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At least 433 records · Page 24Linked to original sources
PubMed2005

Health related quality of life in patients with supination-external rotation stage IV ankle fractures.

BACKGROUND: While open reduction of displaced ankle fractures generally is accepted as the standard of care, relatively little is known about the health related quality of life after treatment. It is generally accepted that clinical results of treatment for supination-external rotation stage IV ankle fractures are favorable. The goal of this investigation was to determine the relationship between clinical results and health-related quality of life outcome measures in a consecutive series of patients treated for closed supination-external rotation stage IV ankle fractures. METHODS: Twenty-six of 156 patients who had operative treatment for closed, displaced supination-external rotation stage IV ankle fractures during a 9-year period, completed the Short Musculoskeletal Function Assessment (SMFA) outcome questionnaire. Radiographs and clinical records were reviewed to determine quality of operative repair, postoperative morbidity, and the development of post-traumatic arthritis. RESULTS: There were no postoperative complications. Of the 26 patients who returned the SMFA questionnaires, 19 had "good," and seven had "fair" reduction of their fractures. Six showed radiographic evidence of arthritis at followup. Study participants reported scores that were similar to the general population in five of the six domains of the SMFA. Their scores in the mobility index were statistically less favorable (23.72 vs. 13.61, p = 0.016) when compared to the general population. Participants with "good" operative reductions and no evidence of arthritis at followup showed no significant difference to the general population. Participants with either a "fair" operative reduction or evidence of postoperative arthritis at followup had less favorable scores in the daily activities (mean 13.45 vs. 11.82, p = 0.004), mobility (43.43 vs. 13.61, p = 0.001), dysfunction (32.89 vs. 12.70, p = 0.014), and bother (35.80 vs. 13.77, p = 0.020) domains, when compared to the general population. CONCLUSIONS: The results of this investigation suggest that patients with excellent radiographic operative reductions and no arthritis as early as 6 months after surgery sustain no lasting unfavorable effect on health related quality of life. Patients with "fair" radiographic reduction, or presence of arthritis or both at followup, are likely to have a negative effect on their quality of life.

Activities of Daily Living↗
PubMed2005

Cheyne-Stokes respiration and supine dependency.

The influence of position during sleep on central apnoeas during Cheyne-Stokes respiration has not previously been studied systematically. The current authors aimed to study the effect of body position and sleep stages on central sleep apnoeas during Cheyne-Stokes respiration. A total of 20 consecutive patients with cardiovascular diseases and central sleep apnoea during Cheyne-Stokes respiration were investigated using nocturnal polysomnography, including a body position sensor mounted on the patient's sternum. The mean central apnoea-hypopnoea index was significantly higher in the supine position than in nonsupine positions (41+/-13 versus 26+/-12). The central apnoea-hypopnoea index was highest in sleep stages 1 and 2, and lowest in slow-wave sleep and rapid eye movement sleep. In every sleep stage, central apnoeas and hypopnoeas were more prevalent in the supine position compared with nonsupine positions. In conclusion, sleep in the supine body position increases the frequency of apnoeas and hypopnoeas in patients with Cheyne-Stokes respiration.

Adult↗
PubMed2005

A prospective comparison of supine chest radiography and bedside ultrasound for the diagnosis of traumatic pneumothorax.

BACKGROUND: Supine anteroposterior (AP) chest radiography may not detect the presence of a small or medium pneumothorax (PTX) in trauma patients. OBJECTIVES: To compare the sensitivity and specificity of bedside ultrasound (US) in the emergency department (ED) with supine portable AP chest radiography for the detection of PTX in trauma patients, and to determine whether US can grade the size of the PTX. METHODS: This was a prospective, single-blinded study with convenience sampling, based on researcher availability, of blunt trauma patients at a Level 1 trauma center with an annual census of 75,000 patients. Enrollment criteria were adult trauma patients receiving computed tomography (CT) of the abdomen and pelvis (which includes lung windows at the authors' institution). Patients in whom the examination could not be completed were excluded. During the initial evaluation, attending emergency physicians performed bedside trauma US examinations to determine the presence of a sliding lung sign to rule out PTX. Portable, supine AP chest radiographs were evaluated by an attending trauma physician, blinded to the results of the thoracic US. The CT results (used as the criterion standard), or air release on chest tube placement, were compared with US and chest radiograph findings. Sensitivities and specificities with 95% confidence intervals (95% CIs) were calculated for US and AP chest radiography for the detection of PTX, and Spearman's rank correlation was used to evaluate for the ability of US to predict the size of the PTX on CT. RESULTS: A total of 176 patients were enrolled in the study over an eight-month period. Twelve patients had a chest tube placed prior to CT. Pneumothorax was detected in 53 (30%) patients by US, and 40 (23%) by chest radiography. There were 53 (30%) true positives by CT or on chest tube placement. The sensitivity for chest radiography was 75.5% (95% CI = 61.7% to 86.2%) and the specificity was 100% (95% CI = 97.1% to 100%). The sensitivity for US was 98.1% (95% CI = 89.9% to 99.9%) and the specificity was 99.2% (95% CI = 95.6% to 99.9%). The positive likelihood ratio for a PTX was 121. Spearman's rank correlation showed at rho of 0.82. CONCLUSIONS: With CT as the criterion standard, US is more sensitive than flat AP chest radiography in the diagnosis of traumatic PTX. Furthermore, US allowed sonologists to differentiate between small, medium, and large PTXs with good agreement with CT results.

Adult↗
PubMed2006

Feasibility of automated matching of supine and prone CT-colonography examinations.

Matching of prone and supine positions in CT colonography may improve accuracy of polyp detection. The purpose of this study was to investigate the feasibility of automatic prone-supine matching in CT-colonography using proven polyps as fixed points of reference. The method is based on similarities in the direction of centre-lines and allows for compression and extraction of the centre-lines in both positions. To illustrate the impact of the match error of the new method in practice, the visibility of the matched polyps in a primary three-dimensional unfolded cube setting was determined as well. The method was compared with a method that relies on the normalized distance along the centre-line (NDAC method). The median absolute match error was 14 mm (range 0-59 mm, average 20 mm) either proximal or distal from the actual polyp in prone position. In the observer study, 70% (26/37) of the polyps were directly visible in prone view. The overall difference in median absolute match error between both methods was small (2 mm), although half way along the centre-line there were polyps with substantial differences in match error (larger with NDAC). We concluded that automated prone-supine matching of CT-colonography studies is feasible and has a low match error. The difference with the NDAC method was small and not significant, although half way along the centre-line some differences were seen.

Algorithms↗
PubMed1997

Metabolic behavior of angiotensins in normotensive human plasma in the supine and upright postures.

The effect of activating the renin-angiotensin system on the metabolism of angiotensins (ANGs) in normotensive human plasma was investigated. In normotensive supine human plasma, four peptides with in vitro angiotensin I-converting enzyme (ACE) inhibitory activity which correspond to the sequence of ANG (3-8), ANG (4-8), ANG (5-8), and ANG (3-4) existed at a concentration of > 39 fmol/ml of plasma. When activating the renin activity by keeping upright in posture for 60 min, ANG II and the four peptides significantly increased as compared with the levels in the supine posture, except for ANG I. In particular, Val-Tyr corresponding to ANG (3-4) in the upright posture was about 4-fold more than the value in the supine posture, and was predominantly present (447 fmol/ml of plasma) as well as ANG I. As a result of in vitro degradation tests on ANGs, ANG (3-4) was produced from ANG I, and not from ANG II, III or (3-8), during the 30-min incubation.

Adult↗
PubMed2002

The effect of rotational malunion of the radius and the ulna on supination and pronation.

We have assessed the influence of isolated and combined rotational malunion of the radius and ulna on the rotation of the forearm. Osteotomies were made in both the radius and the ulna at the mid-diaphyseal level of five cadaver forearms and stabilised with intramedullary metal implants. Malunion about the axis of the respective forearm bone was produced at intervals of 10 degrees. The ranges of pronation and supination were recorded by a potentiometer under computer control. We examined rotational malunions of 10 degrees to 80 degrees of either the radius or ulna alone and combined rotational malunions of 20 degrees to 60 degrees of both the radius and ulna. Malunion of the ulna in supination had little effect on rotation of the forearm. Malunion of either the radius or of the ulna in pronation gave a moderate reduction of rotation of the forearm. By contrast, malunion of the radius in supination markedly reduced rotation of the forearm, especially with malunion greater than 60 degrees. Combined rotational malunion produced contrasting results. A combination of rotational malunion of the radius and ulna in the same direction had an effect similar to that of an isolated malunion of the radius. A combination in the opposite direction gave the largest limitation of the range of movement. Clinically, rotational malunion may be isolated or part of a complex angular/rotational deformity and rotational malunion may lead to marked impairment of rotation of the forearm. A reproducible method for assessing rotational malunion is therefore needed.

Cadaver↗
PubMed1994

Normal values for single exhalation diffusing capacity and pulmonary capillary blood flow in sitting, supine positions, and during mild exercise.

Previous approaches to the measurements of pulmonary diffusing capacity (DL) and pulmonary capillary blood flow (QC) utilized either the rebreathing or the single inhalation technique in conjunction with radioisotope gas and mass spectrometry. In the present study, we utilized a newly developed rapid infrared analyzer in conjunction with the slow single exhalation technique on 100 healthy volunteers to establish normal values for DL and QC under sitting, supine, and exercise conditions. The exercise level was determined by a target heart rate: HRex = ([HRmax - HRrest]/3) + HRrest. Prediction equations based on regressions on age, sex, height, or weight were then computed for sitting, supine, and exercise values. We found that mean DL and QC increased by approximately 12 percent and 8 percent, respectively, from sitting to supine posture, and by approximately 30 percent and 100 percent, respectively, from sitting (rest) to mild exercise. These results provided a database for further studies in the single exhalation method in various clinical settings.

Acetylene↗
PubMed2006

Effect of prone and supine position on sleep, apneas, and arousal in preterm infants.

OBJECTIVE: Prematurely born compared with term born infants are at increased risk of sudden infant death syndrome, particularly if slept prone. The purpose of this work was to test the hypothesis that preterm infants with or without bronchopulmonary dysplasia being prepared for neonatal unit discharge would sleep longer and have less arousals and more central apneas in the prone position. METHODS: This was a prospective observational study in a tertiary NICU. Twenty-four infants (14 with bronchopulmonary dysplasia) with a median gestational age of 27 weeks were studied at a median postconceptional age of 37 weeks. Video polysomnographic recordings of 2-channel electroencephalogram, 2-channel electro-oculogram, nasal airflow, chest and abdominal wall movements, limb movements, electrocardiogram, and oxygen saturation were made in the supine and prone positions, each position maintained for 3 hours. The duration of sleep, sleep efficiency (total sleep time/total recording time), and number and type of apneas, arousals, and awakenings were recorded. RESULTS: Overall, in the prone position, infants slept longer, had greater sleep efficiency (89.5% vs 72.5%), and had more central apneas (median: 5.6 vs 2.2), but fewer obstructive apneas (0.5 vs 0.9). The infants had more awakenings (9.7 vs 3.5) and arousals per hour (13.6 vs 9.0) when supine. There were similar findings in the bronchopulmonary dysplasia infants. CONCLUSIONS: Very prematurely born infants studied before neonatal unit discharge sleep more efficiently with fewer arousals and more central apneas in the prone position, emphasizing the importance of recommending supine sleeping after neonatal unit discharge for prematurely born infants.

Arousal↗
PubMed1994

Functional electrical stimulation (FES) to the biceps brachii for controlling forearm supination in the paralyzed upper extremity.

Control of forearm supination using the functional electrical stimulation (FES) to the biceps brachii was studied in a C4 quadriplegic patient. As a result of FES to the biceps brachii, and the other elbow flexors and extensors, supination was induced in maintenance of the elbow in the maximum flexion and extension, respectively. Although a range of the movements was still small and limited, these findings indicated a possibility of FES to the biceps brachii for controlling supination in paralyzed upper extremities.

Adult↗
PubMed1995

Electromyographic (EMG) study of the elbow flexors during supination and pronation of the forearm.

Activities of the elbow flexors during supination and pronation of the forearm in a normal human volunteer were studied by an electromyography (EMG). The volunteer performed the movement slowly or quickly holding elbow flexion at various angles with or without a load. The biceps brachii showed an increase and a decrease of EMG activities during supination and pronation, respectively. The brachialis and brachioradialis showed a reduction and an increment of EMG activities accompanied by an increase and a decrease of EMG activities in the biceps brachii, respectively. These findings seem to indicate that reciprocal contractions among the elbow flexors permit the biceps brachii to work for supination without an induction of elbow flexion.

Adult↗
PubMed1999

CT colonography: value of scanning in both the supine and prone positions.

OBJECTIVE: The purpose of this study was to evaluate the effectiveness of CT colonography when patients were imaged in both the supine and prone positions. We evaluated whether imaging in two positions decreased the number of collapsed colonic segments and increased sensitivity for polyp detection. MATERIALS AND METHODS: Twenty-three patients underwent CT colonography in both the supine and prone positions. Colonic distention for each of the 46 scans was graded. Adequacy of distention for either position alone was compared with that of the combination of the two positions. Polyp data revealed by colonoscopy were reviewed, and the CT data were then retrospectively reviewed for polyp detection. RESULTS: When each scan was considered alone without benefit of the scan obtained in the opposite position, 27 (58.7%) of 46 scans showed inadequate distention. When scans obtained in both positions were considered together, 20 (87.0%) of 23 patients had adequate distention with the grading system used. However, this value increased to 23 (100%) of 23 patients when the reasons for inadequate distention in the three patients were considered. Of the 27 polyps detected with colonoscopy, 21 (77.8%) were also detected retrospectively with CT colonography. Colonoscopy showed 20 polyps that were 5 mm or larger; nineteen (95.0%) of these 20 polyps were also detected retrospectively with CT colonography, nine (47.4%) of which were seen in only one position. CONCLUSION: Use of both the supine and prone positions for patients undergoing CT colonography improves evaluation of the colon and increases sensitivity for polyp detection.

Aged↗
PubMed1990

An adjustable splint for forearm supination.

The adjustable supination splint is used in select cases in which traditional mobilization therapy is not productive in supination gains. The success of the splint varies depending on many factors, including the type and severity of the injury; the timing of the intervention; the patient's age; and the patient's tolerance of and compliance with the treatment program. The therapist must consult with the physician and have his or her approval before initiating the treatment regimen. Splint use is contraindicated in patients with unstable fractures or with injuries that require surgical intervention before splinting. Therapists should watch for edema, pain, and neurological changes. Depending on the severity of these symptoms, the splint may need to be discontinued or the wearing time and tension adjusted. In our experience at Union Memorial Hospital and in our weighing of the above considerations, we have found favorable results in the use of the adjustable supination splint, with gains in range of motion and function in select patients.

Adolescent↗
PubMed1998

[Measurement of the strength of pronation and supination forces and its significance in radius fracture displacement].

The strength of pronation and supination was measured by "Forearm-Rotate-Dynamometer" on 524 male and female students ranging in age from 16 to 32. The study showed that the strength of supination was 13% greater than that of pronation for 91.3% of all the tested subjects (1048 sides). Based on this finding, the pattern of displacement fracture of the middle lower segment of the radius was discussed. It was concluded that the proximal fragment displacement will show supination, adduction and flexion when a proximal fragment displacement occurs.

Adolescent↗
PubMed2000

[Evaluation of varicocele by ultrasonography through a water bag in the supine position].

Recently, ultrasonography has been widely used to evaluate varicocele. However, it is difficult to obtain reproducible scrotal images with a hand probe in the standing position. We, therefore, applied the water bag technique during ultrasonographic examination of the scrotal contents in the supine position. The ultrasonographic images thus obtained were compared with physical findings and scrotal scintigraphic findings. Forty-five varicocele patients diagnosed by palpation and ultrasonography were enrolled in this study. An ultrasonographic examination through a water bag in the supine position has the following advantages 1) it is easy to perform and stable images are obtained, 2) varicoceles that are not palpable can be detected and 3) examinations can be repeated both pre- and postoperatively. Of the 45 patients, 39 and 41 had positive findings on the ultrasonographic images and physical examinations, respectively. Four patients had negative findings on physical examination but positive findings on the ultrasonographic images. Thus, ultrasonographic images through a water bag in the supine position proved to be a useful method of confirming the hemodynamics in varicoceles.

Adolescent↗
PubMed1995

Calf venous compliance measured with head-up tilt equals supine calf compliance.

Elevated calf compliance may contribute to orthostatic intolerance following space flight and bed rest. Calf venous compliance is measured conventionally with venous occulusion plethysmography in supine subjects. With this well-established technique, subjects undergo inflation of a pressure cuff around the thigh just above the knee, which increases calf venous pressure. A plethysmograph simultaneously measures calf volume elevation. Compliance equals calf volume elevation per mm Hg thigh occlusion (calf venous) pressure in relaxed legs of the supine subjects. Compliance may also be measured during stepwise head-up tilt (HUT) as calf volume elevation per mm Hg gravitational venous pressure elevation produced by HUT. However, during HUT on a tilt table with a footplate, calf muscles activate to counteract gravity: this is an obvious and natural response to gravitational force. Such muscle activation conceivably could reduce calf compliance, yet relatively little calf muscle activation occurs during HUT and orthostasis (<10% of maximal voluntary levels). Also, this activation produces minimal calf volume change (<0.3%). Therefore, we hypothesized that calf compliance measured with HUT equals that measured with supine venous occlusion.

Adult↗
PubMed1998

Influence of landing on the supination and pronation in the foot joint.

The purpose of this study was to measure the changes of supination and pronation in the ankle joint at landing to quantify the influence of shock attenuation during landing. The subjects did two different motions, jumping down on the force platform from posterior and lateral views. The rear view of single foot contact in a jump from height of 30 and 60 cm showed a landing on the inside of the rear part of the foot (pronation) followed after about 0.03 sec by a rolling outward of the foot (supination). The variables describing changes in three angles of the ankle joint indicated that the standing position was more sensitive on the pronation and supination during ground contact.

Adult↗
PubMed2000

Effects of supine floating on heart rate, blood pressure and cardiac autonomic nervous system activity.

It is known that heart rate, oxygen uptake and body temperature during exercise in water are affected by water temperature, buoyancy and so on. Relaxation in water (supine floating) has been performed in hydrotherapy and aqua exercise. But there were few reports about supine floating (Schulz and Kaspar 1994). The purpose of this study was to make clear the effects of supine floating on heart rate, blood pressure and cardiac autonomic nervous system activity in males.

Adult↗
PubMed2002

[Central venous pressure. Variations in patients with intolerance to supine decubitus].

An accurate measure of central venous pressure has great clinical value; although at times due to causes inherent in the pathology of a patient this cannot be measured be the utmost conditions. The position a patient has in bed invariably affects the final measurement of central venous pressure in that patient. It is important to bear this in mind for patients who do not tolerate a supine position, such as those with polytraumatic injuries. The authors studied the variations in central venous pressure values taken on the same patient when he was in a supine position and when he had his bed inclined 45; the authors opted for an analytical study using 1061 measurements on patients checked into the intensive care ward at the Nuestra Señora de Fatima Clinic in Seville. The correct placement of the central catheter, either clavicle, jugular or "DRUM" placement, was confirmed by means of radiological testing in each of these patients. After obtaining these central venous pressure measurement values, the authors related these to the patient's corporal mass index, a comparison of weight in kilograms to height en square meters; they observed that when a patient's corporal volume is greater, greater is the difference between the measurements in a supine position and with bed inclined 45 degrees, in favor of the first measurement.

Blood Pressure Determination↗