the VO2 slow component (bout 1: 0.40 +/- 0.29 vs. bout 2: 0.41 +/- 0.20 l/min; P = 0.86). These results suggest that the performance of prior heavy exercise enables a speeding of phase 2 VO2 kinetics during heavy exercise in the supine position, presumably by negating an O2 delivery limitation that was extant in the control condition, but not during upright exercise, where muscle O2 supply was probably not limiting.

Adaptation, Physiological↗
PubMed2000

Is there significance of the choice of prone versus supine position in the treatment of proximal ureter stones with extracorporeal shock wave lithotripsy?

OBJECTIVE: To determine whether there is a significance of the choice of prone versus supine position in the treatment of proximal ureter stones with extracorporeal shock wave lithothripsy (ESWL). METHODS: Ninety-six patients with proximal ureter stones underwent ESWL. The procedure was performed in the supine position in 48 of them (group 1) and in the prone position in the other 48 patients (group 2). Stone-free rates, repeat ESWL rates, shocks per patient and shocks per session were compared in both groups. RESULTS: The mean session number per patients was 1.64+/-0.75 in group 1 and 1. 33+/-0.59 in group 2 (p = 0.224). The stone-free rates 3 months after ESWL were 88.3% in group 1 and 90.6% in group 2. The difference between the results was statistically insignificant (p<0.05). Therefore, these two parameters were similar in both groups. On the other hand, the number of shocks per session was 4,863.54+/-2, 114.85 in group 1 and 3,704.16+/-1,726.75 in group 2. This difference was statistically significant (p = 0.011). The patients tolerated the supine position better in general. Patients in the prone position experienced discomfort on inspiration and expiration and pain localized to the lumbar vertebrae. CONCLUSION: These results suggest that the supine position decreases the number of shocks per session in the treatment of proximal ureter stones with ESWL and this will be cost-effective.

Humans↗
PubMed1969

Regional pulmonary blood flow in sitting and supine man during and after acute hypoxia.

Regional pulmonary blood flow was measured by external counting of intravenously injected (133)Xe during 20 min of breathing 14.2% oxygen and during 20 min of recovery from hypoxia. 16 normal human volunteers were studied, nine sitting and seven supine. During hypoxia there was a slight but significant increase in relative perfusion of the upper portions of the lungs in both the sitting and supine subjects. During recovery from hypoxia, blood flow distribution differed significantly from the control. The erect subjects showed increased relative perfusion of the lung bases and the supine subjects showed increased relative perfusion of the upper zones. Comparison of the distribution of inhaled and intravenously injected isotope showed that in the sitting subjects the altered distribution during hypoxia tended to make alveolar oxygen tension more uniform. In the supine subjects, however, the shift in blood flow increased the perfusion of the regions with the lowest ventilation/perfusion, tending to accentuate uneven alveolar oxygen tension. Therefore it does not seem that the altered blood flow distribution during hypoxia was due to selective vasoconstriction in the regions of lowest alveolar oxygen tension, but rather that vasoconstriction was greatest in the lower lung zones because the vessels there are more responsive to hypoxia. During mild acute hypoxia, vasoconstrictor tone does not seem to effectively match ventilation and perfusion. The altered distribution of pulmonary blood flow during recovery from hypoxia suggests the occurrence of posthypoxic vasodilation. Failure to consider this possibility may lead to erroneous interpretation of pulmonary hemodynamic measurements made after the inspired oxygen concentration has been changed.

Adult↗
PubMed1983

Functional ophthalmodynamometry. Comparison between brachial and ophthalmic blood pressure in sitting and supine position.

Ophthalmodynamometry was done by 96 normotensive volunteers and 62 hypertensive patients in sitting and supine position. A high correlation between the brachial and ophthalmic blood pressure was found in both groups, and in both positions. The brachial blood pressure of normotensive subjects did not show any difference in both positions. Although the systolic brachial blood pressure did not show significant changes in hypertension, the diastolic--and the calculated mean brachial blood pressure has been slightly but significantly decreased in the supine position. In both groups, normotension and hypertension, the ophthalmic blood pressure was found to be dependent from the level of the systemic blood pressure and the position of patient. It is significantly higher in the supine position than in the sitting position. The higher the systemic blood pressure in the sitting position, the less was the increase of the ophthalmic blood pressure in the supine position.

Blood Pressure↗
PubMed1990

Does inhalation of pentamidine in the supine position increase deposition in the upper part of the lung?

To assess the effect of posture on the distribution of nebulized pentamidine isethionate deposition in the lung, ten patients with AIDS were studied. Two nebulizer systems, System 22 Mizer (MedicAid) and Respirgard II (Marquest) were modified by adding 40 cm of corrugated tubing (volume 150 ml) to allow the patients to be studied in both the sitting and supine posture. Modification of the nebulizers caused a reduction in lung deposition in the sitting position for the System 22 Mizer but increased deposition in the Respirgard II compared with the unmodified apparatus. The ratio of upper to lower zone deposition (corrected for 133Xe distribution) was increased in the supine position for both devices (p less than 0.01). The best upper zone deposition was achieved with the unmodified System 22 Mizer in the sitting position. Respirgard II had the lowest nonpulmonary deposition and the lowest incidence of adverse effects. The supine position was associated with a redistribution of deposition to the upper zones. To attempt to reduce upper zone recurrence of Pneumocystis carinii pneumonia, the supine posture is suggested for less efficient nebulizer devices, ie, the Respirgard II, but for more efficient systems, ie, System 22 Mizer, the sitting position is probably suitable. This postulate needs to be confirmed by a clinical trial.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Effect of warning signal on reaction time and EMG activity of the biceps brachii muscle in elbow flexion and forearm supination.

Using a reaction time (RT) task, the biceps brachii muscle was investigated in five healthy subjects to determine whether EMG in the initial phase of activity is dependent upon the direction of movement, i.e., elbow flexion and forearm supination, and/or influenced by the presence or absence of warning signal. Results showed that in the presence of warning EMG-RT of forearm supination was faster than that of elbow flexion, and that the reverse occurred in the absence of warning. The warning signal significantly reduced EMG-RT of both movements and the reduction of EMG-RT was larger in supination than flexion. Compared to forearm supination, large amplitude potentials were observed during elbow flexion. The warning suppressed EMG activities of both movements within 30 msec after their initiation. The present study indicates that the biceps brachii muscle exhibits a motor response program specific to the direction of movements and that preparatory set conditioned by warning shortens RT and also suppresses EMG activities.

Action Potentials↗
PubMed1995

Circulatory regulation during supine and sitting intermittent isometric handgrip in a hot environment.

We studied the circulatory regulation during intermittent isometric handgrip (IIHG, six seconds contraction + six seconds relaxation) in supine and sitting postures in a hot environment (40 degrees C, RH: 50%). Eight healthy male subjects performed thrice 5-minute period IIHG at three different work loads (10%, 20% and 30% MVC). The IIHG was performed with the right hand in the two postures. Heart rate (HR), cardiac output (CO), mean arterial blood pressure (MBP), forearm blood flow (FBF), skin blood flow (SBF), foot swelling (FSW) and tympanic temperature (Tty) were measured during IIHG, resting and recovery periods. During IIHG in a hot environment, HR, MBP, FSW and Tty showed higher values in the sitting than in the supine posture. FBF during relaxation showed higher values at high work load than at low work load in the two postures. FBF showed higher values in the sitting than in the supine posture, except during relaxation at 30% MVC. It was concluded that the decrements of blood volume of splanchnic organs might be greater in the sitting than in the supine posture due to sympathetic vasoconstrictor activity, and were responsible for the redistribution of blood flow. Posture had an effect on FBF because of hydrostatic pressure.

Adult↗
PubMed1983

The supine view in double-contrast knee arthrography.

Knee arthrography is a widely used diagnostic procedure, but there is disagreement regarding the relative efficacy of single vs. double-contrast examinations in the evaluation for meniscal tears. In 353 double-contrast knee arthrograms, combining supine positioning with the routinely accepted prone views, there were 222 meniscal tears diagnosed using prone positioning alone, and seven additional tears were found with the added supine maneuver. Even though the knee joint was distended with both contrast material and air, the prone views tended to outline the meniscus in a double-contrast fashion, whereas the supine views provided single positive contrast detail of the same area. Supine views are particularly helpful when an obvious meniscal tear is not fluoroscopically apparent during prone filming.

Adolescent↗
PubMed1991

Diagnosis of pneumoperitoneum on supine abdominal radiographs.

A blinded, retrospective study was performed to determine the value of supine abdominal radiographs in diagnosing pneumoperitoneum. Supine films from 44 cases of pneumoperitoneum were randomly interspersed among supine films from 87 control subjects without free air, and the films were reviewed for the presence or absence of various signs of pneumoperitoneum, including Rigler's sign (gas on both sides of the bowel wall), the falciform ligament sign (gas outlining the falciform ligament), the football sign (gas outlining the peritoneal cavity), the inverted-V sign (gas outlining the medial umbilical folds), and the right-upper-quadrant gas sign (localized gas in the right upper quadrant). One or more of these signs were present in 26 cases (59%) of pneumoperitoneum, including the right-upper-quadrant gas sign in 18 cases (41%), Rigler's sign in 14 cases (32%), and the falciform ligament and football signs in one case each (2%). Unfortunately, there were frequent errors in the interpretation of the right-upper-quadrant gas sign and Rigler's sign, with a total of 11 false-positive cases (13%). Further analysis of the true-positive right-upper-quadrant gas signs showed that these gas collections were always triangular or linear with an inferolateral to superomedial orientation and, if triangular, a concave superolateral border. In the true-positive Rigler's signs, the bowel wall thickness ranged from 1 to 8 mm, whereas the false positives all had a bowel wall thickness of 1 mm or less. Proper interpretation of the various signs of pneumoperitoneum on supine films should lead to more accurate diagnosis of this condition.

False Positive Reactions↗
PubMed2004

Standing and Supine Hamstring Stretching Are Equally Effective.

OBJECTIVE: To evaluate the relative effectiveness of standing and supine hamstring stretching in increasing hamstring flexibility as measured by increasing range of motion at the knee. DESIGN AND SETTING: The trial was randomized, and the setting was local academic physical therapy and physical therapist assistant programs. SUBJECTS: Twenty-nine healthy subjects who exhibited limited hamstring muscle flexibility bilaterally (22 women, 7 men, 25.9 +/- 6.13 years of age) volunteered to participate in this study. Subjects were randomly assigned a different stretch for each leg. Each leg was stretched 3 days per week for 3 weeks (3 x 30 seconds). Stretching sessions were supervised. MEASUREMENTS: We measured supine active knee extension. Measurements were taken before and after the 3-week stretching phase by the same investigator, who was blind to limb assignment. We calculated a 2-way mixed-design analysis of variance and Tukey Honestly Significant Difference post hoc tests to analyze data. An independent t test was performed to determine whether the change scores in the stretching groups differed by sex. RESULTS: Prestretching and poststretching measurements were significantly different for both the standing and supine stretch (<0.05). No significant difference (P > .05) in change score existed between the 2 stretches or between the sexes. CONCLUSIONS: The standing and supine hamstring stretches were comparably effective in improving flexibility.

Journal Article↗
PubMed2005

[Effects of lung protective ventilation in prone or supine position on inhibiting adrenomedullin release in acute respiratory distress syndrome caused by pulmonary and extra-pulmonary insults in dog].

OBJECTIVE: To investigate the changes in adrenomedullin release in bronchial alveolar lavage fluid (BALF) from different lung areas in acute respiratory distress syndrome (ARDS) of produced dogs, by pulmonary and extra-pulmonary causes, with low tidal volume and positive end expiratory pressure (PEEP) treatment under supine and prone position. METHODS: Twenty-four male mongrel dogs were randomly divided into ARDSp (ARDS caused by pulmonary causes) supine group, ARDSp prone group, ARDSexp (ARDS caused by extra-pulmonary causes) supine group, and ARDSexp prone group. A detergent to cause lung injury in ARDSp dogs, and intravenous oleic acid was given in ARDSexp dogs. The results of adrenomedullin in different areas of dog's lung (upper lobe, middle lobe, and lower lobe) and arterial blood gas under lung protective ventilation treatment were measured. RESULTS: After lung injury, the arterial oxygenation index was lowered, and the levels of adrenomedullin in the upper lobe and middle lobe of ARDSp dogs were higher than that of ARDSexp dogs. After receiving low tidal volume and PEEP ventilation, the conditions of all the dogs were gradually getting ameliorated, and prone position ventilation gave better effects on lung injury dogs by inhibiting adrenomedullin release. CONCLUSION: There are statistical differences in adrenomedullin release in different lung areas between ARDSp dogs and ARDSexp dogs, and in both ARDSexp dogs and ARDSp dogs low tidal volume and PEEP treatment under prone position ventilation give better results compared to supine position.

Adrenomedullin↗
PubMed1987

Supine cross-table lateral chest roentgenogram for the detection of pericardial effusion.

We performed a prospective, blinded, controlled study to test the hypothesis that supine cross-table lateral chest roentgenograms might have an advantage over conventional lateral chest roentgenograms for the detection of pericardial effusion using the epicardial fat stripe sign. In comparison with echocardiography as the gold standard, we found that supine cross-table lateral chest roentgenograms had greater sensitivity (51%) for pericardial effusions than conventional lateral chest roentgenograms (sensitivity, 31%). Specificity was essentially the same for both techniques. A large pericardial effusion was more readily detected by supine cross-table lateral chest roentgenograms (86%) than by the conventional lateral chest roentgenograms (36%). We conclude that a supine cross-table lateral chest roentgenogram should be included in the evaluation of patients with suspected pericardial effusion or in patients in whom a large cardiac silhouette is detected on a standard chest roentgenogram.

Adipose Tissue↗
PubMed1984

[Supine thoracic images with a mobile roentgen unit: comparison between the soft-ray and hard-ray technics].

To compare the influence of kilovoltage on the quality of supine chest roentgenograms obtained with a mobile x-ray unit, we examined the films of 50 patients on whom supine chest radiographs had been taken incidentally within a period of 24 hours both with high and with low-kVp technique. For evaluation of the image quality, a total of 11 criteria were compared and quantitated by 5 observers using a simple score method. The same advantages that have been attributed to the high-kVp technique on upright films were found on the corresponding supine examinations. These films showed a more balanced penetration and greater sharpness than those taken with low-kVp. The wider latitude of the high-kVp technique simplifies the exposure, and fewer repeat takes will therefore be necessary. The diagnostic gain outweights the few disadvantages, which are mostly coupled to the increase in scattered radiation. This, as well as the availability of more powerful and efficient mobile generators, should promote routine application of high-kVp technique for supine chest examinations.

Humans↗
PubMed1980

Clinical evaluation of a "short" supine pressor test for pregnancy-induced hypertension.

A modified supine pressor test was performed on 304 apparently normal primigravidas between 28 and 32 weeks' gestation. The blood pressure was measured with the patient first in lateral position and within 2 minutes thereafter in the supine position. Of those patients showing an increase of at least 20 mmHg in the diastolic blood pressure while in the supine position, 13 of 76 (17%) developed pregnancy-induced hypertension. Of those patients without an increase of at least 20 mmHg in the diastolic blood pressure, 33 of 228 (14%) became hypertensive. The results of this study do not substantiate the use of the "short" supine pressor test as an accurate predictor of pregnancy-induced hypertension.

Diagnostic Errors↗