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PubMed2000

Core temperature measurement during supine exercise: esophageal, rectal, and intestinal temperatures.

BACKGROUND: The purpose of this study was to characterize intestinal temperature (T(in)) in comparison to esophageal (T(es)) and rectal temperature (T(re)) during supine exercise. METHODS: Seven subjects completed a continuous supine protocol of 20 min of rest, 20 min of cycle exercise at 40% peak oxygen consumption (V(O2peak)), 20 min of cycle exercise at 65G% V(O2peak), and 20 min of recovery. T(es), T(re), and T(in) were recorded each min. RESULTS: Temperatures were not different after 20 min of rest, but T(es) and T(in) were greater than T(re) at the end of the 40% (T(es): 37.38 +/- 0.11; T(in): 37.35 +/- 0.06; T(re): 37.20 +/- 0.10 degrees C) and 65% V(O2peak) stages (T(es): 37.83 +/- 0.10; T(in): 37.75 +/- 0.05; T(re): 37.63 +/- 0.08 degrees C). After 20 min of recovery, T(es) (37.24 +/- 0.011 degrees C) was less than either T(re) or T(in), which were not different from each other (T(in): 37.39 +/- 0.09; T(re): 37.44 +/- 0.09 degrees C). Time to threshold for increased temperature from rest (+0.10 degrees C) for T(es) (10.0 +/- 1.1 min) was not different from T(in) (14.0 +/- 1.2 min) but less than T(re) (15.7 +/- 1.6 min). Time to reach peak temperature was less for T(es) (36.6 +/- 1.8 min) than T(in) (40.6 +/- 0.9 min) and T(re) (41.4 +/- 0.5 min). Similarly, time to a decrease in temperature (-0.10 degrees C) after exercise was less for T(es) (3.7 +/- 0.4 min) than T(in) (7.1 +/- 1.5 min) and T(re) (10.6 +/- 1.9). CONCLUSIONS: Measurement of T(in) may be an alternative to T(es) to measure T(core) specific time points during exercise with an understanding of the slower response of Tin compared with T(es).

Adult↗
PubMed1976

Metabolic clearance rate of dehydroisoandrosterone sulfate. VII. Effect of lateral versus supine recumbency.

The physiologic events which may occur with the gravid women in the supine position suggest that uteroplacental blood flow may be impaired as a consequence of decreased venous return to the heart and the resulting decrease in cardiac output. Since the metabolic clearance rate of dehydroisoandrosterone sulfate (MCRDS) previously has been shown to reflect alterations in uteroplacental perfusion, the MCRDS was measured in a variety of different obstetric conditions during lateral and supine recumbency. No significant difference in the MCRDS was induced by this specific positional change, suggesting that uteroplacental perfusion was not altered. Experimental data are discussed which support this observation, and a possible mechanism for maintenance of uteroplacental blood flow under these circumstances is presented.

Dehydroepiandrosterone↗
PubMedDate not supplied

[Sleeping in the supine position in the ASL 11 region of Piemonte. Assessment of the efficacy of a promotional campaign].

OBJECTIVES: To record the prevalence of the sleeping position of sucklings living in the ASL 11-Regione Piemonte; to make an information campaign about the utility of sleeping in the supine position (most important protection factor against the SIDS); to find out its efficacy for a short or long time. METHODS: During the first two months of 2002 all the parents coming to the consulting rooms for the compulsory vaccinations of their 3 and 5 months old babies have been interviewed about the position of their babies during sleep. The same recording has been made in the first two months of 2003 and 2004. During 2002 various consciousness campaigns have been made, above all for medical operators of hospital nurseries and of Mother-and-Child Departments and Prevention Departments in ASL 11 area. RESULTS: Before the consciousness campaign the percentage of 3 months old sucklings sleeping in the supine position was 62,3% and 55% for the 5 months old suckings; after the campaign the percentage has grown to 77,4% for 3 months old sucklings and 74,5% for 5 months old sucklings during 2003 and during 2004 the percentage has grown to 80,3% and 74,2%, respectively. CONCLUSIONS: A simple and not expensive but capillary consciousness and information campaign addressed to medical operators has obtained valid and statistically relevant results in a short time.

Health Promotion↗
PubMed1991

[Venous air embolism following repositioning from sitting to supine].

We have experienced a patient in whom venous air embolism reoccurred, when the patient's position was changed from sitting to supine. A 40 year old male with Arnold-Chiari malformation underwent suboccipital decompression and cervical laminectomy under the sitting position. During surgery, three episodes of venous air embolism were detected by high pitched sound through precordial ultrasound Doppler stethoscope, an abrupt increase in pulmonary arterial pressure, a decrease in end-tidal carbon dioxide concentration; and a small amount of bubbled air was removed from the central venous catheter. At the end of surgery when the patient was turned to supine position, the signs of venous air embolism reappeared and 3 ml of bubbled air was also removed. This case suggests that there is some remaining air in the large veins of the upper part of the body once the air embolism has occurred during sitting position and thus we need to confirm that no air is left in the large veins before repositioning. We should be cautious of reoccurrence of venous air embolism whenever patient's position is changed.

Adult↗
PubMed1990

[Influence of fetal position on respiratory function and its modification by epidural anesthesia in supine pregnant women].

We investigated the influence of fetal position on respiratory function and its modification by epidural anesthesia in supine pregnant women. We found that supine pregnant women in whom the fetus was in the right occipital anterior position (ROA) had lower inspiratory reserve volume (IRV) and vital capacity (VC) than controls in whom the fetus was in the left occipital anterior position (LOA). When the analgesic level was up to Th7 or lower, epidural anesthesia increased the VC of women with a ROA fetus and also increased IRV. With higher analgesic levels up to Th4-Th6, tidal volume (TV) and VC increased independently of fetal position. We speculate that the pressure caused by the ROA fetus on thorax of the mother is stronger and that after epidural anesthesia this pressure decreases even though the analgesic level is low, and with the analgesic level up to Th4-Th6, the level used for Cesarean section, the displacement of the uterus makes respiration during rest easier regardless of fetal position.

Anesthesia, Epidural↗
PubMed1989

[Supination stability of the Adimed-Stabil-II shoe in capsule-ligament instability of the upper ankle joint].

A prerequisite for functional treatment of an unstable capsular ligament of the ankle joint is sufficient protection against supination through exterior stabilization. Examination of 20 such patients provided with a Adimed-Stabil II shoe proved that the new, improved Adimed-Stabil II shoe is reliable and sufficient protection against supination. All 20 patients had an unstable capsular ligament of the ankle joint, which was later proved by operation. In suitable cases, treatment with this shoe can be recommended to reduce the duration of disablement.

Adolescent↗
PubMed1989

[Changes in the cardiac dynamics in passive tile to the supine position--impedance cardiography measurements].

Passive tilt is an effective means to manipulate cardiodynamic processes. While there is a large amount of literature available concerning cardiac function with upright tilt, passive tilt into the supine position is poorly investigated. There is evidence that adapting processes to the new position do not show analogy in both conditions. In this study we investigated cardiodynamic changes occurring with passive-graded tilt from the upright position to 20 degrees headdown tilt. Twenty healthy students of both sexes participated in the study. Using impedance cardiography combined with phonocardiography it was possible to acquire stroke volume, heart rate, Heather index, and systolic time intervals. The whole procedure was repeated to test the reliability of impedance data. There was no steady augmentation of stroke volume. Between 90 degrees and 60 degrees stroke volume remained stable and showed only little change between 60 degrees and 30 degrees. Between 30 degrees and the supine position there was a steep increase of stroke volume. Tilting into the upright position apparently has a different effect. The onset of heart rate decline preceded the increase of stroke volume. It is concluded that only little changes of stroke volume/preload are necessary to induce vagal response. In the 30 degrees position both cardiac output and Heather index were minimal; this may be due to decreased sympathetic output. Systolic time intervals showed volume dependancy. Correlations between the first and second part of the study were high for all variables.

Adult↗
PubMed1987

[The supinator syndrome. Study of the course in 20 patients and therapeutic recommendations].

Between 1972 and 1984, 20 cases of the supinator syndrome were examined with clinical and electrophysiological methods in our clinic. In 12 cases we found an idiopathic supinator syndrome in the strict sense and in 8 cases a traumatic lesion of the r. profundus of the radial nerve. We carried out follow-up studies in most of the patients. From these findings we attempt to derive guidelines for treatment. An absolute indication for operative revision in our opinion is present only in the case of complete transsection by trauma. Otherwise, the spontaneous course can be observed. The operative results in idiopathic cases are poor; it seems to be purposeless to operate patients who have a paresis for a long time. Therefore, the decision for or against an operative intervention has to be made soon after the diagnosis is secured.

Adolescent↗
PubMed1987

Supine urethroscopic and standing cystometry as screening methods for the detection of detrusor instability.

Two hundred eighteen women undergoing multichannel urethrocystometry were also studied with supine urethroscopic cystometry and/or standing single-channel cystometry to evaluate the use of the latter two studies in screening patients at risk for detrusor instability. Thirty-one percent of the women were found to have detrusor instability on multichannel urethrocystometry. Only 24.6% of these patients were detected with supine urethroscopic cystometry, whereas 59.3% were detected with standing single-channel cystometry. The specificity of these tests was better (94.4 and 82.4%, respectively) than the above sensitivities, but analysis of their predictive values confirmed that they are both poor screening tools for populations at risk for detrusor instability.

Adolescent↗
PubMed1987

The supine pneumothorax.

The consequences of an undiagnosed pneumothorax can be life-threatening, particularly in patients with trauma to the head or multiple injury and in those requiring mechanical ventilation. Yet it is these patients, whose films will be assessed initially by the surgeon, who are more likely to have a chest X-ray taken in the supine position. The features of supine pneumothoraces are described and discussed together with radiological techniques used to confirm the diagnosis, including computed tomography (CT) which may be of particular importance in patients with associated cranial trauma.

Diaphragm↗
PubMed1987

[Electrophysiologic study in supine and upright positions in patients with Wolff-Parkinson-White syndrome].

It is well known that in patients with Wolff-Parkinson-White (W.P.W.) adrenergic activity stimulation induced by exercise or isoproterenol I.V. infusion shortens the anterograde effective refractory period (E.R.P.) of the accessory pathway. Our purpose was to evaluate whether the upright position produces similar changes on the electrophysiologic properties of the accessory pathway and influences reciprocating tachycardias induction. In 18 patients, with W.P.W. syndrome, who underwent electrophysiologic study, we determined the anterograde E.R.P. of the accessory pathway and attempted to induce a reciprocating tachycardia in the supine and in the upright position. In 13 patients (72%) the anterograde E.R.P. of the accessory pathway shortened in the upright position (303 +/- 104 msec vs 331 +/- 123 msec; p less than 0.001); in 4 patients (22%) it was unchanged; in 1 patient was not defined, being inferior to the atrium E.R.P. We were able to induce a reciprocating tachycardia in 3 patients in the supine position, in 6 patients in the upright position. Electrophysiologic testing in the upright position improves the evaluation of the accessory pathway electrophysiologic properties.

Adolescent↗
PubMed1986

Arginine-vasopressin response to supine-erect posture change: an index for evaluation of the integrity of the afferent component of baroregulatory system in diabetic neuropathy.

The arginine-vasopressin (AVP) response to supine-standing postural change was evaluated in eight healthy subjects and in fourteen diabetic patients. Plasma AVP levels were found to increase in the controls and in nine subjects from the diabetic group. In the controls the increase was 139% 5 min. after standing and 275% 120 min. after standing. In four of the diabetics affected by autonomic neuropathy AVP failed to increase in response to standing, thus suggesting lesions of the neurogenic pathways connecting baroreceptors to neurohypophysis. Consequently, a failure of the afferent limb in the baroregulatory system must be taken into account among other localizations of autonomic neuropathy. On this basis, AVP measurement both in supine and erect positions could represent an additional test for assessing the integrity of the autonomic nervous system.

Adolescent↗
PubMed1986

[Significance of the Bárány convection hypothesis for thermal nystagmus. Quantitative comparison of the intensity of thermal nystagmus in supine and prone position].

The hypothesis of Bárány explaining thermic nystagmus has been shaken. We must accept a non-convective triggering of nystagmus in extraterrestrial space. Under terrestrial conditions, however, the reversibility of the thermic nystagmus by changing from supine to prone position continues to support the convection hypothesis. We examined the nystagmus intensity in the supine and prone position with 22 healthy ears. The thermic stimulus was monitored via computer-controlled alternating irrigation system. The sequence of examinations was randomised and the evaluation of the nystagmus effected by automatic analysis. Our data allow to assess the importance of the non-convective nystagmus. With clinical test conditions about 85% of the maximal thermal reaction can be explained by the convection hypothesis of Bárány. However, interindividual variance is considerable, and one exceptional case with predominantly non-convectively released nystagmus is presented.

Adult↗
PubMedDate not supplied

Evaluation of differential linear transformers as a non-invasive ventilatory method in supine subjects.

We present a new method to measure thoraco-abdominal perimeter variations using differential linear transformers inserted in belts. The high sensitivity (250 mV/mm), the low time drift (1 mV/24 h compared to a 1 V output for a tidal volume), the good frequency response (up to 10 Hz) and low cost (12,000 FF) are the major advantages over other devices. After calibration (using change contribution of thorax and abdomen and the least square method for calculation of volume-motion coefficients), estimated tidal volumes in 23 adults in supine position are within 0.06 +/- 5.17% and changes in functional residual capacity (43-453 ml) are within 3.4 +/- 15.3% when compared with direct spirometry. These results show that the method can be used to monitor ventilation accurately in supine healthy subjects.

Adolescent↗
PubMed1985

Supine position in labor and associated fetal heart rate changes.

Presented is an investigation of the relationship of fetal heart rate (FHR) deceleration and position of the patient in labor. In a group of 902 laboring patients, 126 (14%) demonstrated late decelerations. Of the 126, 24 (19%) patients demonstrated late decelerations in the supine position only. These occurred during uterine contractions and were associated with reduced femoral arterial blood pressure and amplitude of the capillary pulse of the big toe. A drop in capillary blood pH of the fetal scalp could also be demonstrated. These effects reproducibly appeared and disappeared when supine and lateral positions were alternated. These data would suggest that maternal aortic compression by the pregnant uterus plays a role in the etiology of fetal stress as expressed by changes in fetal heart rate and acid base balance. This effect can be evaluated and monitored simply by recording the pulse pressure of the big toe and femoral arterial pressure. These atraumatic procedures can be applied to any patient.

Aorta, Abdominal↗
PubMed1985

Therapeutic doses of phenylpropanolamine increase supine systolic blood pressure.

The anorectic agent phenylpropanolamine (PPA) has a low therapeutic index and can cause severe hypertension at doses as low as 85 mg. To determine the effects of a therapeutic dose on blood pressure, PPA 37.5 mg (as a commercially available immediate release formulation) or placebo was administered orally to ten normotensive subjects using a randomized double-blinded crossover design. The mean increase in supine systolic blood pressure (BP) was greater after PPA (18.5 +/- 10.7 mmHg) than after placebo (5.1 +/- 5.4 mmHg, P = 0.005). Increases in systolic BP after PPA ranged from 8 to 43 mmHg. The BP increase due to PPA was postural, and there was no change in sitting or standing BP. Doses of PPA available in over-the-counter formulations can increase supine systolic BP. Recent use of products containing PPA should be considered when evaluating patients with hypertension.

Adolescent↗
PubMed1985

Anatomic and radiographic appearance of a sesamoid bone in the tendon of origin of the supinator muscle of dogs.

Radiologic and anatomic studies of the elbow of 100 dogs of 17 different breeds showed that a sesamoid bone may be located in a constantly present sesamoid cartilage associated with the tendon of origin of the supinator muscle. The sesamoid was observed in 31% of the radiographs of 100 supinator tendons dissected from 50 of the dogs. The bone was usually bilateral and was best demonstrated in craniocaudal medial-to-lateral oblique radiographs of the elbow where it articulated with the craniolateral aspect of the head of the radius.

Animals↗