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At least 937 records · Page 52Linked to original sources
PubMed1991

Leg movements in the supine position of infants with spastic diplegia.

Leg movements in the supine position of 49 infants with spastic diplegia (three to 11 months corrected age) were examined. Only simultaneous flexion and extension of the hips and knees were seen, with exceptional isolated hip movements; the simultaneous movements had synergic features. When the knees were flexed, the hips were flexed, abducted and externally rotated, and the ankles were dorsiflexed. When the knees were extended, the hips were extended, adducted and internally rotated and the ankles were plantar-flexed. Hip flexion combined with knee extension (leg elevation) and isolated knee movements were not seen in diplegic infants, but were seen in all control preterm infants with a good prognosis, after five and six months corrected age, respectively. The absence of these movements is a useful diagnostic item for spastic diplegia.

Cerebral Palsy↗
PubMed1997

Randomised trial comparing the upright and supine positions for the second stage of labour.

OBJECTIVE: To assess the maternal and neonatal effects of upright compared with recumbent positions during delivery, in terms of defined outcome variables. DESIGN: A randomised controlled trial. SETTING: St Monica's Nursing Home, a midwife based maternity unit in Cape Town, South Africa. PARTICIPANTS: Five hundred and seventeen women of low obstetrical risk assigned to deliver at the nursing home. RESULTS: The trial showed that women who adopted the upright posture for delivery experienced less pain. perineal trauma and fewer episiotomies than those who delivered in the supine position. CONCLUSION: The data suggest that in women of low obstetrical risk, choice of posture during delivery may be encouraged.

Adolescent↗
PubMed1982

Effects of externally applied compression on blood flow in subcutaneous and muscle tissue in the human supine leg.

The effect of positive tissue pressure on blood flow in subcutaneous adipose tissue and skeletal muscle tissue was studied in eight healthy humans resting in the supine position. Blood flow was measured by the local 133Xe clearance technique in the mid-calf region. Tissue pressure was increased by inflating a whole leg cuff to pressure levels between 10 and 60 mmHg. In subcutaneous tissue as well as in skeletal muscle tissue, blood flow and local vascular resistance was not significantly changed at compression with 10 mmHg (P greater than 0.1). The pressure-flow curve obtained from subcutaneous tissue was curvilinear with the convexity towards the pressure axis, as blood flow was significantly reduced, while local vascular resistance was significantly increased by further increase in cuff pressure. Compression with 60 mmHg reduced subcutaneous blood flow to 21% of the reference value (P less than 0.01), while local vascular resistance was increased 91% above the reference value (P less than 0.01). In skeletal muscle tissue the pressure-flow curve was curvilinear with the convexity towards the flow axis, as local vascular resistance was reduced to 93% of the reference value at compression with 20 mmHg (P less than 0.05). Compression with 60 mmHg reduced muscle blood flow to 41% of the reference value (P less than 0.01), while local vascular resistance was increased 32% above the reference value (P less than 0.05). Venous distension in compressed subcutaneous tissue increased blood flow with 46% (P less than 0.02), while regional vascular resistance was reduced with 53% (P less than 0.01). In skeletal muscle tissue the same procedure was not followed by significant changes in blood flow or vascular resistance (P less than 0.01). It is concluded that the observed difference between the two tissues could be caused by a difference in vessel collapsibility. Another mechanism responsible could be a difference in autoregulatory capacity.

Adipose Tissue↗
PubMed1967

Circulatory responses of supine subjects to the exposure of parts of the body below the xiphisternum to subatmospheric pressure.

1. Observations are reported on the effects of exposure of parts of the body below the level of the xiphisternum of supine subjects to a pressure 70 mm Hg below atmospheric for 1 min.2. The stress on the circulation was greater than when parts below the iliac crests were similarly exposed. Heart rate increased by 15-20 beats/min, there was a sustained fall in arterial blood pressure, and forearm blood flow fell profoundly and in some subjects was reduced to below 0.1 ml./100 ml. min.3. In arms that were sympathectomized, or had received an intraarterial infusion of an adrenergic blocking drug, the fall in forearm blood flow was much less and could be related to the fall in arterial pressure.4. When the suction was released there was a brief overshoot of arterial blood pressure and brief cardiac slowing. Forearm blood flow rose to reach a peak some 15 sec after the release.5. In the sympathectomized forearm on release of suction there was an immediate rise in blood flow which was proportionately much greater than the rise in arterial blood pressure.6. This rise was not due to circulating vasodilator substances or to the activity of cholinergic vasodilator nerves. The possibility that it was the result of a change in the tone of the resistance vessels occurring in response to the sudden change in transmural pressure is discussed.

Journal Article↗
PubMed2002

Renal tubular events following passage from the supine to the standing position in patients with compensated liver cirrhosis: loss of tubuloglomerular feedback.

BACKGROUND AND AIMS: Patients with preascitic liver cirrhosis display significant renal sodium retention in the upright posture and an exaggerated natriuresis during recumbency. To date, intrarenal sodium handling in these patients has not been studied using lithium clearance and fractional excretion techniques during recumbency and orthostatism. METHODS: Ten patients with preascitic (Child-Pugh A) liver cirrhosis and 10 healthy subjects underwent the following measurements during recumbency and then after four hours of standing: (a) active renin and aldosterone plasma levels; and (b) renal clearance of creatinine, sodium, potassium, and lithium (an index of fluid delivery to the loop of Henle). RESULTS: Unlike the control group, in the upright posture patients had significantly lower values of lithium clearance and fractional excretion compared with recumbency (21.6 (8.6) v 30.5 (10.2) ml/min (p<0.03) and 12.8 (4.4)% v 20.8 (4.9)% (p<0.01), respectively). Our patients showed maintenance of the glomerular-tubular balance-that is, the correlation between creatinine clearance and proximal tubular reabsorption of fluid-during both recumbency and in the upright posture (r=0.96, p<0.001; r=0.97, p<0.001, respectively). In contrast, patients displayed tubuloglomerular feedback only in the supine position. This was demonstrated by the observation of a negative correlation between lithium fractional excretion (a measure of the fractional delivery of sodium to the distal nephron) and filtered sodium load only in recumbency (r=-0.73; p< 0.03) and not during standing (r=0.22; p> 0.05). CONCLUSIONS: This study suggests that both the reduction in fluid and sodium delivery to the distal nephron and loss of tubuloglomerular feedback (the mechanism increasing glomerular filtration rate when the distal tubule is reached by a reduced sodium load) contribute towards the tendency to sodium retention in compensated cirrhosis during prolonged upright posture.

Adult↗
PubMed1979

Maximal supine exercise haemodynamics after open heart surgery for Fallot's tetralogy.

Maximal supine exercise studies at the time of heart catheterisation were performed one to five years after open heart surgery for Fallot's tetralogy on 29 subjects 6 to 16 years of age. During exercise right ventricular systolic pressure exceeded 50 mmHg in all but 2 subjects, and end-diastolic pressure increased to over 15 mmHg in 10 subjects. Pulmonary artery peak systolic pressure was abnormal in 5 patients. Maximal exercise cardiac index was below the normal range in only 2 subjects, but below the mean for normals in 80 per cent of the patients. Only 3 patients had clinical exercise performances below the 3rd centile of normal subjects using a maximal upright bicycle exercise test, and only 1 subject was below the normal range for endurance time on the Bruce treadmill test. The patients in this series performed better than those in other series, possibly because of their younger age at operation, the use of a large control series of normal subjects taken from a clinic population, the willingness of the patients to work to near exhaustion, and previous encouragement of the patients to become normally active children.

Adolescent↗
PubMed1980

Assessment of left ventricular contractility during supine exercise in children with left-sided cardiac disease.

Exercise stresses the cardiovascular system and causes it to use its reserve capacities. Exercise assessment may unmask abnormalities of left ventricular contractility not suspected from or detected by resting measurements. We have studied the following indices of left ventricular contractility in 21 children with left-sided congenital heart disease: maximum dP/dt, Vmax, Vpm, Vcf, and peak meridional wall stress. Studies were performed in the supine posture at rest, and at 25 per cent, and 50 per cent of a predetermined maximal upright workload on a bicycle ergometer. The method of measurement used simultaneous high fidelity catheter pressure tracings and M-mode echocardiography. There were no complications and the technique appeared practical and safe. The measurements of contractility differentiated patients with left ventricular volume or pressure overload from each other and from patients with either volume plus pressure overload, or myocardial dysfunction. These measurements can be used to measure the functional reserve capacity of patients with left-sided lesions, and may be useful in follow-up studies, especially before and after operation.

Adolescent↗
PubMed1982

Evaluation of left ventricular performance during supine exercise by transoesophageal M-mode echocardiography in normal subjects.

In order to evaluate left ventricular function during dynamic exercise transoesophageal M-mode recordings of the left ventricle were carried out with a newly developed transducer gastroscope system. Twelve healthy subjects performed a graded supine bicycle exercise test. Stable and good quality images of the left ventricle at rest and during exercise at different steps up to a maximum workload of 100 watts were obtained in all patients. Isotonic maximum exercise resulted in a significant increase in fractional shortening of the left ventricle, peak shortening rate, and peak lengthening rate of the left ventricular minor axis. Left ventricular end-diastolic dimension decreased significantly. With increasing workload the pressure rate product increased significantly. It is concluded that transoesophageal M-mode echocardiography is a useful method of evaluating left ventricular performance during dynamic exercise.

Adolescent↗
PubMed1976

Mechanism of the inverted supinator reflex. A clinical and neurophysiological study.

The inverted supinator reflex sign was analysed in two patients by recording the response of the finger flexor muscles of the forearm to tapping of the styloid process of the radius before and after procain infiltration of these muscles. It was found that the response persisted despite the block. The findings support the concept that the underlying mechanism is increased alpha motoneurone excitability below the level of the lesion; however, a possible contribution of the dynamic muscle spindles could not be excluded.

Evoked Potentials↗
PubMed1977

The widened interspinous distance: a useful sign of anterior cervical dislocation in the supine frontal projection.

Anterior dislocation of the cervical spine may be detected reliably in the supine frontal projection by evaluating the cervical spinous processes. A widened interspinous distance (ISD) which measures more than one and one-half times the ISD above and more than one and one-half times the ISD below indicates the presence of an anterior cervical dislocation at the level of abnormal widening. Measurements of the interspinous distances from the C3-C4 interval through the C7-T1 interval in 500 patients with normal cervical spines and in 14 patients with documented anterior cervical dislocations revealed neither false positive nor false negative diagnoses by these criteria.

Adolescent↗
PubMed1979

Supine pedal venous measurement in patients with venous disease.

The measurement of supine pedal venous pressure as a screening test for deep venous thrombosis is re-evaluated. In 83 extremities studied in 50 patients, the false-positive rate was 62%, the false-negative rate 8%. Chronic venous disease, whatever its etiology but particularly in association with the post-phlebitis syndrome, can be a source of error in relying upon this measurement.

Chronic Disease↗
PubMed1984

Hydropneumothorax: detection on supine radiographs.

Hydropneumothorax may be diagnosed on a supine radiograph by recognition of a pleural line with increased density lateral to it in the pleural space. Recognition of this condition may have implications for therapeutic chest tube placement.

Adolescent↗
PubMed1985

Supine thallium 201 cardiac testing compared with treadmill testing.

Although thallium 201 stress testing is usually performed on a treadmill (Tl-TM), supine bicycle-ergometer-exercise thallium 201 testing (Tl-SB) has been reported. We performed a study to evaluate the accuracy of Tl-SB in evaluation of coronary artery disease and to correlate its results with those of Tl-TM. Fifty patients underwent both Tl-SB and Tl-TM testing in random sequence an average of 1 week apart. Tl-TM produced significantly higher maximal pulse rates and pulse-pressure products. Cardiac thallium kinetics differed significantly between Tl-SB and Tl-TM with Tl-TM producing greater initial myocardial uptake and greater thallium 201 washout between immediate and delayed images. Compared with results of catheterization, Tl-TM was significantly more accurate than Tl-SB for evaluation of coronary artery disease, with higher sensitivity and specificity.

Coronary Disease↗
PubMed1989

Sagittal tomography in the supine patient.

The authors have developed a multidirectional tomographic unit to obtain sagittal images with the patient in the supine or prone position. The apparatus is particularly useful for examination of the vertebral column and sella turcica. It can be employed in circular (0 degrees -40 degrees) and spiral (10 degrees -32 degrees) motions. The apparatus provides correct and easy positioning of subjects with easy maintenance of posture. It reduces the distortional effects of respiration and thereby markedly improves reproducibility.

Humans↗
PubMed1975

Effective respiratory system elastance during positive-pressure breathing in supine man.

Two healthy males relaxing supine on a ballistobed were mechanically ventilated at positive end-expiratory pressures (PEEP) from 0 to 19 cmH2O. Pressures at the airway opening, middle esophagus, and stomach were monitored, together with tidal volume (VT) and ballistobed displacement. The effective elastance (i.e., sum of active and passive components) of the respiratory system (E'rs) and its components--abdominal muscle (E'ab), diaphragm (E'di), and rib cage (E'rc)--were calculated. With increasing PEEP, lung compliance increased slightly, E'rc and E'di decreased linearly, and E'ab increased linearly. The combined effective elastance of abdomen and diaphragm (E'ab+di) first decreased and then increased again. The abdomen-diaphragm contribution to VT during mechanical ventilation was approximately half that of spontaneous breathing.

Abdomen↗
PubMed1980

Chest wall motion and distribution of inspired gas in anesthetized supine dogs.

Changes in the anterior-posterior (AP) and lateral diameters of the rib cage and abdomen were assessed by magnetometry in seven anesthetized supine dogs during spontaneous respiration (SR) and mechanical ventilation after muscle paralysis (MV). Regional distribution of inspired gas was measured for both modes of ventilation by determining regional 133Xe clearances. Marked differences in chest wall motion were observed between SR and MV: during MV, the changes in lateral rib cage diameter from FRC to end inspiration were larger, and the changes in both abdominal diameters smaller than during SR. AP rib cage diameter changes were similar for both modes of ventilation. Inward motion of the lateral rib cage during initial inspiration was observed in four dogs during SR; it disappeared consistently with MV. Regional 133Xe clearances were not significantly different: there was no cephalocaudal gradient, and the vertical gradient in regional ventilation was similar with MV and SR. We conclude that significant changes in chest wall motion and shape are not necessarily associated with detectable differences in the distribution of regional ventilation.

Animals↗