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PubMed1980

Supine pressor (roll-over) test: an evaluation.

One hundred supine pressor (roll-over) tests were reviewed and results were compared with clinical outcome and the literature. The present study revealed statistical differences, except for test sensitivity, in a comparison of all pregnancies without a prior history of hypertension, with subgroupings excluding patients with history of or potential urinary disease and patients with a recorded elevation in blood pressure occurring only in the early postpartum period. This lent support to the lowest false positive and false negative rates observed, 46% and 27%, respectively, seen in the subgroup having neither history of urinary disease nor significant potential for renal disease. For this subgroup, sensitivity of the test was 60%. Data were combined to create a hypothetical situation and reveal maximal potential in test predictability.

Adolescent↗
PubMed1986

Supine exercise testing in the selection of suprainguinal versus infrainguinal bypass in patients with multisegmental arterial occlusive disease.

Proper assessment of aortoiliac disease requires hemodynamic evaluation during lower extremity vasodilatation. Two tests that meet this criterion, intraarterial papaverine injection and supine exercise of the lower extremities, were compared in 35 extremities of 27 patients. Hemodynamic improvement as measured postoperatively was used as the standard for comparison. Ergometer and papaverine tests were 100 percent and 94 percent accurate, respectively, had sensitivities of 100 percent and 100 percent, specificities of 100 percent and 93 percent, positive predictive values of 100 percent and 75 percent, and negative predictive values of 100 percent and 100 percent. The lower accuracy rate for the papaverine test was the result of two borderline (false-positive) examinations. The ergometer test is more accurate but less applicable than the papaverine test. Routine papaverine testing with adjunctive ergometer testing is a highly accurate method of assessing the hemodynamic significance of aortoiliac disease.

Aorta, Abdominal↗
PubMed1995

Plasma neurotransmitters, blood pressure, and heart rate during supine resting, orthostasis, and moderate exercise in dysthymic depressed patients.

Dysthymic depressed patients showed platelet-serotonin (pS) + plasma-free serotonin values greater than normal as well as plasma noradrenaline values lower than normal during supine resting period (0'). Conversely, no significant differences were observed in the 0' values of any other of the measured parameters: systolic, diastolic and differential blood pressure (SBP, DBP, DP), heart rate (HR), adrenaline (Ad), dopamine (DA), cortisol, and platelet aggregability between patients and controls. Although patients showed then normal DP reduction at orthostasis (1'), this was not prevented by atropine as it does in controls. Patients but not normals showed significant rises of DBP at orthostasis and exercise (5') periods, which were positively correlated with NA rises. On the contrary, the abnormally raised resting fS values registered in patients showed progressive and significant reductions throughout the test that were negatively correlated with DBP-NA values. Adrenaline did not show the normal 5'-fS peak. The above findings suggest that dysthymics show hypoactivity of the two branches of the sympathetic system (neural + adrenal) along with hyperparasympathetic activity. Furthermore, their low NA + high pS values contrast with the high NA + low pS registered in major depressed subjects.

Adolescent↗
PubMed1983

A method for quantification of alternate pronation and supination of forearms.

A method for quantitative evaluation of diadochokinesia test (alternate pronation and supination of forearms) has been developed. Ten parameters that quantify features of movements were established. The method was applied to a group of healthy people and a group of patients with methylmercury poisoning. Significant differences between the two groups were noted in many parameters. To interpret the parameters synthetically, principal component analysis was applied and a scatter diagram on the first two principal components indicated the difference in distribution between the two groups. Among the established parameters, there were six related to regularity. They were combined in a linear form to define a summarized measure for regularity. The measure agreed very well with visual judgment. The obtained results demonstrated the usefulness of the method in daily clinical practices.

Forearm↗
PubMed1976

Effect of negative abdominal pressure on regional lung volumes in supine dogs.

Using 133Xe we measured regional lung volumes from apex to base in supine dogs during the application of negative abdominal pressure (-50 cm H2O). Changes in rib cage shape were monitored with magnetometers. Negative abdominal pressure caused a decrease of 5% in the cross-sectional area of the upper rib cage and a decrease of 19% in the cross-sectional area of the lower rib cage. These changes were similar to those observed when the dog was tilted to the erect position. Over the 10 cm of lung examined, control measurements showed a mean apex-to-base gradient of 1.4% TLC/cm, apical regions being more expanded than basal. Negative abdominal pressure increased this gradient to a mean of 2.1% TLC/cm. This change was in qualitative agreement with measurements of costal pleural surface pressure made in similar experiments by others. However, the changes we observed tended to be smaller than those predicted on the basis of costal pleural surface pressure. Since regional volumes represented the average of the pressures operating on lung regions, it was suggested that during negative abdominal pressure this average differed from pressure measured at the costal surface.

Abdomen↗
PubMed1978

Chest wall configuration in supine man: wakefulness and sleep.

We measured the anteroposterior and lateral diameter of the rib cage (RC), the anteroposterior diameter of the abdomen (ABD) and the cranio caudal abdominal dimension during breathing in supine posture, in order to analyze the shape of the chest wall in both awake and sleep conditions. By comparing the active breath holding and relaxation curves, it appeared that during activity of the respiratory muscles the RC is both expanded and distorted at the highest volumes and mainly distorted at the lowest volumes. During sleep the abdominal protrusion is smaller and the lateral sides of the rib cage expand more than during wakefulness. This might explain the higher rib cage motion during sleep found by some authors who measured the rib cage circumference and not confirmed by others who measured only its anteroposterior diameter. The motion of the rib cage is similar during sleep and wakefulness, its lateral parts leading the anteroposterior ones, showing that the pattern of motion of the rib cage is not affected by the different activation of the respiratory muscles. The possibility of a distorsion within the front part of the rib cage has been also discussed.

Adult↗
PubMed1987

Echocardiographic evaluation of left ventricular reserve in normal children during supine bicycle exercise.

To evaluate left ventricular reserve in normal children 127 healthy boys and girls (71 males, 56 females) were investigated with echocardiography during supine bicycle exercise at levels of 6, 9, 12 and 15 kpm/min/kg body weight. Left ventricular function parameters were obtained from the M-mode echocardiogram, electrocardiogram and phonocardiogram. The children were separated into three groups according to body surface area: group I less than 1.1 m2, group II 1.1-1.4 m2, and group III greater than 1.4 m2. Fractional shortening (FS) of the left ventricle rose during exercise from 37 +/- 4 to 46 +/- 4% with no significant differences between the three groups. Velocity of circumferential fiber shortening (Vcf) in group I augmented from 1.3 to 2.25 circ./sec, in group II from 1.29 to 2.60 circ./sec, and in group III from 1.17 to 2.74 circ./sec (P = 0.01). In the recovery period heart rate (HR) and blood pressure normalized earlier than did fractional shortening and velocity of circumferential fiber shortening. This could be expressed best by the ratios FS/HR and Vcf/HR. There were no significant differences between sexes, although there was a tendency to higher blood pressure and heart rate, a greater increase in velocity of circumferential fiber shortening and a smaller increase in fractional shortening in girls. These data indicate that girls increased cardiac output during exercise more by increasing their heart rate than did boys.

Adolescent↗
PubMed1987

Circadian fluctuation of plasma epinephrine in supine humans.

Previous studies have demonstrated circadian fluctuations of systemic catecholamines in man. However, methodological differences and conflicting results with epinephrine are apparent. In the present study, plasma and urinary epinephrine and norepinephrine and plasma cortisol were studied in healthy young adult males over 24 hr with 20 min plasma sampling and EEG monitoring of sleep. Plasma epinephrine did not have a circadian variation in supine subjects. Urinary epinephrine levels and small urinary circadian variations were increased by normal posture and activity. Sleep and sleep stage were not associated with different plasma epinephrine levels, and no ultradian fluctuation was observed. Levels of norepinephrine and cortisol were normal. Based on all studies to date, it appears that basal plasma epinephrine has either a very small amplitude or no circadian rhythm, but that changes in posture and activity or the rest/activity cycle may modify this pattern.

Activity Cycles↗
PubMed1989

Accuracy of cardiac output measured by continuous wave Doppler echocardiography during dynamic exercise testing in the supine position in patients with coronary artery disease.

To estimate the accuracy of cardiac output measured by continuous wave Doppler echocardiography from the suprasternal notch and the utility of this method for evaluating left ventricular function during dynamic exercise, simultaneous thermodilution and Doppler cardiac output were measured in 34 patients with coronary artery disease during multistage ergometer exercise in the supine position. Cardiac output was measured at rest and during each stage of exercise. Twenty-five of the 34 patients whose thermodilution curves were adequate for analysis were studied during exercise. The correlation coefficient for the two methods was 0.85 at rest and 0.84 during exercise. Differences between the two methods were not significant at rest but were significant during exercise, with the thermodilution method giving the higher values. Underestimation by the Doppler method is probably due to technical problems and changes in aortic diameter during exercise. The 25 patients were classified into two groups according to pulmonary artery wedge pressure at peak exercise. There were 11 patients in Group 1 pressure (greater than or equal to 20 mm Hg at peak exercise) and 14 in Group 2 pressure (less than 20 mm Hg at peak exercise). There were significant differences in the change in cardiac index and in peak aortic velocity from rest to peak exercise between the two groups. A significant linear correlation between the percent change in peak aortic velocity and in pulmonary artery wedge pressure from rest to peak exercise was observed (r = -0.66, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Simultaneous estimation of liquid and solid gastric emptying using radiolabelled egg and water in supine normal subjects.

To develop an additional method for the measurement of gastric emptying in supine subjects, 10 normal subjects were given a test meal containing 99Tc-labelled scrambled egg as the "solid" phase marker and 111In in tapwater as the marker for the "liquid" phase. The mean time for emptying 50% of the "solid" phase (t1/2) was 85 min and 29 min for the "liquid" phase. Three individuals were restudied with a mean difference between the two determinations of 10.8% for the "solid" phase and 6.5% for the "liquid" phase. Twenty-six additional studies attempted have been successfully completed in symptomatic patients with advanced cancer. This method provides a simple and reproducible procedure for the determination of gastric emptying that yields results similar to those reported for other test meals and can be used in debilitated patients.

Adult↗
PubMed2005

Reliability of the soleus H-reflex from supine to standing in young and elderly.

OBJECTIVE: Many recent studies have used the soleus H-reflex methodology to examine age-related changes in neuromuscular function. However, reliability of the method has only been tested in young adults. The purpose of this study was to evaluate the inter-trial reliability of the soleus H-reflex in both young and elderly subjects during supine and standing conditions. METHODS: The experiment was carried out on 10 young and 10 elderly subjects. For each subject, 10 standardized soleus H-reflex trials were collected during each of the postural conditions. Intraclass correlations were calculated for the first 4, 6, 8, and 10 trials for each group at each body position. RESULTS: The largest decreases in reliability in this study were observed with a decrease in the number of trials used to estimate the elderly soleus H-reflex during the standing condition. The change from using ten trials to using four trials led to an 8% decrease in reliability. CONCLUSIONS: Due to the decreased postural control ability in the elderly population, at least ten trials should be used to estimate soleus H-reflex characteristics during standing or other functional weight-bearing conditions. SIGNIFICANCE: Using fewer than 10 trials could lead to an increase in statistical errors and misinterpretation of results.

Adult↗
PubMed1977

Hemodynamics of supine bicycle exercise in "normal" children.

Sixty children age 5 to 16 years with normal or nearly normal hearts performed submaximal and maximal supine bicycle exercise. Submaximal cardiac output was linearly correlated with work load (r = 0.80). After 2 minutes' exercise cardiac output was over 90 per cent of the value for 6 minutes' exercise. Maximal cardiac index was 10.1 +/- 1.8 for boys and 8.6 +/- 1.8 L. per minute per square meter for girls. Stroke volume was highest during the recovery period after maximal exercise. Pulmonary artery PO2 fell to 24 mm. Hg, oxygen saturation to 33 per cent, and pH to 7.21. During maximal exercise mean pulmonary artery pressure was 24 +/- 5 mm. Hg and mean brachial artery pressure was 113 +/- 8. There were no major differences between children aged 5 to 9 years of age and those 10 to 16 years, except for higher hemoglobin values in postpubertal children.

Adolescent↗
PubMed1983

Radionuclide analysis of peak filling rate, filling fraction, and time to peak filling rate. Response to supine bicycle exercise in normal subjects and patients with coronary disease.

Using gated equilibrium radionuclide angiography, variables of diastolic filling were analyzed at rest and during supine bicycle exercise in normal subjects (Group 1, n = 18), coronary patients with normal resting ejection fractions (Group 2, n = 26), and coronary patients with reduced resting ejection fractions (Group 3, n = 8). Indexes analyzed were peak filling rate and filling fraction during the first third of diastole. At rest, the peak filling rate was significantly lower in coronary patients than in normal subjects (3.18 +/- 0.82 end-diastolic volume [EDV]/s in Group 1 versus 2.41 +/- 0.66 EDV/s in Group 2, p less than 0.005; and 1.34 +/- 0.26 EDV/s in Group 3, p less than 0.001 versus Group 1). These differences persisted at peak exercise. Coronary patients also had significantly lower filling fractions at rest and during exercise than did normal control subjects. The time from end-systole to peak filling rate was longer at rest in patients in Group 2 (203 +/- 52 ms) than in subjects in Group 1 (172 +/- 50 ms, p less than 0.025). This remained true when the time to peak filling was normalized by the R-R interval. Although the exercise time to peak filling was longer in coronary patients in both Groups 2 and 3 than in Group 1, these differences were not apparent when the interval was normalized by the R-R interval. Thus, abnormalities in peak filling rate and filling fraction exist in patients with coronary disease both at rest and during exercise, but large overlaps exist between normal and coronary patients. Caution is advised in comparing the timing of events during diastole because apparent group differences may be related in part to rest or exercise heart rate.

Adult↗
PubMed1995

Comparison of the 10-minute supine-30-minute tilt test with 24-hour ambulatory blood pressure for the diagnosis of diastolic systemic hypertension.

A variant of the protracted tilt test, the 10-minute supine -30-minute tilt test (10S-30TT), has been proposed by us for the evaluation of blood pressure (BP). The present investigation compares parameters of diastolic BP by 3 methods: office measurements, 10S-30TT, and 24-hour ambulatory monitoring; the last method served as a reference standard. Twenty patients presenting at the office with diastolic BP values ranging from 80 to 120 mm Hg (median 90) were studied. Statistically significant correlations were observed between the following parameters: diastolic office BP and average ambulatory awake diastolic BP (r = 0.64, p = 0.002); average tilt-test diastolic BP and average ambulatory awake diastolic BP (r = 0.69, p = 0.0006); frequency of elevated diastolic BP values during the tilt test and frequency of elevated ambulatory awake diastolic BP values (r = 0.69, p = 0.0007). Diastolic BP diagnosis scores exhibited strong correlation only between the ambulatory and tilt-test diagnosis (kappa = 0.70), but not between ambulatory and office BP diagnosis (kappa = 0.50). Based on the close correlation between results of the 10S-30TT and ambulatory monitoring in the evaluation of diastolic BP, we suggest that the faster and cheaper tilt test may serve as a substitute in certain categories of patients.

Adult↗
PubMed1980

The supinator notch sign in rheumatoid arthritis.

Erosion of the ulna, giving a notch-like appearance in the region of the supinator groove, is reported in 18% of 110 unselected outpatients attending a rheumatoid clinic. The characteristic radiological, arthrographic and scintigraphic findings are presented. The mechanism, significance and differential diagnosis is discussed.

Aged↗
PubMed1986

Supine flexible cystoscopy.

We attempted cystoscopy with a flexible instrument and ureteral catheter insertion in 152 supine patients. Cystoscopy was successful in 147 patients (97 per cent) and ureteral catheters were inserted in 133 (91 per cent). Examinations with this instrument are tolerated better than those with rigid cystoscopes, which may improve patient compliance with followup examinations. The current drawbacks, namely a smaller field of view, lower visual acuity and, sometimes, inadequate irrigant flow rates, may be reduced or overcome with improvements in instrument design.

Adolescent↗
PubMed1999

Influence of abdomen on respiratory mechanics in supine rabbits.

Previous studies showed that abdominal evisceration has no effect on respiratory system compliance. We hypothesized that this could be related to lung distortion in eviscerated animals. Methods were developed for continuous recording of pleural pressure (Ppl) at various sites over the costal (co) and diaphragmatic lung surface (di) in acutely and chronically instrumented rabbits. We compared deltaPpl,co and deltaPpl,di recorded at mid-lung height during inflations in anesthetized, paralyzed supine rabbits before and after evisceration. Cranial and caudal deltaPpl.co were the same under all conditions. In intact animals, deltaPpl.co and deltaPpl,di were equal at all inflation volumes, whilst in eviscerated animals, deltaPpl,di were smaller than deltaPpl,co, the difference increasing with lung inflation. At any given volume, rib cage circumference (Crc) was smaller after evisceration, but the Crc deltaPpl,co relationship remained unchanged. These results are indicative of non-uniform lung expansion after evisceration and are consistent with model predictions based on cylindrical deformation and lung stress-strain relationship. This deformation should mimic the effect of a reduced lung compliance, keeping respiratory system compliance of eviscerated animals nearly normal. Similar deformation should have occurred also in intact rabbits during strong inspiratory efforts and in the erect posture, because lower Ppl,di than Ppl,co values were observed at the same lung height under these conditions.

Abdomen↗