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Sample records for supine predominant osa

  1. Autonomic and metabolic effects of OSA in childhood obesity.

    Science.gov (United States)

    Oliveira, F M; Tran, W H; Lesser, D; Bhatia, R; Ortega, R; Mittelman, S D; Keens, T G; Davidson Ward, S L; Khoo, M C

    2010-01-01

    This study investigates the effects of exposure to intermittent hypoxia on cardiovascular autonomic control and metabolic function in obese children with obstructive sleep apnea (OSA). Each subject underwent: (1) a polysomnography; (2) morning fasting blood samples and a subsequent FSIVGTT; (3) noninvasive measurement of respiration, arterial blood pressure, and heart rate during supine and standing postures. Assessment of adiposity was performed using a DEXA scan. From these measurements, we deduced the pertinent sleep parameters, Bergman minimal model parameters and the parameters characterizing a minimal model of cardiovascular variability. Results suggest that intermittent hypoxia in OSA contributes independently to insulin resistance and autonomic dysfunction in overweight children.

  2. Dynamic loop gain increases upon adopting the supine body position during sleep in patients with obstructive sleep apnoea.

    Science.gov (United States)

    Joosten, Simon A; Landry, Shane A; Sands, Scott A; Terrill, Philip I; Mann, Dwayne; Andara, Christopher; Skuza, Elizabeth; Turton, Anthony; Berger, Philip; Hamilton, Garun S; Edwards, Bradley A

    2017-11-01

    Obstructive sleep apnoea (OSA) is typically worse in the supine versus lateral sleeping position. One potential factor driving this observation is a decrease in lung volume in the supine position which is expected by theory to increase a key OSA pathogenic factor: dynamic ventilatory control instability (i.e. loop gain). We aimed to quantify dynamic loop gain in OSA patients in the lateral and supine positions, and to explore the relationship between change in dynamic loop gain and change in lung volume with position. Data from 20 patients enrolled in previous studies on the effect of body position on OSA pathogenesis were retrospectively analysed. Dynamic loop gain was calculated from routinely collected polysomnographic signals using a previously validated mathematical model. Lung volumes were measured in the awake state with a nitrogen washout technique. Dynamic loop gain was significantly higher in the supine than in the lateral position (0.77 ± 0.15 vs 0.68 ± 0.14, P = 0.012). Supine functional residual capacity (FRC) was significantly lower than lateral FRC (81.0 ± 15.4% vs 87.3 ± 18.4% of the seated FRC, P = 0.021). The reduced FRC we observed on moving to the supine position was predicted by theory to increase loop gain by 10.2 (0.6, 17.1)%, a value similar to the observed increase of 8.4 (-1.5, 31.0)%. Dynamic loop gain increased by a small but statistically significant amount when moving from the lateral to supine position and this may, in part, contribute to the worsening of OSA in the supine sleeping position. © 2017 Asian Pacific Society of Respirology.

  3. How well tolerated is supine percutaneous nephrolithotomy?

    NARCIS (Netherlands)

    Baard, Joyce; Kamphuis, Guido M.; Westendarp, Matias; de La Rosette, Jean J. M. C. H.

    2014-01-01

    Supine percutaneous nephrolithotomy (PCNL) has been described in 1988 and several modifications followed since. Despite claimed benefits, supine PCNL is still neglected by the majority of urologists. Lack of experience and the fear of complications are possible explanations for the resistance to

  4. Security Analysis of Parlay/OSA Framework

    NARCIS (Netherlands)

    Corin, R.J.; Di Caprio, G.; Etalle, Sandro; Gnesi, S.; Lenzini, Gabriele; Moiso, C.; Villain, B.

    2004-01-01

    This paper analyzes the security of the Trust and Security Management (TSM) protocol, an authentication protocol which is part of the Parlay/OSA Application Program Interfaces (APIs). Architectures based on Parlay/OSA APIs allow third party service providers to develop new services that can access,

  5. Security Analysis of Parlay/OSA Framework

    NARCIS (Netherlands)

    Corin, R.J.; Di Caprio, G.; Etalle, Sandro; Gnesi, S.; Lenzini, Gabriele; Moiso, C.

    This paper analyzes the security of the Trust and Security Management (TSM) protocol, an authentication protocol which is part of the Parlay/OSA Application Program Interfaces (APIs). Architectures based on Parlay/OSA APIs allow third party service providers to develop new services that can access,

  6. Cognitive MAC designs for OSA networks

    CERN Document Server

    Derakhshani, Mahsa

    2014-01-01

    This SpringerBrief presents recent advances in the cognitive MAC designs for opportunistic spectrum access (OSA) networks. It covers the basic MAC functionalities and MAC enhancements of IEEE 802.11. Later chapters discuss the existing MAC protocols for OSA and classify them based on characteristic features. The authors provide new research in adaptive carrier sensing-based MAC designs tailored for OSA, which optimize spectrum utilization and ensure a peaceful coexistence of licensed and unlicensed systems. Analytically devised via optimization and game-theoretic approaches, these adaptive M

  7. Endocrine and Metabolic Aspects of OSA

    Directory of Open Access Journals (Sweden)

    Ravinder Goswami

    2014-03-01

    Full Text Available Obstructive sleep apnea (OSA is characterized by repeated spells of apnea.Collapsibility of hypopharynx due to multiple factors involving pharyngeal dilatormuscles and deposition of fat or fluid in the surrounding soft tissues are importantcontributing factors in its pathogenesis. OSA commonly affects obese individuals.Males are more commonly affected than the females probably due to the disturbingeffect of testosterone on sleep.The impact of OSA on human health include disturbances in endocrine and metabolicsystem affecting hypothalamic-pituitary-gonadal axis, adrenocorticotrophic-cortisolaxis, growth hormone, antidiuretic hormones and insulin resistance. There is atendency for predisposition of the metabolic syndrome or its components includingglycemic dysregulation, hypertension, hyperlipidemia and physical parameters relatedto adiposity. On the other hand, several endocrine disorders such as hypothyroidism,growth hormone excess, polycystic ovarian disease and testosterone replacement areassociated with increased prevalence of OSA.There is limited information on the effect of treatment of OSA by continuous positiveairway pressure (CPAP on the endocrine and metabolic disturbances. There is a needto conduct randomized controlled trials using CPAP therapy in patients with OSA andto study its cause and effect relationship with endocrine and metabolic disturbances.

  8. Can you die from obstructive sleep apnoea syndrome (OSAS)?

    LENUS (Irish Health Repository)

    O'Carroll, G

    2015-02-01

    Studies suggest an independent association between Obstructive Sleep Apnoea Syndrome (OSAS) and cardiovascular death. The purpose of our study is to examine doctors\\' awareness of this association and to determine whether this correlates with recording of OSAS on death certificates. We contacted the Central Statistics Office (CSO) and obtained relevant mention of OSAS on death certificates. We surveyed doctors on their view of OSAS-related deaths, CSO data from 2008-2011 reveal two deaths with OSAS documented as a direct cause and 52 deaths with OSAS as a contributory cause. Seventy-five doctors\\' surveyed (41%) believe OSAS can be a direct cause of death and 177 (96%) believe OSAS can be an indirect cause of death. Only 22 (12%) had putdown OSAS as a cause of death. OSAS is seldom recorded on death certificates. This is at odds with epidemiological forecasts and contrary to an opinion poll from a selection of doctors.

  9. online-osa festivalil / Tiia Johannson

    Index Scriptorium Estoniae

    Johannson, Tiia, 1965-2002

    1998-01-01

    Prantsusmaa, Balti ja Põhjamaade video ja uue meedia festival "offline@online" Eesti Kunstiakadeemias. Ka eesti netikunstist, festivali korralduslikust küljest, tulevikuplaanidest. Erilist äramärkimist leidis sloveenia kunstniku Vuk Cosici töö "ascii history of moving images", online-presentatsioonide osas Lev Manovichi teoreetiline loeng "Uue meedia keel". Aadress festivali netikunsti vaatamiseks

  10. Determinants of Unintentional Leaks During CPAP Treatment in OSA.

    Science.gov (United States)

    Lebret, Marius; Arnol, Nathalie; Martinot, Jean-Benoît; Lambert, Loïc; Tamisier, Renaud; Pepin, Jean-Louis; Borel, Jean-Christian

    2018-04-01

    Unintentional leakage from the mouth or around the mask may lead to cessation of CPAP treatment; however, the causes of unintentional leaks are poorly understood. The objectives of this study were (1) to identify determining factors of unintentional leakage and (2) to determine the effect of the type of mask (nasal/oronasal) used on unintentional leakage. Seventy-four polysomnograms from patients with OSA syndrome treated with auto-CPAP were analyzed (23 women; 56 ± 13 years; BMI, 32.9 kg/m 2 (range, 29.0-38.0 kg/m 2 ). Polysomnographic recordings were obtained under auto-CPAP, and mandibular behavior was measured with a magnetic sensor. After sleep and respiratory scoring, polysomnographic signals were computed as mean values over nonoverlapping 10-s intervals. The presence/absence of unintentional leakage was dichotomized for each 10-s interval (yes/no). Univariate and multivariate conditional regression models estimated the risk of unintentional leaks during an interval "T" based on the explanatory variables from the previous interval "T-1." A sensitivity analysis for the type of mask was then conducted. The univariate analysis showed that mandibular lowering (mouth opening), a high level of CPAP, body position (other than supine), and rapid eye movement (REM) sleep increased the risk of unintentional leaks and microarousal decreased it. In the multivariate analysis, the same variables remained independently associated with an increased risk of unintentional leakage. The sensitivity analysis showed that oronasal masks reduced the risk of unintentional leaks in cases of mouth opening and REM sleep. Mouth opening, CPAP level, sleep position, and REM sleep independently contribute to unintentional leakage. These results provide a strong rationale for the definition of phenotypes and the individual management of leaks during CPAP treatment. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  11. CPAP increases bronchial reactivity in OSAS patients

    Directory of Open Access Journals (Sweden)

    P. Korczyski

    2008-06-01

    Full Text Available Continuous positive airways pressure (CPAP is a well known and safe method of treatment patients with obstructive sleep apnoea syndrome (OSAS. The effects of CPAP administration on the upper respiratory tract are known. However its effects on the lower respiratory tract still needs to be determined. Studies on bronchial hyperreactivity in patients treated by CPAP are contradictory. The aim of the study was to assess the influence of a 3-week CPAP treatment in patients with OSAS and to evaluate associations between changes in bronchial reactivity and clinical features of OSAS and lung function tests (LFT. Patients with newly diagnosed OSAS and lack of infection or chronic illness of the respiratory tract or other conditions which could influence bronchial hyperreactivity (BHR were included. Investigations were performed in 101 patients. There were 88 males and 13 females, mean age 51.5±11.2 years and BMI 32.6±5.4 kg·m–2. Qualified patients were randomly divided into 2 groups: 76 patients to CPAP treatment group, 25 control group. Both groups did not differ in anthropometrics features, severity of OSAS and LFT. Metacholine challenge test (MchCT was performed at baseline and repeated after 3 weeks. Analysis of the individual results showed that in 11 patients the MchCT was positive (6 in the CPAP and 5 in the control groups. After 3 weeks in the group of CPAP treated patients an increase of BHR was noted. Log PC20M decreased from 1.38±0.3 to 1.26±0.5 (p<0.05. The number of patients with a positive result in the MchCT increased from 6 to 16 patients. There was no significant change in BHR in the control group. It was found that CPAP treated patients with BHR were older, had less severe OSAS and lower FEV1 (p<0.05. In none of the patients positive result of BHR did no affect compliance to CPAP treatment. Conclusions: CPAP therapy increases bronchial reactivity, but does not affect compliance to treatment.

  12. A Simple Technique of Supine Craniospinal Irradiation

    International Nuclear Information System (INIS)

    Munshi, Anusheel; Jalali, Rakesh

    2008-01-01

    We describe a simple procedure of craniospinal irradiation in supine position. The procedure was carried out with a 100-cm isocenter linear accelerator and compatible simulator. Treatment was with a 1 or 2 posteroanterior (PA)-directed spinal fields abutting lateral-directed cranial fields. Abutment of the fields was established by placement of markers on the neck of the patient, which provided a measure of the divergence of the spinal field. The precision and reproducibility of this technique, including the placement of junctions, appeared to be as good as for treatment in the prone position. The same could be verified with port films. We conclude that this new technique of supine craniospinal treatment is a simple and convenient alternative to traditional treatment in the prone position

  13. Influencing factors on CPAP adherence and anatomic characteristics of upper airway in OSA subjects.

    Science.gov (United States)

    Park, Pona; Kim, Jinil; Song, Yoon Jae; Lim, Jae Hyun; Cho, Sung Woo; Won, Tae-Bin; Han, Doo Hee; Kim, Dong-Young; Rhee, Chae Seo; Kim, Hyun Jik

    2017-12-01

    Although continuous positive airway pressure (CPAP) is the most effective treatment modality, poor adherence still remains a problem for obstructive sleep apnea (OSA) treatment and there is little evidence regarding how this might be improved. This study aims to analyze the anatomic and clinical factors of OSA subjects who failed to comply with CPAP therapy.The medical records of 47 OSA subjects who received CPAP therapy as a first-line treatment modality were retrospectively reviewed. The medical records were reviewed for demographic and polysomnographic data and anatomic findings of the nasal cavity and oropharynx.24 patients who adhered to CPAP therapy and 23 patients who were nonadherent were enrolled in the study. There were no statistically significant differences in sleep parameters between CPAP-adherent patients and CPAP nonadherent subjects. Mean body mass index of CPAP nonadherent group was significantly higher than CPAP adherent group. Higher grades of septal deviation and hypertrophic change of the inferior turbinate were observed more in the CPAP nonadherent group. In addition, CPAP nonadherent subjects showed considerably bigger tonsils and higher grade palatal position comparing with the CPAP adherent subjects. Subjective discomfort including inconvenience, mouth dryness, and chest discomfort were the main problems for OSA subjects who did not comply with CPAP therapy.Excessive upper airway blockage in the nasal cavity and oropharynx was predominant in CPAP nonadherent subjects, which might cause the reported subjective discomfort that reduces CPAP compliance. Therefore, resolution of these issues is needed to enhance CPAP compliance for control of OSA. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  14. Value of arthrography after supination trauma of the ankle

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    Dijk, C.N. van; Tol, J.L.; Marti, R.K. [Acad. Med. Centre, Amsterdam (Netherlands). Dept. of Orthopaedic Surg.; Molenaar, A.H.M. [Department of Radiology, Canisius Ziekenhuis, Weg door Jonkerbos 100, 6532 SZ Nijmegen (Netherlands); Cohen, R.H. [Department of Radiology, Stichting Ziekenhuis Amstelveen, Laan van de Helende Meesters 8, 1186 AM Amstelveen (Netherlands); Bossuyt, P.M.M. [Department of Epidemiology, Academic Medical Centre, P.O. Box 22700, 1100 DE Amsterdam (Netherlands)

    1998-05-01

    Objective. To investigate the merits of arthrography after supination trauma of the ankle. Design and patients. In a group of 160 consecutive patients operative exploration was performed in cases where arthrography and/or a delayed physical examination showed positive findings. In all patients arthrography was performed within 48 h after trauma. To determine interobserver agreement, all arthrograms were independently evaluated by two radiologists, both ignorant of the first assessment. Results. The prevalence of an ankle ligament lesion was found to be 76%. Of the 122 patients with a rupture of one or more ankle ligaments, 52% had an isolated anterior talofibular ligament lesion, 3% had an isolated calcaneofibular ligament lesion, and 45% had combined lesions. The site of the lesion was predominantly intraligamentous. In the determination of the presence or absence of an ankle ligament lesion, the specificity and sensitivity of the ankle arthrogram were 71% and 96% respectively. Interobserver agreement on the arthrogram was very good ({kappa} 0.9). In 1% of patients a clear diagnosis was not possible by means of arthrography. Conclusion. Arthrography provides information of high diagnostic quality with excellent interobserver agreement and therefore remains the gold standard for early diagnosis (within 48 h) of a lateral ankle ligament rupture. (orig.) With 4 figs., 5 tabs., 24 refs.

  15. Value of arthrography after supination trauma of the ankle

    International Nuclear Information System (INIS)

    Dijk, C.N. van; Tol, J.L.; Marti, R.K.; Cohen, R.H.; Bossuyt, P.M.M.

    1998-01-01

    Objective. To investigate the merits of arthrography after supination trauma of the ankle. Design and patients. In a group of 160 consecutive patients operative exploration was performed in cases where arthrography and/or a delayed physical examination showed positive findings. In all patients arthrography was performed within 48 h after trauma. To determine interobserver agreement, all arthrograms were independently evaluated by two radiologists, both ignorant of the first assessment. Results. The prevalence of an ankle ligament lesion was found to be 76%. Of the 122 patients with a rupture of one or more ankle ligaments, 52% had an isolated anterior talofibular ligament lesion, 3% had an isolated calcaneofibular ligament lesion, and 45% had combined lesions. The site of the lesion was predominantly intraligamentous. In the determination of the presence or absence of an ankle ligament lesion, the specificity and sensitivity of the ankle arthrogram were 71% and 96% respectively. Interobserver agreement on the arthrogram was very good (κ 0.9). In 1% of patients a clear diagnosis was not possible by means of arthrography. Conclusion. Arthrography provides information of high diagnostic quality with excellent interobserver agreement and therefore remains the gold standard for early diagnosis (within 48 h) of a lateral ankle ligament rupture. (orig.)

  16. Reliability of isometric subtalar pronator and supinator strength testing.

    Science.gov (United States)

    Hagen, Marco; Lahner, Matthias; Winhuysen, Martin; Maiwald, Christian

    2015-01-01

    Due to the specific anatomy of the subtalar joint with its oblique axis, isometric pronator and supinator strength is not well documented. The purpose of this study was to determine intra- and between-session reliability of pronator and supinator strength and lower leg muscle activity measurements during maximum voluntary isometric contractions (MVIC). Pronator and supinator peak torques (PT), with and without supplementary visual muscle strength biofeedback (FB), and muscular activities of peroneus longus (PL) and tibialis anterior (TA) were assessed twice 3 days apart by the same examiner in 21 healthy young male adults (mean age: 27.6 years; SD = 3.9). Limits of agreement (LoA) and minimum detectable change (MDC) were evaluated. By applying FB, reliability of both pronator and supinator PT was improved: LoA were reduced from 32% to 26% and from 20% to 18% and MDC from 20% to 15% and from 16% to 12% in supinator and pronator PT, respectively. Learning effects in pronator and supinator PT (p isometric subtalar pronator and supinator strength testing is reliable in healthy subjects. LoA of 18% and 26% have to be exceeded for pronator and supinator PT, respectively, to detect relevant effects in repeated measures.

  17. Brain metabolic impairment of OSAS: evidence from MRS

    International Nuclear Information System (INIS)

    Shen Jie; Long Miaomiao; Shen Wen; Qi Ji

    2011-01-01

    Objective: To evaluate the impact of obstructive sleep apnea syndrome (OSAS) on human cerebral metabolism by using magnetic resonance spectroscopy (MRS). Materials and methods: Twenty-one severe OSAS patients, 14 mild-moderate OSAS patients, and 15 healthy control subjects were included. All subjects underwent MRS using the point-resolved echo spin spectroscopy (PRESS). Proton volumes of interest were placed in the bilateral frontal lobes and left temporal -parietal-occipital cortex, and left hippocampus. Results: 1. Compared to the controls, the NAA/Cr ratio was significantly decreased in the left frontal lobe in the severe OSAS group (P=0.004), and in the right frontal lobe in the severe (P=0.002) and mild-moderate (P=0.007) OSAS patients. The NAA/Cr ratio trended to be decreased in the left hippocampus in the OSAS patients compared to controls. 2. A significant increase in the ml/Cr ratio was detected in the right frontal regions in the severe (P=0.008) and mild-moderate (P<0.001) OSAS groups. 3. Clx/Cr ratio values were significantly smaller than controls in the left (P=0.006) and right (P=0.027) frontal regions. Conclusion: Bilateral frontal lobes are the vulnerable location in patients with OSAS. MRS can be used to screen the brain metabolic impairment. (authors)

  18. Overlap syndrome of COPD and OSA in Koreans.

    Science.gov (United States)

    Choi, Kyung-Mee; Thomas, Robert J; Kim, Jinkwan; Lee, Seung Ku; Yoon, Dae Wui; Shin, Chol

    2017-07-01

    Overlap syndrome of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) leads to increased morbidity and mortality. There have been no reports available on the overlap syndrome for Koreans. Our primary aim was to identify prevalence and predictors of the overlap syndrome in Koreans.This is a cross-sectional study with a community-based sample of 1298 participants (mean age, 59.7 ± 6.7) from the cohort of Korean Genomic and Epidemiologic Study during 2013 to 2014. OSA and COPD were assessed by apnea-hypopnea index (AHI) and the ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC syndrome. The prevalence of COPD remained the same as 10.8% regardless of the presence of OSA. The mean ratio of FEV1/FVC for those with COPD was 0.77, regardless of OSA. The OR increased for age (OR, 1.1; 95% CI, 1.0-1.1) and smokers (OR, 3.6; 95% CI, 2.0-6.4), but decreased for body mass index (BMI) (OR, 0.84; 95% CI, 0.8-0.9) and overweight state (OR, 0.4; 95% CI, 0.2-0.7). Risk factors of the overlap syndrome differed by OSA severity, that is, BMI in those with moderate-to-severe OSA, whereas sex (OR, 4.7; 95% CI, 2.1-10.6) and age (OR, 1.1; 95% CI, 1.0-1.1) in those with mild OSA.In a population study from Korea, 10.8% of OSA patients had an overlap syndrome with COPD. Although BMI is a well-known risk factor of OSA, it is likely that being overweight may be protective for moderate-to-severe OSA patients from the risk of COPD (i.e., overlap syndrome).

  19. Sonographic appearance of a partial rupture of the supinator muscle.

    Science.gov (United States)

    Chen, Chih-Chun; Chiou, Hong-Jen; Kao, Chung-Lan; Chan, Rai-Chi

    2008-05-01

    We report the case of a 51-year-old woman who experienced pain and swelling in the right forearm after spinning cotton. History taking and physical examinations helped identify a tear of the supinator muscle, which was confirmed via sonographic examination. To our knowledge, this article is the first report of a supinator muscle tear diagnosed with sonography. (c) 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2008.

  20. Ventilatory sensitivity to mild asphyxia: prone versus supine sleep position

    OpenAIRE

    Galland, B; Bolton, D; Taylor, B; Sayers, R; Williams, S

    2000-01-01

    AIMS—To compare the effects of prone and supine sleep position on the main physiological responses to mild asphyxia: increase in ventilation and arousal.
METHODS—Ventilatory and arousal responses to mild asphyxia (hypercapnia/hypoxia) were measured in 53 healthy infants at newborn and 3 months of age, during quiet sleep (QS) and active sleep (AS), and in supine and prone sleep positions. The asphyxial test mimicked face down rebreathing by slowly altering the inspired air: C...

  1. Comparison of supine, upright, and prone positions for liver scans

    International Nuclear Information System (INIS)

    Harolds, J.A.; Brill, A.B.; Patton, J.A.; Touya, J.J.

    1983-01-01

    We compared liver scan interpretations based on anterior images obtained in the upright, prone, and supine positions. Receiver-operating-characteristic curves were generated for three well trained observers. Results showed that reading the three different views together was more accurate than the reading of any individual image. Furthermore, interpretations based on either the prone or upright view were superior to those using the supine view alone. The prone and upright views should be used more often in liver scanning

  2. Kuninglikus õukonnateatris. I-IV osa / Jaanus Rohumaa

    Index Scriptorium Estoniae

    Rohumaa, Jaanus, 1969-

    1999-01-01

    Jaanus Rohumaa Londonis Royal Court Theatre' poolt korraldatud residentuuris, mis on mõeldud tänapäeva näitekirjanikele ja lavastajatele. Muljeid kokkutulnud eri maade näitekirjanikest ja lavastajatest. Jaanus Rohumaa lavastab Londonis Royal Shakespeare Company teatris Jaan Tätte näidendit "Ristumine peateega"(II osa) Inglise näitekirjaniku Sarah Kane'i loomingust, Robert Lepage'i lavastusest "Imede geomeetria" (III osa)

  3. Supine vs decubitus lateral patient positioning in vertebral fracture assessment.

    Science.gov (United States)

    Paggiosi, Margaret Anne; Finigan, Judith; Peel, Nicola; Eastell, Richard; Ferrar, Lynne

    2012-01-01

    In vertebral fracture assessment (VFA), lateral scans are obtained with the patient positioned supine (C-arm densitometers) or lateral decubitus (fixed-arm densitometers). We aimed to determine the impact of positioning on image quality and fracture definition. We performed supine and decubitus lateral VFA in 50 postmenopausal women and used the algorithm-based qualitative method to identify vertebral fractures. We compared the 2 techniques for the identification of fractures (kappa analysis) and compared the numbers of unreadable vertebrae (indiscernible endplates) and vertebrae that were projected obliquely (Wilcoxon matched-pairs signed-rank test). The kappa score for agreement between the VFA techniques (to identify women with vertebral fractures) was 0.84 (95% confidence interval [CI]: 0.68-0.99), and for agreement with fracture assessments made from radiographs, kappa was 0.76 (95% CI: 0.57-0.94) for both supine and decubitus lateral VFA. There were more unreadable vertebrae with supine lateral (48 vertebrae in supine lateral compared with 14 in decubitus lateral; p=0.001), but oblique projection was less common (93 vertebrae compared with 145 in decubitus lateral; p=0.002). We conclude that there were significantly different projection effects with supine and decubitus lateral VFA, but these differences did not influence the identification of vertebral fractures in our study sample. Copyright © 2012 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

  4. Digital Morphometrics: A New Upper Airway Phenotyping Paradigm in OSA.

    Science.gov (United States)

    Schwab, Richard J; Leinwand, Sarah E; Bearn, Cary B; Maislin, Greg; Rao, Ramya Bhat; Nagaraja, Adithya; Wang, Stephen; Keenan, Brendan T

    2017-08-01

    OSA is associated with changes in pharyngeal anatomy. The goal of this study was to objectively and reproducibly quantify pharyngeal anatomy by using digital morphometrics based on a laser ruler and to assess differences between subjects with OSA and control subjects and associations with the apnea-hypopnea index (AHI). To the best of our knowledge, this study is the first to use digital morphometrics to quantify intraoral risk factors for OSA. Digital photographs were obtained by using an intraoral laser ruler and digital camera in 318 control subjects (mean AHI, 4.2 events/hour) and 542 subjects with OSA (mean AHI, 39.2 events/hour). The digital morphometric paradigm was validated and reproducible over time and camera distances. A larger modified Mallampati score and having a nonvisible airway were associated with a higher AHI, both unadjusted (P digital morphometrics is an accurate, high-throughput, and noninvasive technique to identify anatomic OSA risk factors. Morphometrics may also provide a more reproducible and standardized measurement of the Mallampati score. Digital morphometrics represent an efficient and cost-effective method of examining intraoral crowding and tongue size when examining large populations, genetics, or screening for OSA. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  5. How do we recognize the child with OSAS?

    Science.gov (United States)

    Joosten, Koen F; Larramona, Helena; Miano, Silvia; Van Waardenburg, Dick; Kaditis, Athanasios G; Vandenbussche, Nele; Ersu, Refika

    2017-02-01

    Obstructive sleep-disordered breathing includes a spectrum of clinical entities with variable severity ranging from primary snoring to obstructive sleep apnea syndrome (OSAS). The clinical suspicion for OSAS is most often raised by parental report of specific symptoms and/or abnormalities identified by the physical examination which predispose to upper airway obstruction (e.g., adenotonsillar hypertrophy, obesity, craniofacial abnormalities, neuromuscular disorders). Symptoms and signs of OSAS are classified into those directly related to the intermittent pharyngeal airway obstruction (e.g., parental report of snoring, apneic events) and into morbidity resulting from the upper airway obstruction (e.g., increased daytime sleepiness, hyperactivity, poor school performance, inadequate somatic growth rate or enuresis). History of premature birth and a family history of OSAS as well as obesity and African American ethnicity are associated with increased risk of sleep-disordered breathing in childhood. Polysomnography is the gold standard method for the diagnosis of OSAS but may not be always feasible, especially in low-income countries or non-tertiary hospitals. Nocturnal oximetry and/or sleep questionnaires may be used to identify the child at high risk of OSAS when polysomnography is not an option. Endoscopy and MRI of the upper airway may help to identify the level(s) of upper airway obstruction and to evaluate the dynamic mechanics of the upper airway, especially in children with combined abnormalities. Pediatr Pulmonol. 2017;52:260-271. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  6. [Treatment of supine position-related obstructive sleep apnea with smartphone applications].

    Science.gov (United States)

    Haas, D; Birk, R; Maurer, J T; Hörmann, K; Stuck, B A; Sommer, J U

    2017-02-01

    Positional obstructive sleep apnea (POSA) is common in mild and moderate forms of obstructive sleep apnea (OSA). Two smartphone applications (apps) professing to avoid the supine position (SP) are available: for Android the "Apnea Sleep Position Trainer" and for iOS the "SomnoPose-Sleep Position Monitor". The smartphone needs to be attached to the chest to recognize SP, which then triggers a vibration alarm. This is intended to encourage the patient to change position and the vibration stops as soon as SP is left. These apps, however, have not yet undergone a systematic evaluation. Adult patients with polysomnographically diagnosed POSA were invited to participate in the study. POSA was defined as an apnea-hypopnea index (AHI) in SP >10, with AHI in a lateral position sleep time and to an overall AHI smartphone apps have the capability to prevent PS in POSA patients and can potentially offer a cost-effective option in the treatment of POSA.

  7. The diagnostic value of supine blood pressure in hypertension.

    Science.gov (United States)

    Krzesiński, Paweł; Stańczyk, Adam; Gielerak, Grzegorz; Piotrowicz, Katarzyna; Banak, Małgorzata; Wójcik, Agnieszka

    2016-04-01

    Correct blood pressure (BP) measurement is crucial in the diagnosis of arterial hypertension (AH), and controversy exists whether supine BP should be treated as equal to sitting BP. The aim of this study was to evaluate the relation of supine BP to sitting BP and ambulatory BP with regard to identification of diagnostic cut-offs for hypertension. This study included 280 patients with AH (mean age: 44.3 ±10.6 years). The following measurements of BP were performed and analyzed: 1) sitting office blood pressure measurement (OSBP and ODBP); 2) supine BP (supSBP and supDBP), measured automatically (5 times with a 2-minute interval) during evaluation by the Niccomo device (Medis, Germany); 3) 24-hour ambulatory blood pressure (ABP) monitoring. The mean supSBP and supDBP were found to be lower than OSBP and ODBP (130.9 ±14.2 vs. 136.6 ±15.5 mm Hg and 84.8 ±9.4 vs. 87.8 ±10.2 mm Hg, respectively; p AUC: 0.820 vs. 0.550; sensitivity 80.7% vs. 57.4%; specificity 83.2% vs. 52.7%; p blood pressure during a 10-minute supine rest was lower than in the sitting position. The supine blood pressure ≥ 130/80 mm Hg was found to be a specific and sensitive threshold for hypertension.

  8. The effect of CPAP treatment on EEG of OSAS patients.

    Science.gov (United States)

    Zhang, Cheng; Lv, Jun; Zhou, Junhong; Su, Li; Feng, Liping; Ma, Jing; Wang, Guangfa; Zhang, Jue

    2015-12-01

    Continuous positive airway pressure (CPAP) is currently the most effective treatment method for obstructive sleep apnea syndrome (OSAS). The purpose of this study was to compare the sleep electroencephalogram (EEG) changes before and after the application of CPAP to OSAS patients. A retrospective study was conducted and 45 sequential patients who received both polysomnography (PSG) and CPAP titration were included. The raw data of sleep EEG were extracted and analyzed by engineers using two main factors: fractal dimension (FD) and the zero-crossing rate of detrended FD (zDFD). FD was an effective indicator reflecting the EEG complexity and zDFD was useful to reflect the variability of the EEG complexity. The FD and zDFD indexes of sleep EEG of 45 OSAS patients before and after CPAP titration were analyzed. The age of 45 OSAS patients was 52.7 ± 5.6 years old and the patients include 12 females and 33 males. After CPAP treatment, FD of EEG in non-rapid eye movement (NREM) sleep decreased significantly (P CPAP therapy (P CPAP therapy had a significant influence on sleep EEG in patients with OSAHS, which lead to a more stable EEG pattern. This may be one of the mechanisms that CPAP could improve sleep quality and brain function of OSAS patients.

  9. Effect of supine exercise on platelet aggregation and fibrinolytic activity

    DEFF Research Database (Denmark)

    Dag, B; Fornitz, Gitte Gleerup; Bak, A M

    1994-01-01

    In 12 healthy young men, strenuous cycling exercise in the supine position, caused platelet aggregability to decrease and the ADP threshold to rise from 7.0 microM resting, to 9.5 exercising (P ... from 178 to 68 min, PAI-1 fell from 8.91 to 5.16 IU ml-1, and t-PA rose from 0.56 to 3.95 IU ml-1, all three values were significant to P exercise, it did not increase platelet activity as expected, but caused a modest increase...... of fibrinolytic activity. These results suggest that supine exercise will not affect the haemostatic system adversely....

  10. The USC-OSA-EPS section activities in optics

    Science.gov (United States)

    Aymerich, María.; Cambronero-López, Ferran; Aragón, Ángel L.; Delgado, Tamara; Blanco, Manuel; Gómez Varela, Ana I.; Gargallo, Ana; Williamson, Sandra; Amorín, Adán.; Sánchez-García, Ángel; Bao-Varela, Carmen; Flores-Arias, M. Teresa

    2017-08-01

    The USC-OSA Student Chapter and USC-EPS Young Minds Section is a group financed by The Optical Society (OSA) and the European Physical Society (EPS). It is formed by PhD and degree students from the Universidade de Santiago de Compostela (USC) and one supervisor of the Faculty of Physics. Its main goal is to promote and diffuse Optics in the society. For this purpose, the group carries out several activities in the academic and non-academic community. The group is also committed to the professional development of our members and motivates the exposition of our work into the scientific community.

  11. Neuromuscular-skeletal origins of predominant patterns of coordination in rhythmic two-joint arm movement.

    Science.gov (United States)

    de Rugy, Aymar; Riek, Stephan; Carson, Richard G

    2006-01-01

    The authors tested for predominant patterns of coordination in the combination of rhythmic flexion-extension (FE) and supination- (SP) at the elbow-joint complex. Participants (N=10) spontaneously established in-phase (supination synchronized with flexion) and antiphase (pronation synchronized with flexion) patterns. In addition, the authors used a motorized robot arm to generate involuntary SP movements with different phase relations with respect to voluntary FE. The involuntarily induced in-phase pattern was accentuated and was more consistent than other patterns. The result provides evidence that the predominance of the in-phase pattern originates in the influence of neuromuscular-skeletal constraints rather than in a preference dictated by perceptual-cognitive factors implicated in voluntary control. Neuromuscular-skeletal constraints involved in the predominance of the in-phase and the antiphase patterns are discussed.

  12. WBFSH aastakoosolek Varssavis. I-II osa / Raigo Kollom

    Index Scriptorium Estoniae

    Kollom, Raigo, 1936-

    2013-01-01

    Poolas 7.-9. oktoobrini Maailma Sporthobuste Kasvatajate Föderatsiooni peaassambleel toimunust ning loengutest ja aruteludest: Hobuste "genoomilisest aretusest", Jõudluskontrolli ja terviseandmete kasutamisest Rootsi aretuses, Hobuste lineaarse kirjeldamise meetodist, tõuraamatute tulevikust. Teises osas: Hobusekasvatuse seisust Poolas, Janow Podlaski hobusekasvatusest ja üldisest eluolust

  13. Omal jalal maailma : 1.-5.osa / Paul Salopek ; fotografeerinud John Stanmeyer

    Index Scriptorium Estoniae

    Salopek, Paul

    2016-01-01

    Artikli 2. osa räägib autori rännakust läbi Saudi Araabias asuva Al-Hijāzi kõrbe, 3. osa rännakust piki Jordaania piiri ja Iisraelis, 4. osa rännakust Ida-Türgis ning kohtumistest Süüria sõjapõgenikega, 5. osa Armeeniast ja Türgist

  14. Obesity and Obstructive Sleep Apnea: Or is it OSA and Obesity?

    Science.gov (United States)

    2008-01-01

    32–44. 66] A.K. Al-Shukaili, A.A. Al-Jabri, Rheumatoid arthritis , cytokines and hypoxia. What is the link? Saudi Med. J. 27 (2006) 1642–1649. 67...OSA. OSA appears to increase secretion of and/or lter responsiveness to the adipocyte hormone leptin and the rexigenic hormone ghrelin , and these...diabetes, dementia, arthritis , nd OSA itself [65–69]. Sequelae of obesity and OSA cross all organ systems. or example, chronic excessive

  15. Uus äriseadustik lihtsustab osaühingu asutamist ja juhtimist / Karina Paatsi

    Index Scriptorium Estoniae

    Paatsi, Karina

    2010-01-01

    Osaühingut puudutavatest äriseadustiku muudatustest (sissemakseta osaühing, osa võõrandamise võimaluste laienemine, juhatuse liikme valimine tähtajatuks perioodiks, nõukogu nõude kaotamine, elukoha piirangu kaotamine, mitterahalise sissemakse hindamine, reservkapitali nõude kadumine)

  16. The retrorenal colon in the supine and prone patient

    International Nuclear Information System (INIS)

    Hopper, K.D.; Sherman, J.L.; Luethke, J.M.; Ghaed, N.

    1986-01-01

    Ninety patients underwent CT in both supine and prone positions so that the orientation of the retroperitoneal colon about the kidneys could be determined. Particular attention was given to bowel found posterior to the kidneys, the so-called retrorenal colon. The frequency of retrorenal colon increased from 1.9% on supine studies to 10.7% on prone studies. Since most invasive renal procedures performed with the patient prone would miss retrorenal colon located behind the lateral one third of the kidney, the data were reevaluated, excluding these patients. The resulting frequency of significant retrorenal colon found on prone studies was 4.7%. Significant retrorenal colon was found exclusively at the level of the lower renal poles, and the involved colon in these patients was extensively distended with gas. Particular attention should be given, under fluoroscopic guidance, to detecting this unusual posteriorly positioned, air-filled colon before one undertakes any invasive renal procedure

  17. Supine proton beam craniospinal radiotherapy using a novel tabletop adapter

    International Nuclear Information System (INIS)

    Buchsbaum, Jeffrey C.; Besemer, Abby; Simmons, Joseph; Hoene, Ted; Simoneaux, Victor; Sandefur, Amy; Wolanski, Mark; Li, Zhao; Cheng, Chee-Wei

    2013-01-01

    To develop a device that allows supine craniospinal proton and photon therapy to the vast majority of proton and photon facilities currently experiencing limitations as a result of couch design issues. Plywood and carbon fiber were used for the development of a prototype unit. Once this was found to be satisfactory after all design issues were addressed, computer-assisted design (CAD) was used and carbon fiber tables were built to our specifications at a local manufacturer of military and racing car carbon fiber parts. Clinic-driven design was done using real-time team discussion for a prototype design. A local machinist was able to construct a prototype unit for us in <2 weeks after the start of our project. Once the prototype had been used successfully for several months and all development issues were addressed, a custom carbon fiber design was developed in coordination with a carbon fiber manufacturer in partnership. CAD methods were used to design the units to allow oblique fields from head to thigh on patients up to 200 cm in height. Two custom-designed carbon fiber craniospinal tabletop designs now exist: one long and one short. Four are in successful use in our facility. Their weight tolerance is greater than that of our robot table joint (164 kg). The long unit allows for working with taller patients and can be converted into a short unit as needed. An affordable, practical means of doing supine craniospinal therapy with protons or photons can be used in most locations via the use of these devices. This is important because proton therapy provides a much lower integral dose than all other therapy methods for these patients and the supine position is easier for patients to tolerate and for anesthesia delivery. These units have been successfully used for adult and pediatric supine craniospinal therapy, proton therapy using oblique beams to the low pelvis, treatment of various spine tumors, and breast-sparing Hodgkin's therapy

  18. Supine proton beam craniospinal radiotherapy using a novel tabletop adapter

    Energy Technology Data Exchange (ETDEWEB)

    Buchsbaum, Jeffrey C., E-mail: jbuchsba@iupui.edu [IU Health Proton Therapy Center, Bloomington, IN (United States); Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States); Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN (United States); Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN (United States); Besemer, Abby; Simmons, Joseph; Hoene, Ted; Simoneaux, Victor; Sandefur, Amy [IU Health Proton Therapy Center, Bloomington, IN (United States); Wolanski, Mark; Li, Zhao; Cheng, Chee-Wei [IU Health Proton Therapy Center, Bloomington, IN (United States); Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States)

    2013-04-01

    To develop a device that allows supine craniospinal proton and photon therapy to the vast majority of proton and photon facilities currently experiencing limitations as a result of couch design issues. Plywood and carbon fiber were used for the development of a prototype unit. Once this was found to be satisfactory after all design issues were addressed, computer-assisted design (CAD) was used and carbon fiber tables were built to our specifications at a local manufacturer of military and racing car carbon fiber parts. Clinic-driven design was done using real-time team discussion for a prototype design. A local machinist was able to construct a prototype unit for us in <2 weeks after the start of our project. Once the prototype had been used successfully for several months and all development issues were addressed, a custom carbon fiber design was developed in coordination with a carbon fiber manufacturer in partnership. CAD methods were used to design the units to allow oblique fields from head to thigh on patients up to 200 cm in height. Two custom-designed carbon fiber craniospinal tabletop designs now exist: one long and one short. Four are in successful use in our facility. Their weight tolerance is greater than that of our robot table joint (164 kg). The long unit allows for working with taller patients and can be converted into a short unit as needed. An affordable, practical means of doing supine craniospinal therapy with protons or photons can be used in most locations via the use of these devices. This is important because proton therapy provides a much lower integral dose than all other therapy methods for these patients and the supine position is easier for patients to tolerate and for anesthesia delivery. These units have been successfully used for adult and pediatric supine craniospinal therapy, proton therapy using oblique beams to the low pelvis, treatment of various spine tumors, and breast-sparing Hodgkin's therapy.

  19. Proximal supination osteotomy of the first metatarsal for hallux valgus.

    Science.gov (United States)

    Yasuda, Toshito; Okuda, Ryuzo; Jotoku, Tsuyoshi; Shima, Hiroaki; Hida, Takashi; Neo, Masashi

    2015-06-01

    Risk factors for hallux valgus recurrence include postoperative round-shaped lateral edge of the first metatarsal head and postoperative incomplete reduction of the sesamoids. To prevent the occurrence of such conditions, we developed a proximal supination osteotomy of the first metatarsal. Our aim was to describe this novel technique and report the outcomes in this report. Sixty-six patients (83 feet) underwent a distal soft tissue procedure combined with a proximal supination osteotomy. After the proximal crescentic osteotomy, the proximal fragment was pushed medially, and the distal fragment was abducted, and then the distal fragment of the first metatarsal was manually supinated. Outcomes were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) score and radiographic examinations. The average follow-up duration was 34 (range, 25 to 52) months. The mean AOFAS score improved significantly from 58.0 points preoperatively to 93.8 points postoperatively (P hallux valgus and intermetatarsal angle decreased significantly from 38.6 and 18.0 degrees preoperatively to 11.0 and 7.9 degrees postoperatively, respectively (both, P hallux valgus, defined as a hallux valgus angle ≥ 25 degrees. The rates of occurrence of a positive round sign and incomplete reduction of the sesamoids significantly decreased postoperatively, which may have contributed to the low hallux valgus recurrence rates. We conclude that a proximal supination osteotomy was an effective procedure for correction of hallux valgus and can achieve a low rate of hallux valgus recurrence. Level IV, retrospective case series. © The Author(s) 2015.

  20. Nonrapid Eye Movement-Predominant Obstructive Sleep Apnea: Detection and Mechanism.

    Science.gov (United States)

    Yamauchi, Motoo; Fujita, Yukio; Kumamoto, Makiko; Yoshikawa, Masanori; Ohnishi, Yoshinobu; Nakano, Hiroshi; Strohl, Kingman P; Kimura, Hiroshi

    2015-09-15

    Obstructive sleep apnea (OSA) can be severe and present in higher numbers during rapid eye movement (REM) than nonrapid eye movement (NREM) sleep; however, OSA occurs in NREM sleep and can be predominant. In general, ventilation decreases an average 10% to 15% during transition from wakefulness to sleep, and there is variability in just how much ventilation decreases. As dynamic changes in ventilation contribute to irregular breathing and breathing during NREM sleep is mainly under chemical control, our hypothesis is that patients with a more pronounced reduction in ventilation during the transition from wakefulness to NREM sleep will have NREM- predominant rather than REM-predominant OSA. A retrospective analysis of 451 consecutive patients (apnea-hypopnea index [AHI] > 5) undergoing diagnostic polysomnography was performed, and breath-to-breath analysis of the respiratory cycle duration, tidal volume, and estimated minute ventilation before and after sleep onset were examined. Values were calculated using respiratory inductance plethysmography. The correlation between the percent change in estimated minute ventilation during wake-sleep transitions and the percentage of apnea-hypopneas in NREM sleep (%AHI in NREM; defined as (AHI-NREM) / [(AHI-NREM) + (AHI-REM)] × 100) was the primary outcome. The decrease in estimated minute ventilation during wake-sleep transitions was 15.0 ± 16.6% (mean ± standard deviation), due to a decrease in relative tidal volume. This decrease in estimated minute ventilation was significantly correlated with %AHI in NREM (r = -0.222, p sleep contributes to the NREM predominant OSA phenotype via induced ventilatory instability. © 2015 American Academy of Sleep Medicine.

  1. CT simulation technique for craniospinal irradiation in supine position

    International Nuclear Information System (INIS)

    Lee, Suk; Kim, Yong Bae; Chu, Sung Sil; Suh, Chang Ok; Kwon, Soo Il

    2002-01-01

    In order to perform craniospinal irradiation (CSI) in the supine position on patients who are unable to lie in the prone position, a new simulation technique using a CT simulator was developed and its availability was evaluated. A CT simulator and a 3-D conformal treatment planning system were used to develop CSI in the supine position. The head and neck were immobilized with a thermoplastic mask in the supine position and the entire body was immobilized with a Vac-Loc. A volumetric image was then obtained using the CT simulator. In order to improve the reproducibility of the patients' setup, datum lines and points were marked on the head and the body. Virtual fluoroscopy was performed with the removal of visual obstacles such as the treatment table or the immobilization devices. After the virtual simulation, the treatment isocenters of each field were marked on the body and the immobilization devices at the conventional simulation room. Each treatment field was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR)/digitally composite radiography (DCR) images from the virtual simulation. The port verification films from the first treatment were also compared with the DRR/DCR images for a geometrical verification. CSI in the supine position was successfully performed in 9 patients. It required less than 20 minutes to construct the immobilization device and to obtain the whole body volumetric images. This made it possible to not only reduce the patients' inconvenience, but also to eliminate the position change variables during the long conventional simulation process. In addition, by obtaining the CT volumetric image, critical organs, such as the eyeballs and spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. The difference between the DRRs and the portal films were less than 3 mm in the vertebral contour. CSI in the supine position is feasible in patients who cannot lie on

  2. CT simulation technique for craniospinal irradiation in supine position

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Suk; Kim, Yong Bae; Chu, Sung Sil; Suh, Chang Ok [Yonsei Cancer Center, College of Medicine, Yonsei University, Seoul (Korea, Republic of); Kwon, Soo Il [Kyonggi University, Seoul (Korea, Republic of)

    2002-06-15

    In order to perform craniospinal irradiation (CSI) in the supine position on patients who are unable to lie in the prone position, a new simulation technique using a CT simulator was developed and its availability was evaluated. A CT simulator and a 3-D conformal treatment planning system were used to develop CSI in the supine position. The head and neck were immobilized with a thermoplastic mask in the supine position and the entire body was immobilized with a Vac-Loc. A volumetric image was then obtained using the CT simulator. In order to improve the reproducibility of the patients' setup, datum lines and points were marked on the head and the body. Virtual fluoroscopy was performed with the removal of visual obstacles such as the treatment table or the immobilization devices. After the virtual simulation, the treatment isocenters of each field were marked on the body and the immobilization devices at the conventional simulation room. Each treatment field was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR)/digitally composite radiography (DCR) images from the virtual simulation. The port verification films from the first treatment were also compared with the DRR/DCR images for a geometrical verification. CSI in the supine position was successfully performed in 9 patients. It required less than 20 minutes to construct the immobilization device and to obtain the whole body volumetric images. This made it possible to not only reduce the patients' inconvenience, but also to eliminate the position change variables during the long conventional simulation process. In addition, by obtaining the CT volumetric image, critical organs, such as the eyeballs and spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. The difference between the DRRs and the portal films were less than 3 mm in the vertebral contour. CSI in the supine position is feasible in patients who cannot

  3. Setup accuracy for prone and supine whole breast irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Mulliez, Thomas; Vercauteren, Tom; Greveling, Annick van; Speleers, Bruno; Neve, Wilfried de; Veldeman, Liv [University Hospital Ghent, Department of Radiotherapy, Ghent (Belgium); Gulyban, Akos [University Hospital Ghent, Department of Radiotherapy, Ghent (Belgium); University Hospital Liege, Department of Radiotherapy, Liege (Belgium)

    2016-04-15

    To evaluate cone-beam computed tomography (CBCT) based setup accuracy and margins for prone and supine whole breast irradiation (WBI). Setup accuracy was evaluated on 3559 CBCT scans of 242 patients treated with WBI and uncertainty margins were calculated using the van Herk formula. Uni- and multivariate analysis on individual margins was performed for age, body mass index (BMI) and cup size. The population-based margin in vertical (VE), lateral (LA) and longitudinal (LO) directions was 10.4/9.4/9.4 mm for the 103 supine and 10.5/22.4/13.7 mm for the 139 prone treated patients, being significantly (p < 0.01) different for the LA and LO directions. Multivariate analysis identified a significant (p < 0.05) correlation between BMI and the LO margin in supine position and the VE/LA margin in prone position. In this series, setup accuracy is significantly worse in prone compared to supine position for the LA and LO directions. However, without proper image-guidance, uncertainty margins of about 1 cm are also necessary for supine WBI. For patients with a higher BMI, larger margins are required. (orig.) [German] Ziel der Arbeit war es, die interfraktionelle Repositionierungsgenauigkeit in Bauchlage (BL) versus Rueckenlage (RL) bei Ganzbrustbestrahlung (GBB) mittels Cone-Beam-CT (CBCT) zu bestimmen, um die notwendigen PTV-Sicherheitsabstaende zu definieren. Die Repositionierungsgenauigkeit wurde basierend an 3559 CBCT-Scans von 242 mit GBB behandelten Patienten ausgewertet. Die PTV-Sicherheitsabstaende wurden unter Verwendung der ''van-Herk''-Formel berechnet. Uni- und multivariable Analysen wurden fuer Sicherheitsabstaende in jede Richtung auf Basis von Alter, Body-Mass-Index (BMI) und Koerbchengroesse durchgefuehrt. Die basierend auf den taeglichen CBCT-Verschiebungen berechneten PTV-Sicherheitsabstaende betrugen in anteroposteriorer (AP), lateraler (LT oder links-rechts) und kraniokaudaler (CC) Richtung 10,4/9,4/9,4 mm fuer die RL (103 Patienten) und

  4. [Surgical treatment of pronation and supination external rotation trimalleolar fractures].

    Science.gov (United States)

    Xu, Ye-qing; Zhan, Bei-lei; He, Fei-xiong; Wei, Hong-da

    2008-04-01

    To explore the operative method and its clinical effects of pronation and supination external rotation trimalleolar fractures. From March 2000 to July 2006,42 patients of the pronation and supination external rotation trimalleolar fractures treated with open reduction and internal fixation. Thirty-one were males and 11 were females,with an average age of 40.5 years (from 19 to 76 years). Four cases were open fractures and 38 cases close fractures. The fractures were classified as pronation-external rotation (grade IV) injury in 18 cases and supination-external rotation (grade IV)in 24 cases according to the system of Lauge-Hansen. The time of injury to operation was 2 hours to 27 days. The medial, lateral and posterior malleolus were exposed by standard anteromedial and Gatellier-Chastang approaches. The reduction and internal fixation started with the posterior,then the medial and the lateral malleolus and distal tibiofibular syndesmosis in sequence. The anteroposterior, lateral and mostise X-ray films were taken after operation. All the patients were followed up for an average time of 13.5 months(from 6 to 24 months). The time of union was from 12 to 16 weeks. The results were excellent in 20,good in 16, fair in 4 and poor in 2 cases according to Baird-Jackson ankle scoring system based on pain, stability, walking ability,range of motion and radiological manifestations. The excellent and good rate was 85.7%. There were no infection,malunion and nonunion of the fractures except that the inserted screw to distal tibiofibular syndesmosis was broken in 1 case. The key of operative treatment is to restore the anatomy of ankle and to regain the ankle function maximally.

  5. Exaggerated supine oblique view of the cervical spine

    International Nuclear Information System (INIS)

    Abel, M.S.

    1982-01-01

    The technique of the 60 degree supine oblique view is described together with anatomic skeletal studies of this projection. The view is convenient for emergency room radiography and useful in other clinical radiography. The view separates widely the anterior and posterior portions of the vertebrae in a side to side projection. This makes for an elongated but detailed view of the articular processes, pedicles, and intervertebral foramina. In the cadavar specimen and clinically the view is shown to be useful in delineating fracture deformities of the articular process and visualizing constriction of the intervertebral foramen superiorly. Encroachment of the foramen superiorly is likely to compromise the emerging nerve root in this area

  6. Supine Percutaneous Nephrolithotripsy in Double-S Position.

    Science.gov (United States)

    Giusti, Giuseppe; De Lisa, Antonello

    2018-01-01

    At present, the percutaneous nephrolithotripsy (PCNL) is performed both in supine and in prone position. The aim of this paper is to describe an innovative position during PCNL. We describe a supine position. The patient's legs are slightly abducted at the hips. The thorax is laterally tilted (inclination 30°-35°) and kept in the right position by one or two gel pads placed between the scapula and the vertebrae. External genitalia can be accessed at any time, so that it is always possible to use flexible instruments in the upper urinary tract. We used this position for a period of 12 months to treat with PCNL 45 patients with renal lithiasis. All the procedures were successfully completed without complications, using the position we are describing. The following are some of its benefits: an easier positioning of the patient; a better exposure of the flank for an easier access to the posterior renal calyces of the kidney; a lower risk of pressure injuries compared to positions foreseeing the use of knee crutches; the possibility of combined procedures (ECIRS) through the use of flexible instruments; and a good fluoroscopic visualization of the kidney not overlapped by the vertebrae. This position is effective, safe, easy, and quick to prepare and allows for combined anterograde/retrograde operations.

  7. Supine Percutaneous Nephrolithotripsy in Double-S Position

    Directory of Open Access Journals (Sweden)

    Giuseppe Giusti

    2018-01-01

    Full Text Available Background. At present, the percutaneous nephrolithotripsy (PCNL is performed both in supine and in prone position. The aim of this paper is to describe an innovative position during PCNL. Methods. We describe a supine position. The patient’s legs are slightly abducted at the hips. The thorax is laterally tilted (inclination 30°–35° and kept in the right position by one or two gel pads placed between the scapula and the vertebrae. External genitalia can be accessed at any time, so that it is always possible to use flexible instruments in the upper urinary tract. We used this position for a period of 12 months to treat with PCNL 45 patients with renal lithiasis. Results. All the procedures were successfully completed without complications, using the position we are describing. The following are some of its benefits: an easier positioning of the patient; a better exposure of the flank for an easier access to the posterior renal calyces of the kidney; a lower risk of pressure injuries compared to positions foreseeing the use of knee crutches; the possibility of combined procedures (ECIRS through the use of flexible instruments; and a good fluoroscopic visualization of the kidney not overlapped by the vertebrae. Conclusions. This position is effective, safe, easy, and quick to prepare and allows for combined anterograde/retrograde operations.

  8. Peridural anesthesia and the distribution of blood in supine humans

    International Nuclear Information System (INIS)

    Arndt, J.O.; Hoeck, A.S.; Stanton-Hicks, M.; Stuehmeier, K.D.

    1985-01-01

    To determine the effects of vasomotor tone on intrathoracic and splanchnic blood volume, the distribution of radioactively (/sup 99m/Tc) labeled erythrocytes was recorded by whole body scintigraphy before and during peridural anesthesia (PDA) in eight supine men. The radioactivity was recorded with a gamma camera and its distribution determined in the thorax, abdomen, and limbs. Arterial and central venous pressure, heart rate, and calf volume and flow also were measured. During PDA with a sensory block up to T4/5, radioactivity increased only in the denervated legs, whereas it decreased in all other regions, i.e., in the thorax, the innervated upper limbs, and in the splanchnic vasculature. However, in two of the subjects, after an initial decrease, splanchnic blood content increased while intrathoracic blood volume decreased further. The effects of PDA on thoracic and splanchnic filling could be duplicated by the sequestration of about 500-600 ml of blood in both legs. In supine humans high peridural anesthesia evokes the same decrease in intrathoracic blood volume as orthostasis. Potential circulatory collapse may ensue when the vasoconstrictor response fails in the splanchnic circulation

  9. Low morning serum cortisol levels in children with tonsillar hypertrophy and moderate-to-severe OSA.

    Science.gov (United States)

    Malakasioti, Georgia; Alexopoulos, Emmanouel I; Varlami, Vasiliki; Chaidas, Konstantinos; Liakos, Nikolaos; Gourgoulianis, Konstantinos; Kaditis, Athanasios G

    2013-09-01

    Hypertrophic tonsillar tissue in children with obstructive sleep apnea (OSA) has enhanced expression of glucocorticoid receptors, which may reflect low endogenous cortisol levels. We have evaluated the effect of the interaction between tonsillar hypertrophy and OSA severity on morning serum cortisol levels. Children with and without snoring underwent polysomnography, tonsillar size grading, and measurement of morning serum cortisol. Seventy children (2-13 years old) were recruited: 30 with moderate-to-severe OSA (apnea-hypopnea index [AHI] > 5 episodes/h), 26 with mild OSA (AHI > 1 and ≤ 5), and 14 controls (no snoring; AHI ≤ 1). Tonsillar hypertrophy was present in 56.7%, 53.8%, and 42.9% of participants in each group, respectively. Application of a general linear model demonstrated a significant effect of the interaction between severity of OSA and tonsillar hypertrophy on cortisol levels (P = 0.04), after adjustment for obesity, gender, and age. Among children with tonsillar hypertrophy, subjects with moderate-to-severe OSA (n = 17; AHI 14.7 ± 10.6), mild OSA (n = 14; AHI 2.3 ± 1.2), and control participants (n = 6; AHI 0.7 ± 0.2) were significantly different regarding cortisol levels (P = 0.02). Subjects with moderate-to-severe OSA had lower cortisol (16.9 ± 8.7 mcg/dL) than those with mild OSA (23.3 ± 4.2; P = 0.01) and those without OSA (controls) (23.6 ± 5.3 mcg/dL; P = 0.04). In contrast, children with normal-size tonsils and moderate-to-severe OSA, mild OSA, and controls did not differ in cortisol levels. Children with moderate-to-severe obstructive sleep apnea and the phenotype of hypertrophic tonsils have reduced morning serum cortisol levels and potentially decreased glucocorticoid inhibitory effects on tonsillar growth.

  10. Comparison of supine and prone positions for percutaneous nephrolithotomy in treatment of staghorn stones.

    Science.gov (United States)

    Gökce, Mehmet İlker; Ibiş, Arif; Sancı, Adem; Akıncı, Aykut; Bağcı, Uygar; Ağaoğlu, Eylül Asya; Süer, Evren; Gülpınar, Ömer

    2017-12-01

    Percutaneous nephrolithotomy (PNL) is the primary treatment modality for management of staghorn stones. PNL in supine position has important advantages over prone positon. However, studies comparing prone and supine positions for PNL in staghorn stone patients have conflicting results, and the aim of the current study was to compare prone and supine positions for PNL in staghorn stone cases. Data of patients underwent PNL for staghorn stones in supine or prone position by a single urologist were collected prospectively. The supine and prone position groups were compared for stone free rate (SFR) and complication rates. All patients were evaluated with NCCT for evaluation of SFR. Chi-square test was used to compare categorical variables and Student t test was applied for continuous variables of the treatment groups. The groups were similar for demographic and stone-related characteristics. Multi-caliceal and intercostal access was more common in prone position. Operation duration was significantly shorter and hemoglobin drop was significantly less in supine group. SFR was 64.1 and 60.4% in the supine and prone groups, respectively (p = 0.72). Complication rates were similar in the two groups but Clavien III complications were observed in two patients in the prone group. PNL in supine position is an effective treatment for management of staghorn stones. The need for multi-caliceal and intercostal puncture is less when combined with retrograde intrarenal surgery. PNL in supine position should be considered as primary treatment option in staghorn stone cases.

  11. Isometric elbow extensors strength in supine- and prone-lying positions.

    Science.gov (United States)

    Abdelzaher, Ibrahim E; Ababneh, Anas F; Alzyoud, Jehad M

    2013-01-01

    The purpose of this study was to compare isometric strength of elbow extensors measured in supine- and prone-lying positions at elbow flexion angles of 45 and 90 degrees. Twenty-two male subjects under single-blind procedures participated in the study. Each subject participated in both supine-lying and prone-lying measuring protocols. Calibrated cable tensiometer was used to measure isometric strength of the right elbow extensors and a biofeedback electromyography was used to assure no substitution movements from shoulder girdle muscles. The mean values of isometric strength of elbow extensors measured from supine-lying position at elbow flexion angles of 45 and 90 degrees were 11.1  ±  4.2 kg and 13.1  ±  4.6 kg, while those measured from prone-lying position were 9.9  ±  3.6 kg and 12  ±  4.2 kg, respectively. There is statistical significant difference between the isometric strength of elbow extensors measured from supine-lying position at elbow flexion angles of 45 and 90 degrees compared to that measured from prone-lying position (p  isometric strength of elbow extensors since supine-lying starting position is better than prone-lying starting position.

  12. Analysis of OSAS incidence and influential factors in middle-aged and elderly patients with hypertension.

    Science.gov (United States)

    Wang, Shuang; Niu, Xinqing; Zhang, Peipei; Su, Dexing; Zhang, Jing; Liu, Wei

    2018-04-24

    To investigate the detection rate and influencing factors of obstructive sleep apnea syndrome (OSAS) in middle-aged and elderly patients with hypertension. A total of 440 patients with hypertension were selected as the research objects, all of them participated in the Berlin questionnaire survey, and the polysomnography (PSG) was performed on the patients with a high risk of OSAS. The detection rate of OSAS was analyzed, the clinical data between non-OSAS group and OSAS group were compared and stepwise linear regression and Logistic regression were used to analyze the related influencing factors to apnea hyponea index (AHI) and OSAS in hypertensive patients. A total of 235 patients completed PSG and 196 patients were diagnosed as OSAS with the detection rate of 83.40%. The detection rate of OSAS in male patients was higher than that in females (89.04% vs.74.16%, x²=8.025, P=0.006). The detection rates of OSAS in normal BMI group, overweight group and obesity group were 56.52%, 92.37% and 100%, respectively (x²=36.438, P<0.001). The detection rates of OSAS in normal waistline group and central obesity group were 74.42% and 88.59% (x²=7.539, P=0.016). The detection rates of OSAS in grade1, grade 2 and grade 3 hypertension groups were 57.47%, 98.23% and 100%, respectively (x²=44.623, P<0.001). BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), low density lipoprotein (LDL) and waist circumference of OSAS group were all higher than those in non-OSAS group (P<0.05). BMI, SBP and DBP were positively correlated with AHI (p<0.05), which were independent risk factors of OSAS [OR value (95%CI) = 2.548 (1.449-4.327), 1.342 (1.214-1.965) and 1.169 (1.025-1.622), respectively, P<0.05]. The incidence of OSAS in middle-aged and elderly patients with hypertension is high. High BMI, SBP, and DBP are independent risk factors of OSAS.

  13. Arterial wave reflection decreases gradually from supine to upright

    DEFF Research Database (Denmark)

    van den Bogaard, Bas; Westerhof, Berend E; Best, Hendrik

    2011-01-01

    BACKGROUND. An increase in total peripheral resistance (TPR) usually increases arterial wave reflection. During passive head-up tilt (HUT), however, arterial wave reflection decreases with increasing TPR. This study addressed whether arterial wave reflection gradually decreases during HUT. METHODS....... In 10 healthy volunteers (22-39 years, nine males), we recorded finger arterial pressures in supine position (0°), and 30°and 70°degrees HUT and active standing (90°). Aortic pressure was constructed from the finger pressure signal and hemodynamics were calculated. Arterial wave reflection...... from 0.9 dyn s/cm(5) at 0? to 1.2, 1.4 and 1.4 dyn s/cm(5) at 30°, 70° and 90° (p wave reflection...

  14. Evaluation of degree of lacunar infarction and carotid atherosclerosis in patients with different severity of OSAS

    Directory of Open Access Journals (Sweden)

    Ming Du

    2016-07-01

    Full Text Available Objective: To assess the degree of lacunar infarction and carotid atherosclerosis in patients with different severity of obstructive sleep apnea syndrome (OSAS. Methods: A total of 198 patients with OSAS were retrospectively studied from case information and test results, and were divided into mild group 84 cases, medium group 70 cases and severe group 44 cases according to apnea-hypopnea index (AHI, and 176 cases of non-OSAS people who received physical examination in our hospital during the same period were selected as healthy control group. Differences in the values of serum lacunar infarction-related indexes, blood viscosity and hemocyte-related indexes, carotid structure and function parameters, serum arteriosclerosis-related indexes and so on were compared among groups. Results: t-PA value of healthy control group was higher than those of OSAS group while vWF, PAI-1 and Fg values were lower than those of OSAS group (P<0.05, and with the increase of OSAS severity, t-PA value decreased while vWF, PAI-1 and Fg values increased (P<0.05; blood viscosity, Hct, PDW, RDW and EFR values of healthy control group were lower than those of OSAS group (P<0.05, and with the increase of OSAS severity, blood viscosity, Hct, PDW, RDW and EFR values increased (P<0.05; FMD, NID and DC values of healthy control group were higher than those of OSAS group while Dis, CC and PWV values were lower than those of OSAS group (P<0.05, and with the increase of OSAS severity, FMD, NID and DC values decreased while Dis, CC and PWV values increased (P<0.05; blood uric acid and EF-1 values of healthy control group were lower than those of OSAS group while CGRP and fetuin A levels were higher than those of OSAS group (P<0.05, and with the aggravation of OSAS, blood uric acid and EF-1 levels increased while CGRP and fetuin A levels decreased, and differences among groups were significant (P<0.05. Conclusions: With the aggravation of OSAS, patients’ microcirculation

  15. Assessment of the Depression, Anxiety, and Stress Scale (DASS-21) in untreated obstructive sleep apnea (OSA).

    Science.gov (United States)

    Nanthakumar, Shenooka; Bucks, Romola S; Skinner, Timothy C; Starkstein, Sergio; Hillman, David; James, Alan; Hunter, Michael

    2017-10-01

    The assessment of depression in obstructive sleep apnea (OSA) is confounded by symptom overlap. The Depression, Anxiety, and Stress Scale-short form (DASS-21) is a commonly used measure of negative affect, but it not known whether the DASS-21 is suitable for use in an OSA sample. This study compared the fit of Lovibond and Lovibond's (1995) correlated 3-factor structure of the DASS-21 and measurement invariance between a non-OSA and an OSA sample using confirmatory factor analysis. As measurement invariance was not found, to determine the source of non-invariance differential item functioning (DIF) was examined using dMACS. The correlated 3-factor structure (with correlated errors) of the DASS-21 was a better fit in the non-OSA sample. dMACS indicated that there was a degree of DIF for each of the subscales, especially for the Anxiety subscale, in which 2 symptoms (that are also physiological symptoms of OSA) produced lower severity scores in the OSA sample compared with the non-OSA sample. However, the degree of DIF for each of the subscales is not sufficient to cause concern when using the DASS-21; therefore, the total DASS-21 is suitable for use in an OSA sample. Interestingly, the impact of symptom overlap in anxiety symptoms may be reducing anxiety scores because of DIF, which contrasts with the proposed effect of symptom overlap in depression, where it leads to the inflation of depression scores in OSA. This deserves greater consideration in relation to OSA and other clinical disorders or chronic illness conditions with different patterns of overlapping symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  16. Biceps brachii can add to performance of tasks requiring supination in cerebral palsy patients

    NARCIS (Netherlands)

    de Bruin, M.; Veeger, H.E.J.; Kreulen, M.; Smeulders, M.J.C.; Bus, S.A.

    2013-01-01

    The aim of this study was to assess whether cerebral palsy patients can use biceps brachii for supination during movement tasks requiring supination and pronation. 3D upper extremity kinematic and EMG-data of 12 patients (mean age 13. y 8. mo. ±. 36. mo) were compared to 10 healthy age-matched

  17. Biceps brachii can add to performance of tasks requiring supination in cerebral palsy patients

    NARCIS (Netherlands)

    de Bruin, M.; Veeger, H. E. J.; Kreulen, M.; Smeulders, M. J. C.; Bus, S. A.

    2013-01-01

    The aim of this study was to assess whether cerebral palsy patients can use biceps brachii for supination during movement tasks requiring supination and pronation. 3D upper extremity kinematic and EMG-data of 12 patients (mean age 13 y 8 mo ± 36 mo) were compared to 10 healthy age-matched controls.

  18. Preparation And Physicochemical Properties of Octenyl Succinic Anhydride (OSA) Modified Sago Starch

    International Nuclear Information System (INIS)

    Nur Farhana Zainal Abiddin; Anida Yusoff; Noorlaila Ahmad

    2016-01-01

    Starch from sago (Metroxylon sagu) was esterified with octenyl succinic anhydride (OSA) in order to regulate its shortcoming by adding amphiphilic properties. The objective of this work is to determine the physicochemical properties of native sago and OSA sago starches. The OSA sago starch was produced according to the optimum condition generated via response surface methodology (RSM) with 5.00 % OSA at pH 7.20 and a reaction time of 9.65 hours. The esterified sago starch gives a degree of substitution (DS) value of 0.012. The physicochemical properties of OSA sago starch was determined by measuring the amylose content, laser diffraction particle size analyzer, scanning electron microscopy (SEM) and Fourier transform infrared (FT-IR). The amylose content for OSA sago starch was found to be reduced after esterification reaction. The particle size of OSA sago starch was found to increase significantly (p<0.05) compared to their native starches. Scanning electron microscopy (SEM) revealed that OSA starch developed slightly rough surface and their edges lost some definition. FT-IR spectroscopy shows that there was appearance of new absorption correspond to ester carbonyl group (1717 cm -1 ) and carboxylate RCOO- (1569 cm -1 ). This study showed that the physicochemical properties of modified starches were influenced not only by DS but also on the botanical origin of the starches. (author)

  19. Análise da atividade florestal no município de Viçosa-MG Analysis of forest activity in Viçosa-MG

    Directory of Open Access Journals (Sweden)

    Alessandro Albino Fontes

    2003-08-01

    Full Text Available Estudou-se a atividade florestal no município de Viçosa-MG, a partir de questionário aplicado aos agricultores cujas propriedades rurais possuíam florestas plantadas. Foi amostrado um total de 63 propriedades rurais, abrangendo uma área de 2.096,95 ha. As áreas de floresta nativa e plantada, na amostra, foram de 372,00 e 260,17 ha, o que corresponde, respectivamente, a 17,74 e 12,41% da área amostrada. O tipo de floresta nativa predominante foi a capoeira (67,55%, e a espécie preferida para o reflorestamento foi o eucalipto (92,68%. O uso médio da mão-de-obra nas fases de implantação, manutenção e colheita dos plantios florestais foi estimado em 30,21, 13,64 e 61,25 dias-homem/ha, respectivamente, totalizando 105,10 dias-homem/ha, sendo a participação da mão-de-obra familiar de 25,24%. Os custos inerentes à atividade florestal foram estimados em R$419,30/ha para implantação; R$146,49/ha e R$80,34/ha para manutenção no primeiro e segundo ano, respectivamente; e R$2,11/m³ para colheita da madeira. Os plantios florestais concentram-se nas áreas de encostas, e o número médio de empregos gerados pelo reflorestamento (eucalipto foi 0,042 emprego/ha. Concluiu-se, de modo geral, que o reflorestamento é considerado atividade pouco atrativa, não identificando propriedades tipicamente florestais, sendo recomendada a elaboração de políticas públicas de incentivo ao reflorestamento.Forest activity was studied in Viçosa-MG, through a questionnaire applied to farmers who planted forests. A total of 63 farms were sampled, comprising an area of 2,096.95 ha. The natural and planted forest areas sampled were of 372.00 ha and 260.17 ha, corresponding to 17.74% and 12.41%, respectively. The predominant natural forest was the secondary forest (capoeira (67.55%, and the species chosen for reforestation was eucalypt (92.68%. Average labor use in the phases of implementation, maintenance and harvest of the forest plantations was

  20. Comparative Emulsifying Properties of Octenyl Succinic Anhydride (OSA-Modified Starch: Granular Form vs Dissolved State.

    Directory of Open Access Journals (Sweden)

    María Matos

    Full Text Available The emulsifying ability of OSA-modified and native starch in the granular form, in the dissolved state and a combination of both was compared. This study aims to understand mixed systems of particles and dissolved starch with respect to what species dominates at droplet interfaces and how stability is affected by addition of one of the species to already formed emulsions. It was possible to create emulsions with OSA-modified starch isolated from Quinoa as sole emulsifier. Similar droplet sizes were obtained with emulsions prepared at 7% (w/w oil content using OSA-modified starch in the granular form or molecularly dissolved but large differences were observed regarding stability. Pickering emulsions kept their droplet size constant after one month while emulsions formulated with OSA-modified starch dissolved exhibited coalescence. All emulsions stabilized combining OSA-modified starch in granular form and in solution showed larger mean droplet sizes with no significant differences with respect to the order of addition. These emulsions were unstable due to coalescence regarding presence of free oil. Similar results were obtained when emulsions were prepared by combining OSA-modified granules with native starch in solution. The degree of surface coverage of starch granules was much lower in presence of starch in solution which indicates that OSA-starch is more surface active in the dissolved state than in granular form, although it led to unstable systems compared to starch granule stabilized Pickering emulsions, which demonstrated to be extremely stable.

  1. Network science meets respiratory medicine for OSAS phenotyping and severity prediction

    Directory of Open Access Journals (Sweden)

    Stefan Mihaicuta

    2017-05-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS is a common clinical condition. The way that OSAS risk factors associate and converge is not a random process. As such, defining OSAS phenotypes fosters personalized patient management and population screening. In this paper, we present a network-based observational, retrospective study on a cohort of 1,371 consecutive OSAS patients and 611 non-OSAS control patients in order to explore the risk factor associations and their correlation with OSAS comorbidities. To this end, we construct the Apnea Patients Network (APN using patient compatibility relationships according to six objective parameters: age, gender, body mass index (BMI, blood pressure (BP, neck circumference (NC and the Epworth sleepiness score (ESS. By running targeted network clustering algorithms, we identify eight patient phenotypes and corroborate them with the co-morbidity types. Also, by employing machine learning on the uncovered phenotypes, we derive a classification tree and introduce a computational framework which render the Sleep Apnea Syndrome Score (SASScore; our OSAS score is implemented as an easy-to-use, web-based computer program which requires less than one minute for processing one individual. Our evaluation, performed on a distinct validation database with 231 consecutive patients, reveals that OSAS prediction with SASScore has a significant specificity improvement (an increase of 234% for only 8.2% sensitivity decrease in comparison with the state-of-the-art score STOP-BANG. The fact that SASScore has bigger specificity makes it appropriate for OSAS screening and risk prediction in big, general populations.

  2. Effects of supine, prone, and lateral positions on cardiovascular and renal variables in humans

    DEFF Research Database (Denmark)

    Pump, Bettina; Talleruphuus, Ulrik; Christensen, Niels Juel

    2002-01-01

    The hypothesis was tested that changing the direction of the transverse gravitational stress in horizontal humans modulates cardiovascular and renal variables. On different study days, 14 healthy males were placed for 6 h in either the horizontal supine or prone position following 3 h of being...... supine. Eight of the subjects were in addition investigated in the horizontal left lateral position. Compared with supine, the prone position slightly increased free water clearance (349 +/- 38 vs. 447 +/- 39 ml/6 h, P = 0.05) and urine output (1,387 +/- 55 vs. 1,533 +/- 52 ml/6 h, P = 0...

  3. Comparison of the kidney dose between supine and prone position for pelvic and periaortic irradiation

    International Nuclear Information System (INIS)

    Mison, Chun; Haejin, Kang; Juree, Kim; Heesuk, Ryu; Hyunsoo, Shin

    1996-01-01

    We compared the doses received by the kidney in supine and prone positions for pelvic and periaortic irradiation. Kidney locations were verified by CT images taken with patients in the same position as during the treatment. Due to the shift of the kidney anteriorly during prone position, treatment in supine position delivered a much lower dose to most of the kidney than treatment in the prone position. Therefore, for periaortic irradiation treatment, the supine position should be considered to minimize the dose to the kidneys, even though the prone position with a belly board can reduce the dose to the small bowel

  4. Assessment of the Depression, Anxiety, and Stress Scale (DASS-21) in untreated obstructive sleep apnea (OSA)

    DEFF Research Database (Denmark)

    Nanthakumar, Shenooka; Bucks, Romola S.; Skinner, Timothy C.

    2017-01-01

    compared the fit of Lovibond and Lovibond's (1995) correlated 3-factor structure of the DASS-21 and measurement invariance between a non-OSA and an OSA sample using confirmatory factor analysis. As measurement invariance was not found, to determine the source of non-invariance differential item functioning...... (DIF) was examined using dMACS. The correlated 3-factor structure (with correlated errors) of the DASS-21 was a better fit in the non-OSA sample. dMACS indicated that there was a degree of DIF for each of the subscales, especially for the Anxiety subscale, in which 2 symptoms (that are also...

  5. The supinated mediolateral radiograph for detection of humeral head osteochondrosis in the dog

    International Nuclear Information System (INIS)

    Callahan, T.F.; Ackerman, N.

    1985-01-01

    Mediolateral and supinated mediolateral radiographs of the shoulder joint were compared in 19 dogs. Twenty shoulders, representing 15 dogs (5 had bilateral lesions), had osteochondrosis of the humeral head. The flattened humeral head and subchondral defect were detectable in both views in all affected shoulders. The lesions were slightly more easily detected in the supinated view. The supinated view more consistently demonstrated the presence of a calcified cartilage flap and therefore, could be useful in determining a course of therapy. In four dogs (8 shoulders) without osteochondrosis and six normal shoulders from affected dogs, there were no instances in which a shoulder appeared normal on one view, but demonstrated a lesion on the other. The supinated view should be obtained in addition to the mediolateral view in dogs with osteochondrosis of the humeral head

  6. Vertebral Fracture Assessment in Supine Position : Comparison by Using Conventional Semiquantitative Radiography and Visual Radiography

    NARCIS (Netherlands)

    Hospers, Ilone C.; van der Laan, Johan G.; Zeebregts, Clark J.; Nieboer, Patrick; Wolffenbuttel, Bruce H. R.; Dierckx, Rudi A.; Kreeftenberg, Herman G.; Jager, Pieter L.; Slart, Riemer H. J. A.

    Purpose: To retrospectively evaluate the accuracy of vertebral fracture assessment (VFA) performed with the patient in the supine position and conventional semiquantitative radiography of the spine by using conventional visual radiography of the spine as the reference standard. Materials and

  7. Effects of upright and supine position on cardiac rest and exercise response in aortic regurgitation.

    Science.gov (United States)

    Shen, W F; Roubin, G S; Fletcher, P J; Choong, C Y; Hutton, B F; Harris, P J; Kelly, D T

    1985-02-01

    The effects of upright and supine position on cardiac response to exercise were assessed by radionuclide ventriculography in 15 patients with moderate to severe aortic regurgitation (AR) and in 10 control subjects. In patients with AR, heart rate was higher during upright exercise, but systolic and diastolic blood pressure and left ventricular (LV) output were similar during both forms of exercise. LV stroke volume and end-diastolic volume were not altered during supine exercise. LV end-systolic volume increased and ejection fraction decreased during supine exercise, but both were unchanged during upright exercise. Of 15 patients, 5 in the upright and 12 in the supine position had an abnormal LV ejection fraction response to exercise (p less than 0.01). Right ventricular ejection fraction increased and regurgitant index decreased with both forms of exercise and was not significantly different between the 2 positions. Thus, posture is important in determining LV response to exercise in patients with moderate to severe AR.

  8. Teadusseltside osa rahvuskultuuris ja Õpetatud Eesti Selts / Tiit Rosenberg

    Index Scriptorium Estoniae

    Rosenberg, Tiit, 1946-

    2005-01-01

    Seltsid said alguse 17. sajandil ja levisid Baltimaadesse 19. sajandiks. Ettekanne Eesti Teaduste Akadeemiaga assotsieerunud teadusseltside ühiskonverentsil (21.05.2003. a.) "Teadusseltside osa Eesti rahvusliku identiteedi kujunemisel ja säilimisel"

  9. The utility of the elbow sign in the diagnosis of OSA

    Directory of Open Access Journals (Sweden)

    Haytham Samy Diab

    2015-04-01

    Conclusion: The elbow sign questionnaire is a simple and quick screening tool for OSA with good sensitivity and specificity in comparison to other questionnaires, further studies are needed in other populations to determine its reliability and predictive utility.

  10. Migrantide raha hoiab vee peal suurt osa endisest NL-ist / Ahto Lobjakas

    Index Scriptorium Estoniae

    Lobjakas, Ahto, 1970-

    2007-01-01

    Brüsselis tutvustatud Maailmapanga uuringust, mille kohaselt on suure osa endise NSVL-i vabariikide jaoks arvestatav sissetulekuallikas migrantide kojusaadetud raha. Lisa: Lääne-Euroopasse ja Venemaale

  11. A Prospective Study of Intrafraction Prostate Motion in the Prone vs. Supine Position

    International Nuclear Information System (INIS)

    Wilder, Richard B.; Chittenden, Lucy; Mesa, Albert V.; Bunyapanasarn, Jane; Agustin, Jeff; Lizarde, Jessica; Ravera, John; Tokita, Kenneth M.

    2010-01-01

    Purpose: To prospectively analyze prostate intrafraction motion in the prone vs. supine position and to assess patient satisfaction with these two positions. Methods and Materials: Fifteen prostate cancer patients underwent implantation of five fiducial gold seeds in their prostate for localization. Patients were treated with high-dose-rate brachytherapy to 2,200 cGy followed by intensity-modulated radiation therapy (IMRT) to 5,040 cGy. Patients underwent computed tomography simulation and IMRT in the prone position. For the first five IMRT treatments, an electronic portal imaging system was used to acquire anteroposterior (AP) and lateral images pretreatment and posttreatment. We then repositioned each patient supine and repeated the process, resulting in 600 images. Results: Mean ± standard deviation intrafraction prostate motion was 2.1 ± 1.2 mm and 1.7 ± 1.4 mm (AP, p = 0.47), 2.2 ± 2.0 mm and 1.6 ± 1.8 mm (superoinferior, p = 0.16), and 1.0 ± 1.2 mm and 0.6 ± 0.9 mm (left-right, p = 0.03) in the prone and supine positions, respectively. Eighty percent of patients stated that they were more comfortable in the supine position (p = 0.02). Conclusions: Prone and supine positions resulted in a similar magnitude of AP and superoinferior intrafraction prostate motion (2 mm). Because there was no significant difference in the magnitude of AP and superoinferior prostate motion prone vs. supine and patients were more comfortable in the supine position, patients now undergo IMRT to the prostate and seminal vesicles at our center in the supine position.

  12. Remote sensing of methane emissions by combining optical similitude absorption spectroscopy (OSAS and lidar

    Directory of Open Access Journals (Sweden)

    Galtier Sandrine

    2018-01-01

    Full Text Available Monitoring the emission of gases is difficult to achieve in industrial sites and in environments presenting poor infrastructures. Hence, robust methodologies should be developed and coupled to Lidar technology to allow remote sensing of gas emission. OSAS is a new methodology to evaluate gas concentration emission from spectrally integrated differential absorption measurements. Proof of concept of OSAS-Lidar for CH4 emission monitoring is here presented.

  13. Remote sensing of methane emissions by combining optical similitude absorption spectroscopy (OSAS) and lidar

    Science.gov (United States)

    Galtier, Sandrine; Anselmo, Christophe; Welschinger, Jean-Yves; Cariou, Jean-Pierre; Sivignon, Jean-François; Miffre, Alain; Rairoux, Patrick

    2018-04-01

    Monitoring the emission of gases is difficult to achieve in industrial sites and in environments presenting poor infrastructures. Hence, robust methodologies should be developed and coupled to Lidar technology to allow remote sensing of gas emission. OSAS is a new methodology to evaluate gas concentration emission from spectrally integrated differential absorption measurements. Proof of concept of OSAS-Lidar for CH4 emission monitoring is here presented.

  14. Comparison of supine and prone craniospinal irradiation in children with medulloblastoma.

    Science.gov (United States)

    Verma, Jonathan; Mazloom, Ali; Teh, Bin S; South, Michael; Butler, E Brian; Paulino, Arnold C

    2015-01-01

    To compare port film rejection and treatment outcome according to craniospinal irradiation (CSI) position for medulloblastoma. We retrospectively searched for patients ≤19 years treated with CSI for medulloblastoma at 1 department. We collected the following data: age; sex; risk group; need for general anesthesia; radiation therapy (RT) dose and fractionation; and the acceptance or rejection of weekly port films during treatment. We also collected data on outcomes, including neuraxis recurrence and possible complications such as myelitis. Of 46 children identified, 23 were treated prone (median age, 8.1 years) and 23 supine (median age, 7.2 years). High-risk disease was seen in 26% of prone and 35% of supine patients (P = .25). There was no difference in use of general anesthesia between those treated prone versus supine (57% vs 61%). The rejection rate of cranial port films in the prone position was 35%, which was significantly higher than the rate of 8% in patients treated supine (P < .0001). The 5-year progression-free (P = .37) and overall survival (P = .18) rates were 62% and 67% for prone and 76% and 84% for supine patients. There were no isolated junctional failures or radiation myelitis in either CSI position. The supine position for CSI was found to have similar survival outcomes compared with the prone position. A higher proportion of rejected cranial port films was seen in children treated in the prone position. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  15. Asthma Control and Its Relationship with Obstructive Sleep Apnea (OSA in Older Adults

    Directory of Open Access Journals (Sweden)

    Mihaela Teodorescu

    2013-01-01

    Full Text Available Background/Objectives. Asthma in older individuals is poorly understood. We aimed to characterize the older asthma phenotype and test its association with obstructive sleep apnea (OSA. Design. Cross-sectional. Setting. Pulmonary and Asthma/Allergy clinics. Participants. 659 asthma subjects aged 18–59 years (younger and 154 aged 60–75 (older. Measurements. Sleep Apnea scale of Sleep Disorders Questionnaire (SA-SDQ, asthma severity step (1–4, severe if step 3 or 4, established OSA diagnosis, continuous positive airway pressure (CPAP use, and comorbidities. Results. Older versus younger had worse control, as assessed by asthma step, lung function, and inhaled corticosteroid use. Among older subjects, after controlling for known asthma aggravators, OSA diagnosis was the only factor robustly associated with severe asthma: on average, OSA was associated with nearly 7 times greater likelihood of severe asthma in an older individual (OR=6.67. This relationship was of greater magnitude than in younger subjects (OR=2.16. CPAP use attenuated the likelihood of severe asthma in older subjects by 91% (P=0.005, much more than in the younger asthmatics. Conclusion. Diagnosed OSA increases the risk for worse asthma control in older patients, while CPAP therapy may have greater impact on asthma outcomes. Unrecognized OSA may be a reason for poor asthma control, particularly among older patients.

  16. Effect of CPAP Therapy in Improving Daytime Sleepiness in Indian Patients with Moderate and Severe OSA.

    Science.gov (United States)

    Battan, Gulshan; Kumar, Sanjeev; Panwar, Ajay; Atam, Virendra; Kumar, Pradeep; Gangwar, Anil; Roy, Ujjawal

    2016-11-01

    Obstructive Sleep Apnoea (OSA) is a highly prevalent disease and a major public health issue in India. Excessive daytime sleepiness is an almost ubiquitous symptom of OSA. Epworth Sleepiness Scale (ESS) score is a validated objective score to measure the degree of daytime sleepiness. Continuous Positive Airway Pressure (CPAP) therapy has been established as the gold standard treatment modality for OSA patients. A few Indian studies have reported the effectiveness of CPAP therapy in improving ESS scores after 1 st month of CPAP use. To observe both, short-term (one month) and long-term (three month) effects of CPAP therapy on ESS scores in moderate to severe OSA patients. The patients complaining of excessive day-time sleepiness, snoring and choking episodes during sleep, consecutively presenting to medicine OPD over a period of 2 years, were subjected to Polysomnography (PSG). Seventy-three patients with apnoea-hypopnea index (AHI) ≥15 were categorised as having moderate to severe forms of OSA (moderate OSA with AHI=15-30 and severe OSA with AHI >30), and were scheduled for an initial trial of CPAP therapy. Forty-seven patients reported good tolerance to CPAP therapy after a trial period of 2 weeks and comprised the final study group. ESS scores in these patients were recorded at the baseline, and after 1 st and 3 rd month of CPAP therapy, and statistically analysed for significance. Mean ESS score at the baseline among moderate and severe OSA patients were 13.67±2.29 and 16.56 ±1.87, respectively. ESS score in both these subgroups improved significantly to 11.63±3.79, p=0.022, CI (0.3293-4.0106)} and 14.13 ±3.74, p CPAP therapy. Likewise, mean ESS scores among moderate and severe OSA patients improved significantly to 9.84 ±2.97, p = 0.022, CI (0.3293-4.0106) and 12.29 ±3.97, p CPAP therapy. The result of the present study shows that CPAP therapy is significantly effective in improving ESS scores in Indian patients having moderate to severe OSA. Benefits

  17. Quality of Life in Youth With Obstructive Sleep Apnea Syndrome (OSAS) Treated With Continuous Positive Airway Pressure (CPAP) Therapy.

    Science.gov (United States)

    Lynch, Mary K; Elliott, Lindsey C; Avis, Kristin T; Schwebel, David C; Goodin, Burel R

    2017-05-30

    Improvement is sought for youth with obstructive sleep apnea syndrome (OSAS) who have poor quality of life (QoL), which resolves somewhat following treatment. One mitigating factor in improved QoL following treatment may be adherence to the CPAP protocol, which presents a barrier to most youth. This study explored relations between CPAP adherence and QoL in youth with OSAS. We recruited 42 youth-caregiver dyads in which youth between the ages of 8 and 16 years were diagnosed with OSAS and required CPAP use as part of their treatment plan. Following diagnosis of OSAS requiring treatment with CPAP therapy, caregivers completed baseline measures of OSAS-specific QoL. The OSAS-specific QoL domains assessed included sleep disturbance, physical symptoms, emotional distress, daytime function, and caregiver concern. Families received routine CPAP care for three months, after which caregivers again completed measures of OSAS-specific QoL. Adherence data were collected from smartcards within the CPAP machine after three months of treatment. Fifteen youth were adherent to CPAP therapy and 10 were not adherent. CPAP-adherent youth demonstrated significant changes in two domains of OSAS-specific QoL when compared to nonadherent youth: decreased sleep disturbance and decreased caregiver concern. CPAP adherence appears to be associated with positive changes in OSAS-specific QoL domains. It will be important for future research and clinical work to examine strategies for improving CPAP adherence in youth with OSAS.

  18. The effect of allergic rhinitis on the degree of stress, fatigue and quality of life in OSA patients.

    Science.gov (United States)

    Park, Cheol Eon; Shin, Seung Youp; Lee, Kun Hee; Cho, Joong Saeng; Kim, Sung Wan

    2012-09-01

    Both allergic rhinitis (AR) and obstructive sleep apnea (OSA) are known to increase stress and fatigue, but the result of their coexistence has not been studied. The objective of this study was to evaluate the amount of stress and fatigue when AR is combined with OSA. One hundred and twelve patients diagnosed with OSA by polysomnography were enrolled. Among them, 37 patients were diagnosed with AR by a skin prick test and symptoms (OSA-AR group) and 75 patients were classified into the OSA group since they tested negative for allergies. We evaluated the Epworth sleepiness scale (ESS), stress score, fatigue score, ability to cope with stress, and rhinosinusitis quality of life questionnaire (RQLQ) with questionnaires and statistically compared the scores of both groups. There were no significant differences in BMI and sleep parameters such as LSAT, AHI, and RERA between the two groups. However, the OSA-AR group showed a significantly higher ESS score compared to the OSA group (13.7 ± 4.7 vs. 9.3 ± 4.8). Fatigue scores were also significantly higher in the OSA-AR group than in the OSA group (39.8 ± 11.0 vs. 30.6 ± 5.4). The OSA-AR group had a significantly higher stress score (60.4 ± 18.6 vs. 51.2 ± 10.4). The ability to cope with stress was higher in the OSA group, although this difference was not statistically significant. RQLQ scores were higher in the OSA-AR group (60.2 ± 16.7 compared to 25.1 ± 13.9). In conclusion, management of allergic rhinitis is very important in treating OSA patients in order to eliminate stress and fatigue and to minimize daytime sleepiness and quality of life.

  19. A study of semi-rigid support on ankle supination sprain kinematics.

    Science.gov (United States)

    Tang, Y M; Wu, Z H; Liao, W H; Chan, K M

    2010-12-01

    Ankle sprain injury is very common in sports and the use of ankle support is crucial. This research investigated the effect of an ankle brace in reducing the ankle angular displacement and angular velocity during sudden supination. In the experiment, 11 healthy males were tested. The bracing condition, semi-rigid ankle braces were investigated. The angular displacement and angular velocity of the ankle were computed. The motion-capture system was adopted to capture the three-dimensional coordinates of the reflective markers. The coordinates of the reflective markers were used to compute the ankle kinematics during simulated ankle supination. A mechanical supination platform was used to simulate the sprain motions. Experimental results showed that the semi-rigid brace tested significantly reduced the ankle angular displacement and angular velocity compared with control conditions during sudden supination. In conclusion, the semi-rigid-type brace can provide significant restriction to reduce the magnitudes of the angular displacement and angular velocity of the ankle during sudden supination sprain. The semi-rigid-type brace is suggested as the prophylactic bracing for the ankle. © 2009 John Wiley & Sons A/S.

  20. Effect of Pelvic Tilt and Rotation on Cup Orientation in Both Supine and Standing Positions.

    Science.gov (United States)

    Yun, Hohyun; Murphy, William S; Ward, Daniel M; Zheng, Guoyan; Hayden, Brett L; Murphy, Stephen B

    2018-05-01

    The purpose of this study is to analyze the effect of pelvic tilt and rotation on radiographic measurement of cup orientation. A total of 68 patients (79 hips) were included in this study. The patients had a computed tomography study and approximately 3 months of postoperative standing anteroposterior pelvic radiographs in both supine and standing positions. We used 2-dimensional (2D)/3-dimensional (3D) matching to measure pelvic tilt and rotation, and cup orientation. There was a wide range of pelvic tilt between individuals in both supine and standing positions. Supine pelvic tilt was different from standing pelvic tilt (P cup anteversion before and after 2D/3D matching in both supine and standing positions (P cup anteversion before and after 2D/3D matching. When all 79 hips were separated into right and left side, pelvic rotation inversely correlated with the pelvic tilt-adjusted difference in anteversion before and after 2D/3D matching of the right side but directly correlated with that of the left side in both supine and standing positions. This study demonstrated that the measurement of cup anteversion on anteroposterior radiographs is significantly affected by both pelvic tilt and pelvic rotation (depending on the side). Improved understanding of pelvic orientation and improved ability to measure pelvic orientation may eventually allow for desired cup positioning to potentially protect against complications associated with malposition of the cup. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Modified supine versus prone percutaneous nephrolithotomy: Surgical outcomes from a tertiary teaching hospital

    Directory of Open Access Journals (Sweden)

    Madeleine Nina Jones

    2016-07-01

    Full Text Available Purpose: The traditional prone positioning of percutaneous nephrolithotomy (PCNL is associated with various anesthetic and logistic difficulties. We aimed to compare the surgical outcomes of PCNLs performed using our modified supine position with those performed in the standard prone position. Materials and Methods: A prospective group of 236 renal units (224 patients undergoing PCNL were included in this 2 site study: 160 were performed in the modified supine position were compared with 76 undergoing PCNL in the prone position. The outcomes of radiation dose, radiation time, stone free rate, body mass index (BMI, stone size, operative time, length of stay (LOS, in hospital and complications were compared. Chi-square and t-tests were used. Results: There were no significant differences in mean radiation time, radiation dose or stone size between the modified supine and prone groups. The supine group had a higher mean BMI (31 kg/m2 vs. 28 kg/m2 , p=0.03, shorter mean surgical time (93 minutes vs. 123 minutes, p<0.001, shorter mean LOS (2 days vs. 3 days, p=0.005 and higher stone free rate (70% vs. 50%, p=0.005. There were no differences in septic or bleeding complications but the prone group had a higher rate of overall complications. Conclusions: Modified supine PCNL has significantly lower operative time, shorter LOS and higher stone-free rate compared with prone in our series, while remaining a safe procedure.

  2. SU-E-T-307: Dosimetric Comparison of Prone Versus Supine Positioning for Adjuvant Breast Radiation Therapy

    International Nuclear Information System (INIS)

    Pope, C; O’Connor, B; Hayes, L; Rella, J; Ruiz, B; Yang, J

    2015-01-01

    Purpose: The prone treatment position has been used to reduce ipsilateral lung and heart dose in left breast radiation. We conducted a retrospective study to evaluate the difference in the dosimetry between prone and supine treatment positions. Methods: Eight left breast cancer patients were simulated in both the supine and prone positions as a pretreatment evaluation for the optimal treatment position. Treatment plans were created for all patients in both the supine and prone positions using a field in field three dimensional planning technique. Prescribed dose was 45 Gy delivered by two tangential photon fields. Irradiated volume (IV) was evaluated by V50, V100, and dose to lung and heart by V5, V10, V20, and the mean dose were evaluated. Results: All dosimetry metrics for both the supine and prone plans met our internal normal structure guidelines which are based on Quantec data. The average IVs (50% and 100%) were 2223cc and 1361cc prone, 2315cc and 1315cc supine. The average ipsilateral lung Mean dose (0.83Gy prone vs 5.8Gy supine), V5 (1.6% prone vs 20.9% supine), V10 (0.78% prone vs 15% supine) and V20 (0.36% prone vs 11% supine) were significantly lower in prone position. Heart Mean dose (1.4Gy prone vs 2.9Gy supine), V10 (1.4% prone vs 5.0% supine) and V20 (0.4% prone vs 3.5% supine) were found improved for all patients except one where the mean dose was the same and all other values were improved. Conclusion: The prone position offer preferable dosimetry for all patients planned in our study. These patients were chosen based on the physician’s belief that they would benefit from prone treatment either because they had large pendulous breasts or due to the amount of heart seen in the field on CT simulation

  3. Converting a manned LCU into an unmanned surface vehicle (USV): an open systems architecture (OSA) case study

    OpenAIRE

    Smith, Montrell F.

    2014-01-01

    Approved for public release; distribution is unlimited This thesis demonstrates the process by which the concepts of open systems architecture (OSA) might be applied within the context of an existing systems engineering methodology to result in a flexible system. This is accomplished by combining an existing systems engineering process model with OSA management and business principles to execute a successful asset-repurposing program. To demonstrate utility of this OSA approach to systems ...

  4. Evaluation of supine and sitting cardiac blood pool scans with sup(99m)Tc-HSA

    International Nuclear Information System (INIS)

    Bunko, Hisashi; Kuwajima, Akira; Hisada, Kinichi

    1977-01-01

    In the differential diagnosis of enlarged cardiac silhouette on plain chest x-ray film, cardiac blood pool scan was usually performed at first. However, small amount of pericardial effusion was difficult to detect on cardiac blood pool scan and differentiation of pericardial effusion from myocardial thickening was sometimes difficult. We evaluated cardiac blood pool scan with sup(99m)Tc-HSA(human serum albumin) and gamma camera imaged on both supine and sitting position, and evaluated diagnostic efficiency of criteria for pericardial effusion of these scans. Fifty-seven patients suspected of having pericardial effusion were included in the study. Sixteen of these patients had pericardial effusion and 2 of these 16 patients had free pleural effusion. Three patients had pleural effusion alone and excluded from the study. Of the five criteria for pericardial effusion, separation between heart and right lung activities was most frequent in both effusion (true positive, TP=100% on both supine and sitting) and no effusion (false positive, FP=18.4% on supine and 23.7% on sitting) groups. However, increased heart and right lung separation on sitting position was rather frequent in effusion group, and this finding was also thought to be typical for effusion but not for myocardial thickening. Decreased cardiohepatic separation on sitting position was frequent in no effusion group, and FP rate was decreased from 18.4% (supine) to 10.5% (sitting). Two patients with both pericardial effusion and free pleural effusion were easily diagnosed on sitting cardiac blood pool scan. With ROC(receiver operating characteristic) curve, three criteria should be agreed on either supine or sitting scan for diagnosis of pericardial effusion, and six criteria should be agreed when both supine and sitting scans were employed for diagnosis of pericardial effusion. (auth.)

  5. Increased MCP-1 gene expression in monocytes of severe OSA patients and under intermittent hypoxia.

    Science.gov (United States)

    Chuang, Li-Pang; Chen, Ning-Hung; Lin, Yuling; Ko, Wen-Shan; Pang, Jong-Hwei S

    2016-03-01

    Obstructive sleep apnea (OSA) is known to be a risk factor of coronary artery disease. Monocyte chemoattractant protein-1 (MCP-1), as a critical factor for monocyte infiltration, is known to play a role in the development of atherosclerosis. This study aimed to investigate the effect of intermittent hypoxia, the hallmark of OSA, on the MCP-1 expression of monocytes. Peripheral blood was sampled from 61 adults enrolled for suspected OSA. RNA was prepared from the isolated monocytes for the analysis of MCP-1. The effect of in vitro intermittent hypoxia on the regulation and function of MCP-1 was investigated on THP-1 monocytic cells and human monocytes. The mRNA and secreted protein levels were investigated by RT/real-time PCR and enzyme-linked immunosorbent assay, respectively. Monocytic MCP-1 gene expression was found to be increased significantly in severe OSA patients. In vitro intermittent hypoxia was demonstrated to increase the mRNA and protein expression levels of MCP-1 dose- and time-dependently in THP-1 monocytic cells. The MCP-1 mRNA expression in monocytes isolated from OSA patient was induced to a much higher level compared to that from normal control. Pre-treatment with inhibitor for p42/44 MAPK or p38 MAPK suppressed the activation of MCP-1 expression by intermittent hypoxia. This is the first study to demonstrate the increase of MCP-1 gene expression in monocytes of severe OSA patients. In addition, monocytic MCP-1 gene expression can be induced under intermittent hypoxia.

  6. OSA screening with the pediatric sleep questionnaire for adolescents undergoing bariatric surgery in teen-LABS.

    Science.gov (United States)

    Ishman, Stacey; Heubi, Christine; Jenkins, Todd; Michalsky, Marc; Simakajornboon, Narong; Inge, Thomas

    2016-11-01

    Obstructive sleep apnea (OSA) is reported in 70% of adolescents who present for bariatric surgery. The Pediatric Sleep Questionnaire (PSQ) was developed to identify children at risk for OSA but is not validated in adolescents with obesity. The aims of this study were: (1) to assess validity of the PSQ to detect OSA and (2) to determine the correlation between anthropometric and polysomnography measurements. A cross-sectional assessment of Teen-Longitudinal Assessment of Bariatric Surgery participants at high risk for OSA was performed. Participants completed an overnight polysomnography, and caregivers completed the PSQ. Forty-five participants (84% female, 78% Caucasian, mean age = 16.7 ± 1.5 years) were evaluated. Mean BMI was 51.3 ± 7.7 kg/m 2 and mean obstructive apnea-hypopnea index (oAHI) was 6.1 ± 5.9 events/h. For diagnosis of OSA (oAHI ≥5), the total PSQ score sensitivity, specificity, and positive predictive value (PPV) were 86%, 38%, and 55%, respectively. For snoring >50% of the time, PPV was 84%, sensitivity was 64%, and specificity was 43%. Sagittal abdominal diameter correlated with oAHI and oxygen saturation nadir (ρ = 0.34, P = 0.027), whereas BMI, neck, and waist circumference correlated with neither. The PSQ demonstrated low specificity, and PPV and the question regarding snoring >50% of the time did not effectively identify OSA. Sagittal abdominal diameter correlated with oAHI and oxygen saturation nadir. © 2016 The Obesity Society.

  7. Trunk muscle activity during different variations of the supine plank exercise

    DEFF Research Database (Denmark)

    Calatayud, Joaquin; Casaña, Jose; Martín, Fernando

    2017-01-01

    Background Exercises providing neuromuscular challenges of the spinal muscles are desired for core stability, which is important for workers with heavy manual labour as well as people recovering from back pain. Purpose This study evaluated whether using a suspended modality increases trunk muscle...... voluntary isometric contraction (MVIC). Results No differences between exercises were found for UP ABS, LOW ABS and OBLIQ muscle activity. The unilateral suspended supine plank provided the highest LUMB activity (20% of MVIC) whiles the bilateral stable supine plank provided the lowest activity (11% of MVIC...

  8. Obstructive sleep apnea (OSA): a complication of acute infectious mononucleosis infection in a child.

    Science.gov (United States)

    Cheng, Jeffrey

    2014-03-01

    Independently, obstructive sleep apnea (OSA) and infectious mononucleosis are not uncommon in the pediatric population, but acute onset of OSA, as a respiratory complication in the setting of acute EBV infection is extremely uncommon. Previous reports of this clinical entity are sparse and from nearly two decades ago. Urgent adenotonsillectomy was commonly advocated. This complication may be managed medically with systemic corticosteroids and non-invasive continuous positive airway pressure (CPAP), and a case is presented to highlight an updated management approach to this rarely encountered clinical problem in children. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Lizards and Amphisbaenians, municipality of Viçosa, state of Minas Gerais, southeastern Brazil

    Directory of Open Access Journals (Sweden)

    Rodrigues, A. C.

    2009-01-01

    Full Text Available We performed a survey of lizards and amphisbaenians from municipality of Viçosa, in Atlantic Forest from state ofMinas Gerais, southeastern Brazil, based on data of the herpetological collections of Museu de Zoologia João Moojen,Universidade Federal de Viçosa, and Museu de Zoologia, Universidade de São Paulo. One hundred and forty sixspecimens of 14 species were analyzed, belonging to the following families: Amphisbaenidae, Anguidae, Gekkonidae,Gymnophthalmidae, Leiosauridae, Polychrotidae, Scincidae, Teiidae and Tropiduridae. We hope to supply basicinformation that helps to understand species distribution of this group in the Atlantic Forest of Minas Gerais andsoutheastern Brazil.

  10. Predicting uptake of continuous positive airway pressure (CPAP) therapy in obstructive sleep apnoea (OSA)

    DEFF Research Database (Denmark)

    Skinner, Timothy; McNeil, Lindsay; Olaithe, Michelle

    2013-01-01

    diagnosed with OSA. Epworth sleepiness scale (ESS), Fatigue Severity Scale, Depression Anxiety Stress Scale and Illness Perception Questionnaire-Revised (IPQ-R) were administered at time of sleep study. These, patient demographics and sleep study variables were used to determine factors predicting patient......Purpose: Obstructive sleep apnoea (OSA) is a common disorder, for which continuous positive airway pressure (CPAP) therapy is a standard treatment. Despite its well-established efficacy, many patients choose not to initiate CPAP treatment. The present study investigated the degree to which...

  11. Dosimetric effects of the prone and supine positions on image guided localized prostate cancer radiotherapy

    International Nuclear Information System (INIS)

    Liu Bei; Lerma, Fritz A.; Patel, Shilpen; Amin, Pradip; Feng Yuanming; Yi, B.-Y.; Yu, Cedric

    2008-01-01

    Purpose: To compare target coverage and doses to rectum and bladder in IMRT of localized prostate cancer in the supine versus prone position, with the inclusion of image guidance. Materials and methods: Twenty patients with early stage localized prostate carcinoma who received external beam radiotherapy in the supine and prone positions underwent approximately 10 serial CT examinations in their respective treatment position in non-consecutive days, except for one patient who was treated prone but serially imaged supine. The prostate, bladder and rectum were contoured on all CT scans. A PTV was generated on the first scan of each patient's CT series by expanding the prostate with a 5 mm margin and an IMRT plan was created. The resultant IMRT plan was then applied to that patient's remaining serial CT scans by aligning the initial CT image set with the subsequent serial CT image sets using (1) skin marks, (2) bony anatomy and (3) center of mass of the prostate. The dosimetric results from these three alignments were compared between the supine and prone groups. To account for the uncertainties associated with prostate delineation and intra-fractional geometric changes, a fictional 'daily PTV' was generated by expanding the prostate with a 3 mm margin on each serial CT scan. Thus, a more realistic target coverage index, V95, was quantified as the fraction of the daily PTV receiving at least 95% of the prescription dose. Dose-volume measures of the organs at risk were also compared. The fraction of the daily PTV contained by the initial PTV after each alignment method was quantified on each patient's serial CT scan, and is defined as PTV overlap index. Results: As expected, alignment based on skin marks yielded unacceptable dose coverage for both groups of patients. Under bony alignment, the target coverage index, V95, was 97.3% and 93.6% for prone and supine patients (p < 0.0001), respectively. The mean PTV overlap indices were 90.7% and 84.7% for prone and supine

  12. Improvement in Obstructive Sleep Apnea With Weight Loss is Dependent on Body Position During Sleep.

    Science.gov (United States)

    Joosten, Simon A; Khoo, Jun K; Edwards, Bradley A; Landry, Shane A; Naughton, Matthew T; Dixon, John B; Hamilton, Garun S

    2017-05-01

    Weight loss fails to resolve obstructive sleep apnea (OSA) in most patients; however, it is unknown as to whether weight loss differentially affects OSA in the supine compared with nonsupine sleeping positions. We aimed to determine if weight loss in obese patients with OSA results in a greater reduction in the nonsupine apnea/hypopnea index (AHI) compared with the supine AHI, thus converting participants into supine-predominant OSA. Post hoc analysis of data from a randomized controlled trial assessing the effect of weight loss (bariatric surgery vs. medical weight loss) on OSA in 60 participants with obesity (body mass index: >35 and sleep study at 2 years. Eight of 37 (22%) patients demonstrated a normal nonsupine AHI (sleep avoidance may cure their OSA. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  13. Age, gender, neck circumference, and Epworth sleepiness scale do not predict obstructive sleep apnea (OSA in moderate to severe chronic obstructive pulmonary disease (COPD: The challenge to predict OSA in advanced COPD.

    Directory of Open Access Journals (Sweden)

    Xavier Soler

    Full Text Available The combination of chronic obstructive pulmonary disease (COPD and obstructive sleep apnea (OSA is associated with substantial morbidity and mortality. We hypothesized that predictors of OSA among patients with COPD may be distinct from OSA in the general population. Therefore, we investigated associations between traditional OSA risk factors (e.g. age, and sleep questionnaires [e.g. Epworth Sleepiness Scale] in 44 patients with advanced COPD. As a second aim we proposed a pilot, simplified screening test for OSA in patients with COPD. In a prospective, observational study of patients enrolled in the UCSD Pulmonary Rehabilitation Program we collected baseline characteristics, cardiovascular events (e.g. atrial fibrillation, and sleep questionnaires [e.g. Pittsburgh Sleep Quality Index (PSQI]. For the pilot questionnaire, a BMI ≥25 kg/m2 and the presence of cardiovascular disease were used to construct the pilot screening test. Male: 59%; OSA 66%. FEV1 (mean ± SD = 41.0±18.2% pred., FEV1/FVC = 41.5±12.7%]. Male gender, older age, and large neck circumference were not associated with OSA. Also, Epworth Sleepiness Scale and the STOP-Bang questionnaire were not associated with OSA in univariate logistic regression. In contrast, BMI ≥25 kg/m2 (OR = 3.94, p = 0.04 and diagnosis of cardiovascular disease (OR = 5.06, p = 0.03 were significantly associated with OSA [area under curve (AUC = 0.74]. The pilot COPD-OSA test (OR = 5.28, p = 0.05 and STOP-Bang questionnaire (OR = 5.13, p = 0.03 were both associated with OSA in Receiver Operating Characteristics (ROC analysis. The COPD-OSA test had the best AUC (0.74, sensitivity (92%, and specificity (83%. A ten-fold cross-validation validated our results. We found that traditional OSA predictors (e.g. gender, Epworth score did not perform well in patients with more advanced COPD. Our pilot test may be an easy to implement instrument to screen for OSA. However, a larger validation study is necessary

  14. Age, gender, neck circumference, and Epworth sleepiness scale do not predict obstructive sleep apnea (OSA) in moderate to severe chronic obstructive pulmonary disease (COPD): The challenge to predict OSA in advanced COPD.

    Science.gov (United States)

    Soler, Xavier; Liao, Shu-Yi; Marin, Jose Maria; Lorenzi-Filho, Geraldo; Jen, Rachel; DeYoung, Pamela; Owens, Robert L; Ries, Andrew L; Malhotra, Atul

    2017-01-01

    The combination of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is associated with substantial morbidity and mortality. We hypothesized that predictors of OSA among patients with COPD may be distinct from OSA in the general population. Therefore, we investigated associations between traditional OSA risk factors (e.g. age), and sleep questionnaires [e.g. Epworth Sleepiness Scale] in 44 patients with advanced COPD. As a second aim we proposed a pilot, simplified screening test for OSA in patients with COPD. In a prospective, observational study of patients enrolled in the UCSD Pulmonary Rehabilitation Program we collected baseline characteristics, cardiovascular events (e.g. atrial fibrillation), and sleep questionnaires [e.g. Pittsburgh Sleep Quality Index (PSQI)]. For the pilot questionnaire, a BMI ≥25 kg/m2 and the presence of cardiovascular disease were used to construct the pilot screening test. Male: 59%; OSA 66%. FEV1 (mean ± SD) = 41.0±18.2% pred., FEV1/FVC = 41.5±12.7%]. Male gender, older age, and large neck circumference were not associated with OSA. Also, Epworth Sleepiness Scale and the STOP-Bang questionnaire were not associated with OSA in univariate logistic regression. In contrast, BMI ≥25 kg/m2 (OR = 3.94, p = 0.04) and diagnosis of cardiovascular disease (OR = 5.06, p = 0.03) were significantly associated with OSA [area under curve (AUC) = 0.74]. The pilot COPD-OSA test (OR = 5.28, p = 0.05) and STOP-Bang questionnaire (OR = 5.13, p = 0.03) were both associated with OSA in Receiver Operating Characteristics (ROC) analysis. The COPD-OSA test had the best AUC (0.74), sensitivity (92%), and specificity (83%). A ten-fold cross-validation validated our results. We found that traditional OSA predictors (e.g. gender, Epworth score) did not perform well in patients with more advanced COPD. Our pilot test may be an easy to implement instrument to screen for OSA. However, a larger validation study is necessary before

  15. Posture and movement in healthy preterm infants in supine position in and outside the nest

    NARCIS (Netherlands)

    Ferrari, F.; Bertoncelli, N.; Gallo, C.; Roversi, M. F.; Guerra, M. P.; Ranzi, A.; Madders-Algra, M.

    Objective: To evaluate whether lying in a nest affects the posture and spontaneous movements of healthy preterm infants. Method: 10 healthy preterm infants underwent serial video recording in the supine position, when lying in a nest and outside it, at three ages: 30-33 weeks postmenstrual age (PMA)

  16. Supine or prone position for mini-PNL procedure: does it matter.

    Science.gov (United States)

    Tokatlı, Zafer; Gokce, Mehmet Ilker; Süer, Evren; Sağlam, Remzi

    2015-06-01

    In this study it is aimed to compare the success and complication rates of mini-PNL procedure in supine and prone positions. In this retrospective study data of 180 patients treated with MPNL either in supine (n = 54) or prone (n = 126) positions between May 2009 and August 2014 was investigated. Success was defined as no visible stones >2 mm. Perioperative complications were classified using the modified Clavien system. Groups were compared with Chi square test or Student t test and for statistical significance p value of 0.05 was accepted. Mean age of the population was 42.5 ± 8.2 years and mean stone size was 23.9 ± 4.1 mm. The two groups were similar with regard to demographic characteristics and stone related characteristics except the ASA status. Success rates of the supine and prone groups were 85.1 and 87.3%, respectively (p = 0.701). No statistically significant differences in terms of complications were observed. Mean operative time was the only parameter different between the two groups (55 vs 82 min, p = 0.001). Supine position for PNL seems to be promising and the complication and success rates are shown to be similar to the prone position with MPNL technique. The only significant benefit of this technique is shorter operative time.

  17. Physiological Response to Static Muscle Contractions in Standing and Supine Positions

    DEFF Research Database (Denmark)

    Pedersen, Jens Meldgaard; Andersen, T. Bull

    2013-01-01

    The purpose of this study was to investigate the physiological responses to static muscle contractions in the standing position and the supine position. Eight subjects performed static contractions of the ankle extensors in both positions. Blood pressure (SBP and DBP), heart rate (HR...

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

    International Nuclear Information System (INIS)

    Jacobson, A.F.; Parker, J.A.; Royal, H.D.; Silverman, K.J.; Gervino, E.V.; Kolodny, G.M.

    1987-01-01

    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

  19. Prone versus supine thallium myocardial SPECT: A method to decrease artifactual inferior wall defects

    International Nuclear Information System (INIS)

    Segall, G.M.; Davis, M.J.

    1989-01-01

    Artifactual inferior wall defects as a result of diaphragmatic attenuation of activity are a frequent source of error in thallium myocardial single photon emission computed tomography (SPECT) studies. Thirty-four patients and 11 clinically normal volunteers were studied prospectively to see if specificity of inferior wall defects for right coronary artery disease could be improved by scanning patients prone versus supine. All individuals were scanned both prone and supine, in random order, following symptom limited treadmill exercise. Images were acquired at 3 degrees steps, 25 sec per frame, in a 180 degrees elliptical orbit always beginning in the 45 degrees right anterior oblique position relative to the patient. Polar maps generated from the short axis slices were used to calculate the average regional activity. The prone studies showed consistently higher inferior wall activity compared to the supine studies on both the exercise (182 +/- 22 vs. 160 +/- 23, p less than or equal to 0.001) and 4-hr delay studies (183 +/- 20 vs. 175 +/- 21, p less than or equal to 0.001). Prone imaging resulted in a significantly higher specificity for RCA disease compared to supine imaging (90% vs. 66%, p less than 0.05) with an improvement in accuracy from 71% to 82%. Sensitivity, specificity, and accuracy for left anterior descending and left circumflex artery disease were not significantly affected by patient position during imaging. All patients having SPECT thallium myocardial perfusion studies should be imaged prone to minimize artifactual inferior wall defects and improve accuracy

  20. Dorian Supin käis Pärdi asjus Argentinas / T.T.

    Index Scriptorium Estoniae

    T.T.

    2003-01-01

    Dokumentaalfilm helilooja Arvo Pärdist "24 prelüüdi ühele fuugale". Filmi stsenarist, režissöör ja operaator Dorian Supin näitas seda suure menuga Buenos Airese San Martini ülikoolis spetsiaalse seminari osavõtjatele

  1. Video-assisted thoracic surgery for superior posterior mediastinal neurogenic tumour in the supine position

    Directory of Open Access Journals (Sweden)

    Darlong Laleng

    2009-01-01

    Full Text Available Video-assisted thoracic surgery (VATS for a superior posterior mediastinal lesion is routinely done in the lateral decubitus position similar to a standard thoracotomy using a double-lumen endotracheal tube for one-lung ventilation. This is an area above the level of the pericardium, with the superior thoracic opening as its superior limit and its inferior limit at the plane from the sternal angle to the level of intervertebral disc of thoracic 4 to 5 vertebra lying behind the great vessels. The lateral decubitus position has disadvantages of the double-lumen endotracheal tube getting malpositioned during repositioning from supine position to the lateral decubitus position, shoulder injuries due to the prolonged abnormal fixed posture and rarer injuries of the lower limb. There is no literature related to VATS in the supine position for treating lesions in the posterior mediastinum because the lung tissue falls in the dependent posterior mediastinum and obscures the field of surgery; however, VATS in the supine position is routinely done for lesions in the anterior mediastinum and single-stage bilateral spontaneous pneumothorax. Thus, in the selected cases, ′VATS in supine position′ allows an invasive procedure to be completed in the most stable anatomical posture.

  2. Normovolemia defined according to cardiac stroke volume in healthy supine humans

    DEFF Research Database (Denmark)

    Bundgaard-Nielsen, Morten; Jørgensen, Christoffer C; Kehlet, Henrik

    2010-01-01

    , mean +/- SD), SV was measured by esophageal Doppler before and after fluid administration to evaluate whether SV increases in healthy, non-fasting, supine subjects. Two hundred millilitres of a synthetic colloid (hydroxyethyl starch, HES 130/0.4) was provided and repeated if a >or=10% increment in SV...

  3. Remote sensing of methane with OSAS-lidar on the 2ν3 band Q-branch: Experimental proof

    Science.gov (United States)

    Galtier, Sandrine; Anselmo, Christophe; Welschinger, Jean-Yves; Sivignon, J. F.; Cariou, Jean-Pierre; Miffre, Alain; Rairoux, Patrick

    2018-06-01

    Optical sensors based on absorption spectroscopy play a central role in the detection and monitoring of atmospheric trace gases. We here present for the first time the experimental demonstration of OSAS-Lidar on the remote sensing of CH4 in the atmosphere. This new methodology, the OSAS-Lidar, couples the Optical Similitude Absorption Spectroscopy (OSAS) methodology with a light detection and ranging device. It is based on the differential absorption of spectrally integrated signals following Beer Lambert-Bouguer law, which are range-resolved. Its novelty originates from the use of broadband laser spectroscopy and from the mathematical approach used to retrieve the trace gas concentration. We previously applied the OSAS methodology in laboratory on the 2ν3 methane absorption band, centered at the 1665 nm wavelength and demonstrated that the OSAS-methodology is almost independent from atmospheric temperature and pressure. In this paper, we achieve an OSAS-Lidar device capable of observing large concentrations of CH4 released from a methane source directly into the atmosphere. Comparison with a standard in-situ measurement device shows that the path-integrated concentrations retrieved from OSAS-Lidar methodology exhibit sufficient sensitivity (2 000 ppm m) and observational time resolution (1 s) to remotely sense methane leaks in the atmosphere. The coupling of OSAS-lidar with a wind measurement device opens the way to monitor time-resolved methane flux emissions, which is important in regards to future climate mitigation involving regional reduction of CH4 flux emissions.

  4. Lack of effect of sleep apnea on oxidative stress in obstructive sleep apnea syndrome (OSAS patients.

    Directory of Open Access Journals (Sweden)

    M Simiakakis

    Full Text Available PURPOSE: The aim of this study was to evaluate markers of systemic oxidative stress and antioxidant capacity in subjects with and without OSAS in order to investigate the most important factors that determine the oxidant-antioxidant status. METHODS: A total of 66 subjects referred to our Sleep laboratory were examined by full polysomnography. Oxidative stress and antioxidant activity were assessed by measurement of the derivatives of reactive oxygen metabolites (d-ROMs and the biological antioxidant capacity (BAP in blood samples taken in the morning after the sleep study. Known risk factors for oxidative stress, such as age, sex, obesity, smoking, hypelipidemia, and hypertension, were investigated as possible confounding factors. RESULTS: 42 patients with OSAS (Apnea-Hypopnea index >15 events/hour were compared with 24 controls (AHI<5. The levels of d-ROMS were significantly higher (p = 0.005 in the control group but the levels of antioxidant capacity were significantly lower (p = 0.004 in OSAS patients. The most important factors predicting the variance of oxidative stress were obesity, smoking habit, and sex. Parameters of sleep apnea severity were not associated with oxidative stress. Minimal oxygen desaturation and smoking habit were the most important predicting factors of BAP levels. CONCLUSION: Obesity, smoking, and sex are the most important determinants of oxidative stress in OSAS subjects. Sleep apnea might enhance oxidative stress by the reduction of antioxidant capacity of blood due to nocturnal hypoxia.

  5. OSAS Surgery and Postoperative Discomfort: Phase I Surgery versus Phase II Surgery

    Directory of Open Access Journals (Sweden)

    Giulio Gasparini

    2015-01-01

    Full Text Available Introduction. This study aims to investigate the reasons that discourage the patients affected by OSAS to undergo orthognathic surgery and compares the postoperative discomfort of phase I (soft tissue surgery and phase II (orthognathic surgery procedures for treatment of OSAS. Material and Methods. A pool of 46 patients affected by OSAS was divided into two groups: “surgery patients” who accepted surgical treatments of their condition and “no surgery patients” who refused surgical procedures. The “surgery patients” group was further subdivided into two arms: patients who accepted phase I procedures (IP and those who accepted phase II (IIP. To better understand the motivations behind the refusal of II phase procedures, we asked the patients belonging to both the IP group and “no surgery” group to indicate the main reason that influenced their decision to avoid II phase procedures. We also monitored and compared five parameters of postoperative discomfort: pain, painkiller assumption, length of hospitalization, foreign body sensation, and diet assumption following IP and IIP procedures. Results. The main reason to avoid IIP procedures was the concern of a more severe postoperative discomfort. Comparison of the postoperative discomfort following IP versus IIP procedures showed that the former scored worse in 4 out of 5 parameters analyzed. Conclusion. IIP procedures produce less postoperative discomfort. IIP procedures, namely, orthognathic surgery, should be the first choice intervention in patients affected by OSAS and dentoskeletal malformation.

  6. Nocturnal gastro-oesophageal reflux, asthma and symptoms of OSA: a longitudinal, general population study.

    Science.gov (United States)

    Emilsson, Össur I; Bengtsson, Anna; Franklin, Karl A; Torén, Kjell; Benediktsdóttir, Bryndís; Farkhooy, Amir; Weyler, Joost; Dom, Sandra; De Backer, Wilfried; Gislason, Thorarinn; Janson, Christer

    2013-06-01

    Nocturnal gastro-oesophageal reflux (nGOR) is associated with asthma and obstructive sleep apnoea (OSA). Our aim was to investigate whether nGOR is a risk factor for onset of asthma and onset of respiratory and OSA symptoms in a prospective population-based study. We invited 2640 subjects from Iceland, Sweden and Belgium for two evaluations over a 9-year interval. They participated in structured interviews, answered questionnaires, and underwent spirometries and methacholine challenge testing. nGOR was defined by reported symptoms. Subjects with persistent nGOR (n=123) had an independent increased risk of new asthma at follow-up (OR 2.3, 95% CI 1.1-4.9). Persistent nGOR was independently related to onset of respiratory symptoms (OR 3.0, 95% CI 1.6-5.6). The risk of developing symptoms of OSA was increased in subjects with new and persistent nGOR (OR 2.2, 95% CI 1.3-1.6, and OR 2.0, 95% CI 1.0-3.7, respectively). No significant association was found between nGOR and lung function or bronchial responsiveness. Persistent symptoms of nGOR contribute to the development of asthma and respiratory symptoms. New onset of OSA symptoms is higher among subjects with symptoms of nGOR. These findings provide evidence that nGOR may play a role in the genesis of respiratory symptoms and diseases.

  7. Particle size and cholesterol content of a mayonnaise formulated by OSA-modified potato starch

    Directory of Open Access Journals (Sweden)

    Shiva Ghazaei

    2015-03-01

    Full Text Available Egg yolk was partially replaced (0, 25, 50, 75, and 100% with octenyl succinic anhydride (OSA-modified potato starch in a reduced-fat mayonnaise formulation to curtail the problems associated with high cholesterol and induced allergic reactions. The physicochemical properties included parameters such as: pH, fat content, and emulsion stability of the formulations analyzed. The samples with 75% and 100% egg yolk substitute showed the maximum emulsion stability (>95% after two of months storage, and they were selected according to cholesterol content, particle size distributions, dynamic rheological properties, microstructure, and sensory characteristic. A significant reduction (84-97% in the cholesterol content was observed in the selected samples. Particle size analysis showed that by increasing the amount of OSA starch, the oil droplets with the peak size of 70 µm engulfed by this compound became larger. The rheological tests elucidated that in the absence of egg yolk, OSA starch may not result in a final product with consistent texture and that the best ratio of the two emulsifiers (OSA starch/egg yolk to produce stable reduced-fat, low cholesterol mayonnaise is 75/25. The microscopic images confirmed the formation of a stable cohesive layer of starch surrounding the oil droplets emulsified in the samples selected.

  8. A Formal Security Analysis of an OSA/Parlay Authentication Interface

    NARCIS (Netherlands)

    Corin, R.J.; Di Caprio, G.; Etalle, Sandro; Gnesi, S.; Lenzini, Gabriele; Moiso, C.

    2005-01-01

    We report on an experience in analyzing the security of the Trust and Security Management (TSM) protocol, an authentication procedure within the OSA/Parlay Application Program Interfaces (APIs) of the Open Service Access and Parlay Group. The experience has been conducted jointly by research

  9. Osa Pärnu poliitikuid saab ärimeestelt igakuist tasu / Teet Roosaar

    Index Scriptorium Estoniae

    Roosaar, Teet, 1963-

    2005-01-01

    Kuigi Pärnu uus linnavalitsus kärpis volikogu liikmete äriühingute nõukogudest makstavat tasu poole väiksemaks, saab osa poliitikuid endiselt lisasissetulekut, teiste seas linnakassast doteeritavalt Pärnu ATP-lt

  10. Nasal vs Oronasal CPAP for OSA Treatment: A Meta-Analysis.

    Science.gov (United States)

    Andrade, Rafaela G S; Viana, Fernanda M; Nascimento, Juliana A; Drager, Luciano F; Moffa, Adriano; Brunoni, André R; Genta, Pedro R; Lorenzi-Filho, Geraldo

    2018-03-01

    Nasal CPAP is the "gold standard" treatment for OSA. However, oronasal masks are frequently used in clinical practice. The aim of this study was to perform a meta-analysis of all randomized and nonrandomized trials that compared nasal vs oronasal masks on CPAP level, residual apnea-hypopnea index (AHI), and CPAP adherence to treat OSA. The Cochrane Central Register of Controlled Trials, Medline, and Web of Science were searched for relevant studies in any language with the following terms: "sleep apnea" and "CPAP" or "sleep apnea" and "oronasal mask" or "OSA" and "oronasal CPAP" or "oronasal mask" and "adherence." Studies on CPAP treatment for OSA were included, based on the following criteria: (1) original article; (2) randomized or nonrandomized trials; and (3) comparison between nasal and oronasal CPAP including pressure level, and/or residual AHI, and/or CPAP adherence. We identified five randomized and eight nonrandomized trials (4,563 patients) that reported CPAP level and/or residual AHI and/or CPAP adherence. Overall, the random-effects meta-analysis revealed that as compared with nasal, oronasal masks were associated with a significantly higher CPAP level (Hedges' g, -0.59; 95% CI, -0.82 to -0.37; P CPAP level, higher residual AHI, and poorer adherence than nasal masks. PROSPERO database; No.: CRD42017064584; URL: https://www.crd.york.ac.uk/prospero/. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  11. Driving simulator and neuropsychological [corrected] testing in OSAS before and under CPAP therapy.

    Science.gov (United States)

    Orth, M; Duchna, H-W; Leidag, M; Widdig, W; Rasche, K; Bauer, T T; Walther, J W; de Zeeuw, J; Malin, J-P; Schultze-Werninghaus, G; Kotterba, S

    2005-11-01

    Patients with obstructive sleep apnoea syndrome (OSAS) have an increased car accident rate. Investigations on accident frequency are based on case history, insurance reports and driving simulator studies. The present study combines neuropsychological testing of different attention aspects engaged in driving a car and driving simulation to evaluate a suitable instrument for assessing therapeutic effects of continuous positive airway pressure (CPAP). Driving simulator investigation and neuropsychological testing of alertness, vigilance and divided attention were performed in 31 patients with polysomnographically confirmed OSAS (apnoea-hypopnoea index 24.8+/-21.5.h(-1)) before, and 2 and 42 days after initiation of CPAP. Divided attention and alertness improved significantly during CPAP, whereas vigilance remained unchanged. However, accident frequency (OSAS before therapy: 2.7+/-2.0; 2 days after CPAP: 1.5+/-1.4; 42 days after CPAP: 0.9+/-1.3) and frequency of concentration faults (OSAS before therapy: 12.4+/-5.1; 2 days after CPAP: 6.5+/-3.9; 42 days after CPAP: 4.9+/-3.3) decreased in the simulated driving situation after 2 and 42 days of therapy. There was no relation between accident frequency, concentration faults and daytime sleepiness, as measured by the Epworth Sleepiness Scale, and polysomnographic or neuropsychological findings, respectively. In conclusion, the present results suggest that driving simulation is a possible benchmark parameter of driving performance in obstructive sleep apnoea syndrome patients.

  12. CHARACTERISTICS OF MAXIMUM PERFORMANCE OF PEDALING EXERCISE IN RECUMBENT AND SUPINE POSITIONS

    Directory of Open Access Journals (Sweden)

    Morimasa Kato

    2011-09-01

    Full Text Available To determine the characteristics of maximum pedaling performance in the recumbent and supine positions, maximum isokinetic leg muscle strength was measured in eight healthy male subjects during pedaling at three velocities (300°/s, 480°/s, and 660°/s, and maximum incremental tests were performed for each position. The maximum isokinetic muscle strength in the recumbent position was 210.0 ± 29.2 Nm at 300°/s, 158.4 ± 19.8 Nm at 480°/s, and 110.6 ± 13.2 at 660°/s. In contrast, the muscle strength in the supine position was 229.3 ± 36.7 Nm at 300°/s, 180. 7 ± 20.3 Nm at 480°/s, and 129.6 ± 14.0 Nm at 660°/s. Thus, the maximum isokinetic muscle strength showed significantly higher values in the supine position than in the recumbent position at all angular velocities. The knee and hip joint angles were measured at peak torque using a goniometer; the knee joint angle was not significantly different between both positions, whereas the hip joint angle was greater in the supine position than in the recumbent position (Supine position: 137.3 ± 9. 33 degree at 300°/s, 140.0 ± 11.13 degrees at 480°/s, and 141.0 ± 9.61 degrees at 660°/s. Recumbent position: 99.5 ± 12.21 degrees at 300°/s, 101.6 ± 12.29 degrees at 480°/s, and 105.8 ± 14.28 degrees at 660°/s. Peak oxygen uptake was higher in the recumbent position (50.3 ± 4.43 ml·kg-1·min-1 than in the supine position (48.7 ± 5.10 ml·kg-1·min-1. At maximum exertion, the heart rate and whole-body rate of perceived exertion (RPE were unaffected by position, but leg muscle RPE was higher in the supine position (19.5 ± 0.53 than in the recumbent position (18.8 ± 0.71. These results suggest that the supine position is more suitable for muscle strength exertion than the recumbent position, and this may be due to different hip joint angles between the positions. On the contrary, the endurance capacity was higher in the recumbent position than in the supine position. Since leg muscle

  13. Marcadores de estrés oxidativo en placentas de gestantes añosas

    Directory of Open Access Journals (Sweden)

    Silvia Suárez

    2007-12-01

    Full Text Available Introducción: Un factor de riesgo alto ginecoobstétrico que contribuye a la morbimortalidad materna perinatal es la edad materna mayor de 35 años. Es posible que el estado oxidativo en la placenta de la gestante añosa sea mayor a la de la gestante no añosa. Objetivo: Evaluar el estado oxidativo de la placenta en gestantes mayores de 35 años. Diseño: Estudio observacional y transversal. Lugar: Hospital Nacional Docente Materno Infantil San Bartolomé y Centro de Investigación de Bioquímica y Nutrición de la Universidad Nacional Mayor de San Marcos. Material biológico: 28 placentas de gestantes de 35 años o más y 28 placentas de gestantes de menos de 35 años, obtenidas de partos vaginales a término. Intervenciones: La muestra de placenta se homogenizó al 10% con buffer fosfato 10 mM, pH 7,4, se centrifugó a 2000 rpm por 5’. Parte del sobrenadante se usó para analizar lipoperoxidación y glutatión (GSH; el sobrenadante restante fue centrifugado a 42 000 rpm por 1 hora, para medir actividad de superóxido dismutasa (SOD. Principales medidas de resultados: Estado oxidativo de placentas obtenidas de mujeres añosas y no añosas. Resultados: La actividad de la SOD y el contenido de GSH placentarios en añosas fue 43,52 U/g de tejido y 4,67 µmol/mL x 10-²; para el grupo control fueron 54,13 U/g de tejido y 6,02 µmol/mL x 10-², respectivamente; en ambos hubo significancia estadística (p < 0,05. La medición de TBARS (lipoperoxidación no mostró diferencias significativas. Conclusiones: Las placentas obtenidas de mujeres añosas muestran menor capacidad de defensa antioxidante frente a las placentas obtenidas de mujeres no añosas.

  14. Effect of Sitting Pause Times on Balance After Supine to Standing Transfer in Dim Light.

    Science.gov (United States)

    Johnson, Eric G; Albalwi, Abdulaziz A; Al-Dabbak, Fuad M; Daher, Noha S

    2017-06-01

    The risk of falling for older adults increases in dimly lit environments. Longer sitting pause times, before getting out of bed and standing during the night, may improve postural stability. The purpose of this study was to measure the effect of sitting pause times on postural sway velocity immediately after a supine to standing transfer in a dimly lit room in older adult women. Eighteen healthy women aged 65 to 75 years who were able to independently perform supine to standing transfers participated in the study. On each of 2 consecutive days, participants assumed the supine position on a mat table and closed their eyes for 45 minutes. Then, participants were instructed to open their eyes and transfer from supine to sitting, with either 2- or 30-second pause in the sitting position followed by standing. The sitting pause time order was randomized. A significant difference was observed in postural sway velocity between the 2- and 30-second sitting pause times. The results revealed that there was less postural sway velocity after 30-second than 2-second sitting pause time (0.61 ± 0.19 vs 1.22 ± 0.68, P Falls related to bathroom usage at night are the most common reported falls among older adults. In the present study, the investigators studied the effect of sitting pause times on postural sway velocity after changing position from supine to standing in a dimly lit environment. The findings showed that the mean postural sway velocity was significantly less after 30-second sitting pause time compared with 2-second sitting pause time. Postural sway velocity decreased when participants performed a sitting pause of 30 seconds before standing in a dimly lit environment. These results suggest that longer sitting pause times may improve adaptability to dimly lit environments, contributing to improved postural stability and reduced risk of fall in older adult women when getting out of bed at night.

  15. TU-H-CAMPUS-TeP1-02: Seated Treatment: Setup Uncertainty Comparable to Supine

    Energy Technology Data Exchange (ETDEWEB)

    McCarroll, R [UT MD Anderson Cancer Center, Houston, TX (United States); UT Health Science Center, Graduate School of Biomedical Sciences, Houston, TX (United States); Beadle, B; Fullen, D; Balter, P; Followill, D; Stingo, F; Yang, J; Court, L [UT MD Anderson Cancer Center, Houston, TX (United States)

    2016-06-15

    Purpose: For some head and neck patients, positioning in the supine position is not well tolerated. For these patients, treatment in a seated position would be preferred. We have evaluated inter- and intra- fraction uncertainty of patient set-up in a novel treatment chair which is compatible with modern linac designs. Methods: Five head-and-neck cancer patients were positioned in the chair, fitted with immobilization devices, and imaged with orthogonal X-rays. The couch (with chair attached) was rotated to simulate delivery (without actual treatment), another set of images were acquired, providing a measure of intra-fraction displacement. The patient then got off of and back onto the chair and the process was repeated, thus providing a measure of inter-fraction set-up uncertainty. Six sub-regions in the head-and-neck were rigidly registered to evaluate local intra- and interfraction displacement. Image guidance was simulated by first registering one sub-region; the residual displacement of other sub-regions was then measured. Additionally, a patient questionnaire was administered to evaluate tolerance of the seated position. Results: The chair design is such that all advantages of couch motions may be utilized. Average inter- and intrafraction displacements of all sub-regions in the seated position were less than 2 and 3 mm, respectively. When image guidance was simulated, interfraction displacements were reduced by an average of 4 mm, providing comparable setup to the supine position. The enrolled patients, who had no indication for a seated treatment position, reported no preference for the seated or the supine position. Conclusion: The novel chair design provides acceptable inter- and intra-fraction displacement, with reproducibility similar to that observed for patients in the supine position. Such a chair will be utilized for patients who cannot tolerate the supine position and use with CBCT images for planning, in a fixed-beam linac system, and for other

  16. Difference in human cardiovascular response between upright and supine recovery from upright cycle exercise.

    Science.gov (United States)

    Takahashi, T; Okada, A; Saitoh, T; Hayano, J; Miyamoto, Y

    2000-02-01

    Cardiovascular responses were examined in seven healthy male subjects during 10 min of recovery in the upright or supine position following 5 min of upright cycle exercise at 80% peak oxygen uptake. An initial rapid decrease in heart rate (fc) during the early phase of recovery followed by much slower decrease was observed for both the upright and supine positions. The average fc at the 10th min of recovery was significantly lower (P position than in the upright position, while they were both significantly greater than the corresponding pre-exercise levels (each P positions was reduced with a decrease in mean R-R interval, the relationship being expressed by a regression line--mean R-R interval = 0.006 x HF amplitude + 0.570 (r = 0.905, n = 28, P positions is partly attributable to a retardation in the restoration of the activity of the cardiac parasympathetic nervous system. Post-exercise upright stroke volume (SV, by impedance cardiography) decreased gradually to just below the pre-exercise level, whereas post-exercise supine SV increased markedly to a level similar to that at rest before exercise. The resultant cardiac output (Qc) and the total peripheral vascular resistance (TPR) in the upright and supine positions returned gradually to their respective pre-exercise levels in the corresponding positions. At the 10th min of recovery, both average SV and Qc were significantly greater (each P position, while average TPR was significantly lower (P position. In contrast, immediately after exercise, mean blood pressure dropped markedly in both the supine and upright positions, and their levels at the 10th min of recovery were similar. Therefore we concluded that arterial blood pressure is maintained relatively constant through various compensatory mechanisms associated with fc, SV, Qc, and TPR during rest and recovery in different body positions.

  17. The USC-OSA Student Chapter: goals and benefits for the optics community

    Science.gov (United States)

    Gómez-Varela, A. I.; Gargallo, Ana; González Núñez, Héctor; Delgado-García, Tamara; Almaguer-Gómez, Citlalli; Cambronero-López, F.; Flores-Arias, M. T.

    2014-07-01

    The USC-OSA Student Chapter has been constituted in March 2013 by members of the University of Santiago de Compostela (USC) in Spain and sponsored by The Optical Society of America (OSA). It is formed by five graduate and one undergraduate students with the common interest in Optics and Photonics research and a professor of the USC is also involved as a faculty advisor. We decided to start this group with the aim of involving kids, precollege and undergraduate students in the world of Optics and Photonics. The activities that the USC-OSA Student Chapter members intend to realize are mainly educational tasks for the spreading of knowledge in Photonics by means of basic experiments, demonstrations and lectures by leading researchers and teachers. Most of the needed resources to accomplish these activities are provided by the OSA, such as educational posters and a portable kit for demonstrating Optics to students. At this moment the USC-OSA Student Chapter is carrying out several activities, as educational journeys at the Santiago de Compostela University Hospital Complex (CHUS), where hospitalized children can approach to Optics through some simple experiments and games. A teaching program is also being organized in collaboration with Galician secondary schools in order to show students the importance and uses of Optics and Photonics and to arouse their interest in this field, as well as encouraging them to develop their scientific thinking. Another activity will take place in November during the Science Week, which includes a program of lectures targeted to undergraduate students and an exposition of several demonstrations

  18. Does CPAP treatment lead to gastroesophageal reflux in patients with moderate and severe OSA?

    Science.gov (United States)

    Ozcelik, Hatice; Kayar, Yusuf; Danalioglu, Ahmet; Arabaci, Elif; Uysal, Omer; Yakar, Fatih; Kart, Levent

    2017-03-01

    Obstructive sleep apnea (OSA) leads to upper respiratory tract obstruction, causing increased abdominal-gastric pressure and decreased lower esophageal sphincter (LES) pressure and thus gastroesophageal reflux (GER). Continuous positive airway pressure (CPAP) is known to be an effective method for OSA treatment, but its effect on GER is still controversial. There are a very few studies investigating CPAP and GER relationship and performed based on pre- and post-treatment objective parameters of GER in patients with OSA. The study investigated the effect of CPAP treatment in patients with moderate and severe OSA without GER complaints on pre- and post-treatment objective GER parameters. The study included 25 patients with respiratory disturbance indices >15 without reflux symptoms who had undergone polysomnography at sleep laboratory. Age, sex, body mass index (BMI), waist, and neck circumference of the patients were documented. DeMeester score, LES pressure, and polysomnography parameters were evaluated pre- and post-CPAP. The results were statistically evaluated, and p value CPAP phase, mean sphincter pressure was 22.2 ± 1.2 (range 8-73), and mean DeMeester score was 18 ± 15.5 (range 0.2-57). At the post-CPAP, mean sphincter pressure was 22.9 ± 1.6 (range 9-95), and mean DeMeester score was 16.3 ± 14.8 (range 0.2-55). No significant difference (p > 0.05) was found comparing pre-CPAP and post-CPAP measurements. Objective criteria show that CPAP treatment does not cause reflux in patients with OSA. Unlike studies reported in the literature, this conclusion has been reached by pre- and post-CPAP assessments.

  19. Effect of scanning in the supine and prone positions on dilation of air-charged colon in CTVC

    International Nuclear Information System (INIS)

    Ye Jing; Chen Junkun; Zhang Zongjun; Wang Junpeng; Gao Dazhi

    2003-01-01

    Objective: To evaluate the effect of scanning in the supine and prone positions on dilation of air-charged colon in CT virtual colonoscopy (CTVC). Methods: Thirty cases underwent CTVC scanning in both the supine and prone positions immediately before colonoscopy, and the dilation of each intestine was graded. The differences of colon dilation in different positions were compared. Results: In supine and prone position, there were 26 (17.3%) and 22 (14.7%) insufficient dilating colon segments, respectively, and only 5 (3.3%) insufficient dilating colon segments in double positions. 15(50.0%) and 13(43.3%) colons dilated insufficiently in supine and prone position, respectively, and decreased to 5 (16.7%) in double positions. The dilation of rectum, sigmoid colon, and transverse colon had significant difference in different positions. Conclusion: When performing CTVC, it is highly necessary to scan in both the supine and prone positions in order to ensure the sufficient dilation of colon. In supine position, the dilation of transverse colon is better, while the dilation of rectum and sigmoid colon in prone position is superior to that in supine position

  20. Frequency of obstructive sleep apnea (OSA in patients with gastroesophageal reflux disease (GERD and the effect of nasal continuous positive airway pressure

    Directory of Open Access Journals (Sweden)

    Amany Shaker

    2016-10-01

    Conclusion: (1 A high risk for OSA development is more frequent in GERD patients especially NERD ones and who experience nighttime symptoms, (2 there is a mutual relationship between OSA and GERD reinforcing each other, and (3 CPAP therapy has a good role in the treatment of both OSA and GERD symptoms.

  1. Conventional Supine MRI With a Lumbar Pillow-An Alternative to Weight-bearing MRI for Diagnosing Spinal Stenosis?

    DEFF Research Database (Denmark)

    Hansen, Bjarke Brandt; Hansen, Philip; Grindsted, Jacob

    2017-01-01

    to conventional MRI were included to an additional positional MRI scan (0.25T G-Scan) performed in: (1) conventional supine, (2) standing, (3) supine with a lumbar pillow in the lower back. LSS was evaluated for each position in consensus on a 0 to 3 semi-quantitative grading scale. Independently, L2-S1 lordosis...... included. The lordosis angle increased significantly from supine to standing (3.2° CI: 1.2-5.2) and with the lumbar pillow (12.8° CI: 10.3-15.3). One-way analysis of variance (ANOVA) showed significant differences between positions (P 

  2. Goal-directed fluid therapy: stroke volume optimisation and cardiac dimensions in supine healthy humans

    DEFF Research Database (Denmark)

    Jans, O.; Tollund, C.; Bundgaard-Nielsen, M.

    2008-01-01

    BACKGROUND: Based on maximisation of cardiac stroke volume (SV), peri-operative individualised goal-directed fluid therapy improves patient outcome. It remains, however, unknown how fluid therapy by this strategy relates to filling of the heart during supine rest as reference for the anaesthetised...... by thoracic electrical admittance, central venous oxygenation and pressure, and arterial plasma atrial natriuretic peptide. Also, muscle and brain oxygenation were assessed by near infrared spectroscopy (n=7). RESULTS: The HUT reduced the mentioned indices of CBV, the end-diastolic dimensions of the heart...... therapy is that when a maximal SV is established for patients, cardiac pre-load is comparable to that of supine healthy subjects Udgivelsesdato: 2008/4...

  3. Cognition and nocturnal disturbance in OSA: the importance of accounting for age and premorbid intelligence

    DEFF Research Database (Denmark)

    Olaithe, Michelle; Skinner, Timothy C.; Hillman, David

    2015-01-01

    and a tertiary hospital sleep clinic. All underwent comprehensive, laboratory-based polysomnography (PSG) and completed assessments of cognition including attention, short- and long-term memory and executive function. Structural equation modelling (SEM) was used to construct a theoretically-driven model......© 2014, Springer-Verlag Berlin Heidelberg. Introduction: Obstructive sleep apnea (OSA) is a common disorder that is associated with impaired attention, memory and executive function. However, the mechanisms underlying such dysfunction are unclear. To determine the influence of sleep fragmentation...... these significant relationships. No significant predictors of memory function were found. Conclusions: The mechanisms underlying the effects of OSA on cognition remain to be defined. Implications are discussed in light of these findings....

  4. Comparison of the Effects of Seated, Supine, and Walking Interset Rest Strategies on Work Rate.

    Science.gov (United States)

    Ouellette, Kristen A; Brusseau, Timothy A; Davidson, Lance E; Ford, Candus N; Hatfield, Disa L; Shaw, Janet M; Eisenman, Patricia A

    2016-12-01

    Ouellette, KA, Brusseau, TA, Davidson, LE, Ford, CN, Hatfield, DL, Shaw, JM, and Eisenman, PA. Comparison of the effects of seated, supine, and walking interset rest strategies on work rate. J Strength Cond Res 30(12): 3396-3404, 2016-The idea that an upright posture should be maintained during the interset rest periods of training sessions is pervasive. The primary aim of this study was to determine differences in work rate associated with 3 interset rest strategies. Male and female members of the CrossFit community (male n = 5, female n = 10) were recruited to perform a strenuous training session designed to enhance work capacity that involved both cardiovascular and muscular endurance exercises. The training session was repeated on 3 separate occasions to evaluate 3 interset rest strategies, which included lying supine on the floor, sitting on a flat bench, and walking on a treadmill (0.67 m·s). Work rate was calculated for each training session by summing session joules of work and dividing by the time to complete the training session (joules of work per second). Data were also collected during the interset rest periods (heart rate [HR], respiratory rate [RR], and volume of oxygen consumed) and were used to explain why one rest strategy may positively impact work rate compared with another. Statistical analyses revealed significant differences (p ≤ 0.05) between the passive and active rest strategies, with the passive strategies allowing for improved work rate (supine = 62.77 ± 7.32, seated = 63.66 ± 8.37, and walking = 60.61 ± 6.42 average joules of work per second). Results also suggest that the passive strategies resulted in superior HR, RR, and oxygen consumption recovery. In conclusion, work rate and physiological recovery were enhanced when supine and seated interset rest strategies were used compared with walking interset rest.

  5. Pronation-Supination Motion Is Altered in a Rat Model of Post-Traumatic Elbow Contracture.

    Science.gov (United States)

    Dunham, Chelsey L; Castile, Ryan M; Chamberlain, Aaron M; Galatz, Leesa M; Lake, Spencer P

    2017-07-01

    The elbow joint is highly susceptible to joint contracture, and treating elbow contracture is a challenging clinical problem. Previously, we established an animal model to study elbow contracture that exhibited features similar to the human condition including persistent decreased range of motion (ROM) in flexion-extension and increased capsule thickness/adhesions. The objective of this study was to mechanically quantify pronation-supination in different injury models to determine if significant differences compared to control or contralateral persist long-term in our animal elbow contracture model. After surgically inducing soft tissue damage in the elbow, Injury I (anterior capsulotomy) and Injury II (anterior capsulotomy with lateral collateral ligament transection), limbs were immobilized for 6 weeks (immobilization (IM)). Animals were evaluated after the IM period or following an additional 6 weeks of free mobilization (FM). Total ROM for pronation-supination was significantly decreased compared to the uninjured contralateral limb for both IM and FM, although not different from control limbs. Specifically, for both IM and FM, total ROM for Injury I and Injury II was significantly decreased by ∼20% compared to contralateral. Correlations of measurements from flexion-extension and pronation-supination divulged that FM did not affect these motions in the same way, demonstrating that joint motions need to be studied/treated separately. Overall, injured limbs exhibited persistent motion loss in pronation-supination when comparing side-to-side differences, similar to human post-traumatic joint contracture. Future work will use this animal model to study how elbow periarticular soft tissues contribute to contracture.

  6. Arm rotated medially with supination – the ARMS variant: description of its surgical correction

    Directory of Open Access Journals (Sweden)

    Melcher Sonya E

    2009-03-01

    Full Text Available Abstract Background Patients who have suffered obstetric brachial plexus injury (OBPI have a high incidence of musculoskeletal complications stemming from the initial nerve injury. The presence of muscle imbalances and contractures leads to typical bony changes affecting the shoulder, including the SHEAR (Scapular Hypoplasia, Elevation and Rotation deformity. The SHEAR deformity commonly occurs in conjunction with Medial Rotation Contracture (MRC of the arm. OBPI also causes muscle imbalances at the level of the forearm, that lead to a fixed supination deformity (SD in a small number of patients. Both MRC and SD will cause severe functional limitations without surgical intervention. Methods Fourteen OBPI patients were diagnosed with MRC of the shoulder and SD of the forearm along with SHEAR deformity during a 16 month study period, with eight patients available to long-term follow-up (age range 2.2 – 18 years. Surgical correction of the MRC was performed as a triangle tilt or humeral osteotomy depending on the age of the child, after which, the patients were treated with a radial osteotomy to correct the fixed supination deformity. Function was assessed using the modified Mallet scale, examination of apparent supination and appearance of the extremity at rest. Results Significant functional improvements were observed in patients with surgical reconstruction. Mallet score increased by an average of 5.2 (p Conclusion The simultaneous presence of two opposing deformities in the same limb will visually offset each other at the level of the wrist and hand, giving the false impression of neutral positioning of the limb. In reality, the neutral-appearing position of the hand indicates a fixed supination posture of the forearm in the face of a medial rotation contracture of the shoulder. Both of these deformities require surgical attention, and the presence of concurrent MRC and SD should be monitored for in OBPI patients.

  7. Registration of prone and supine CT colonography scans using correlation optimized warping and canonical correlation analysis

    International Nuclear Information System (INIS)

    Wang Shijun; Yao Jianhua; Liu Jiamin; Petrick, Nicholas; Van Uitert, Robert L.; Periaswamy, Senthil; Summers, Ronald M.

    2009-01-01

    Purpose: In computed tomographic colonography (CTC), a patient will be scanned twice--Once supine and once prone--to improve the sensitivity for polyp detection. To assist radiologists in CTC reading, in this paper we propose an automated method for colon registration from supine and prone CTC scans. Methods: We propose a new colon centerline registration method for prone and supine CTC scans using correlation optimized warping (COW) and canonical correlation analysis (CCA) based on the anatomical structure of the colon. Four anatomical salient points on the colon are first automatically distinguished. Then correlation optimized warping is applied to the segments defined by the anatomical landmarks to improve the global registration based on local correlation of segments. The COW method was modified by embedding canonical correlation analysis to allow multiple features along the colon centerline to be used in our implementation. Results: We tested the COW algorithm on a CTC data set of 39 patients with 39 polyps (19 training and 20 test cases) to verify the effectiveness of the proposed COW registration method. Experimental results on the test set show that the COW method significantly reduces the average estimation error in a polyp location between supine and prone scans by 67.6%, from 46.27±52.97 to 14.98 mm±11.41 mm, compared to the normalized distance along the colon centerline algorithm (p<0.01). Conclusions: The proposed COW algorithm is more accurate for the colon centerline registration compared to the normalized distance along the colon centerline method and the dynamic time warping method. Comparison results showed that the feature combination of z-coordinate and curvature achieved lowest registration error compared to the other feature combinations used by COW. The proposed method is tolerant to centerline errors because anatomical landmarks help prevent the propagation of errors across the entire colon centerline.

  8. SU-F-T-536: Contra-Lateral Breast Study for Prone Versus Supine Patients

    Energy Technology Data Exchange (ETDEWEB)

    Marrero, M; Joseph, K; Klein, E [Northwell Health, Lake Success, NY (United States)

    2016-06-15

    Purpose: There are several advantages to utilizing the prone technique for intact breast cancer patients. However, as the topography changes, accompanied by the influence of a supporting breast board and patient treatment couch, the question that arises is to whether there is a concern for contralateral breast dose for intact breast cancer patients being treated with this technique. Methods: An anthropomorphic phantom with breast mounds to duplicate intact breast cancer treatment was planned in prone and supine position. Two tangential beams were executed in the similar manner for as the radiotherapy planning system. For the prone setup, a breast dense foam board was used to support the phantom. A grid of 24 OSL nanodots was placed at 6cm, 4cm, and 2cm apart from the medial border for both prone and supine setups. The phantom was set up using megavoltage imaging and treated as per plan. Additional, a similar study was performed on a patient treated in prone position. Results: Overall, the contralateral breast dose was generally higher for prone setups at all locations especially when close to the medial border. The average mean dose was found to be 1.8%, 2.5% of the prescribed dose for supine respectively prone position. The average of the standard deviation is 1.04%, 1.38% for supine respectively prone position. As for patient treated in prone position average mean dose was found to be 1.165% of the prescribed dose and average of the standard deviation is 9.456%. Conclusion: There is minimal influence of scatter from the breast board. It appears that the volatility of the setup could lead to higher doses than expected from the planning system to the contralateral breast when the patient is in the prone position.

  9. [Outcome of operative treatment for supination-external rotation Lauge-Hansen stage IV ankle fractures].

    Science.gov (United States)

    Kołodziej, Łukasz; Boczar, Tomasz; Bohatyrewicz, Andrzej; Zietek, Paweł

    2010-01-01

    Ankle fractures are among the most common musculoskeletal injures. These fractures occur with an overall age- and sex-adjusted incidence rate around 180 per 100 000 person-years. The most frequent mechanism is considered to be supination-external rotation (60 to 80% of all ankle fractures) consisting of pathologic external rotation of the foot initially placed in some degree of supination. According to Lauge-Hansen classification, ankle joint structures are damaged in a sequence where the final, stage IV injuries, represents transverse fracture of the medial malleolus or its equivalent-rupture of the deltoid ligament. The aim of this study is to compare the results of two subtypes of supination-external rotation stage IV fractures. 43 patients treated surgically in 2006 to 2007 at Authors institution because of stage IV supination-external rotation ankle fracture were submitted to retrospective analysis. There were 25 patients with bimalleolar fracture (type 1) and in 18 patients with lateral malleolar fracture with accompanying rupture of the deltoid ligament (type 2). The mean age was 46 years (from 20 to 82 years). Average follow up period was 37 months (from 24 to 46 months). For the evaluation of treatment AOFAS hind-foot score (American Orthopedic Foot and Ankle Society) was used. The mean AOFAS score scale for Type 1 fractures was 85 points and for type 2 was significantly higher and amounted to 91 points (p ankle fractures with medial malleolar fracture, requires the implementation of additional diagnostic and therapeutic strategies and procedures in order to improve the outcome of results.

  10. Olulist pärimisseadusest. [1.-3. osa] / Albert Paltser

    Index Scriptorium Estoniae

    Paltser, Albert, 1931-2007

    1998-01-01

    Pärandamise ja pärimise liikidest, esimese, teise ja kolmanda järjekorra seadusjärgsetest pärijatest ning abikaasa õigusest eelosale. Testamendi liikidest (notariaalne testament, notari hoiule antud testament, kodune testament), pärija pärandi osa määramisest testamendis, annakust, ase- ja järelpärijast, testamendi tühistamisest ja abikaasade vastastikusest testamendist. Pärimislepingust ja pärandi sundosast

  11. Effect of CPAP Withdrawal on BP in OSA: Data from Three Randomized Controlled Trials.

    Science.gov (United States)

    Schwarz, Esther I; Schlatzer, Christian; Rossi, Valentina A; Stradling, John R; Kohler, Malcolm

    2016-12-01

    Based on meta-analyses, the BP-lowering effect of CPAP therapy in patients with OSA is reported to be approximately 2 to 3 mm Hg. This figure is derived from heterogeneous trials, which are often limited by poor CPAP adherence, and thus the treatment effect may possibly be underestimated. We analyzed morning BP data from three randomized controlled CPAP withdrawal trials, which included only patients with optimal CPAP compliance. Within the three trials, 149 patients with OSA who were receiving CPAP were randomized to continue therapeutic CPAP (n = 65) or to withdraw CPAP (n = 84) for 2 weeks. Morning BP was measured at home before and after sleep studies in the hospital. CPAP withdrawal was associated with a return of OSA (apnea-hypopnea index [AHI] at a baseline of 2.8/h and at follow-up of 33.2/h). Office systolic BP (SBP) increased in the CPAP withdrawal group compared with the CPAP continuation group by +5.4 mm Hg (95% CI, 1.8-8.9 mm Hg; P = .003) and in the home SBP group by +9.0 mm Hg (95% CI, 5.7-12.3 mm Hg; P CPAP withdrawal results in a clinically relevant increase in BP, which is considerably higher than in conventional CPAP trials; it is also underestimated when office BP is used. Greater OSA severity is associated with a higher BP rise in response to CPAP withdrawal. ClinicalTrials.gov; No.: NCT01332175 and NCT01797653) URL: www.clinicaltrials.gov and ISRCTN registry (ISRCTN 93153804) URL: http://www.isrctn.com/. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  12. Supinator Extender (SUE): a pneumatically actuated robot for forearm/wrist rehabilitation after stroke.

    Science.gov (United States)

    Allington, James; Spencer, Steven J; Klein, Julius; Buell, Meghan; Reinkensmeyer, David J; Bobrow, James

    2011-01-01

    The robot described in this paper, SUE (Supinator Extender), adds forearm/wrist rehabilitation functionality to the UCI BONES exoskeleton robot and to the ArmeoSpring rehabilitation device. SUE is a 2-DOF serial chain that can measure and assist forearm supination-pronation and wrist flexion-extension. The large power to weight ratio of pneumatic actuators allows SUE to achieve the forces needed for rehabilitation therapy while remaining lightweight enough to be carried by BONES and ArmeoSpring. Each degree of freedom has a range of 90 degrees, and a nominal torque of 2 ft-lbs. The cylinders are mounted away from the patient's body on the lateral aspect of the arm. This is to prevent the danger of a collision and maximize the workspace of the arm robot. The rotation axis used for supination-pronation is a small bearing just below the subject's wrist. The flexion-extension motion is actuated by a cantilevered pneumatic cylinder, which allows the palm of the hand to remain open. Data are presented that demonstrate the ability of SUE to measure and cancel forearm/wrist passive tone, thereby extending the active range of motion for people with stroke.

  13. Treatment of OSA with CPAP Is Associated with Improvement in PTSD Symptoms among Veterans

    Science.gov (United States)

    Orr, Jeremy E.; Smales, Carolina; Alexander, Thomas H.; Stepnowsky, Carl; Pillar, Giora; Malhotra, Atul; Sarmiento, Kathleen F.

    2017-01-01

    Study Objectives: Posttraumatic stress disorder (PTSD) is common among veterans of the military, with sleep disturbance as a hallmark manifestation. A growing body of research has suggested a link between obstructive sleep apnea and PTSD, potentially due to obstructive sleep apnea (OSA) related sleep disruption, or via other mechanisms. We examined the hypothesis that treatment of OSA with positive airway pressure would reduce PTSD symptoms over 6 months. Methods: A prospective study of Veterans with confirmed PTSD and new diagnosis of OSA not yet using PAP therapy were recruited from a Veteran's Affairs sleep medicine clinic. All subjects were instructed to use PAP each night. Assessments were performed at 3 and 6 months. The primary outcome was a reduction in PTSD symptoms at 6 months. Results: Fifty-nine subjects were enrolled; 32 remained in the study at 6 months. A significant reduction in PTSD symptoms, measured by PCL-S score was observed over the course of the study (60.6 ± 2.7 versus 52.3 ± 3.2 points; p J Clin Sleep Med. 2017;13(1):57–63. PMID:27707436

  14. The comparison of nasal surgery and CPAP on daytime sleepiness in patients with OSAS.

    Science.gov (United States)

    Tagaya, M; Otake, H; Suzuki, K; Yasuma, F; Yamamoto, H; Noda, A; Nishimura, Y; Sone, M; Nakashima, T; Nakata, S

    2017-09-01

    Residual sleepiness after continuous positive airway pressure (CPAP) is a critical problem in some patients with obstructive sleep apnea syndrome (OSAS). However, nasal surgery is likely to reduce daytime sleepiness and feelings of unrefreshed sleep. The aim of this study is to clarify the effects of nasal surgery and CPAP on daytime sleepiness. This is a retrospective and matched-case control study. The participants were consecutive 40 patients with OSAS who underwent nasal surgery (Surgery group) and 40 matched patients who were treated with CPAP (CPAP group). In the Surgery group, although the nasal surgery did not decrease either apnea or hypopnea, it improved oxygenation, the quality of sleep. In the CPAP Group, the CPAP treatment reduced apnea and hypopnea, and improved oxygenation, quality of sleep. The degree of relief from daytime sleepiness was different between the two groups. The improvement of Epworth Sleepiness Scale was more significant in the Surgery Group than those in the CPAP Group (Surgery from 11.0 to 5.1, CPAP from 10.0 to 6.2). These findings suggest that the results of the nasal surgery is more satisfactory for some patients with OSAS than CPAP on daytime sleepiness.

  15. Comparison of Radiation Treatment Plans for Breast Cancer between 3D Conformal in Prone and Supine Positions in Contrast to VMAT and IMRT Supine Positions

    Science.gov (United States)

    Bejarano Buele, Ana Isabel

    The treatment regimen for breast cancer patients typically involves Whole Breast Irradiation (WBI). The coverage and extent of the radiation treatment is dictated by location of tumor mass, breast tissue distribution, involvement of lymph nodes, and other factors. The current standard treatment approach used at our institution is a 3D tangential beam geometry, which involves two fields irradiating the breast, or a four field beam arrangement covering the whole breast and involved nodes, while decreasing the dose to organs as risk (OARs) such as the lung and heart. The coverage of these targets can be difficult to achieve in patients with unfavorable thoracic geometries, especially in those cases in which the planning target volume (PTV) is extended to the chest wall. It is a well-known fact that exposure of the heart to ionizing radiation has been proved to increase the subsequent rate of ischemic heart disease. In these cases, inverse planned treatments have become a proven alternative to the 3D approach. The goal of this research project is to evaluate the factors that affect our current techniques as well as to adapt the development of inverse modulated techniques for our clinic, in which breast cancer patients are one of the largest populations treated. For this purpose, a dosimetric comparison along with the evaluation of immobilization devices was necessary. Radiation treatment plans were designed and dosimetrically compared for 5 patients in both, supine and prone positions. For 8 patients, VMAT and IMRT plans were created and evaluated in the supine position. Skin flash incorporation for inverse modulated plans required measurement of the surface dose as well as an evaluation of breast volume changes during a treatment course. It was found that prone 3D conformal plans as well as the VMAT and IMRT plans are generally superior in sparing OARs to supine plans with comparable PTV coverage. Prone setup leads to larger shifts in breast volume as well as in

  16. Obstructive Sleep Apnea Syndrome (OSAS, metabolic syndrome and mental health in small enterprise workers. feasibility of an Action for Health.

    Directory of Open Access Journals (Sweden)

    Sergio Garbarino

    Full Text Available OBJECTIVE: To determine the frequency of obstructive sleep apnea syndrome (OSAS, metabolic syndrome and common mental disorders in the working population of 11 small enterprises and the feasibility of a program of action for health. METHOD: The clinical risk of OSAS, the prevalence of metabolic syndrome, and the level of psychological disorders were assessed during routine medical examination at the workplace in 2012. The response to medical advice was assessed in 2013. RESULTS: 12.3% of the workers were suspected of being affected by OSAS. One or more components of metabolic syndrome were present in 24.5% of cases. OSAS in "healthy" workers was significantly associated with the presence of one or more components of metabolic syndrome (OR = 3.83; 95%CI 1.45-10.13 and with a psychological disorders score in the highest quartile (OR = 4.67; 95%CI = 1.72-12.64. Workers with suspected OSAS were reluctant to follow advice about undergoing further tests under the NHS. However, in some cases, confirmation of the OSAS diagnosis and subsequent treatment led to an improvement in metabolic condition. CONCLUSION: Although participation in treatment was limited, anecdotal cases support the idea that prevention of obstructive sleep apnea in the workplace might be useful for workers' health.

  17. TU-H-CAMPUS-JeP2-01: Inter-Observer Delineation Comparison of Visible Glandular Breast Tissue On Magnetic Resonance Imaging and Computed Tomography (prone and Supine)

    International Nuclear Information System (INIS)

    Pogson, EM; Delaney, G; Yap, M; Ahern, V; Boxer, M; David, S; Dimigen, M; Harvey, J; Koh, E; Batumalai, V; Lim, K; Papadatos, G; Metcalfe, P

    2016-01-01

    Purpose: Breast cancers predominantly arise from Glandular Breast Tissue (GBT). If the GBT can be treated effectively post-operatively utilising radiotherapy this may be adequate volumetric coverage for adjuvant breast radiotherapy. Adequate imaging of the GBT is necessary and will be assessed between MRI and CT modalities. GBT visualisation is acknowledged to be qualitatively superior on Magnetic Resonance Image (MRI) compared to Computed Tomography (CT), the current radiotherapy imaging standard, however this has not been quantitatively assessed. For radiotherapy purposes it is important that any treatment volume can be consistently defined between observers. This study investigates the consistency of CT and MRI GBT contours for potential radiotherapy planning. Methods: Ten experts (9 breast radiation oncologists and 1 radiologist) contoured the extent of the visible GBT for 33 patients on MRI and CT (both without contrast), which was performed according to a contouring guideline in supine and prone patient positions. The GBT volume was not a conventional whole breast radiotherapy planning volume, but rather the extent of GBT that was indicated from the CT or MR imaging. Volumes were compared utilizing the dice similarity coefficient (DSC), kappa statistic, and Hausdorff Distances (HDs) to ascertain the modality that was most consistently volumed. Results: The inter-observer concordance was of substantial agreement (kappa above 0.6) for the CT supine, CT prone, MRI supine and MRI prone datasets. The MRI GBT volumes were larger than the CT GBT volumes (p<0.001). Inter-observer conformity was higher for CT than MRI, although the magnitude of this difference was small (VOI<0.04). Conformity between modalities (CT and MRI) was in agreement for both prone and supine, DSC=0.75. Prone GBT volumes were larger than supine for both MRI and CT. Conclusion: MRI improves the extent of GBT delineation. The role of MRI guided, GBT-targeted radiotherapy requires investigation in

  18. TU-H-CAMPUS-JeP2-01: Inter-Observer Delineation Comparison of Visible Glandular Breast Tissue On Magnetic Resonance Imaging and Computed Tomography (prone and Supine)

    Energy Technology Data Exchange (ETDEWEB)

    Pogson, EM [Institute of Medical Physics, University of Sydney, Sydney, NSW (Australia); University of Wollongong, Wollongong, NSW (Australia); Liverpool and Macarthur Cancer Therapy Centres, Liverpool, NSW (United Kingdom); Ingham Institute for Applied Medical Research, Liverpool Hospital, Sydney, NSW (Australia); Delaney, G; Yap, M [Liverpool and Macarthur Cancer Therapy Centres, Liverpool, NSW (United Kingdom); Ingham Institute for Applied Medical Research, Liverpool Hospital, Sydney, NSW (Australia); South Western Sydney Clinical School, University of New South Wales, Sydney, NSW (Australia); School of Medicine, University of Western Sydney, Sydney, NSW (Australia); Ahern, V [Westmead Hospital, Westmead, NSW (Australia); Boxer, M [Liverpool and Macarthur Cancer Therapy Centres, Liverpool, NSW (United Kingdom); Ingham Institute for Applied Medical Research, Liverpool Hospital, Sydney, NSW (Australia); David, S [Peter MacCallum Cancer Institute,, Melbourne, VIC (Australia); Dimigen, M [Department of Radiology, Liverpool Hospital, NSW (United Kingdom); Harvey, J [University of Queensland, Brisbane, QLD (Australia); Princess Alexandra Hospital, QLD (Australia); Koh, E; Batumalai, V [Liverpool and Macarthur Cancer Therapy Centres, Liverpool, NSW (United Kingdom); Ingham Institute for Applied Medical Research, Liverpool Hospital, Sydney, NSW (Australia); South Western Sydney Clinical School, University of New South Wales, Sydney, NSW (Australia); Lim, K; Papadatos, G [Liverpool and Macarthur Cancer Therapy Centres, Liverpool, NSW (United Kingdom); Metcalfe, P [University of Wollongong, Wollongong, NSW (Australia); Liverpool and Macarthur Cancer Therapy Centres, Liverpool, NSW (United Kingdom); Ingham Institute for Applied Medical Research, Liverpool Hospital, Sydney, NSW (Australia); and others

    2016-06-15

    Purpose: Breast cancers predominantly arise from Glandular Breast Tissue (GBT). If the GBT can be treated effectively post-operatively utilising radiotherapy this may be adequate volumetric coverage for adjuvant breast radiotherapy. Adequate imaging of the GBT is necessary and will be assessed between MRI and CT modalities. GBT visualisation is acknowledged to be qualitatively superior on Magnetic Resonance Image (MRI) compared to Computed Tomography (CT), the current radiotherapy imaging standard, however this has not been quantitatively assessed. For radiotherapy purposes it is important that any treatment volume can be consistently defined between observers. This study investigates the consistency of CT and MRI GBT contours for potential radiotherapy planning. Methods: Ten experts (9 breast radiation oncologists and 1 radiologist) contoured the extent of the visible GBT for 33 patients on MRI and CT (both without contrast), which was performed according to a contouring guideline in supine and prone patient positions. The GBT volume was not a conventional whole breast radiotherapy planning volume, but rather the extent of GBT that was indicated from the CT or MR imaging. Volumes were compared utilizing the dice similarity coefficient (DSC), kappa statistic, and Hausdorff Distances (HDs) to ascertain the modality that was most consistently volumed. Results: The inter-observer concordance was of substantial agreement (kappa above 0.6) for the CT supine, CT prone, MRI supine and MRI prone datasets. The MRI GBT volumes were larger than the CT GBT volumes (p<0.001). Inter-observer conformity was higher for CT than MRI, although the magnitude of this difference was small (VOI<0.04). Conformity between modalities (CT and MRI) was in agreement for both prone and supine, DSC=0.75. Prone GBT volumes were larger than supine for both MRI and CT. Conclusion: MRI improves the extent of GBT delineation. The role of MRI guided, GBT-targeted radiotherapy requires investigation in

  19. Image to physical space registration of supine breast MRI for image guided breast surgery

    Science.gov (United States)

    Conley, Rebekah H.; Meszoely, Ingrid M.; Pheiffer, Thomas S.; Weis, Jared A.; Yankeelov, Thomas E.; Miga, Michael I.

    2014-03-01

    Breast conservation therapy (BCT) is a desirable option for many women diagnosed with early stage breast cancer and involves a lumpectomy followed by radiotherapy. However, approximately 50% of eligible women will elect for mastectomy over BCT despite equal survival benefit (provided margins of excised tissue are cancer free) due to uncertainty in outcome with regards to complete excision of cancerous cells, risk of local recurrence, and cosmesis. Determining surgical margins intraoperatively is difficult and achieving negative margins is not as robust as it needs to be, resulting in high re-operation rates and often mastectomy. Magnetic resonance images (MRI) can provide detailed information about tumor margin extents, however diagnostic images are acquired in a fundamentally different patient presentation than that used in surgery. Therefore, the high quality diagnostic MRIs taken in the prone position with pendant breast are not optimal for use in surgical planning/guidance due to the drastic shape change between preoperative images and the common supine surgical position. This work proposes to investigate the value of supine MRI in an effort to localize tumors intraoperatively using image-guidance. Mock intraoperative setups (realistic patient positioning in non-sterile environment) and preoperative imaging data were collected from a patient scheduled for a lumpectomy. The mock intraoperative data included a tracked laser range scan of the patient's breast surface, tracked center points of MR visible fiducials on the patient's breast, and tracked B-mode ultrasound and strain images. The preoperative data included a supine MRI with visible fiducial markers. Fiducial markers localized in the MRI were rigidly registered to their mock intraoperative counterparts using an optically tracked stylus. The root mean square (RMS) fiducial registration error using the tracked markers was 3.4mm. Following registration, the average closest point distance between the MR

  20. Single-staged uniportal VATS in the supine position for simultaneous bilateral primary spontaneous pneumothorax.

    Science.gov (United States)

    Kim, Kyung Soo

    2017-05-15

    Simultaneous bilateral primary spontaneous pneumothorax (SBPSP) is rare, but requires surgery on both sides, in patients with definite bilateral bullae to prevent life-threatening conditions. Recently, uniportal video-assisted thoracoscopic surgery (VATS) has been widely accepted as a less invasive technique for the treatment of pneumothorax. Thus, we introduced single-staged uniportal VATS technique in the supine position, for the management of two cases of SBPSP. A 17-year-old boy presented with bilateral spontaneous pneumothorax and he underwent single-staged uniportal VATS in the supine position. Single wide draping in consecutive bilateral approaches removes the needs of changing patients' position. Whole thoracoscopic procedure for wedge resection of bullae lesions was conducted without difficulty. The total operation time took 65 min and the patient discharged 3 days after the operation. The patient was followed for 24 months without recurrence of both sides. Another 18-year-old boy was admitted with bilateral spontaneous pneumothorax and single-staged uniportal VATS was also performed in the supine position. The total operation time took 79 min and the patient discharged on postoperative day 4. He was followed for 19 months without recurrence of both sides. Single-staged uniportal VATS approach yielded satisfactory results from simplicity that not requires position change compared to conventional multi-ports VATS in the lateral position, and with better cosmetics. This technique is thought to be a feasible procedure in selective patients with SBPSP or with contralateral bullae for preventive role.

  1. Supine exercise during lower body negative pressure effectively simulates upright exercise in normal gravity

    Science.gov (United States)

    Murthy, G.; Watenpaugh, D. E.; Ballard, R. E.; Hargens, A. R.

    1994-01-01

    Exercise within a lower body negative pressure (LBNP) chamber in supine posture was compared with similar exercise against Earth's gravity (without LBNP) in upright posture in nine healthy male volunteers. We measured footward force with a force plate, pressure in soleus and tibialis anterior muscles of the leg with transducer-tipped catheters, calf volume by strain gauge plethysmography, heart rate, and systolic and diastolic blood pressures during two conditions: 1) exercise in supine posture within an LBNP chamber during 100-mmHg LBNP (exercise-LBNP) and 2) exercise in upright posture against Earth's gravity without LBNP (exercise-1 G). Subjects exercised their ankle joints (dorsi- and plantarflexions) for 5 min during exercise-LBNP and for 5 min during exercise-1 G. Mean footward force produced during exercise-LBNP (743 +/- 37 N) was similar to that produced during exercise-1 G (701 +/- 24 N). Peak contraction pressure in the antigravity soleus muscle during exercise-LBNP (115 +/- 10 mmHg) was also similar to that during exercise-1 G (103 +/- 13 mmHg). Calf volume increased significantly by 3.3 +/- 0.5% during exercise-LBNP compared with baseline values. Calf volume did not increase significantly during exercise-1 G. Heart rate was significantly higher during exercise-LBNP (99 +/- 5 beats/min) than during exercise-1 G (81 +/- 3 beats/min). These results indicate that exercise in supine posture within an LBNP chamber can produce similar musculoskeletal stress in the legs and greater systemic cardiovascular stress than exercise in the upright posture against Earth's gravity.

  2. Syndesmotic fixation in supination-external rotation ankle fractures: a prospective randomized study.

    Science.gov (United States)

    Pakarinen, Harri J; Flinkkilä, Tapio E; Ohtonen, Pasi P; Hyvönen, Pekka H; Lakovaara, Martti T; Leppilahti, Juhana I; Ristiniemi, Jukka Y

    2011-12-01

    This study was designed to assess whether transfixion of an unstable syndesmosis is necessary in supination-external rotation (Lauge-Hansen SE/Weber B)-type ankle fractures. A prospective study of 140 patients with unilateral Lauge-Hansen supination-external rotation type 4 ankle fractures was done. After bony fixation, the 7.5-Nm standardized external rotation (ER) stress test for both ankles was performed under fluoroscopy. A positive stress examination was defined as a difference of more than 2 mm side-to-side in the tibiotalar or tibiofibular clear spaces on mortise radiographs. If the stress test was positive, the patient was randomized to either syndesmotic transfixion with 3.5-mm tricortical screws or no syndesmotic fixation. Clinical outcome was assessed using the Olerud-Molander scoring system, RAND 36-Item Health Survey, and Visual Analogue Scale (VAS) to measure pain and function after a minimum 1-year of followup. Twenty four (17%) of 140 patients had positive standardized 7.5-Nm ER stress tests after malleolar fixation. The stress view was positive three times on tibiotalar clear space, seven on tibiofibular clear space, and 14 times on both tibiotalar and tibiofibular clear spaces. There was no significant difference between the two randomization groups with regards to Olerud-Molander functional score, VAS scale measuring pain and function, or RAND 36-Item Health Survey pain or physical function at 1 year. Relevant syndesmotic injuries are rare in supination-external rotation ankle fractures, and syndesmotic transfixion with a screw did not influence the functional outcome or pain after the 1-year followup compared with no fixation.

  3. Body height and arterial pressure in seated and supine young males during +2 G centrifugation

    DEFF Research Database (Denmark)

    Arvedsen, Sine K.; Eiken, Ola; Kölegård, Roger

    2015-01-01

    by the use of a human centrifuge would increase mean arterial pressure (MAP) more in tall than in short males in the seated position. In short (162-171cm, n=8) and tall (194-203cm, n=10) healthy males (18-41yr), brachial arterial pressure, heart rate (HR) and cardiac output were measured during +2G...... centrifugation, while they were seated upright with the legs kept horizontal (+2Gz). In a separate experiment, the same measurements were done with the subjects supine (+2Gx). During +2Gz MAP increased in the short (22±2 mmHg, P 

  4. Face-down positioning versus non-supine positioning in macular hole surgery

    DEFF Research Database (Denmark)

    Alberti, Mark; Dornonville de la Cour, Morten

    2015-01-01

    AIM: To evaluate the full thickness macular hole (FTMH) closure rate in patients positioning non-supine (NSP) compared with patients positioning face-down (FDP). METHODS: We retrospectively reviewed two FTMH case series-postoperative positioning was FDP and NSP, respectively. All eyes were...... group fully complied with the recommended positioning protocol. CONCLUSIONS: Results from consistent FTMH repair indicate similar anatomical success rates in FDP and NSP groups, suggesting that FDP is unnecessary. Objective monitoring of positioning would be beneficial in future FTMH studies to be able...

  5. Recognition of upper airway and surrounding structures at MRI in pediatric PCOS and OSAS

    Science.gov (United States)

    Tong, Yubing; Udupa, J. K.; Odhner, D.; Sin, Sanghun; Arens, Raanan

    2013-03-01

    Obstructive Sleep Apnea Syndrome (OSAS) is common in obese children with risk being 4.5 fold compared to normal control subjects. Polycystic Ovary Syndrome (PCOS) has recently been shown to be associated with OSAS that may further lead to significant cardiovascular and neuro-cognitive deficits. We are investigating image-based biomarkers to understand the architectural and dynamic changes in the upper airway and the surrounding hard and soft tissue structures via MRI in obese teenage children to study OSAS. At the previous SPIE conferences, we presented methods underlying Fuzzy Object Models (FOMs) for Automatic Anatomy Recognition (AAR) based on CT images of the thorax and the abdomen. The purpose of this paper is to demonstrate that the AAR approach is applicable to a different body region and image modality combination, namely in the study of upper airway structures via MRI. FOMs were built hierarchically, the smaller sub-objects forming the offspring of larger parent objects. FOMs encode the uncertainty and variability present in the form and relationships among the objects over a study population. Totally 11 basic objects (17 including composite) were modeled. Automatic recognition for the best pose of FOMs in a given image was implemented by using four methods - a one-shot method that does not require search, another three searching methods that include Fisher Linear Discriminate (FLD), a b-scale energy optimization strategy, and optimum threshold recognition method. In all, 30 multi-fold cross validation experiments based on 15 patient MRI data sets were carried out to assess the accuracy of recognition. The results indicate that the objects can be recognized with an average location error of less than 5 mm or 2-3 voxels. Then the iterative relative fuzzy connectedness (IRFC) algorithm was adopted for delineation of the target organs based on the recognized results. The delineation results showed an overall FP and TP volume fraction of 0.02 and 0.93.

  6. Topical nasal steroid treatment does not improve CPAP compliance in unselected patients with OSAS.

    Science.gov (United States)

    Strobel, Werner; Schlageter, Manuel; Andersson, Morgan; Miedinger, David; Chhajed, Prashant N; Tamm, Michael; Leuppi, Jörg D

    2011-02-01

    Continuous positive airways pressure (CPAP) for treatment of obstructive sleep apnea (OSA) can produce troublesome nasal symptoms (i.e. congestion, rhinorrhea) that may reduce the compliance of CPAP. Topical nasal steroids are often prescribed to reduce these side effects, although scientific data are scarce supporting any benefits of this treatment for CPAP-induced nasal side effects. To study whether a topical nasal steroid can reduce CPAP-induced nasal symptoms and improve CPAP adherence during the initial phase of OSA treatment. A randomized, double-blinded, placebo-controlled study with fluticasone propionate 100 μg/nasal cavity twice daily Treatment was started 10 days prior to and continued throughout the first 4 weeks of CPAP. 63 patients who were selected for CPAP treatment participated. Nasal symptoms were recorded, nasal patency was assessed and lung function was measured with a peak flow meter. The patients' adherence to CPAP was recorded by the CPAP device. Total nasal symptoms increased from baseline to 4 wks after CPAP use for both nasal treatments (p < 0.05). No differences in total nasal symptoms between treatments were seen (p = 1), and no differences in nasal peak flow values after treatment were seen (p = 0.11). Moreover, there were no differences in CPAP use between the treatments. Fluticasone propionate as a nasal topical steroid does not reduce CPAP-induced unwanted nasal side effects, and has no beneficial effect on CPAP compliance during the first four weeks of treatment in unselected patients with OSAS. Copyright © 2010 Elsevier Ltd. All rights reserved.

  7. How accurate are measurements of skin-lesion depths on prebiopsy supine chest computed tomography for transthoracic needle biopsies?

    International Nuclear Information System (INIS)

    Cheung, Joo Yeon; Kim, Yookyung; Shim, Sung Shine; Lee, Jin Hwa; Chang, Jung Hyun; Ryu, Yon Ju; Lee, Rena J.

    2012-01-01

    Aim: To evaluate the accuracy of depth measurements on supine chest computed tomography (CT) for transthoracic needle biopsy (TNB). Materials and methods: We measured skin-lesion depths from the skin surface to nodules on both prebiopsy supine CT scans and CT scans obtained during cone beam CT-guided TNB in the supine (n = 29) or prone (n = 40) position in 69 patients, and analyzed the differences between the two measurements, based on patient position for the biopsy and lesion location. Results: Skin-lesion depths measured on prebiopsy supine CT scans were significantly larger than those measured on CT scans obtained during TNB in the prone position (p < 0.001; mean difference ± standard deviation (SD), 6.2 ± 5.7 mm; range, 0–18 mm), but the differences showed marginal significance in the supine position (p = 0.051; 3.5 ± 3.9 mm; 0–13 mm). Additionally, the differences were significantly larger for the upper (mean ± SD, 7.8 ± 5.7 mm) and middle (10.1 ± 6.5 mm) lung zones than for the lower lung zones (3.1 ± 3.3 mm) in the prone position (p = 0.011), and were larger for the upper lung zone (4.6 ± 5.0 mm) than for the middle (2.4 ± 2.0 mm) and lower (2.3 ± 2.3 mm) lung zones in the supine position (p = 0.004). Conclusions: Skin-lesion depths measured on prebiopsy supine chest CT scans were inaccurate for TNB in the prone position, particularly for nodules in the upper and middle lung zones.

  8. Comparison of Magnetic Resonance Imaging and Computed Tomography for Breast Target Volume Delineation in Prone and Supine Positions

    Energy Technology Data Exchange (ETDEWEB)

    Pogson, Elise M. [Centre for Medical Radiation Physics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong (Australia); Liverpool and Macarthur Cancer Therapy Centres, Liverpool (Australia); Ingham Institute for Applied Medical Research, Liverpool (Australia); Delaney, Geoff P. [Liverpool and Macarthur Cancer Therapy Centres, Liverpool (Australia); Ingham Institute for Applied Medical Research, Liverpool (Australia); South Western Sydney Clinical School, University of New South Wales, Sydney (Australia); School of Medicine, University of Western Sydney, Sydney (Australia); Ahern, Verity [Crown Princess Mary Cancer Care Centre, Westmead Hospital, Westmead (Australia); Boxer, Miriam M. [Liverpool and Macarthur Cancer Therapy Centres, Liverpool (Australia); South Western Sydney Clinical School, University of New South Wales, Sydney (Australia); Chan, Christine [Department of Radiology, Liverpool Hospital, Liverpool (Australia); David, Steven [Peter MacCallum Cancer Centre, Melbourne (Australia); Dimigen, Marion [Department of Radiology, Liverpool Hospital, Liverpool (Australia); Harvey, Jennifer A. [School of Medicine, University of Queensland, Herston (Australia); Princess Alexandra Hospital, Woolloongabba (Australia); Koh, Eng-Siew [Liverpool and Macarthur Cancer Therapy Centres, Liverpool (Australia); Ingham Institute for Applied Medical Research, Liverpool (Australia); South Western Sydney Clinical School, University of New South Wales, Sydney (Australia); Lim, Karen [Liverpool and Macarthur Cancer Therapy Centres, Liverpool (Australia); South Western Sydney Clinical School, University of New South Wales, Sydney (Australia); Papadatos, George [Liverpool and Macarthur Cancer Therapy Centres, Liverpool (Australia); and others

    2016-11-15

    Purpose: To determine whether T2-weighted MRI improves seroma cavity (SC) and whole breast (WB) interobserver conformity for radiation therapy purposes, compared with the gold standard of CT, both in the prone and supine positions. Methods and Materials: Eleven observers (2 radiologists and 9 radiation oncologists) delineated SC and WB clinical target volumes (CTVs) on T2-weighted MRI and CT supine and prone scans (4 scans per patient) for 33 patient datasets. Individual observer's volumes were compared using the Dice similarity coefficient, volume overlap index, center of mass shift, and Hausdorff distances. An average cavity visualization score was also determined. Results: Imaging modality did not affect interobserver variation for WB CTVs. Prone WB CTVs were larger in volume and more conformal than supine CTVs (on both MRI and CT). Seroma cavity volumes were larger on CT than on MRI. Seroma cavity volumes proved to be comparable in interobserver conformity in both modalities (volume overlap index of 0.57 (95% Confidence Interval (CI) 0.54-0.60) for CT supine and 0.52 (95% CI 0.48-0.56) for MRI supine, 0.56 (95% CI 0.53-0.59) for CT prone and 0.55 (95% CI 0.51-0.59) for MRI prone); however, after registering modalities together the intermodality variation (Dice similarity coefficient of 0.41 (95% CI 0.36-0.46) for supine and 0.38 (0.34-0.42) for prone) was larger than the interobserver variability for SC, despite the location typically remaining constant. Conclusions: Magnetic resonance imaging interobserver variation was comparable to CT for the WB CTV and SC delineation, in both prone and supine positions. Although the cavity visualization score and interobserver concordance was not significantly higher for MRI than for CT, the SCs were smaller on MRI, potentially owing to clearer SC definition, especially on T2-weighted MR images.

  9. Association of Type D personality to perceived side effects and adherence in CPAP-treated patients with OSAS.

    Science.gov (United States)

    Broström, Anders; Strömberg, Anna; Mårtensson, Jan; Ulander, Martin; Harder, Lena; Svanborg, Eva

    2007-12-01

    Continuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea syndrome (OSAS), but side effects are common and long-term adherence low. The Type D (distressed) personality is defined as a combination of negative affectivity and social inhibition. The association of Type D personality with adherence has not been studied in CPAP-treated patients with OSAS. This study aimed to describe the prevalence of Type D personality in OSAS patients with CPAP treatment longer than 6 months and the association with self-reported side effects and adherence. A cross-sectional descriptive design was used. A total of 247 OSAS patients with a mean use of CPAP treatment for 55 months (6-182 months) were included. Data collection was achieved by two questionnaires; the Type D scale 14 (DS14) (Type D personality), SECI (side effects of CPAP), as well as from medical records (clinical variables and objective adherence to CPAP treatment). Type D personality occurred in 30% of the patients with OSAS and significantly (P < 0.05-0.001) increased the perceived frequency and severity of a broad range of side effects. The objective adherence was significantly lower (P < 0.001) for OSAS patients with Type D compared to OSAS patients without Type D, both with regard to a mean use of 4 h per night and 85% of the self-rated sleep time per night. The additional effect of a Type D personality on perceived side effects and adherence to CPAP treatment found in this study could be used by healthcare personnel when evaluating patients waiting for treatment.

  10. Comparison of CT myelography performed in the prone and supine positions in the detection of cervical spinal stenosis

    International Nuclear Information System (INIS)

    Blease Graham, Cole III; Wippold, Franz J. II; Bae, Kyongtae T.; Pilgram, Thomas K.; Shaibani, Ali; Kido, Daniel K.

    2001-01-01

    AIM: To quantify the change in the cross-sectional area of the cervical spinal cord and subarachnoid space (SAS) in the supine neutral vs prone extension positions in patients with myelopathy undergoing cervical CT myelography. MATERIAL AND METHODS: Axial CT myelgrams of 21 myelopathic patients were performed in both the supine neutral and prone extension positions. The SAS and cord cross-sectional areas were then measured at the disk spaces and mid-pedicle levels from C2 to T1 in both the supine and prone positions using a public domain NIH Image program, version 156b18. Mean area measurements in both positions were then compared for each level examined. RESULTS: Mean SAS cross-sectional area in the prone position was notably reduced compared with the supine position at C4-C5 [128.8 mm 2 vs 168.1 mm 2 (P 2 vs 143.2 mm 2 (P< .05)] disk levels. The mean cord cross-sectional area failed to change signficantly with positioning. CONCLUSIONS: Prone myelography may demonstrate a greater degree of cervical spine stenosis compared with CT myelography performed in the supine position in myelopathic patients. Imaging with the patient prone with neck extended in both myelography and CTM may improve precision in the results of measurements of the stenotic spinal canal when comparing these two methods. Blease Graham III, C. (2001)

  11. Measuring the thermal insulation and evaporative resistance of sleeping bags using a supine sweating fabric manikin

    International Nuclear Information System (INIS)

    Wu, Y S; Fan, Jintu

    2009-01-01

    For testing the thermal insulation of sleeping bags, standard test methods and procedures using heated manikins are provided in ASTM F1720-06 and EN 13537:2002. However, with regard to the evaporative resistance of sleeping bags, no instrument or test method has so far been established to give a direct measurement. In this paper, we report on a novel supine sweating fabric manikin system for directly measuring the evaporative resistance of sleeping bags. Eleven sleeping bags were tested using the manikin under the isothermal condition, namely, both the mean skin temperature of the manikin and that of the environment were controlled to be the same at 35 °C, with the wind speed and ambient relative humidity at 0.3 m s −1 and 50%, respectively. The results showed that the novel supine sweating fabric manikin is reproducible and accurate in directly measuring the evaporative resistance of sleeping bags, and the measured evaporative resistance can be combined with thermal insulation to calculate the moisture permeability index of sleeping bags

  12. Supinated forearm is correlated with the onset of medial epicondylitis in professional slalom water-skiers.

    Science.gov (United States)

    Rosa, Donato; Di Donato, Sigismondo Luca; Balato, Giovanni; D'Addona, Alessio; Schonauer, Fabrizio

    2016-01-01

    prolonged and laborious activities involving wrists and forearms has been long associated with the onset of epicondylitis. Slalom water-skiing can be included in this category. The purpose of the study is to analyse the correlation between the pronated or supinated position of forearms during water-skiing practice and the presence respectively of lateral and medial epicondylitis. sixty-six pro and semi-pro slalom water-skiers were enrolled in the study. A questionnaire was submitted to each athlete. Diagnosis of lateral or medial epicondylitis was made through anamnesis and clinical exam by an expert orthopaedic surgeon. Chi-squared were performed for categorical variables, and Mann-Whitney U test for continuous ones. from 116 upper limbs examined, we observed 15 (12.9%) cases of lateral epicondylitis, 30 (25.9%) cases of medial epicondylitis, 10 (8.6%) were affected by both lateral and medial epicondylitis. Lateral and medial epicondylitis were associated (95% C.I.=2,489-26,355; P=epicondylitis (95% C.I.=1,529-9,542; P=0.003). slalom water-skiing can be considered a high-risk sport for epicondylitis. In slalom water-skiers there is a correlation between development of lateral and medial epicondylitis in the same upper limb. Supinated position of forearms is strongly associated with the diagnosis of medial epicondylitis.

  13. Supine position and nonmodifiable risk factors for ventilator-associated pneumonia in trauma patients.

    Science.gov (United States)

    Michetti, Christopher P; Prentice, Heather A; Rodriguez, Jennifer; Newcomb, Anna

    2017-02-01

    We studied trauma-specific conditions precluding semiupright positioning and other nonmodifiable risk factors for their influence on ventilator-associated pneumonia (VAP). We performed a retrospective study at a Level I trauma center from 2008 to 2012 on ICU patients aged ≥15, who were intubated for more than 2 days. Using backward logistic regression, a composite of 4 factors (open abdomen, acute spinal cord injury, spine fracture, spine surgery) that preclude semiupright positioning (supine composite) and other variables were analyzed. In total, 77 of 374 (21%) patients had VAP. Abbreviated Injury Score head/neck greater than 2 (odds ratio [OR] 2.79, P = .006), esophageal obturator airway (OR 4.25, P = .015), red cell/plasma transfusion in the first 2 intensive care unit days (OR 2.59, P = .003), and 11 or more ventilator days (OR 17.38, P VAP risk factors, whereas supine composite, scene vs emergency department airway intervention, brain injury, and coma were not. Factors that may temporarily preclude semiupright positioning in intubated trauma patients were not associated with a higher risk for VAP. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. The technique of craniospinal irradiation of paediatric patients in supine position

    International Nuclear Information System (INIS)

    Slampa, P.; Seneklova, Z.; Simicek, J.; Soumarova, R.; Burkon, P.; Burianova, L.

    2001-01-01

    Background. Postoperative radiation therapy has significant impact on local control and overall survival of paediatric patients with brain tumours but an irradiated volume is often a controversial issue. Our aim was to describe a new technique of craniospinal irradiation as a postoperative treatment in patients with the risk of relapse of brain tumours as well as to estimate the side effects of such craniospinal irradiation. Patients and methods. In the last 4 years, 17 paediatric patients under 15 years of age with medulloblastoma (8) ependymoma (6) and glioblastoma (3) received postoperative craniospinal axis radiotherapy by a new technique developed in our departments. This technique is based on irradiation in supine position with the use of asymmetric jaws of the linear accelerator. Results. Radiotherapy was well tolerated and dose-reduction was not needed in any case. Skin reactions were mild in all patients. The gastrointestinal and haematological toxicity was mild to moderate (WHO grade I-II). Conclusion. The proposed new technique of craniospinal irradiation is advantageous in terms of side effects and could be recommended to be widely used. Craniospinal irradiation in supine position is an alternative method to the treatment in prone position. The evaluation of the effectiveness was limited by a short follow-up interval. (author)

  15. AMINO ACID-BASED FERTILIZER AS AN ALTERNATIVE TO CALDA VIÇOSA IN ORGANIC AGRICULTURE

    Directory of Open Access Journals (Sweden)

    Diego Fontebasso Pelizari Pinto

    2017-10-01

    Full Text Available The aim of this study was to propose a mixture of micronutrients with amino acid-based foliar fertilizer as an alternative to calda viçosa for application in organic agriculture. The study was conducted in two simultaneous trials in an experimental field in Ipeúna, SP, Brazil. The test plant was carioca type dry edible bean cv. Pérola. The treatments in trial 1 were: Control 1 = water; FA = JK® amino acid-based foliar fertilizer; and FA+Mi = FA + CuSO4 + ZnSO4 + MnSO4 + H3BO3. In trial 2, the FA treatment was substituted by calda viçosa (CVi. The treatments were through spray application three times. Dry edible bean leaves were sampled for determination of macronutrient and micronutrient concentrations. Platings of the application rates used in the treatments were performed in the laboratory in a mixture with Bacillus thuringiensis and with Beauveria bassiana to compare the degree of compatibility by means of colony forming units (CFU. The FA+Mi and CVi treatments raised the concentrations of Zn, Cu, and Mn in the leaves. The FA+Mi was compatible, the FA was a stimulant, and the CVi was noxious to B. bassiana and to B. thuringiensis when integrated in the spray mixture.

  16. Functional MRI of the pharynx in obstructive sleep apnea (OSA) with rapid 2-D flash sequences

    International Nuclear Information System (INIS)

    Jaeger, L.; Guenther, E.; Gauger, J.; Nitz, W.; Kastenbauer, E.; Reiser, M.

    1996-01-01

    Functional imaging of the pharynx used to be the domain of cineradiography, CT and ultrafast CT. The development of modern MRI techniques led to new access to functional disorders of the pharynx. The aim of this study was to implement a new MRI technique to examine oropharyngeal obstructive mechanisms in patients with obstructive sleep apnea (OSA). Sixteen patients suffering from OSA and 6 healthy volunteers were examined on a 1.5 T whole-body imager ('Vision', Siemens, Erlangen Medical Engineering, Germany) using a circular polarized head coil. Imaging was performed with 2D flash sequences in midsagittal and axial planes. Patients and volunteers were asked to breathe normally through the nose and to simulate snoring and the Mueller maneuver during magnetic resonance imaging (MRI). Prior to MRI, all patients underwent an ear, nose and throat (ENT) examination, functional fiberoptic nasopharyngoscopy and polysomnography. A temporal resolution of 6 images/s and an in-plane resolution of 2.67x1.8 mm were achieved. The mobility of the tongue, soft palate and pharyngeal surface could be clearly delineated. The MRI findings correlated well with the clinical examinations. We propose ultrafast MRI as a reliable and non-invasive method of evaluating pharyngeal obstruction and their levels. (orig.) [de

  17. Specific insomnia symptoms and self-efficacy explain CPAP compliance in a sample of OSAS patients.

    Science.gov (United States)

    Philip, Pierre; Bioulac, Stéphanie; Altena, Elemarije; Morin, Charles M; Ghorayeb, Imad; Coste, Olivier; Monteyrol, Pierre-Jean; Micoulaud-Franchi, Jean-Arthur

    2018-01-01

    This study explores the association between specific insomnia symptoms (sleep onset, sleep maintenance and early morning awakenings symptoms) and self-efficacy (perceived self-confidence in the ability to use CPAP) with CPAP compliance in French patients with obstructive sleep apnea syndrome (OSAS). We performed a retrospective, cross-sectional analysis of CPAP compliance in a cohort of 404 patients diagnosed with OSAS. Patients completed mailed questionnaires on sleepiness (ESS), insomnia (ISI) and self-efficacy in sleep apnea (SEMSA). Linear regression modeling analyses were performed to explore the impact of measured variables on the number of hours of CPAP use. Of the initial pool of 404 patients, 288 returned the questionnaires (71% response rate). Their mean age was 63.16±12.73 yrs, 31% were females, mean BMI was 30.39±6.31 kg/m2, mean daily CPAP use was 6.19±2.03 h, mean number of years of use was 6.58±6.03 yrs, and mean initial AHI before CPAP use was 34.61±20.71 /h. Age (pCPAP use. We found that specific insomnia symptoms and self-efficacy were associated with CPAP compliance. Our findings underline the need to demonstrate that interventions that reduce insomnia symptoms and improve self-efficacy will increase CPAP compliance.

  18. Vertigo as a Predominant Manifestation of Neurosarcoidosis

    Directory of Open Access Journals (Sweden)

    Tasnim F. Imran

    2015-01-01

    Full Text Available Sarcoidosis is a granulomatous disease of unknown etiology that affects multiple organ systems. Neurological manifestations of sarcoidosis are less common and can include cranial neuropathies and intracranial lesions. We report the case of a 21-year-old man who presented with vertigo and uveitis. Extensive workup including brain imaging revealed enhancing focal lesions. A lacrimal gland biopsy confirmed the diagnosis of sarcoidosis. The patient was initially treated with prednisone, which did not adequately control his symptoms, and then was switched to methotrexate with moderate symptomatic improvement. Our patient had an atypical presentation with vertigo as the predominant manifestation of sarcoidosis. Patients with neurosarcoidosis typically present with systemic involvement of sarcoidosis followed by neurologic involvement. Vertigo is rarely reported as an initial manifestation. This case highlights the importance of consideration of neurosarcoidosis as an entity even in patients that may not have a typical presentation or systemic involvement of disease.

  19. Comparison of prone versus supine 18F-FDG-PET of locally advanced breast cancer: Phantom and preliminary clinical studies

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Jason M.; Rani, Sudheer D.; Li, Xia; Whisenant, Jennifer G.; Abramson, Richard G. [Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37232 and Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee 37232 (United States); Arlinghaus, Lori R. [Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37232 (United States); Lee, Tzu-Cheng [Department of Bioengineering, University of Washington, Seattle, Washington 98195 (United States); MacDonald, Lawrence R.; Partridge, Savannah C. [Department of Radiology, University of Washington, Seattle, Washington 98195 (United States); Kang, Hakmook [Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37232 and Department of Biostatistics, Vanderbilt University, Nashville, Tennessee 37232 (United States); Linden, Hannah M. [Department of Medical Oncology, University of Washington, Seattle, Washington 98195 (United States); Kinahan, Paul E. [Department of Radiology, University of Washington, Seattle, Washington 98195 (United States); Department of Bioengineering, University of Washington, Seattle, Washington 98195 (United States); Department of Physics, University of Washington, Seattle, Washington 98195 (United States); Department of Electrical Engineering, University of Washington, Seattle, Washington 98195 (United States); Yankeelov, Thomas E., E-mail: thomas.yankeelov@vanderbilt.edu [Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37232 (United States); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee 37232 (United States); Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee 37232 (United States); Department of Physics, Vanderbilt University, Nashville, Tennessee 37232 (United States); Department of Cancer Biology, Vanderbilt University, Nashville, Tennessee 37232 (United States)

    2015-07-15

    Purpose: Previous studies have demonstrated how imaging of the breast with patients lying prone using a supportive positioning device markedly facilitates longitudinal and/or multimodal image registration. In this contribution, the authors’ primary objective was to determine if there are differences in the standardized uptake value (SUV) derived from [{sup 18}F]fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in breast tumors imaged in the standard supine position and in the prone position using a specialized positioning device. Methods: A custom positioning device was constructed to allow for breast scanning in the prone position. Rigid and nonrigid phantom studies evaluated differences in prone and supine PET. Clinical studies comprised 18F-FDG-PET of 34 patients with locally advanced breast cancer imaged in the prone position (with the custom support) followed by imaging in the supine position (without the support). Mean and maximum values (SUV{sub peak} and SUV{sub max}, respectively) were obtained from tumor regions-of-interest for both positions. Prone and supine SUV were linearly corrected to account for the differences in 18F-FDG uptake time. Correlation, Bland–Altman, and nonparametric analyses were performed on uptake time-corrected and uncorrected data. Results: SUV from the rigid PET breast phantom imaged in the prone position with the support device was 1.9% lower than without the support device. In the nonrigid PET breast phantom, prone SUV with the support device was 5.0% lower than supine SUV without the support device. In patients, the median (range) difference in uptake time between prone and supine scans was 16.4 min (13.4–30.9 min), which was significantly—but not completely—reduced by the linear correction method. SUV{sub peak} and SUV{sub max} from prone versus supine scans were highly correlated, with concordance correlation coefficients of 0.91 and 0.90, respectively. Prone SUV{sub peak} and SUV{sub max} were

  20. Comparison of prone versus supine 18F-FDG-PET of locally advanced breast cancer: Phantom and preliminary clinical studies

    International Nuclear Information System (INIS)

    Williams, Jason M.; Rani, Sudheer D.; Li, Xia; Whisenant, Jennifer G.; Abramson, Richard G.; Arlinghaus, Lori R.; Lee, Tzu-Cheng; MacDonald, Lawrence R.; Partridge, Savannah C.; Kang, Hakmook; Linden, Hannah M.; Kinahan, Paul E.; Yankeelov, Thomas E.

    2015-01-01

    Purpose: Previous studies have demonstrated how imaging of the breast with patients lying prone using a supportive positioning device markedly facilitates longitudinal and/or multimodal image registration. In this contribution, the authors’ primary objective was to determine if there are differences in the standardized uptake value (SUV) derived from [ 18 F]fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in breast tumors imaged in the standard supine position and in the prone position using a specialized positioning device. Methods: A custom positioning device was constructed to allow for breast scanning in the prone position. Rigid and nonrigid phantom studies evaluated differences in prone and supine PET. Clinical studies comprised 18F-FDG-PET of 34 patients with locally advanced breast cancer imaged in the prone position (with the custom support) followed by imaging in the supine position (without the support). Mean and maximum values (SUV peak and SUV max , respectively) were obtained from tumor regions-of-interest for both positions. Prone and supine SUV were linearly corrected to account for the differences in 18F-FDG uptake time. Correlation, Bland–Altman, and nonparametric analyses were performed on uptake time-corrected and uncorrected data. Results: SUV from the rigid PET breast phantom imaged in the prone position with the support device was 1.9% lower than without the support device. In the nonrigid PET breast phantom, prone SUV with the support device was 5.0% lower than supine SUV without the support device. In patients, the median (range) difference in uptake time between prone and supine scans was 16.4 min (13.4–30.9 min), which was significantly—but not completely—reduced by the linear correction method. SUV peak and SUV max from prone versus supine scans were highly correlated, with concordance correlation coefficients of 0.91 and 0.90, respectively. Prone SUV peak and SUV max were significantly lower than supine in both

  1. The rheological properties of blood and the risk of cardiovascular disease in patients with obstructive sleep apnea syndrome (OSAS

    Directory of Open Access Journals (Sweden)

    Władysław Pierzchała

    2011-07-01

    Full Text Available Obstructive sleep apnea (OSA is an important public health concern, which affects around 2–4% of the population. Left untreated, it causes a decrease not only in quality of life, but also of life expectancy. Despite the fact that knowledge about the mechanisms of development of cardiovascular disease in patients with OSA is still incomplete, observations confirm a relationship between sleep disordered breathing and the rheological properties of blood. One possible consequence of an increased incidence of cardiovascular disease may be a rise in mortality in OSA patients. Continuously improved research methods are allowing for an increasingly more accurate understanding of the significance of observed changes. (Folia Histochemica et Cytobiologica 2011, Vol. 49, No. 2, 206–210

  2. Lower pole stones: prone PCNL versus supine PCNL in the International Cooperation in Endourology (ICE) group experience.

    Science.gov (United States)

    Sanguedolce, Francesco; Breda, Alberto; Millan, Felix; Brehmer, Marianne; Knoll, Thomas; Liatsikos, Evangelos; Osther, Palle; Traxer, Olivier; Scoffone, Cesare

    2013-12-01

    To assess efficacy and safety of prone- and supine percutaneous nephrolithotomy (PCNL) for the treatment of lower pole kidney stones. Data from patients affected by lower pole kidney stones and treated with PCNL between December 2005 and August 2010 were collected retrospectively by seven referral centres. Variables analysed included patient demographics, clinical and surgical characteristics, stone-free rates (SFR) and complications. Statistical analysis was conducted to compare the differences for SFRs and complication rates between prone- and supine PCNL. One hundred seventeen patients underwent PCNL (mean stone size: 19.5 mm) for stones harboured only in the lower renal pole (single stone: 53.6%; multiple stones: 46.4%). A higher proportion of patients with ASA score ≥ 3 and harbouring multiple lower pole stones were treated with supine PCNL (5.8 vs. 23.1%; p = 0.0001, and 25 vs. 81.5%; p = 0.0001, respectively, for prone- and supine PCNL). One-month SFR was 88.9%; an auxiliary procedure was needed in 6 patients; the 3-month SFR was 90.2%. There were 9 post-operative major complications (7.7%). No differences were observed in terms of 1- and 3-month SFRs (90.4 vs. 87.7%; p = 0.64; 92.3 vs. 89.2%; p = 0.4) and complication rates (7.6 vs. 7.7%; p = 0.83) when comparing prone- versus supine PCNL, respectively. The results confirm the high success rate and relatively low morbidity of modern PCNL for lower pole stones, regardless the position used. Supine PCNL was more frequently offered in case of patients at higher ASA score and in case of multiple lower pole stones.

  3. Anesthetic Efficacy of Supine and Upright Positions for the Inferior Alveolar Nerve Block: A Prospective, Randomized Study.

    Science.gov (United States)

    Crowley, Chase; Drum, Melissa; Reader, Al; Nusstein, John; Fowler, Sara; Beck, Mike

    2018-02-01

    It has been recommended to place patients in an upright position after administration of an inferior alveolar nerve block (IANB), theoretically allowing the anesthetic to diffuse in an inferior direction and resulting in better pulpal anesthesia. The purpose of this study was to compare an upright versus a supine position on the success of pulpal anesthesia when an IANB was administered in asymptomatic teeth. One hundred ten asymptomatic subjects were randomly given IANBs by using 2% lidocaine with 1:100,000 epinephrine while they were in an upright position and supine position at 2 different appointments spaced at least 2 weeks apart. Pulpal anesthesia was measured in the molars, premolars, and incisors with an electric pulp tester in 4-minute cycles for 60 minutes. Anesthetic success was defined as the subject achieving 2 consecutive 80 readings within 15 minutes of the injection and sustaining the 80 reading for 60 minutes. Success was analyzed by using a mixed model logistic regression. Pulpal anesthesia for the supine position was not statistically more successful than the upright position in the second molars (73% vs 65%), first molars (59% vs 54%), lateral incisors (28% vs 23%), and central incisors (11% vs 8%), respectively. The supine position significantly improved success in the second premolars (63% vs 53%) and first premolars (75% vs 64%). The supine and upright positions were equally successful in the molars and anterior teeth. The supine position was more successful in the premolars. However, clinically, neither position for the IANB administration would provide complete pulpal anesthesia. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  4. Comparability of pulse oximeters used in sleep medicine for the screening of OSA

    International Nuclear Information System (INIS)

    Böhning, N; Schultheiß, B; Eilers, S; Schmittendorf, E; Penzel, T; Böhning, W

    2010-01-01

    Obstructive sleep apnea syndrome (OSA) is a frequent clinical picture. It is characterized by repetitive respiratory arrest with a consecutive decrease in arterial oxygen saturation (SaO 2 ). In clinical practice, the number of desaturations per hour, oxygen desaturation index (ODI), is used as an important diagnostic criterion. Medical literature, however, mentions different threshold values that are defined as pathological. By means of systematic comparative measurements, the study presented here will examine to what extent the diagnosis and the quantification of OSA severity are affected by the device-specific measurement technique, thus impacting the predictive value of nighttime pulse oximetry in outpatient OSA screening. Different pulse oximeters commonly used in clinical practice were analyzed comparatively regarding technical parameters, temporal dynamics and the reproducibility of measuring results. The measurements were executed simultaneously and time synchronized in a reference group of five test subjects (four males, one female, average age 33.0 ± 9.4 years), in a group of five patients (all males, average age 51.8 ± 18.4 years) and using a simulator (pulse oximeter simulator index 2). All devices underestimate the simulator's predetermined oxygen desaturation of 10%. The dispersion of values is high. The device-specific characteristics have a significant influence on the collected data. The fundamental weakness of the systems lies in the reproducibility of measuring results (this only seems adequate at a signal resolution in steps of 0.1%) as well as the differing temporal dynamics. In the synchronous use of different systems on patients for the purpose of a direct comparison of devices, the dispersion of values is serious, reaching a fluctuation range of up to factor 1.42. In measuring dynamic events (apneas), different pulse oximeters do not record identical values. This is due to the different internal signal processing of the devices

  5. Inclusão digital de jovens na microrregião de Viçosa/Minas Gerais: dimensões políticas e subjetivas | Digital inclusion of youngsters in the Viçosa/Minas Gerais micro region: political and subjective dimensions

    Directory of Open Access Journals (Sweden)

    Daniela Alves de Alves

    2012-04-01

    Full Text Available Resumo O presente artigo apresenta resultados de um diagnóstico das implicações das políticas públicas de inclusão digital nas escolas de ensino médio da microrregião de Viçosa. Analisamos a amplitude e os efeitos destas políticas para os jovens da referida região, explorando qualitativamente a dimensão da inclusão, especialmente através da análise dos usos da tecnologia por parte dos jovens considerados incluídos. Constatamos que a inserção dos jovens em políticas de inclusão digital através da escola é limitada e a internet tem sido usada pelos jovens entrevistados predominantemente como espaço de sociabilidade e de pesquisas escolares. O acesso à internet apresenta inúmeras desigualdades. Palavras-chave inclusão digital, internet, rede sociotécnica, jovens, políticas públicas Abstract This article presents results from the diagnosis of the implications of public policies for digital inclusion in secondary schools of the micro-region of Viçosa, Minas Gerais, Brazil. The amplitude and effect of these policies for the youngsters of this region were analyzed, exploring qualitatively the dimensions of the inclusion, especially through the analysis of the uses of technology by the teenagers considered. It could be verified that the insertion of these youngsters in digital inclusion policies at school is limited, and that the Internet has been used by the juveniles interviewed predominantly as a space for sociability and school research. Access to the Internet represents innumerable inequalities. Keywords digital inclusion, internet, socio-technical web, youngsters, public policies

  6. Accuracy of the diagnosis of pleural effusion on supine chest X-ray

    International Nuclear Information System (INIS)

    Emamian, S.A.; Kaasboel, M.A.; Olsen, J.F.; Pedersen, J.F.

    1997-01-01

    Diagnosis of pleural effusion (PE) on supine chest X-ray (SCXR) is considered difficult. This study aimed at evaluating the accuracy of the diagnosis of PE on SCXR and was performed in two phases. At phase 1, a formula for the sonographic estimation of the volume of PE was established by correlating 24 measurements (in 7 patients in whom complete drainage was achieved) with the drained volumes. At phase two, 112 consecutive SCXRs were supplemented by sonography of the chest. The films were evaluated for the presence of PE and for the presence of different radiologic signs of PE. Sonography showed PE in 41 right and 30 left hemithoraces. The overall accuracy of the diagnosis of PE on SCXR was 82 %. Only one of the undiagnosed PEs had a volume of > 300 ml. The most accurate signs were increased density of the hemithorax, blunted costophrenic angle, and loss of the hemidiaphragm silhouette. (orig.). With 2 figs., 3 tabs

  7. Hemodynamic responses to seated and supine lower body negative pressure - Comparison with +Gz acceleration

    Science.gov (United States)

    Polese, Alvese; Sandler, Harold; Montgomery, Leslie D.

    1992-01-01

    The hemodynamic responses to LBNP in seated subjects and in subjects in supine body positions were compared and were correlated with hemodynamic changes which occurred during a simulated (by centrifugation) Shuttle reentry acceleration with a slow onset rate of 0.002 G/s and during gradual onset exposures to +3 Gz and +4 Gz. Results demonstrate that seated LBNP at a level of -40 mm Hg can serve as a static simulator for changes in the heart rate and in mean blood pressure induced by gradual onset acceleration stress occurring during Shuttle reentry. The findings also provide a rationale for using LBNP during weightlessness as a means of imposing G-loading on the circulation prior to reentry.

  8. A functional MRI Exploration of Hamstring Activation During the Supine Bridge Exercise.

    Science.gov (United States)

    Bourne, Matthew; Williams, Morgan; Pizzari, Tania; Shield, Anthony

    2018-02-01

    The single leg supine bridge (SLB) is a commonly employed strengthening exercise and is used as a clinical test for hamstring function in sports, however, little is known about the patterns of muscle activation in this task. To explore these activation patterns, nine healthy, recreationally active males underwent functional magnetic resonance imaging (fMRI) of their thighs at rest and immediately after 5 sets of 10 repetitions of the SLB exercise. Exercise-induced increases in the transverse (T2) relaxation time of the biceps femoris long and short heads, semitendinosus and semimembranosus, were determined via signal intensity changes in pre- and post-exercise images and used as an index of muscle activation. The Bonferroni adjusted alpha was set at phamstring injury prevention and rehabilitation programs. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Supine breast US: how to correlate breast lesions from prone MRI.

    Science.gov (United States)

    Telegrafo, Michele; Rella, Leonarda; Stabile Ianora, Amato A; Angelelli, Giuseppe; Moschetta, Marco

    2016-01-01

    To evaluate spatial displacement of breast lesions from prone MR to supine ultrasound positions, and to determine whether the degree of displacement may be associated with breast density and lesion histotype. 380 patients underwent breast MR and second-look ultrasound. The MR and ultrasound lesion location within the breast gland, distances from anatomical landmarks (nipple, skin and pectoral muscle), spatial displacement (distance differences from the landmarks within the same breast region) and region displacement (breast region change) were prospectively evaluated. Differences between MR and ultrasound measurements, association between the degree of spatial displacement and both breast density and lesion histotypes were calculated. In 290/380 (76%) patients, 300 MR lesions were detected. 285/300 (95%) lesions were recognized on ultrasound. By comparing MR and ultrasound, spatial displacement occurred in 183/285 (64.3%) cases while region displacement in 102/285 (35.7%) cases with a circumferential movement along an arc centred on the nipple, having supine ultrasound as the reference standard. A significant association between the degree of lesion displacement and breast density was found (p < 0.00001) with a significant higher displacement in case of fatty breasts. No significant association between the degree of displacement and lesion histotype was found (p = 0.1). Lesion spatial displacement from MRI to ultrasound may occur especially in adipose breasts. Lesion-nipple distance and circumferential displacement from the nipple need to be considered for ultrasound lesion detection. Second-look ultrasound breast lesion detection could be improved by calculating the lesion-nipple distance and considering that spatial displacement from MRI occurs with a circumferential movement along an arc centred on the nipple.

  10. Verification techniques and dose distribution for computed tomographic planned supine craniospinal radiation therapy

    International Nuclear Information System (INIS)

    Chang, Eric L.; Wong Peifong; Forster, Kenneth M.; Petru, Mark D.; Kowalski, Alexander V.; Maor, Moshe H.

    2003-01-01

    A modified 3-field technique was designed with opposed cranial fields and a single spinal field encompassing the entire spinal axis. Two methods of plan verifications were performed before the first treatment. First, a system of orthogonal rulers plus the thermoplastic head holder was used to visualize the light fields at the craniospinal junction. Second, film phantom measurements were taken to visualize the gap between the fields at the level of the spinal cord. Treatment verification entailed use of a posterior-anterior (PA) portal film and placement of radiopaque wire on the inferior border of the cranial field. More rigorous verification required a custom-fabricated orthogonal film holder. The isocenter positions of both fields when they matched were recorded using a record-and-verify system. A single extended distance spinal field collimated at 42 degree sign encompassed the entire spinal neuraxis. Data were collected from 40 fractions of craniospinal irradiation (CSI). The systematic error observed for the actual daily treatments was -0.5 mm (underlap), while the stochastic error was represented by a standard deviation of 5.39 mm. Measured data across the gapped craniospinal junction with junction shifts included revealed a dose ranging from 89.3% to 108%. CSI can be performed without direct visualization of the craniospinal junction by using the verification methods described. While the use of rigorous film verification for supine technique may have reduced the systematic error, the inability to visualize the supine craniospinal junction on skin appears to have increased the stochastic error compared to published data on such errors associated with prone craniospinal irradiation

  11. Cervical spine trauma radiographs: Swimmers and supine obliques; an exploration of current practice

    Energy Technology Data Exchange (ETDEWEB)

    Fell, Michael, E-mail: michael.fell@mkgeneral.nhs.u [Milton Keynes General Hospital, Radiology Standing Way, Eaglestone, Milton Keynes, Buckinghamshire MK6 5LD (United Kingdom)

    2011-02-15

    The study objectives were: to investigate current cervical spine radiographic imaging practices in conscious adult patients with suspected neck injury; reasons behind variation and consideration of dose estimates were explored. Comparison with a previous survey has been made. Questionnaires were sent to superintendent radiographers responsible for accident and emergency X-ray departments in English trusts with over 8500 emergency admissions per year, with a response rate of 97% (n = 181/186). Departmental cervical spine imaging protocols were reported by 82% of respondents. None use fewer than the three standard projections; if the cervicothoracic junction (C7/T1), is not adequately demonstrated 87% use swimmers projections, 9% supine obliques, 3% CT alone. Following projectional radiography, 97% perform CT. A significant (p = 0.018) increase was found since 1999 in CT use once the swimmers projection fails; fewer now use obliques at this point, continuing with CT instead. No significant difference (p = 0.644) was found in choice of first supplementary radiographs; despite British Trauma Society's recommendation to undertake supine obliques, swimmers remain the most widespread technique. An 85% response rate (n = 103/121) completed a second questionnaire, exploring reasons behind the various practices. Several reported a perceived difficulty in interpreting oblique radiographs, some a concern over high dose of the swimmers. Numerous issues affect the acquisition of cervical spine radiographs. Patient radiation dose should be a major consideration in selection of technique. A potential need for training in interpretation of obliques is highlighted. Specific guidelines for optimum projections should be researched, and protocols issued to ensure best practice.

  12. Epidemiological analysis of structural alterations of the nasal cavity associated with obstructive sleep apnea syndrome (OSA).

    Science.gov (United States)

    Mekhitarian Neto, Levon; Fava, Antonio Sérgio; Lopes, Hugo Canhete; Stamm, Aldo

    2005-01-01

    The objective of this paper is to demonstrate that structural alterations of the nasal cavity, e.g. septal deviation and conchal hypertrophy have high incidence in patients with sleep apnea and hypopnea syndrome and must be addressed with associated specific procedures of the syndrome. Clinical retrospective. A retrospective study of 200 patients was performed, with 196 male and 4 female, attended at the otorhinolaryngology ambulatory of Hospital Prof. Edmundo Vasconcelos and Unidade Paulista de Otorrinolaringologia, all of them subjected to polysomnography, otorhinolaryngological physical exam, endoscopy exam, and surgical treatment with nasal and pharyngeal procedures. All of them were subjected to pharyngeal procedure: uvulopalatopharyngoplasty or uvulopalatoplasty and nose procedure: 176 septoplasty with partial turbinectomy (88%) and 24 isolated turbinectomy, with satisfactory results. We can see that structural alterations of the nasal cavity have high incidence in patients with OSA.

  13. 5-years APAP adherence in OSA patients--do first impressions matter?

    Science.gov (United States)

    van Zeller, Mafalda; Severo, Milton; Santos, Ana Cristina; Drummond, Marta

    2013-12-01

    Although continuous positive airway pressure (CPAP) is effective in treating obstructive sleep apnoea (OSA), inadequate adherence remains a major cause of treatment failure. This study aimed to determine long term adherence to auto adjusting-CPAP (APAP) and its influencing factors including the role of initial compliance. Eighty-eight male patients with newly diagnosed moderate/severe OSA were included. After initiation of APAP treatment, patients had periodic follow-up appointments at 2 weeks, 6 months and then annually for at least 5 years. Patient's compliance to therapy was assessed in each appointment and predictors to treatment abandonment and poor compliance were evaluated. The studied population had a mean age of 53.8 years and mean apnoea-hypopnoea index of 52.71/h. The mean time of follow-up was 5.2 (± 1.6) years, during that time 22 (25%) patients abandoned APAP, those who maintained treatment had good compliance to it since 94% of them used it more than 4 h/day for at least 70% of days. A significant negative association was found between age, % of days and mean time of APAP use on 12th day and 6th month and the risk of abandoning. APAP use lower than 33% and 57% of days at 12th day and 6th month, respectively had high specificity (≈ 100%) to detect treatment abandonment. the majority of patients adheres to long term APAP treatment and has good compliance after 5-years of follow-up. Age and initial compliance (% days of use and mean hour/day) have the ability to predict future adherence, as soon as 12 days and 6 months after initiation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Impact of CPAP on activity patterns and diet in patients with obstructive sleep apnea (OSA).

    Science.gov (United States)

    Batool-Anwar, Salma; Goodwin, James L; Drescher, Amy A; Baldwin, Carol M; Simon, Richard D; Smith, Terry W; Quan, Stuart F

    2014-05-15

    Patients with severe OSA consume greater amounts of cholesterol, protein, and fat as well as have greater caloric expenditure. However, it is not known whether their activity levels or diet change after treatment with CPAP. To investigate this issue, serial assessments of activity and dietary intake were performed in the Apnea Positive Pressure Long-term Efficacy Study (APPLES); a 6-month randomized controlled study of CPAP vs. sham CPAP on neurocognitive outcomes. Subjects were recruited into APPLES at 5 sites through clinic encounters or public advertisement. After undergoing a diagnostic polysomnogram, subjects were randomized to CPAP or sham if their AHI was ≥ 10. Adherence was assessed using data cards from the devices. At the Tucson and Walla Walla sites, subjects were asked to complete validated activity and food frequency questionnaires at baseline and their 4-month visit. Activity and diet data were available at baseline and after 4 months treatment with CPAP or sham in up to 231 subjects (117 CPAP, 114 Sham). Mean age, AHI, BMI, and Epworth Sleepiness Score (ESS) for this cohort were 55 ± 13 [SD] years, 44 ± 27 /h, 33 ± 7.8 kg/m(2), and 10 ± 4, respectively. The participants lacking activity and diet data were younger, had lower AHI and arousal index, and had better sleep efficiency (p Level of adherence defined as hours of device usage per night at 4 months was significantly higher among men in CPAP group (4.0 ± 2.9 vs. 2.6 ± 2.6). No changes in consumption of total calories, protein, carbohydrate or fat were noted after 4 months. Except for a modest increase in recreational activity in women (268 ± 85 vs. 170 ± 47 calories, p increase in recreational activity in women, OSA patients treated with CPAP do not substantially change their diet or physical activity habits after treatment. .

  15. Sleep fragmentation: comparison of two definitions of short arousals during sleep in OSAS patients.

    Science.gov (United States)

    Smurra, M V; Dury, M; Aubert, G; Rodenstein, D O; Liistro, G

    2001-04-01

    The measurement of arousals during sleep is useful to quantify sleep fragmentation. The criteria for electroencephalography (EEG) arousals defined by the American Sleep Disorders Association (ASDA) have recently been criticized because of lack of interobserver agreement. The authors have adopted a scoring method that associates the increase in chin electromyography (EMG) with the occurrence of an alpha-rhythm in all sleep stages (Université Catholique de Louvain (UCL) definition of arousals). The aim of the present study was to compare the two scoring definitions in terms of agreement and repeatability and the time taken for scoring in patients with obstructive sleep apnoea syndrome (OSAS) of varying severity. Two readers using both ASDA and UCL definitions scored twenty polysomnographies (PSGs) each on two occasions. The PSGs were chosen retrospectively to represent a wide range of arousal index (from 6-82) in OSAS patients. There was no difference in the arousal indices between readers and between scoring methods. The mean+/-SD difference between the two definitions (the bias) was 1.1+/-3.76 (95% confidence interval: -0.66-2.86). There was a strong linear relationship between the arousal index scored with the two definitions (r=0.981, pASDA definitions (18.5+/-5.4 versus 25.3+/-6.6 min, p<0.001). In conclusion, it has been found that in obstructive sleep apnoea syndrome patients, the American Sleep Disorders Association and Université Catholique de Louvain definitions were comparable in terms of agreement and repeatability.

  16. Alternated Prone and Supine Whole-Breast Irradiation Using IMRT: Setup Precision, Respiratory Movement and Treatment Time

    International Nuclear Information System (INIS)

    Veldeman, Liv; De Gersem, Werner; Speleers, Bruno; Truyens, Bart; Van Greveling, Annick; Van den Broecke, Rudy; De Neve, Wilfried

    2012-01-01

    Purpose: The objective of this study was to compare setup precision, respiration-related breast movement and treatment time between prone and supine positions for whole-breast irradiation. Methods and Materials: Ten patients with early-stage breast carcinoma after breast-conserving surgery were treated with prone and supine whole breast-irradiation in a daily alternating schedule. Setup precision was monitored using cone-beam computed tomography (CBCT) imaging. Respiration-related breast movement in the vertical direction was assessed by magnetic sensors. The time needed for patient setup and for the CBCT procedure, the beam time, and the length of the whole treatment slot were also recorded. Results: Random and systematic errors were not significantly different between positions in individual patients for each of the three axes (left-right, longitudinal, and vertical). Respiration-related movement was smaller in prone position, but about 80% of observations showed amplitudes <1 mm in both positions. Treatment slots were longer in prone position (21.2 ± 2.5 min) than in supine position (19.4 ± 0.8 min; p = 0.044). Conclusion: Comparison of setup precision between prone and supine position in the same patient showed no significant differences in random and systematic errors. Respiratory movement was smaller in prone position. The longer treatment slots in prone position can probably be attributed to the higher repositioning need.

  17. Differences in abdominal organ movement between supine and prone positions measured using four-dimensional computed tomography

    International Nuclear Information System (INIS)

    Kim, Young Seok; Park, Sung Ho; Ahn, Seung Do; Lee, Jeong Eun; Choi, Eun Kyung; Lee, Sang-wook; Shin, Seong Soo; Yoon, Sang Min; Kim, Jong Hoon

    2007-01-01

    Background and purpose: To analyze the differences in intrafractional organ movement throughout the breathing cycles between the supine and prone positions using four-dimensional computed tomography (4D CT). Materials and methods: We performed 4D CT on nine volunteers in the supine and prone positions, with each examinee asked to breathe normally during scanning. The movement of abdominal organs in the cranio-caudal (CC), anterior-posterior (AP) and right-left (RL) directions was quantified by contouring on each phase between inspiration and expiration. Results: The mean intrafractional motions of the hepatic dome, lower tip, pancreatic head and tail, both kidneys, spleen, and celiac axis in the supine/prone position were 17.3/13.0, 14.4/11.0, 12.8/8.9, 13.0/10.0, 14.3/12.1, 12.3/12.6, 11.7/12.6 and 2.2/1.8 mm, respectively. Intrafractional movements of the liver dome and pancreatic head were reduced significantly in the prone position. The CC directional excursions were major determinants of the 3D displacements of the abdominal organs. Alteration from the supine to the prone position did not change the amount of intrafractional movements of kidneys, spleen, and celiac axis. Conclusion: There was a significant reduction in the movements of the liver and pancreas during the prone position, especially in the CC direction, suggesting possible advantage of radiotherapy to these organs in this position

  18. Target volume shape variation during irradiation of rectal cancer patients in supine position: Comparison with prone position

    International Nuclear Information System (INIS)

    Nijkamp, Jasper; Jong, Rianne de; Sonke, Jan-Jakob; Vliet, Corine van; Marijnen, Corrie

    2009-01-01

    Purpose: To quantify the inter-fraction shape variation of the mesorectum for rectal cancer patients treated with 5 x 5 Gy in supine position and compare it to variation in prone position. Methods and materials: For 28 patients a planning CT (pCT) and five daily cone-beam-CT (CBCT) scans were acquired in supine position. The mesorectal part of the CTV (MesoRect) was delineated on all scans. The shape variation was quantified by the distance between the pCT- and the CBCT delineations and stored in surface maps after online setup correction. Data were analyzed for male and female patients separately and compared to prone data. Results: A large range of systematic, 1-8 mm (1SD), and random, 1-5 mm, shape variation was found, comparable to prone patients. Random-shape variation was comparable for male and female patients, while systematic variation was 3 mm larger for female patients. Conclusions: Shape variation of the MesoRect is substantial, heterogeneous and different between male and female patients. Differences between supine and prone orientation, however, are small. Clinical margins should be differentiated in position along the cranio-caudal axis, in anterior-posterior direction and for gender. Margins should also be increased, even when online setup correction is used. Due to the small margin differences between prone and supine treatments, the setup choice should be determined on dose to the organs at risk.

  19. Nasal obstruction and sleep-disordered breathing: the effect of supine body position on nasal measurements in snorers.

    Science.gov (United States)

    Virkkula, Paula; Maasilta, Paula; Hytönen, Maija; Salmi, Tapani; Malmberg, Henrik

    2003-06-01

    Nasal obstruction is considered to be a potential etiological factor in sleep-disordered breathing. However, a significant correlation between nasal measurements and obstructive sleep apnea has not been demonstrated so far. The aim of this study was to investigate the relationships between nasal resistance, nasal volumes and selected sleep parameters using nasal measurements performed in both seated and supine positions. We also investigated whether snoring patients in our clinical sample showed increased positional or decongestive nasal mucosal changes. Forty-one snoring men on a waiting list for correction of nasal obstruction underwent polysomnography, anterior rhinomanometry and acoustic rhinometry. Nineteen non-snoring control subjects were also recruited. Nasal measurements were performed in a seated position, after lying down in a supine position and, after decongestion of nasal mucosa, in a seated position again. In the overall patient group, nasal volume at a distance 2-4 cm from the nares in the supine position correlated inversely with apnea-hypopnea index (AHI) (r = -0.32, p patients, total nasal resistance measured in a supine position correlated with AHI (r = 0.50, p position and sleep parameters. Postural or decongestive changes in nasal measurements were not increased in snoring patients compared with control subjects. The relationship found between nasal measurements and sleep parameters suggests that nasal obstruction does augment airway collapse.

  20. SU-E-J-227: Breathing Pattern Consistency and Reproducibility: Comparative Analysis for Supine and Prone Body Positioning

    International Nuclear Information System (INIS)

    Laugeman, E; Weiss, E; Chen, S; Hugo, G; Rosu, M

    2014-01-01

    Purpose: Evaluate and compare the cycle-to-cycle consistency of breathing patterns and their reproducibility over the course of treatment, for supine and prone positioning. Methods: Respiratory traces from 25 patients were recorded for sequential supine/prone 4DCT scans acquired prior to treatment, and during the course of the treatment (weekly or bi-weekly). For each breathing cycle, the average(AVE), end-of-exhale(EoE) and end-of-inhale( EoI) locations were identified using in-house developed software. In addition, the mean values and variations for the above quantities were computed for each breathing trace. F-tests were used to compare the cycle-to-cycle consistency of all pairs of sequential supine and prone scans. Analysis of variances was also performed using population means for AVE, EoE and EoI to quantify differences between the reproducibility of prone and supine respiration traces over the treatment course. Results: Consistency: Cycle-to-cycle variations are less in prone than supine in the pre-treatment and during-treatment scans for AVE, EoE and EoI points, for the majority of patients (differences significant at p<0.05). The few cases where the respiratory pattern had more variability in prone appeared to be random events. Reproducibility: The reproducibility of breathing patterns (supine and prone) improved as treatment progressed, perhaps due to patients becoming more comfortable with the procedure. However, variability in supine position continued to remain significantly larger than in prone (p<0.05), as indicated by the variance analysis of population means for the pretreatment and subsequent during-treatment scans. Conclusions: Prone positioning stabilizes breathing patterns in most subjects investigated in this study. Importantly, a parallel analysis of the same group of patients revealed a tendency towards increasing motion amplitude of tumor targets in prone position regardless of their size or location; thus, the choice for body positioning

  1. The efficacy of a brief motivational enhancement education program on CPAP adherence in OSA: a randomized controlled trial.

    Science.gov (United States)

    Lai, Agnes Y K; Fong, Daniel Y T; Lam, Jamie C M; Weaver, Terri E; Ip, Mary S M

    2014-09-01

    Poor adherence to CPAP treatment in OSA adversely affects the effectiveness of this therapy. This randomized controlled trial (RCT) examined the efficacy of a brief motivational enhancement education program in improving adherence to CPAP treatment in subjects with OSA. Subjects with newly diagnosed OSA were recruited into this RCT. The control group received usual advice on the importance of CPAP therapy and its care. The intervention group received usual care plus a brief motivational enhancement education program directed at enhancing the subjects' knowledge, motivation, and self-efficacy to use CPAP through the use of a 25-min video, a 20-min patient-centered interview, and a 10-min telephone follow-up. Self-reported daytime sleepiness adherence-related cognitions and quality of life were assessed at 1 month and 3 months. CPAP usage data were downloaded at the completion of this 3-month study. One hundred subjects with OSA (mean ± SD, age 52 ± 10 years; Epworth Sleepiness Scales [ESS], 9 ± 5; median [interquartile range] apnea-hypopnea index, 29 [20, 53] events/h) prescribed CPAP treatment were recruited. The intervention group had better CPAP use (higher daily CPAP usage by 2 h/d [Cohen d = 1.33, P motivational enhancement education in addition to usual care were more likely to show better adherence to CPAP treatment, with greater improvements in treatment self-efficacy and daytime sleepiness. ClinicalTrials.gov; No.: NCT01173406; URL: www.clinicaltrials.gov.

  2. Detection of Secondary Causes and Coexisting Diseases in Hypertensive Patients: OSA and PA Are the Common Causes Associated with Hypertension.

    Science.gov (United States)

    Wang, Lei; Li, Nanfang; Yao, Xiaoguang; Chang, Guijuan; Zhang, Delian; Heizhati, Mulalibieke; Wang, Menghui; Luo, Qin; Kong, Jianqiong

    2017-01-01

    Since the control rate of blood pressure is lower in mainland China, the aim of this study is to investigate the proportion of secondary causes and coexisting diseases of hypertension in hypertensive patients. Data on consecutive patients with hypertension who visited the Hypertension Center. Diseases were detected using an established strict screening protocol. Detection rate of secondary causes and coexisting diseases of hypertension was 39.5% among 3003 hypertensive patients. Obstructive sleep apnea (OSA) was the most common, accounting for 24.7% of patients, followed by primary aldosteronism (PA) (5.8%) and PA + OSA (4.9%). Endocrine hypertension accounted for 12.1% of patients, including 10.7% of patients with PA, 1.1% with hypothyroidism, 0.1% with pheochromocytoma, 0.1% with Cushing's syndrome, and 0.1% with hyperthyroidism, respectively. Those who smoke, those who are obese, and those who have diabetes accounted for 31.3%, 27.5%, and 16.6% of total patients, respectively. There were overlapping conditions in secondary causes and coexisting diseases of hypertension. OSA was the most common in each age- and BMI-stratified group. Findings from the current study suggest an increasing frequency of secondary forms of hypertension, highlighting the burden of OSA and PA in hypertensive patients.

  3. Detection of Secondary Causes and Coexisting Diseases in Hypertensive Patients: OSA and PA Are the Common Causes Associated with Hypertension

    Directory of Open Access Journals (Sweden)

    Lei Wang

    2017-01-01

    Full Text Available Background. Since the control rate of blood pressure is lower in mainland China, the aim of this study is to investigate the proportion of secondary causes and coexisting diseases of hypertension in hypertensive patients. Methods. Data on consecutive patients with hypertension who visited the Hypertension Center. Diseases were detected using an established strict screening protocol. Results. Detection rate of secondary causes and coexisting diseases of hypertension was 39.5% among 3003 hypertensive patients. Obstructive sleep apnea (OSA was the most common, accounting for 24.7% of patients, followed by primary aldosteronism (PA (5.8% and PA + OSA (4.9%. Endocrine hypertension accounted for 12.1% of patients, including 10.7% of patients with PA, 1.1% with hypothyroidism, 0.1% with pheochromocytoma, 0.1% with Cushing’s syndrome, and 0.1% with hyperthyroidism, respectively. Those who smoke, those who are obese, and those who have diabetes accounted for 31.3%, 27.5%, and 16.6% of total patients, respectively. There were overlapping conditions in secondary causes and coexisting diseases of hypertension. OSA was the most common in each age- and BMI-stratified group. Conclusion. Findings from the current study suggest an increasing frequency of secondary forms of hypertension, highlighting the burden of OSA and PA in hypertensive patients.

  4. CPAP treatment supported by telemedicine does not improve blood pressure in high cardiovascular risk OSA patients: a randomized, controlled trial.

    Science.gov (United States)

    Mendelson, Monique; Vivodtzev, Isabelle; Tamisier, Renaud; Laplaud, David; Dias-Domingos, Sonia; Baguet, Jean-Philippe; Moreau, Laurent; Koltes, Christian; Chavez, Léonidas; De Lamberterie, Gilles; Herengt, Frédéric; Levy, Patrick; Flore, Patrice; Pépin, Jean-Louis

    2014-11-01

    Obstructive sleep apnea (OSA) has been associated with hypertension, which is one of the intermediary mechanisms leading to increased cardiovascular morbidity. This study aimed at evaluating the effects of a combination of continuous positive airway pressure (CPAP) and telemedicine support on blood pressure (BP) reduction in high cardiovascular risk OSA patients. A multi-center randomized controlled trial that compared standard CPAP care and CPAP care and a telemedicine intervention. Sleep clinics in France. 107 adult (18-65 years old) OSA patients (AHI > 15 events/h) with a high cardiovascular risk (cardiovascular SCORE > 5% or secondary prevention). Patients were randomized to either standard care CPAP (n = 53) or CPAP and telemedicine (n = 54). Patients assigned to telemedicine were equipped with a smartphone for uploading BP measurements, CPAP adherence, sleepiness, and quality of life data; in return, they received pictograms containing health-related messages. The main outcome was home self-measured BP and secondary outcomes were cardiovascular risk evolution, objective physical activity, CPAP adherence, sleepiness and quality of life. Self-measured BP did not improve in either group (telemedicine or standard care). Patients in primary prevention showed greater BP reduction with CPAP treatment than those in secondary prevention. CPAP treatment supported by telemedicine alone did not improve blood pressure and cardiovascular risk in high cardiovascular risk OSA patients. This study emphasizes the need for diet and physical activity training programs in addition to CPAP when aiming at decreasing cardiometabolic risk factors in these patients. ClinicalTrials.gov identifier: NCT01226641.

  5. Effect of reducing abdominal compression during prone CT colonography on ascending colonic rotation during supine-to-prone positional change

    International Nuclear Information System (INIS)

    Jang, Jong eon; Park, Seong Ho; Lee, Jong Seok; Kim, Hyun Jin; KIm, Ah Young; Ha, Hyun Kwon

    2016-01-01

    To determine the effect of reduced abdominal compression in prone position on ascending colonic movement during supine-to-prone positional change during CT colonography (CTC). Eighteen consecutive patients who had undergone prone CTC scanning with cushion blocks placed under the chest and hip/thigh to reduce abdominal compression and had confirmed sessile polyps ≥ 6 mm in the well-distended, straight, mid-ascending colon, were included. Radial location along the ascending colonic luminal circumference (°) was measured for 24 polyps and 54 colonic teniae on supine and prone CTC images. The supine-to-prone change ranging between -180° and +180° (- and + for internal and external colonic rotations, respectively), was determined. In addition, possible causes of any ascending colonic rotations were explored. Abdominal compression during prone CTC scanning completely disappeared with the use of cushion blocks in 17 of 18 patients. However, some degrees of ascending colonic rotation were still observed, with the radial location changes of -22° to 61° (median, 13.9°) for the polyps and similar degrees for teniae. Fifty-four percent and 56% of polyps and teniae, respectively, showed changes > 10°. The radial location change of the polyps was significantly associated with the degree of anterior shift of the small bowel and mesentery (r = 0.722, p < 0.001) and the degree of posterior displacement of the ascending colon (r = 0.566, p = 0.004) during supine-to-prone positional change. Ascending colonic rotation upon supine-to-prone positional change during CTC, mostly in the form of external rotation, is not eliminated by removing abdominal compression in prone position

  6. An evaluation of intrafraction motion of the prostate in the prone and supine positions using electromagnetic tracking

    International Nuclear Information System (INIS)

    Shah, Amish P.; Kupelian, Patrick A.; Willoughby, Twyla R.; Langen, Katja M.; Meeks, Sanford L.

    2011-01-01

    Purpose: To evaluate differences in target motion during prostate irradiation in the prone versus supine position using electromagnetic tracking to measure prostate mobility. Materials/methods: Twenty patients received prostate radiotherapy in the supine position utilizing the Calypso Localization System (registered) for prostate positioning and monitoring. For each patient, 10 treatment fractions were followed by a session in which the patient was repositioned prone, and prostate mobility was tracked. The fraction of time that the prostate was displaced by >3, 5, 7, and 10 mm was calculated for each patient, for both positions (400 tracking sessions). Results: Clear patterns of respiratory motion were seen in the prone tracks due to the influence of increased abdominal motion. Averaged over all patients, the prostate was displaced >3 and 5 mm for 37.8% and 10.1% of the total tracking time in the prone position, respectively. In the supine position, the prostate was displaced >3 and 5 mm for 12.6% and 2.9%, respectively. With both patient setups, inferior and posterior drifts of the prostate position were observed. Averaged over all prone tracking sessions, the prostate was displaced >3 mm in the posterior and inferior directions for 11.7% and 9.5% of the total time, respectively. Conclusions: With real-time tracking of the prostate, it is possible to study the effects of different setup positions on the prostate mobility. The percentage of time the prostate moved >3 and 5 mm was increased by a factor of three in the prone versus supine position. For larger displacements (>7 mm) no difference in prostate mobility was observed between prone and supine positions. To reduce rectal toxicity, radiotherapy in the prone position may be a suitable alternative provided respiratory motion is accounted for during treatment. Acute and late toxicity results remain to be evaluated for both patient positions.

  7. Registration of central paths and colonic polyps between supine and prone scans in computed tomography colonography: Pilot study

    International Nuclear Information System (INIS)

    Li Ping; Napel, Sandy; Acar, Burak; Paik, David S.; Jeffrey, R. Brooke Jr.; Beaulieu, Christopher F.

    2004-01-01

    Computed tomography colonography (CTC) is a minimally invasive method that allows the evaluation of the colon wall from CT sections of the abdomen/pelvis. The primary goal of CTC is to detect colonic polyps, precursors to colorectal cancer. Because imperfect cleansing and distension can cause portions of the colon wall to be collapsed, covered with water, and/or covered with retained stool, patients are scanned in both prone and supine positions. We believe that both reading efficiency and computer aided detection (CAD) of CTC images can be improved by accurate registration of data from the supine and prone positions. We developed a two-stage approach that first registers the colonic central paths using a heuristic and automated algorithm and then matches polyps or polyp candidates (CAD hits) by a statistical approach. We evaluated the registration algorithm on 24 patient cases. After path registration, the mean misalignment distance between prone and supine identical anatomic landmarks was reduced from 47.08 to 12.66 mm, a 73% improvement. The polyp registration algorithm was specifically evaluated using eight patient cases for which radiologists identified polyps separately for both supine and prone data sets, and then manually registered corresponding pairs. The algorithm correctly matched 78% of these pairs without user input. The algorithm was also applied to the 30 highest-scoring CAD hits in the prone and supine scans and showed a success rate of 50% in automatically registering corresponding polyp pairs. Finally, we computed the average number of CAD hits that need to be manually compared in order to find the correct matches among the top 30 CAD hits. With polyp registration, the average number of comparisons was 1.78 per polyp, as opposed to 4.28 comparisons without polyp registration

  8. Small bowel protection in IMRT for rectal cancer. A dosimetric study on supine vs. prone position

    Energy Technology Data Exchange (ETDEWEB)

    Koeck, Julia; Kromer, Katharina; Siebenlist, Kerstin; Mai, Sabine; Fleckenstein, Jens; Wenz, Frederik [University of Heidelberg, Department of Radiation Oncology, University Medical Center Mannheim, Mannheim (Germany); Lohr, Frank [Az. Ospedaliero-Universitaria di Modena, Unita Operativa di Radioterapia, Dipartimento di Oncologia, Modena (Italy); Baack, Tobias [GRN Clinic Weinheim, Department of Internal Medicine, Weinheim (Germany); Buettner, Sylvia [University of Heidelberg, Department of Biomathematics and Medical Statistics, University Medical Center Mannheim, Mannheim (Germany)

    2017-07-15

    This treatment planning study analyzes dose coverage and dose to organs at risk (OAR) in intensity-modulated radiotherapy (IMRT) of rectal cancer and compares prone vs. supine positioning as well as the effect of dose optimization for the small bowel (SB) by additional dose constraints in the inverse planning process. Based on the CT datasets of ten male patients in both prone and supine position, a total of four different IMRT plans were created for each patient. OAR were defined as the SB, bladder, and femoral heads. In half of the plans, two additional SB cost functions were used in the inverse planning process. There was a statistically significant dose reduction for the SB in prone position of up to 41% in the high and intermediate dose region, compared with the supine position. Furthermore, the femoral heads showed a significant dose reduction in prone position in the low dose region. Regarding the additional active SB constraints, the dose in the high dose region of the SB was significantly reduced by up to 14% with the additional cost functions. There were no significant differences in the dose distribution of the planning target volume (PTV) and the bladder. Prone positioning can significantly reduce dose to the SB in IMRT for rectal cancer and therefore should not only be used in 3D conformal radiotherapy but also in IMRT of rectal cancer. Further protection of the SB can be achieved by additional dose constraints in inverse planning without jeopardizing the homogeneity of the PTV. (orig.) [German] Diese Planungsstudie analysiert die Dosisverteilung im Zielvolumen und in den Risikoorganen (''organs at risk'', OAR) bei der intensitaetsmodulierten Strahlentherapie (''intensity-modulated radiotherapy'', IMRT) des Rektumkarzinoms und vergleicht hierbei Bauch- und Rueckenlagerung sowie die Effekte der Dosisoptimierung fuer den Duenndarm (DD) durch zusaetzliche Dosiseinschraenkungen bei der inversen Planung. Anhand der

  9. Association between CT-evaluated lumbar lordosis and features of spinal degeneration, evaluated in supine position

    Science.gov (United States)

    Kalichman, Leonid; Li, Ling; Hunter, David; Been, Ella

    2013-01-01

    Background Context Few studies have directly evaluated the association of lumbar lordosis and segmental wedging of the vertebral bodies and intervertebral disks with prevalence of spinal degenerative features. Purpose To evaluate the association of CT-evaluated lumbar lordosis, segmental wedging of the vertebral bodies and that of the intervertebral disks with various spinal degeneration features. Study design This cross-sectional study was a nested project to the Framingham Heart Study. Sample A random consecutive subset of 191 participants chosen from the 3590 participants enrolled in the Framingham Heart Study who underwent multi-detector CT to assess aortic calcification. Outcome Measures Physiologic Measures Dichotomous variables indicating the presence of intervertebral disc narrowing, facet joint osteoarthritis, spondylolysis, spondylolisthesis and spinal stenosis and density (in Hounsfield units) of multifidus and erector spinae muscles were evaluated on supine CT, as well as the lordosis angle (LA) and the wedging of the vertebral bodies and intervertebral disks. Sum of vertebral bodies wedging (ΣB) and sum of intervertebral discs wedging (ΣD) were used in analyses. Methods Mean values (±SD) of LA, ΣB and ΣD were calculated in males and females and compared using the t-test. Mean values (±SD) of LA, ΣB and ΣD in 4 age groups: 0.05) with increasing age. LA showed statistically significant association with presence of spondylolysis (OR(95%CI): 1.08(1.02–1.14)) and with density of multifidus (1.06 (1.01–1.11). as well as a marginally significant association with isthmic spondylolisthesis (1.07(1.00–1.14). ΣB showed a positive association with degenerative spondylolisthesis and disc narrowing ((1.14(1.06–1.23) and 1.04 (1.00–1.08), correspondingly), whereas ΣD showed negative one (0.93(0.87–0.98) and (0.93(0.89–0.97), correspondingly). Conclusions Significant associations were found between lumbar lordosis evaluated in supine position

  10. Supination external rotation ankle fractures: A simpler pattern with better outcomes

    Science.gov (United States)

    Tejwani, Nirmal C; Park, Ji Hae; Egol, Kenneth A

    2015-01-01

    Background: Rotational injuries are the most common and usually classified as per the Lauge Hansen classification; with the most common subgroup being the supination external rotation (SER) mechanism. Isolated fractures of the distal fibula (SE2) without associated ligamentous injury are usually treated with a splint or brace and the patient may be allowed to weight bear as tolerated. This study reports the functional outcomes following a stable, low energy, rotational ankle fracture supination external rotation (SER2) when compared to unstable SER4 fractures treated operatively. Materials and Methods: 64 patients who were diagnosed and treated nonoperatively for a stable SER2 ankle fracture were followed prospectively. In the comparison group, 93 operatively treated fibular fractures were extracted from a prospectively collected database and evaluated comparison. Baseline characteristics obtained by trained interviewers at the time of injury included: Patient demographics, short form-36, short musculoskeletal functional assessment (SMFA) and American Orthopedic Foot and Ankle Society (AOFAS) questionnaires. Patients were followed at 3, 6 and 12 months postsurgery. Additional information obtained at each followup point included any complications or evidence on fracture healing. Data were analyzed by the Student's t-test and theFisher's Exact Test to compare demographic and functional outcomes between the two cohorts. P fracture cohort was 43 versus 45 in the SER4 group. Nearly 64% of the patient population was female when compared with 37% in the operative group. In the SER2 by 6 months all patients had returned to baseline functional status. There were 18 delayed unions (all healed by 6 months). Based on the functional outcome scores all patients had returned to preoperative level. In comparison, SE4 patients had less functional recovery at 3 and 6 months (P delayed unions. Conclusions: An SER2 ankle fracture is a relatively benign injury with functional

  11. Sensitivity of bedside ultrasound and supine anteroposterior chest radiographs for the identification of pneumothorax after blunt trauma.

    Science.gov (United States)

    Wilkerson, R Gentry; Stone, Michael B

    2010-01-01

    Supine anteroposterior (AP) chest radiographs in patients with blunt trauma have poor sensitivity for the identification of pneumothorax. Ultrasound (US) has been proposed as an alternative screening test for pneumothorax in this population. The authors conducted an evidence-based review of the medical literature to compare sensitivity of bedside US and AP chest radiographs in identifying pneumothorax after blunt trauma. MEDLINE and EMBASE databases were searched for trials from 1965 through June 2009 using a search strategy derived from the following PICO formulation of our clinical question: patients included adult (18 + years) emergency department (ED) patients in whom pneumothorax was suspected after blunt trauma. The intervention was thoracic ultrasonography for the detection of pneumothorax. The comparator was the supine AP chest radiograph during the initial evaluation of the patient. The outcome was the diagnostic performance of US in identifying the presence of pneumothorax in the study population. The criterion standard for the presence or absence of pneumothorax was computed tomography (CT) of the chest or a rush of air during thoracostomy tube placement (in unstable patients). Prospective, observational trials of emergency physician (EP)-performed thoracic US were included. Trials in which the exams were performed by radiologists or surgeons, or trials that investigated patients suffering penetrating trauma or with spontaneous or iatrogenic pneumothoraces, were excluded. The methodologic quality of the studies was assessed. Qualitative methods were used to summarize the study results. Data analysis consisted of test performance (sensitivity and specificity, with 95% confidence intervals [CIs]) of thoracic US and supine AP chest radiography. Four prospective observational studies were identified, with a total of 606 subjects who met the inclusion and exclusion criteria. The sensitivity and specificity of US for the detection of pneumothorax ranged from

  12. A computerized method for automated identification of erect posteroanterior and supine anteroposterior chest radiographs

    International Nuclear Information System (INIS)

    Kao, E-Fong; Chou, Ming-Chung; Lin, Wei-Chen; Hsu, Jui-Sheng; Jaw, Twei-Shiun; Liu, Gin-Chung

    2011-01-01

    A computerized scheme was developed for automated identification of erect posteroanterior (PA) and supine anteroposterior (AP) chest radiographs. The method was based on three features, the tilt angle of the scapula superior border, the tilt angle of the clavicle and the extent of radiolucence in lung fields, to identify the view of a chest radiograph. The three indices A scapula , A clavicle and C lung were determined from a chest image for the three features. Linear discriminant analysis was used to classify PA and AP chest images based on the three indices. The performance of the method was evaluated by receiver operating characteristic analysis. The proposed method was evaluated using a database of 600 PA and 600 AP chest radiographs. The discriminant performances Az of A scapula , A clavicle and C lung were 0.878 ± 0.010, 0.683 ± 0.015 and 0.962 ± 0.006, respectively. The combination of the three indices obtained an Az value of 0.979 ± 0.004. The results indicate that the combination of the three indices could yield high discriminant performance. The proposed method could provide radiologists with information about the view of chest radiographs for interpretation or could be used as a preprocessing step for analyzing chest images.

  13. Supine craniospinal irradiation in pediatric patients by proton pencil beam scanning.

    Science.gov (United States)

    Farace, Paolo; Bizzocchi, Nicola; Righetto, Roberto; Fellin, Francesco; Fracchiolla, Francesco; Lorentini, Stefano; Widesott, Lamberto; Algranati, Carlo; Rombi, Barbara; Vennarini, Sabina; Amichetti, Maurizio; Schwarz, Marco

    2017-04-01

    Proton therapy is the emerging treatment modality for craniospinal irradiation (CSI) in pediatric patients. Herein, special methods adopted for CSI at proton Therapy Center of Trento by pencil beam scanning (PBS) are comprehensively described. Twelve pediatric patients were treated by proton PBS using two/three isocenters. Special methods refer to: (i) patient positioning in supine position on immobilization devices crossed by the beams; (ii) planning field-junctions via the ancillary-beam technique; (iii) achieving lens-sparing by three-beams whole-brain-irradiation; (iv) applying a movable-snout and beam-splitting technique to reduce the lateral penumbra. Patient-specific quality assurance (QA) program was performed using two-dimensional ion chamber array and γ-analysis. Daily kilovoltage alignment was performed. PBS allowed to obtain optimal target coverage (mean D98%>98%) with reduced dose to organs-at-risk. Lens sparing was obtained (mean D1∼730cGyE). Reducing lateral penumbra decreased the dose to the kidneys (mean Dmean4cm (mean γ>95%) than at depths<4cm. The reported methods allowed to effectively perform proton PBS CSI. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Left ventricular volume during supine exercise: importance of myocardial scar in patients with coronary heart disease

    International Nuclear Information System (INIS)

    Mann, D.L.; Scharf, J.; Ahnve, S.; Gilpin, E.

    1987-01-01

    Existing studies suggest that exercise-induced ischemia produces an increase in left ventricular end-diastolic volume; however, all of these studies have included patients with previous myocardial infarction. To test whether the end-diastolic volume response to exercise is related to the extent of myocardial scar, the results of gated radionuclide supine exercise tests performed on 130 subjects were reviewed. The patient group comprised 130 subjects were reviewed. The patient group comprised 130 men aged 35 to 65 years (mean +/- SD 52 +/- 5) with documented coronary heart disease. The extent of myocardial ischemia and scar formation was assessed by stress electrocardiography and thallium-201 scintigraphy. Patients were classified into three groups on the basis of left ventricular end-diastolic volume response at peak exercise: group 1 (n = 72) had an increase of end-diastolic volume greater than 10%, group 2 (n = 41) had a change in end-diastolic volume less than 10% and group 3 (n = 17) had a decrease in end-diastolic volume greater than 10% (n = 17). At rest there was no significant difference among groups in heart rate, systolic blood pressure, end-diastolic (EDVrest) or end-systolic volumes or ejection fraction (p greater than 0.05); however, at peak exercise the end-systolic volume response was significantly greater for group 1 (p less than 0.002)

  15. A Medial Malleolar "Fleck Sign" May Predict Ankle Instability in Ligamentous Supination External Rotation Ankle Fractures.

    Science.gov (United States)

    Nwosu, Kenneth; Schneiderman, Brian Andrew; Shymon, Stephen Joseph; Harris, Thomas

    2018-06-01

    Ankle joint stability dictates treatment in ligamentous supination external rotation ankle injuries (LSERAI). Investigation of the medial structures that support the ankle mortise is critical, and a small avulsion fracture, or "fleck", of the medial malleolus is occasionally encountered. This study aimed to assess the utility of this medial malleolus fleck sign (MMFS) in diagnosing instability requiring surgery in LSERAI. This retrospective observational study examined 166 LSERAI at a single level I trauma center. A standardized diagnostic and treatment protocol for ankle fractures was followed. LSERAI at presentation were reported as having a normal, dynamically wide, or statically wide medial clear space. Patient demographics, MMFS characteristics, and the use of operative management were recorded. MMFS incidence in the cohort was 16 (10%) of 166 and was present in 25% of patients with unstable LSERAI. Fifteen (94%) of 16 patients with a MMFS were deemed to have an unstable LSERAI (P < .005). MMFS had a 25% sensitivity and 99% specificity in diagnosing an unstable LSERAI. For the subgroup of patients without a statically wide medial clear space, MMFS had a 50% sensitivity and 99% specificity in determining instability. A MMFS may be indicative of an unstable LSERAI. With previous MRI studies demonstrating complete deltoid disruption in unstable LSERAI, we deduce the MMFS may be associated with extensive deltoid incompetence. The MMFS may help to diagnose a complete deltoid injury in LSERAI with a normal medial clear space, which could influence treatment and reduce patient morbidity, radiation exposure, and healthcare costs. Level III: Retrospective Cohort Study.

  16. Supraesophageal Reflux: Correlation of Position and Occurrence of Acid Reflux-Effect of Head-of-Bed Elevation on Supine Reflux.

    Science.gov (United States)

    Scott, David R; Simon, Ronald A

    2015-01-01

    Supraesophageal reflux of gastric contents can contribute to perennial nasopharyngitis, cough, and asthma. However, effective treatment strategies for supraesophageal reflux disease (SERD) remain inadequately defined. The purpose of this study is to assess the prevalence and timing of SERD and to investigate the efficacy of head-of-bed elevation in its treatment. A retrospective chart review of patients seen at Scripps Clinic Division of Allergy, Asthma and Immunology was performed who had undergone overnight nasopharyngeal pH monitoring with a commercially available nasopharyngeal pH-monitoring device, Dx-pH Measurement System from Restech, San Diego, Calif. Subjects with reflux were classified based on the position of reflux as either supine only, upright only, or both supine and upright. In a subset of subjects with supine-only reflux, pH monitoring was compared before and after elevating the head of bed 6 inches. Adequate nasopharyngeal pH-monitoring data were obtained for 235 patients. Reflux was detected in 113 (48%) patients. The pattern of reflux observed was 62 (55%) supine only, 4 (4%) upright only, and 47 (42%) upright and supine. Sequential overnight nasopharyngeal pH monitoring before and after head-of-bed elevation was obtained in 13 individuals with supine-only reflux. Ten subjects demonstrated significant improvement, 8 of whom demonstrated complete resolution of supine reflux with 6 inches of head-of-bed elevation. This study provides new evidence that SERD frequently occurs in the supine position and that 6 inches of head-of-bed elevation is effective in reducing supine SERD. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  17. The predictive value of drug-induced sleep endoscopy for CPAP titration in OSA patients.

    Science.gov (United States)

    Lan, Ming-Chin; Hsu, Yen-Bin; Lan, Ming-Ying; Huang, Yun-Chen; Kao, Ming-Chang; Huang, Tung-Tsun; Chiu, Tsan-Jen; Yang, Mei-Chen

    2017-12-15

    The aim of this study was to identify possible upper airway obstructions causing a higher continuous positive airway pressure (CPAP) titration level, utilizing drug-induced sleep endoscopy (DISE). A total of 76 patients with obstructive sleep apnea (OSA) underwent CPAP titration and DISE. DISE findings were recorded using the VOTE classification system. Polysomnographic (PSG) data, anthropometric variables, and patterns of airway collapse during DISE were analyzed with CPAP titration levels. A significant association was found between the CPAP titration level and BMI, oxygen desaturation index (ODI), apnea-hypopnea index (AHI), and neck circumference (NC) (P CPAP titration level (P CPAP titration level and any other collapse at the tongue base or epiglottis. By analyzing PSG data, anthropometric variables, and DISE results with CPAP titration levels, we can better understand possible mechanisms resulting in a higher CPAP titration level. We believe that the role of DISE can be expanded as a tool to identify the possible anatomical structures that may be corrected by oral appliance therapy or surgical intervention to improve CPAP compliance.

  18. Piperaceae C. Agardh da Estação Experimental Mata do Paraíso, Viçosa, MG Piperaceae C. Agardh from the Experimental Station of "Mata do Paraíso", Viçosa, MG

    Directory of Open Access Journals (Sweden)

    Rita Maria de Carvalho-Okano

    1998-01-01

    Full Text Available Este trabalho consistiu no levantamento dos representantes de Piperaceae na Estação Experimental Mata do Paraíso, no município de Viçosa, MG (20º42'S e 42º55'W, coberta por Floresta Estacionai Semidecidual Montana. No período de março/97 a junho/98 foram realizadas 30 visitas quinzenais à Estação para coleta de material botânico que se encontra depositado no herbário VIC da Universidade Federal de Viçosa. Foram reconhecidos 18 táxons distribuídos nos gêneros Piper L. com 14 espécies, Ottonia Spreng. com três e Pothomorphe Miq. com uma espécie. As espécies mais abundantes foram Piper caldense C.DC., Piper gaudichaudianum Kunth e Piper vicosanum Yunck. São apresentadas chaves para identificação dos gêneros e espécies, descrições, ilustrações e comentários.An inventory of the Piperaceae species was made at the Experimental Station of "Mata do Paraíso" in Viçosa, Minas Gerais State (20º42'S and 42º55'W, an area covered by the Semideciduous Mesophytic Montana Forest. Thirty visits were made fortnightly to the station, from March/1997 to June/1998, in order to collect botanical material which was deposited in the VIC herbarium (Universidade Federal de Viçosa. Eighteen taxa, represented by the genera Piper L. (14 species, Ottonia Spreng (3 species, and Potliotnorplie Miq. (1 species were recognized. The most abundant species were Piper caldense CDC, Piper gaudichaudianum Kunth and Piper vicosanum Yunck. Identification keys for the genera and species as well as species descriptions, illustrations and comments are presented.

  19. Localization of the surgical bed using supine magnetic resonance and computed tomography scan fusion for planification of breast interstitial brachytherapy

    International Nuclear Information System (INIS)

    Jolicoeur, Marjory; Racine, Marie-Lynn; Trop, Isabelle; Hathout, Lara; Nguyen, David; Derashodian, Talar; David, Sandrine

    2011-01-01

    Purpose: To evaluate the feasibility of supine breast magnetic resonance imaging (MR) for definition and localization of the surgical bed (SB) after breast conservative surgery. To assess the inter-observer variability of surgical bed delineation on computed tomography (CT) and supine MR. Materials and methods: Patients candidate for breast brachytherapy and no contra-indications for MR were eligible for this study. Patients were placed in supine position, with the ipsilateral arm above the head in an immobilization device. All patients underwent CT and MR in the same implant/treatment position. Four points were predefined for CT-MRI image fusion. The surgical cavity was drawn on CT then MRI, by three independent observers. Fusion and analysis of CT and MR images were performed using the ECLIPSE treatment planning software. Results: From September 2005 to November 2008, 70 patients were included in this prospective study. For each patient, we were able to acquire axial T1 and T2 images of good quality. Using the predefined fusion points, the median error following the fusion was 2.7 mm. For each observer, volumes obtained on MR were, respectively, 30%, 38% and 40% smaller than those derived from CT images. A highly significant inter-observer variability in the delineation of the SB on CT was demonstrated (p < 0.0001). On the contrary, all three observers agreed on the volume of the SB drawn on MR. Conclusion: Supine breast MRI yields a more precise definition of the SB with a smaller inter-observer variability than CT and may obviate the need for surgical clips. The volume of the SB is smaller with MRI. In our opinion, CT-MRI fusion should be used for SB delineation, in view of partial breast irradiation.

  20. Prospective Assessment of Optimal Individual Position (Prone Versus Supine) for Breast Radiotherapy: Volumetric and Dosimetric Correlations in 100 Patients

    International Nuclear Information System (INIS)

    Lymberis, Stella C.; Wyngaert, John Keith de; Parhar, Preeti; Chhabra, Arpit M.; Fenton-Kerimian, Maria; Chang Jengwha; Hochman, Tsivia; Guth, Amber; Roses, Daniel; Goldberg, Judith D.; Formenti, Silvia C.

    2012-01-01

    Purpose: Damage to heart and lung from breast radiotherapy is associated with increased cardiovascular mortality and lung cancer development. We conducted a prospective study to evaluate which position is best to spare lung and heart from radiotherapy exposure. Methods and Materials: One hundred consecutive Stage 0–IIA breast cancer patients consented to participate in a research trial that required two computed tomography simulation scans for planning both supine and prone positions. The optimal position was defined as that which best covered the contoured breast and tumor bed while it minimized critical organ irradiation, as quantified by the in-field heart and lung volume. The trial was designed to plan the first 100 patients in each position to study correlations between in-field volumes of organs at risk and dose. Results: Fifty-three left and 47 right breast cancer patients were consecutively accrued to the trial. In all patients, the prone position was optimal for sparing lung volume compared to the supine setup (mean lung volume reduction was 93.5 cc for right and 103.6 cc for left breast cancer patients). In 46/53 (87%) left breast cancer patients best treated prone, in-field heart volume was reduced by a mean of 12 cc and by 1.8 cc for the other 7/53 (13%) patients best treated supine. As predicted, supine-prone differences in in-field volume and mean dose of heart and lung were highly correlated (Spearman's correlation coefficient for left breast cancer patients was 0.90 for heart and 0.94 for lung and 0.92 for right breast cancer patients for lung). Conclusions: Prone setup reduced the amount of irradiated lung in all patients and reduced the amount of heart volume irradiated in 87% of left breast cancer patients. In-field organ volume is a valid surrogate for predicting dose; the trial continued to the planned target of 400.

  1. Anthropometric Renal Anatomic Alterations Between Supine and Prone Positions in Percutaneous Renal Ablation for Renal Cortical Neoplasms.

    Science.gov (United States)

    Lusch, Achim; Fujimoto, Scott; Findeiss, Laura K; Okhunov, Zhamshid; McDougall, Elspeth M; Landman, Jaime

    2016-02-01

    To establish patterns of anatomic changes relevant to the kidney and colon during positional change between the supine and prone positions as noted on CT scans performed during percutaneous cryoablation for renal cortical neoplasms (RCN). Nineteen patients undergoing percutaneous cryoablation for RCN with abdominal CT scan in both the supine and prone positions were included in the study. We documented the anterior/posterior, medial/lateral, and cranial/caudal anatomic changes of the kidney, kidney rotation, and the proportion of the kidney whose access was limited by the liver, spleen, and lung. We also calculated the length of the percutaneous access tract and the distance between the colon and kidney in hilar position as well as the anterior/posterior location of the colon relative to the kidney. In the prone position, the kidney lies significantly more anteriorly on both sides: 4.7 cm vs 4.3 cm (L) and 4.4 cm vs 4.1 cm (R) (p = 0.02 and p = 0.03, respectively). On prone CT images, both kidneys are more cranial when compared with the supine position: 80.4 mm vs 60.8 mm (L) and 87.2 mm vs 57.4 mm (R) (p = 0.002 and p anatomic alterations between supine and prone CT imaging. The changes associated with the prone position modify percutaneous access, particularly for right upper pole tumors. Prone imaging before surgery may be helpful in selected cases.

  2. Ultrasound and supine chest radiograph in road traffic accident patients: a reliable and convenient way to diagnose pleural effusion

    International Nuclear Information System (INIS)

    Mumtaz, U.; Zahur, Z.; Raza, M.A.

    2017-01-01

    Background: Portable bed side ultrasound and supine chest radiograph of 80 traumatic patients excluding very clinically unstable patients who subsequently underwent CT scan chest was done for traumatic effusion showing that ultrasound had a higher sensitivity than CXR, 88.23% and 77.94%, respectively, and a similar specificity of 100% and 100%, respectively. Objective of the study is to compare the diagnostic accuracy of high resolution ultrasound and supine chest x-ray in detection of pleural effusion in road traffic accident patients keeping plain CT chest as gold standard. Methods: This study was conducted in PIMS and PAEC General Hospital, Islamabad from 1st January to 15th December 2015. The current study examined total of 80 trauma (blunt and penetrating) patients coming to emergency departments of both hospitals specifically those who had road traffic accident history. Their portable bed side ultrasound and supine chest radiograph were performed for assessing pleural effusion and subsequently CT scan chest was done for confirmation as it's a gold standard. Results: Using CT findings as gold standard the sensitivity, specificity, positive predictive value and negative predictive value was assessed for both ultrasonography and chest radiography and found to be 88.23%,100%, 100%, 40% and 77.94%, 100%, 100%, 55.55% respectively with diagnostic accuracy of ultrasound 90% as compared to 81.25% for supine chest x-rays when compared with gold standard. Conclusion: Ultrasound and chest x-ray can be used as a useful and suitable adjunct to CT in road traffic accident patients as these are easily available, non-invasive, no contrast required, can be performed on bed side and carries no or little radiation risk. (author)

  3. Supine spinal magnetic resonance imaging with straightened lower extremities in spondylolisthesis: A comparison with the conventional technique

    International Nuclear Information System (INIS)

    Daghighi, Mohammad Hossein; Poureisa, Masoud; Arablou, Farid; Fouladi, Daniel F.

    2015-01-01

    Highlights: • MR imaging with straightened lower extremities was tested in spondylolisthesis. • This technique is more accurate than conventional MR imaging in detecting slip. • Level of spondylolisthesis is the only independent predictor of severity of slip. - Abstract: Objectives: To compare the degree of slip in spondylolisthesis on supine magnetic resonance (MR) images obtained with flexed and straightened lower extremities. Methods: Supine spinal MR studies were performed in 100 cases of symptomatic spondylolisthesis with flexed and then straightened lower extremities. The angle of lumbar lordosis (by Cobb's method) and the degree of slip (by Taillard's method) were compared between the two sets of images. Results: The mean angle of lumbar lordosis increased from 51.65 ± 8.57° on MR images with flexed lower limbs to 57.39 ± 9.05° on MR images with straightened lower limbs (p < 0.001; mean percent increase: 11.51%). Similar change was also observed for the mean degree of slip (from 25.80 ± 7.74% to 28.68 ± 7.93%, p < 0.001; mean percent increase: 12.60%). After MR imaging with straightened lower extremities 22 out of 54 initially grade I cases had grade II disease (p < 0.001). Conclusions: Supine magnetic resonance imaging with straightened lower extremities detects higher degree of slippage in symptomatic patients with spondylolisthesis compared to conventional MRI with flexed lower extremities

  4. Supine spinal magnetic resonance imaging with straightened lower extremities in spondylolisthesis: A comparison with the conventional technique

    Energy Technology Data Exchange (ETDEWEB)

    Daghighi, Mohammad Hossein; Poureisa, Masoud; Arablou, Farid [Department of Radiology, Imam Reza Teaching Center, Tabriz University of Medical Sciences, Tabriz (Iran, Islamic Republic of); Fouladi, Daniel F., E-mail: medicorelax@yahoo.com [Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz (Iran, Islamic Republic of)

    2015-05-15

    Highlights: • MR imaging with straightened lower extremities was tested in spondylolisthesis. • This technique is more accurate than conventional MR imaging in detecting slip. • Level of spondylolisthesis is the only independent predictor of severity of slip. - Abstract: Objectives: To compare the degree of slip in spondylolisthesis on supine magnetic resonance (MR) images obtained with flexed and straightened lower extremities. Methods: Supine spinal MR studies were performed in 100 cases of symptomatic spondylolisthesis with flexed and then straightened lower extremities. The angle of lumbar lordosis (by Cobb's method) and the degree of slip (by Taillard's method) were compared between the two sets of images. Results: The mean angle of lumbar lordosis increased from 51.65 ± 8.57° on MR images with flexed lower limbs to 57.39 ± 9.05° on MR images with straightened lower limbs (p < 0.001; mean percent increase: 11.51%). Similar change was also observed for the mean degree of slip (from 25.80 ± 7.74% to 28.68 ± 7.93%, p < 0.001; mean percent increase: 12.60%). After MR imaging with straightened lower extremities 22 out of 54 initially grade I cases had grade II disease (p < 0.001). Conclusions: Supine magnetic resonance imaging with straightened lower extremities detects higher degree of slippage in symptomatic patients with spondylolisthesis compared to conventional MRI with flexed lower extremities.

  5. Measurement of hemothorax amount in patients with non-penetrating chest trauma by supine chest AP radiograph

    International Nuclear Information System (INIS)

    Han, Heon; Yang, Joo Hyun; Na, Myung Hoon; Baik, Hee Jong

    1994-01-01

    To evaluate the predictability of amount of hemothorax in the patients with blunt chest trauma, supine chest AP radiographs of 66 patients were reviewed and statistically analyzed. In 66 patients, rib fractures were present in 53 patients, hemothorax in 46 patients, pneumothorax in 25 patients, and pulmonary contusions in 18 patients. Width and length of hemothorax were measured on supine chest AP radiograph, and were correlated with known drained amount of hemothorax. The presence and number of rib fracture, pulmonary contusion, subcutaneous emphysema, fracture of scapula and clavicle, and total opacification of hemithorax were also correlated with the drained amount of hemothorax. In multiple logistic regression analysis, width of hemothorax had the highest correlation with drained amount of hemothorax(regression coeffcient 0.718, p value 0.00005). The presence and number of rib fracture, scapular fracture, subcutaneous emphysema were also correlated with drained amount of hemothorax. But length of hemothorax, pulmonary contusion, clavicular fracture, total opacification of hemithorax were not correlated with drained amount of hemothorax. Measured width of hemothorax in supine chest AP radiograph is the most reliable predictor for estimation of the amount of hemothorax, and may also be used as an indication for the application of closed thoracostomy in the treatment of hemothorax

  6. Measurement of hemothorax amount in patients with non-penetrating chest trauma by supine chest AP radiograph

    Energy Technology Data Exchange (ETDEWEB)

    Han, Heon; Yang, Joo Hyun; Na, Myung Hoon; Baik, Hee Jong [Chung-Ang Gil Hospital, Incheon (Korea, Republic of)

    1994-10-15

    To evaluate the predictability of amount of hemothorax in the patients with blunt chest trauma, supine chest AP radiographs of 66 patients were reviewed and statistically analyzed. In 66 patients, rib fractures were present in 53 patients, hemothorax in 46 patients, pneumothorax in 25 patients, and pulmonary contusions in 18 patients. Width and length of hemothorax were measured on supine chest AP radiograph, and were correlated with known drained amount of hemothorax. The presence and number of rib fracture, pulmonary contusion, subcutaneous emphysema, fracture of scapula and clavicle, and total opacification of hemithorax were also correlated with the drained amount of hemothorax. In multiple logistic regression analysis, width of hemothorax had the highest correlation with drained amount of hemothorax(regression coeffcient 0.718, p value 0.00005). The presence and number of rib fracture, scapular fracture, subcutaneous emphysema were also correlated with drained amount of hemothorax. But length of hemothorax, pulmonary contusion, clavicular fracture, total opacification of hemithorax were not correlated with drained amount of hemothorax. Measured width of hemothorax in supine chest AP radiograph is the most reliable predictor for estimation of the amount of hemothorax, and may also be used as an indication for the application of closed thoracostomy in the treatment of hemothorax.

  7. SEA LEVEL RISE AND ITS POTENTIAL IMPACTS ON COASTAL URBAN AREA: A CASE OF ETI-OSA, NIGERIA

    Directory of Open Access Journals (Sweden)

    Ayodele Michael AGBOOLA

    2016-10-01

    Full Text Available This study examines the spatial extent of coastal urban development and its potential sensitivity to sea-level rise. The main aim of the study is to critically examine the extent of growth in Eti-Osa over time, and the potential impacts of sea leve rise. Landsat Enhanced Thematic Mapper Plus (ETM+ imageries of years 2000 and 2015 were used to evaluate the different land use type identified. Post-classification change detection method was used to evaluate the output of the maximum likelihood supervised classification analysis done. This was also used to estimate the changes induces through urban development on the environment which accounts for the biodiversity loss. ASTER GDEM 2 imagery of 2011 was used to generate the elevation data used for the inundation analysis. Thus, both Land use map of Eti-Osa in 2015 and the down scaled Sea-level rise scenarios (at 0.5 to 15 meters were used for the inundation mapping. Results obtained from this research affirms that indeed EtiOsa has been subjected to gross urban expansion giving room for diverse forms of environmental degradation among which are huge replacement of natural land cover with built-up, reclamation of wetlands and sand filling of water bodies. This basically illustrates growth but also the risk that accompanies the advent of excessive alteration of natural ecosystem as Sea-level rise projections imply in this research.

  8. Complete supine percutaneous nephrolithotomy with GoPro®. Ten steps for success.

    Science.gov (United States)

    Vicentini, Fabio Carvalho; Dos Santos, Hugo Daniel Barone; Batagello, Carlos Alfredo; Amundson, Julia Rothe; Oliveira, Evaristo Peixoto; Marchini, Giovanni Scala; Srougi, Miguel; Nahas, Willian Carlos; Mazzucchi, Eduardo

    2018-03-15

    To show a video of a complete supine Percutaneous Nephrolithotomy (csPCNL) performed for the treatment of a staghorn calculus, from the surgeon's point of view. The procedure was recorded with a GoPro® camera, demonstrating the ten essential steps for a successful procedure. The patient was a 38 years-old woman with 2.4cm of left kidney lower pole stone burden who presented with 3 months of lumbar pain and recurrent urinary tract infections. She had a previous diagnosis of polycystic kidney disease and chronic renal failure stage 2. CT scan showed two 1.2cm stones in the lower pole (Guy's Stone Score 2). She had a previous ipsilateral double J insertion due to an obstructive pyelonephritis. The csPCNL was uneventful with a single access in the lower pole. The surgeon had a Full HD GoPro Hero 4 Session® camera mounted on his head, controlled by the surgical team with a remote control. All of the mains steps were recorded. Informed consent was obtained prior to the procedure. The surgical time was 90 minutes. Hemoglobin drop was 0.5g/dL. A post-operative CT scan was stone-free. The patient was discharged 36 hours after surgery. The camera worked properly and didn't cause pain or muscle discomfort to the surgeon. The quality of the recorded movie was excellent. GoPro® camera proved to be a very interesting tool to document surgeries without interfering with the procedure and with great educational potential. More studies should be conducted to evaluate the role of this equipment. Copyright® by the International Brazilian Journal of Urology.

  9. Dynamic QT Interval Changes from Supine to Standing in Healthy Children.

    Science.gov (United States)

    Dionne, Audrey; Fournier, Anne; Dahdah, Nagib; Abrams, Dominic; Khairy, Paul; Abadir, Sylvia

    2018-01-01

    QT-interval variations in response to exercise-induced increases in heart rate have been reported in children and adults in the diagnosis of long QT syndrome (LQTS). A quick standing challenge has been proposed as an alternative provocative test in adults, with no pediatric data yet available. A standing test was performed in 100 healthy children (mean age, 9.7 ± 3.1 years) after 10 minutes in a supine position with continuous electrocardiographic recording. QT intervals were measured at baseline, at maximal heart rate, at maximal QT, and at each minute of a 5-minute recovery while standing. Measurements were taken in leads II/V 5 and were corrected for heart rate (QTc). On standing, the heart rate increased by 29 ± 10 beats per minute (bpm). The QT interval was similar at baseline and on standing (394 ± 34 ms vs 394 ± 34 ms; P = 1.0). However, QTc increased from 426 ± 21 to 509 ± 41 ms (P < 0.001). The 95th percentile for QTc at baseline and maximal heart rate was 457 ms and 563 ms, respectively. At 1 minute of recovery, the QT interval was shorter (375 ± 31 ms) compared with baseline (394 ± 34 ms; P < 0.001) and standing (394 ± 34 ms; P < 0.001). QTc reached baseline values after 1 minute of recovery and remained stable thereafter (423 ± 23 ms at 1 minute; 426 ± 22 ms at 5 minutes; P = 1.0). This first characterization of QTc changes on standing in children shows substantial alterations, which are greater than those seen in adults. Two-thirds of the children would have been misclassified as having LQTS by adult criteria, indicating the need to create child-specific standards. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  10. Supine Versus Prone Position During Percutaneous Nephrolithotomy: A Report from the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study

    DEFF Research Database (Denmark)

    G. Vadivia, José; M. Scarpa, Roberto; Duvdevani, Mordechai

    2011-01-01

    To determine differences in patients' characteristics, operative time and procedures, and perioperative outcomes between prone and supine positioning in percutaneous nephrolithotomy (PCNL) using the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study database....

  11. Prior exercise speeds pulmonary oxygen uptake kinetics and increases critical power during supine but not upright cycling.

    Science.gov (United States)

    Goulding, Richie P; Roche, Denise M; Marwood, Simon

    2017-09-01

    What is the central question of this study? Critical power (CP) represents the highest work rate for which a metabolic steady state is attainable. The physiological determinants of CP are unclear, but research suggests that CP might be related to the time constant of phase II oxygen uptake kinetics (τV̇O2). What is the main finding and its importance? We provide the first evidence that τV̇O2 is mechanistically related to CP. A reduction of τV̇O2 in the supine position was observed alongside a concomitant increase in CP. This effect may be contingent on measures of oxygen availability derived from near-infrared spectroscopy. Critical power (CP) is a fundamental parameter defining high-intensity exercise tolerance and is related to the time constant of phase II pulmonary oxygen uptake kinetics (τV̇O2). To test the hypothesis that this relationship is causal, we determined the impact of prior exercise ('priming') on CP and τV̇O2 in the upright and supine positions. Seventeen healthy men were assigned to either upright or supine exercise groups, whereby CP, τV̇O2 and muscle deoxyhaemoglobin kinetics (τ [HHb] ) were determined via constant-power tests to exhaustion at four work rates with (primed) and without (control) priming exercise at ∼31%Δ. During supine exercise, priming reduced τV̇O2 (control 54 ± 18 s versus primed 39 ± 11 s; P exercise had no effect on τV̇O2 (control 37 ± 12 s versus primed 35 ± 8 s; P = 0.82), τ [HHb] (control 10 ± 5 s versus primed 14 ± 10 s; P = 0.10) or CP (control 235 ± 42 W versus primed 232 ± 35 W; P = 0.57) during upright exercise. The concomitant reduction of τV̇O2 and increased CP following priming in the supine group, effects that were absent in the upright group, provide the first experimental evidence that τV̇O2 is mechanistically related to critical power. The increased τ [HHb+Mb] suggests that this effect was mediated, at least in part, by improved oxygen

  12. The importance of neck circumference to thyromental distance ratio (NC/TM as a predictor of difficult intubation in obstructive sleep apnea (OSA patients

    Directory of Open Access Journals (Sweden)

    Hala Ezzat Abdel Naim

    2014-07-01

    Conclusion: Difficult intubation in OSA obese patients was independently associated with a Mallampati score of III or IV, and NC/TM ⩾5.15. Moreover, NC/TM yielded a high sensitivity, specificity and a negative predictive value.

  13. High Adherence to CPAP Treatment Does Not Prevent the Continuation of Weight Gain among Severely Obese OSAS Patients

    Science.gov (United States)

    Myllylä, Minna; Kurki, Samu; Anttalainen, Ulla; Saaresranta, Tarja; Laitinen, Tarja

    2016-01-01

    Study Objectives: Obstructive sleep apnea syndrome (OSAS) patients benefit from continuous positive airway pressure (CPAP) treatment in a dose-response manner. We determined adherence and weight control, as well as their predictors, among long-term CPAP users. Methods: Cohort of 1,023 OSAS patients had used CPAP on average of 6.6 ± 1.2 years. BMI was determined at baseline and at follow-up visits. There were 7.4 ± 1.7 BMI and 6.5 ± 1.8 CPAP usage measurements per patient on average. Using the Bayesian hierarchical model, we determined the patients' individual trends of BMI and adherence development. Patients with significantly increasing or decreasing trends were identified at the posterior probability level of > 90%. Results: The mean age in the cohort was 55.6 ± 9.8 years, BMI 33.5 ± 6.4 kg/m2, apnea-hypopnea index 33.7 ± 23.1, and CPAP usage 6.0 ± 1.8 h/day. The majority of patients had no significant change in BMI (mean annual weight gain 0.04 ± 0.29 kg/m2) or CPAP adherence (mean annual increase 11.4 ± 7.0 min/day). However, at the individual level, 10% of the patients showed significant annual weight gain (0.63 ± 0.35 kg/m2) during the 5-year follow-up period. At baseline these patients were already more severely obese (mean BMI 40.0 ± 5.9 kg/m2) despite being younger (mean 50.9 ± 9.5 years) than the rest of the cohort. Conclusions: In the majority of CPAP-treated OSAS patients, weight did not significantly change but gained slightly slower than in age-matched population in general. However, in 10% of patients, high adherence to CPAP treatment did not prevent the continuation of weight gain. These patients present a high-risk group for OSAS-related multimorbidity later in life. Citation: Myllylä M, Kurki S, Anttalainen U, Saaresranta T, Laitinen T. High adherence to CPAP treatment does not prevent the continuation of weight gain among severely obese OSAS patients. J Clin Sleep Med 2016;12(4):519–528. PMID:26888588

  14. Combined hyperextension and supination of the elbow joint induces lateral ligament lesions. An experimental study of the pathoanatomy and kinematics in elbow ligament injuries

    DEFF Research Database (Denmark)

    Tyrdal, Stein; Olsen, Bo Sanderhoff

    1998-01-01

    An epidemiological study suggested that the injury mechanism of 'handball goalie's elbow' may be hyperextension. The pathomechanics of hyperextension combined with supination was studied in ten macroscopically normal, male, cadaveric elbow joint specimens. The age of the donors was 28.8 years...... rupture of the lateral collateral ligament. The lesions indicate that combined hyperextension and supination represent a possible mechanism leading to 'handball goalie's elbow'....

  15. Slice-based supine-to-standing posture deformation for chinese anatomical models and the dosimetric results with wide band frequency electromagnetic field exposure: Simulation

    International Nuclear Information System (INIS)

    Wu, T.; Tan, L.; Shao, Q.; Li, Y.; Yang, L.; Zhao, C.; Xie, Y.; Zhang, S.

    2013-01-01

    Standing Chinese adult anatomical models are obtained from supine-postured cadaver slices. This paper presents the dosimetric differences between the supine and the standing postures over wide band frequencies and various incident configurations. Both the body level and the tissue/organ level differences are reported for plane wave and the 3T magnetic resonance imaging radiofrequency electromagnetic field exposure. The influence of posture on the whole body specific absorption rate and tissue specified specific absorption rate values is discussed. . (authors)

  16. The 2-Year Cosmetic Outcome of a Randomized Trial Comparing Prone and Supine Whole-Breast Irradiation in Large-Breasted Women

    Energy Technology Data Exchange (ETDEWEB)

    Veldeman, Liv, E-mail: liv.veldeman@uzgent.be [Department of Radiation Oncology, University Hospital Ghent, Ghent (Belgium); Department of Radiotherapy and Experimental Cancer Research, Ghent University, Ghent (Belgium); Schiettecatte, Kimberly; De Sutter, Charlotte; Monten, Christel; Greveling, Annick van [Department of Radiation Oncology, University Hospital Ghent, Ghent (Belgium); Berkovic, Patrick [Department of Radiation Oncology, University Hospital Ghent, Ghent (Belgium); Department of Radiation Oncology, Centre Hospitalier Universitaire de Liège, Liège (Belgium); Mulliez, Thomas [Department of Radiation Oncology, University Hospital Ghent, Ghent (Belgium); De Neve, Wilfried [Department of Radiation Oncology, University Hospital Ghent, Ghent (Belgium); Department of Radiotherapy and Experimental Cancer Research, Ghent University, Ghent (Belgium)

    2016-07-15

    Purpose: To report the 2-year cosmetic outcome of a randomized trial comparing prone and supine whole-breast irradiation in large-breasted patients. Methods and Materials: One hundred patients with a (European) cup size ≥C were included. Before and 2 years after radiation therapy, clinical endpoints were scored and digital photographs were taken with the arms alongside the body and with the arms elevated 180°. Three observers rated the photographs using the 4-point Harvard cosmesis scale. Cosmesis was also evaluated with the commercially available Breast Cancer Conservation Treatment.cosmetic results (BCCT.core) software. Results: Two-year follow-up data and photographs were available for 94 patients (47 supine treated and 47 prone treated). Patient and treatment characteristics were not significantly different between the 2 cohorts. A worsening of color change occurred more frequently in the supine than in the prone cohort (19/46 vs 10/46 patients, respectively, P=.04). Five patients in the prone group (11%) and 12 patients in the supine group (26%) presented with a worse scoring of edema at 2-year follow-up (P=.06). For retraction and fibrosis, no significant differences were found between the 2 cohorts, although scores were generally worse in the supine cohort. The cosmetic scoring by 3 observers did not reveal differences between the prone and supine groups. On the photographs with the hands up, 7 patients in the supine group versus none in the prone group had a worsening of cosmesis of 2 categories using the (BCCT.org) software (P=.02). Conclusion: With a limited follow-up of 2 years, better cosmetic outcome was observed in prone-treated than in supine-treated patients.

  17. Rupture of the Distal Biceps Tendon Combined with a Supinator Muscle Tear in a 51-Year-Old Woman: A Case Report

    OpenAIRE

    Nayyar, Samir; Quirno, Martin; Hasan, Saqib; Rybak, Leon; Meislin, Robert J.

    2011-01-01

    Distal biceps tendon rupture is a relatively uncommon occurrence in the general female population, and to our knowledge, has not been reported in association with a supinator muscle tear. We report a case of 51-year-old woman who experienced sharp pain in her forearm and elbow after lifting a heavy object. History and physical examination raised suspicion for a distal biceps tendon rupture. MRI imaging determined a combined distal biceps tendon tear with a supinator muscle tear with subsequen...

  18. Algunas plantas leñosas del Trapecio Amazónico Colombiano

    Directory of Open Access Journals (Sweden)

    Dugand Armando

    1956-09-01

    Full Text Available La lista de plantas que compone este breve artículo fue confeccionada extrayendo los datos respectivos de la obra "Woods of Northeastern Peru" de Llewelyn Williams, publicada en FIELD MUSEUMOF NATURAL, HISTORY,BOTANICALSERIES, Vol. 15, pp. 1-509; 1936. En dicha obra el señor Williams cataloga -entre muchas otras de distintas regiones de la Amazonia peruana-- un buen numero de plantas leñosas coleccionadas por él en la hacienda "La Victoria", muy cerca de Leticia, haciéndolas figurar como del Perú. Esto se debe a que en la época que Williams visito aquella región hoy colombiana -a mediados de 1929- no se había perfeccionado todavía, o mejor dicho, no se había puesto en práctica (aunque ya estaba promulgado solemnemente el tratado de fronteras entre Colombia y el Perú que puso fin al litigio que estos dos países sostuvieron por más de un siglo sobre una gran parte del territorio selvoso que se extiende entre los ríos Caquetá y Amazonas. Digo que no se había puesto en practica dicho tratado porque, si bien se firmó el 24 de marzo de 1922 y se promulgo el 31 de marzo de 1938, sólo vino a ejecutarse in situ el 17 de agosto de 1930, después de localizada y amojonada la frontera, mediante la formalidad del acto de entrega y de recibo de los territorios que les tocó definitivamente a un país y al otro. Fue, pues, un año después de la visita de Williams a dicha región cuando la bandera y las autoridades colombianas reemplazaron efectivamente a las peruanas en el llamado "Trapecio Amazónico", cuya población principal es Leticia, sobre el rio Amazonas.

  19. Calidad nutricional y digestibilidad in situ de ensilajes de cuatro leñosas forrajeras

    Directory of Open Access Journals (Sweden)

    María Ligia Roa

    Full Text Available Se evaluó el efecto del tiempo de conservación en la calidad nutricional y la digestibilidad in situ de ensilajes de cuatro plantas leñosas forrajeras: Cratylia argentea (T1, Hibiscus rosa-sinensis (T2, Trichanthera gigantea (T3 y Tithonia diversifolia (T4. Las plantas fueron podadas a los seis meses de establecidas y a los tres meses de rebrote, y se utilizaron las hojas y ramas tiernas pequeñas para confeccionar 64 silos de 10 kg, en bolsas plásticas. Cada tiempo de conservación (0, 30, 60 y 90 días tuvo cuatro repeticiones. Para calcular la digestibilidad de la MS, el NT y la FDN y los parámetros de la digestibilidad efectiva (DE, se utilizaron cuatro bovinos fistulados en el rumen, distribuidos en un diseño cuadrado latino 4 x 4. Los ensilajes presentaron aspecto y olor agradables, con pH entre 4,2 y 4,6 y nitrógeno amoniacal menor que 1 %. El porcentaje de NT fue mayor para T1 (2,52 y T2 (2,43, y este nutriente se redujo hasta los 90 días. La DE de la MS, el NT y la FDN fue superior (p < 0,05 en T2, con tendencia a disminuir con el tiempo de conservación (90 días. Este mismo comportamiento presentaron las fracciones A, B y c. El mayor contenido de lignina se resentó en T3 (5,45 % y T4 (5,60 %, indicador que afectó de manera negativa la cinética ruminal. La disminución de la calidad nutricional y la digestibilidad por el tiempo de conservación fue menor para T2 y T3. Se concluye que las propiedades órganolepticas de los ensilajes fueron óptimas, el nitrógeno amoniacal no superó el 1% y el ácido láctico varió entre 1,0 y 3,6 %; mientras que el tiempo afectó en menor grado la composición nutricional del ensilaje de H. rosa-sinensis, con respecto a las otras forrajeras. Se recomienda ensilar para la época de seca y utilizar los ensilajes antes de los 60 días de conservación.

  20. STUDY OF THE SITUATION OF MASS MOVEMENTS IN THE URBAN AREA OF VIÇOSA (MG

    Directory of Open Access Journals (Sweden)

    Fernando Lucci Resende de Souza

    2005-05-01

    Full Text Available The understanding of the relief goes by something larger than the observation at the way, understanding several other factors as climate, soil types and vegetable covering. However, the forms of the relief interfere as one of the main components of the atmosphere,being necessary its knowledge for the understanding of the dynamics of the area research object.The agreement of the relief passes for something more important that the comment of its form, understanding several other factors as climate, soil types and vegetal covering. However, the forms of the relief are inserting as the one of the main components of theenvironment, being necessary its knowledge for the agreement of the dynamic of the area research object.This knowledge is indispensable, because it is impossible to repress the occupation expansion of the spaces and much less to restraint environmental impacts caused by the men and the nature is not capable to regenerate all of the damaged spaces in a short space of time.Many of the inhabited spaces are fruits of segregation, which would be consequence of the exclusion that the effective economical system imposes to the people and spaces. On the other hand, the environmental problems are not correlated only with outlying neighborhoods, but they come very visible in places where constructions of high purchasing power prevail. But, one thing we can do is to prevent, the areas that are not busy, because it is viable naturally,environmentally and less expensive economically speaking. It is in this context, which the study of the mass movements can be of vital importance. The present work seeks to characterize the mass movements that happen in the urban area of Viçosa, with the objective to relate and to compare the rising done in the urban area of the municipal district at the scale 1: 5000 for Vieira in the year of 2000, in order to verify the evolution of the areas studied by the referred author, being analyzed these progressed or some

  1. Desenvolvimento dos frutos de lulo (Solanum quitoense LAM, em Viçosa-MG

    Directory of Open Access Journals (Sweden)

    Pedro Henrique Monteiro Matarazzo

    2013-03-01

    Full Text Available O lulo é um fruto tropical e exótico, originário dos Andes, tem cor laranja quando maduro, e é uma baga globosa, assemelha- se a um tomate, o epicarpo é grosso e coriáceo, sua polpa é verde-clara, pegajosa, ácida e suculenta, contendo muitas sementes. Objetivou-se acompanhar as características físicas, químicas e fisiológicas ocorridas durante o desenvolvimento do fruto de lulo, da antese ao amadurecimento completo, em Viçosa-MG. Os frutos apresentaram um padrão de crescimento sigmoidal simples em resposta à variação do tempo. O desenvolvimento do fruto foi dividido em três fases. A primeira foi até os 7,39 dias após a antese (DAA, sendo caracterizada pela alta taxa respiratória, provavelmente devido à intensa multiplicação celular, e o pericarpo apresentava coloração verde-clara. A segunda fase estendeu-se a partir dos 7,39 até os 57,63 DAA, sendo caracterizada pelas taxas máximas das características estudadas. A taxa respiratória cresceu até 45 DAA, mantendo-se estável até os 52 DAA. A última fase estendeu-se a partir dos 57,63 DAA até os 95,00 DAA. Essa fase foi caracterizada pela estabilização nas dimensões e no acúmulo de massa fresca. Nesse período, ocorreu a ascensão climatérica (dos 52 aos 59 DAA. O climatério respiratório ocorreu aos 66 DAA, com pico de produção de CO2 de 110,99 mg de CO2 kg-1h-1. O pós-climatério ocorreu dos 73 aos 95 DAA, quando houve aumento no teor de sólidos solúveis e queda da acidez titulável e vitamina C da polpa. Nessa fase, o pericarpo dos frutos apresentava-se com coloração alaranjada.

  2. What happens to the triangular fibrocartilage complex during pronation and supination of the forearm? Analysis of its morphology and diagnostic assessment with MR arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Pfirrmann, C.W.A. [Dept. of Radiology, Veterans Administration Medical Center, San Diego, CA (United States); Dept. of Radiology, Orthopedic University Hospital Balgrist, Zurich (Switzerland); Theumann, N.H. [Dept. of Radiology, Veterans Administration Medical Center, San Diego, CA (United States); Service de Radiologie, CHUV, Lausanne (Switzerland); Chung, C.B.; Trudell, D.J.; Resnick, D. [Dept. of Radiology, Veterans Administration Medical Center, San Diego, CA (United States); Botte, M.J. [Div. of Orthopedic Surgery, Scripps Clinic and Research Foundation, La Jolla, CA (United States)

    2001-12-01

    Objective: To evaluate the dynamic morphologic changes of the triangular fibrocartilage complex (TFCC) during pronation and supination of the forearm using high-resolution MR arthrography in cadavers and to evaluate the impact of these changes on the diagnostic assessment of the normal and abnormal TFCC. Design and specimens: High-resolution MR arthrography of 10 wrists of cadaveric specimens was obtained in maximum pronation, in the neutral position, and in maximum supination of the forearm. The structures of the TFCC were evaluated by two musculoskeletal radiologists and correlated with anatomic sections. The position of the forearm that allowed the best visualization of normal structures and lesions of the TFCC was determined. Results: The shape and extent of the articular disc as well as the radial portions of the radioulnar ligaments did not change with pronation and supination. The articular disc was horizontal in the neutral position and tilted more distally to align with the proximal carpal row in pronation and supination. The fibers of the ulnar part of the radioulnar ligaments (ulnar attachment of the articular disc) revealed the most significant changes: their orientation was coronal in the neutral position and sagittal in positions of pronation and supination. The ulnomeniscal homologue was largest in the neutral position and was reduced in size during pronation and supination. The extensor carpi ulnaris tendon was centered in its groove in the neutral position and pronation. In supination this tendon revealed subluxation from this groove. The dorsal capsule of the distal radioulnar joint was taut in pronation, and the palmar capsule was taut in supination. The preferred forearm position for analysis of most of the structures of the TFCC was the neutral position, followed by the pronated position. The neutral position was rated best for the detection of ulnar and radial detachments of the TFCC, followed by the pronated position, except for two central

  3. Design, development, and performance of an adapter for simulation of ocular melanoma patients in supine position for proton beam therapy

    International Nuclear Information System (INIS)

    Daftari, I.; Phillips, T.L.

    2003-01-01

    A patient assembly adapter system for ocular melanoma patient simulation was developed and its performance evaluated. The aim for the construction of the apparatus was to simulate the patients in supine position using a commercial x-ray simulator. The apparatus consists of a base plate, head immobilization holder, patient assembly system that includes fixation light and collimator system. The reproducibility of the repeated fixation was initially tested with a head phantom. Simulation and verification films were studied for seven consecutive patients treated with proton beam therapy. Patient's simulation was performed in a supine position using a dental fixation bite block and a thermoplastic head mask immobilization device with a patient adapter system. Two orthogonal x rays were used to obtain the x, y, and z coordinates of sutured tantalum rings for treatment planning with the EYEPLAN software. The verification films were obtained in treatment position with the fixation light along the central axis of the eye. The results indicate good agreement within 0.5 mm deviations. The results of this investigation showed that the same planning accuracy could be achieved by performing simulation using the adapter described above with a patient in the supine position as that obtained by performing simulation with the patient in the seated, treatment position. The adapter can also be attached to the head of the chair for simulating in the seated position using a fixed x-ray unit. This has three advantages: (1) this will save radiation therapists time; (2) it eliminates the need for arranging access to the treatment room, thus avoiding potential conflicts in treatment room usage; and (3) it allows the use of a commercial simulator

  4. ECIRS (Endoscopic Combined Intrarenal Surgery) in the Galdakao-modified supine Valdivia position: a new life for percutaneous surgery?

    Science.gov (United States)

    Cracco, Cecilia Maria; Scoffone, Cesare Marco

    2011-12-01

    Percutaneous nephrolithotomy (PNL) is still the gold-standard treatment for large and/or complex renal stones. Evolution in the endoscopic instrumentation and innovation in the surgical skills improved its success rate and reduced perioperative morbidity. ECIRS (Endoscopic Combined IntraRenal Surgery) is a new way of affording PNL in a modified supine position, approaching antero-retrogradely to the renal cavities, and exploiting the full array of endourologic equipment. ECIRS summarizes the main issues recently debated about PNL. The recent literature regarding supine PNL and ECIRS has been reviewed, namely about patient positioning, synergy between operators, procedures, instrumentation, accessories and diagnostic tools, step-by-step standardization along with versatility of the surgical sequence, minimization of radiation exposure, broadening to particular and/or complex patients, limitation of post-operative renal damage. Supine PNL and ECIRS are not superior to prone PNL in terms of urological results, but guarantee undeniable anesthesiological and management advantages for both patient and operators. In particular, ECIRS requires from the surgeon a permanent mental attitude to synergy, standardized surgical steps, versatility and adherence to the ongoing clinical requirements. ECIRS can be performed also in particular cases, irrespective to age or body habitus. The use of flexible endoscopes during ECIRS contributes to minimizing radiation exposure, hemorrhagic risk and post-PNL renal damage. ECIRS may be considered an evolution of the PNL procedure. Its proposal has the merit of having triggered the critical analysis of the various PNL steps and of patient positioning, and of having transformed the old static PNL into an updated approach.

  5. Design, development, and performance of an adapter for simulation of ocular melanoma patients in supine position for proton beam therapy

    Science.gov (United States)

    Daftari, I.; Phillips, T. L.

    2003-06-01

    A patient assembly adapter system for ocular melanoma patient simulation was developed and its performance evaluated. The aim for the construction of the apparatus was to simulate the patients in supine position using a commercial x-ray simulator. The apparatus consists of a base plate, head immobilization holder, patient assembly system that includes fixation light and collimator system. The reproducibility of the repeated fixation was initially tested with a head phantom. Simulation and verification films were studied for seven consecutive patients treated with proton beam therapy. Patient's simulation was performed in a supine position using a dental fixation bite block and a thermoplastic head mask immobilization device with a patient adapter system. Two orthogonal x rays were used to obtain the x, y, and z coordinates of sutured tantalum rings for treatment planning with the EYEPLAN software. The verification films were obtained in treatment position with the fixation light along the central axis of the eye. The results indicate good agreement within 0.5 mm deviations. The results of this investigation showed that the same planning accuracy could be achieved by performing simulation using the adapter described above with a patient in the supine position as that obtained by performing simulation with the patient in the seated, treatment position. The adapter can also be attached to the head of the chair for simulating in the seated position using a fixed x-ray unit. This has three advantages: (1) this will save radiation therapists time; (2) it eliminates the need for arranging access to the treatment room, thus avoiding potential conflicts in treatment room usage; and (3) it allows the use of a commercial simulator.

  6. Supine Craniospinal Irradiation Using Intrafractional Junction Shifts and Field-in-Field Dose Shaping: Early Experience at Methodist Hospital

    International Nuclear Information System (INIS)

    South, Michael C.; Chiu, J. Kam; Teh, Bin S.; Bloch, Charles; Schroeder, Thomas M.; Paulino, Arnold C.

    2008-01-01

    Purpose: To describe our preliminary experience with supine craniospinal irradiation. The advantages of the supine position for craniospinal irradiation include patient comfort, easier access to maintain an airway for anesthesia, and reduced variability of the head tilt in the face mask. Methods and Materials: The cranial fields were treated with near lateral fields and a table angle to match their divergence to the superior edge of the spinal field. The collimator was rotated to match the divergence from the superior spinal field. The spinal fields were treated using a source to surface distance (SSD) technique with the couch top at 100 cm. When a second spinal field was required, the table and collimator were rotated 90 o to allow for the use of the multileaf collimator and so the gantry could be rotated to match the divergence of the superior spinal field. The multileaf collimator was used for daily dynamic featherings and field-in-field dose control. Results: With a median follow-up of 20.2 months, five documented failures and no cases of radiation myelitis occurred in 23 consecutive patients. No failures occurred in the junctions of the spine-spine or brain-spine fields. Two failures occurred in the primary site alone, two in the spinal axis alone, and one primary site failure plus distant metastasis. The median time to recurrence was 17 months. Conclusion: The results of our study have shown that supine approach for delivering craniospinal irradiation is not associated with increased relapses at the field junctions. To date, no cases of radiation myelitis have developed

  7. CPAP Adherence is Associated With Attentional Improvements in a Group of Primarily Male Patients With Moderate to Severe OSA.

    Science.gov (United States)

    Deering, Sean; Liu, Lin; Zamora, Tania; Hamilton, Joanne; Stepnowsky, Carl

    2017-12-15

    Obstructive sleep apnea (OSA) is a widespread condition that adversely affects physical health and cognitive functioning. The prevailing treatment for OSA is continuous positive airway pressure (CPAP), but therapeutic benefits are dependent on consistent use. Our goal was to investigate the relationship between CPAP adherence and measures of sustained attention in patients with OSA. Our hypothesis was that the Psychomotor Vigilance Task (PVT) would be sensitive to attention-related improvements resulting from CPAP use. This study was a secondary analysis of a larger clinical trial. Treatment adherence was determined from CPAP use data. Validated sleep-related questionnaires and a sustained-attention and alertness test (PVT) were administered to participants at baseline and at the 6-month time point. Over a 6-month time period, the average CPAP adherence was 3.32 h/night (standard deviation [SD] = 2.53), average improvement in PVT minor lapses was -4.77 (SD = 13.2), and average improvement in PVT reaction time was -73.1 milliseconds (standard deviation = 211). Multiple linear regression analysis showed that higher CPAP adherence was significantly associated with a greater reduction in minor lapses in attention after 6 months of continuous treatment with CPAP therapy (β = -0.72, standard error = 0.34, P = .037). The results of this study showed that higher levels of CPAP adherence were associated with significant improvements in vigilance. Because the PVT is a performance-based measure that is not influenced by prior learning and is not subjective, it may be an important supplement to patient self-reported assessments. Name: Effect of Self-Management on Improving Sleep Apnea Outcomes, URL: https://clinicaltrials.gov/ct2/show/NCT00310310, Identifier: NCT00310310. © 2017 American Academy of Sleep Medicine

  8. A gamma scintigraphic study to compare oesophageal clearance of 'Expidet' formulations, tablets and capsules in supine volunteers

    International Nuclear Information System (INIS)

    Wilson, C.G.; Washington, N.; Norman, S.; Greaves, J.L.

    1988-01-01

    The relative rates of transit through the oesophagus of radiolablled 'Expidet' formulations, tablets, capsules or liquids were measured in 10 healthy supine male and female subjects. The movement of the formulations was followed by gamma scintigraphy. Liquids were observed to clear rapidly in a monoexponential pattern in all subjects. The transit of capsules and tablets in the same subjects was slower and more variable. In two subjects, capsules and tablets were observed to lodge in the lower third of the oesophagus. The 'Expidet' formulations cleared from the mouth with several swallows and there was no evidence of oesophageal adhesion. There was no satistically significant difference in total transmit time between the formulations

  9. Systematic feasibility analysis of a quantitative elasticity estimation for breast anatomy using supine/prone patient postures.

    Science.gov (United States)

    Hasse, Katelyn; Neylon, John; Sheng, Ke; Santhanam, Anand P

    2016-03-01

    Breast elastography is a critical tool for improving the targeted radiotherapy treatment of breast tumors. Current breast radiotherapy imaging protocols only involve prone and supine CT scans. There is a lack of knowledge on the quantitative accuracy with which breast elasticity can be systematically measured using only prone and supine CT datasets. The purpose of this paper is to describe a quantitative elasticity estimation technique for breast anatomy using only these supine/prone patient postures. Using biomechanical, high-resolution breast geometry obtained from CT scans, a systematic assessment was performed in order to determine the feasibility of this methodology for clinically relevant elasticity distributions. A model-guided inverse analysis approach is presented in this paper. A graphics processing unit (GPU)-based linear elastic biomechanical model was employed as a forward model for the inverse analysis with the breast geometry in a prone position. The elasticity estimation was performed using a gradient-based iterative optimization scheme and a fast-simulated annealing (FSA) algorithm. Numerical studies were conducted to systematically analyze the feasibility of elasticity estimation. For simulating gravity-induced breast deformation, the breast geometry was anchored at its base, resembling the chest-wall/breast tissue interface. Ground-truth elasticity distributions were assigned to the model, representing tumor presence within breast tissue. Model geometry resolution was varied to estimate its influence on convergence of the system. A priori information was approximated and utilized to record the effect on time and accuracy of convergence. The role of the FSA process was also recorded. A novel error metric that combined elasticity and displacement error was used to quantify the systematic feasibility study. For the authors' purposes, convergence was set to be obtained when each voxel of tissue was within 1 mm of ground-truth deformation. The authors

  10. Coronary perfusion pressure and compression quality in maternal cardiopulmonary resuscitation in supine and left-lateral tilt positions: A prospective, crossover study using mannequins and swine models.

    Science.gov (United States)

    Dohi, Satoshi; Ichizuka, Kiyotake; Matsuoka, Ryu; Seo, Kohei; Nagatsuka, Masaaki; Sekizawa, Akihiko

    2017-09-01

    The risk of maternal and fetal mortality is high if cardiopulmonary arrest occurs during pregnancy. To assess the best position for maternal cardiopulmonary resuscitation (CPR), a prospective randomized crossover study was undertaken, involving basic life support mannequin-based simulation (BLS-MS) and a swine model of pulseless electrical activity (an unstable cardiac state) incorporating a fetal mannequin (PEA-FM). The BLS-MS (performed by certified rescuers) served to evaluate the quality of chest compressions in 30° left lateral tilt (LLT) and supine positions. Based on a 5-point scale, each rescuer subjectively graded their experience. The PEA-FM model was used to compare coronary perfusion pressure readings during CPR in supine, supine with left uterine displacement, 30° LLT, and 30° right lateral tilt positions. Compression rate and correctness of hand position, compression depth, and recoil were measures of compression quality (BLS-MS). Compared with LLT position, supine position enabled correct hand position (rate: 0.99 vs 0.88; p<0.05) and compression depth (rate: 0.76 vs 0.36; p<0.001) significantly more often. Moreover, BLS-MS rescuers found chest compressions significantly easier to perform with the mannequin in supine (vs LLT) position (difficulty score: 1.75 vs 3.95; p<0.001). In the PEA-FM study arm, supine position with left uterine displacement and right lateral tilt positions had the highest and lowest recorded coronary perfusion pressure readings, respectively. Supine position with left uterine displacement is optimal for maternal CPR. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  11. Older women play predominant role in building social ties and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-08-03

    Aug 3, 2016 ... Older women play predominant role in building social ties and preventing ... brief demonstrates their contribution to building social cohesion and driving ... From learning to policy-oriented research: Lessons from South Africa's ...

  12. Alternated prone and supine whole-breast irradiation using IMRT: setup precision, respiratory movement and treatment time.

    Science.gov (United States)

    Veldeman, Liv; De Gersem, Werner; Speleers, Bruno; Truyens, Bart; Van Greveling, Annick; Van den Broecke, Rudy; De Neve, Wilfried

    2012-04-01

    The objective of this study was to compare setup precision, respiration-related breast movement and treatment time between prone and supine positions for whole-breast irradiation. Ten patients with early-stage breast carcinoma after breast-conserving surgery were treated with prone and supine whole breast-irradiation in a daily alternating schedule. Setup precision was monitored using cone-beam computed tomography (CBCT) imaging. Respiration-related breast movement in the vertical direction was assessed by magnetic sensors. The time needed for patient setup and for the CBCT procedure, the beam time, and the length of the whole treatment slot were also recorded. Random and systematic errors were not significantly different between positions in individual patients for each of the three axes (left-right, longitudinal, and vertical). Respiration-related movement was smaller in prone position, but about 80% of observations showed amplitudes movement was smaller in prone position. The longer treatment slots in prone position can probably be attributed to the higher repositioning need. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Comparison of Organ Location, Morphology, and Rib Coverage of a Midsized Male in the Supine and Seated Positions

    Directory of Open Access Journals (Sweden)

    Ashley R. Hayes

    2013-01-01

    Full Text Available The location and morphology of abdominal organs due to postural changes have implications in the prediction of trauma via computational models. The purpose of this study is to use data from a multimodality image set to devise a method for examining changes in organ location, morphology, and rib coverage from the supine to seated postures. Medical images of a male volunteer (78.6±0.77 kg, 175 cm in three modalities (Computed Tomography, Magnetic Resonance Imaging (MRI, and Upright MRI were used. Through image segmentation and registration, an analysis between organs in each posture was conducted. For the organs analyzed (liver, spleen, and kidneys, location was found to vary between postures. Increases in rib coverage from the supine to seated posture were observed for the liver, with a 9.6% increase in a lateral projection and a 4.6% increase in a frontal projection. Rib coverage area was found to increase 11.7% for the spleen. Morphological changes in the organs were also observed. The liver expanded 7.8% cranially and compressed 3.4% and 5.2% in the anterior-posterior and medial-lateral directions, respectively. Similar trends were observed in the spleen and kidneys. These findings indicate that the posture of the subject has implications in computational human body model development.

  14. Effect of the Stroop test performed in supine position on the heart rate variability in both genders.

    Science.gov (United States)

    Vazan, Rastislav; Filcikova, Diana; Mravec, Boris

    2017-12-01

    The effect of Stroop test (ST)-induced stress on autonomic nervous system activity is often examined via measurement of heart rate variability (HRV). However, HRV may be significantly affected by interfering factors, including vocalization and inappropriate body position. Surprisingly, published studies ignore these issues, so the aim of our study was to test the innovative procedure for correct HRV measurement in individuals exposed to ST. Moreover, we examined possible gender differences in HRV and heart rate (HR) during ST. Healthy participants (21 men, 34 women) were placed in a supine position (no orthostatic activation) and then exposed to a 5 min relaxation period and a 5 min period of computerized ST (no vocalization). We found significant differences in HR and HRV parameters in both genders during ST when compared to relaxation (baseline) values. On the other hand, there were no significant differences in HR and HRV between males and females (except for a higher baseline HR in women). Also, reactivity to ST stress (difference between baseline and ST value) showed no gender differences. In conclusion, when performed in a supine position and without vocalization, the ST induces significant stress-related changes of HR and HRV in both genders, with no gender differences in the magnitude of reaction to ST stress. This experimental procedure can be used for correct examination of mental stress-related changes in the autonomic nervous system, and is particularly useful for examining mixed-gender experimental groups. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Change in Acetabular Cup Orientation From Supine to Standing Position and Its Effect on Wear of Highly Crosslinked Polyethylene.

    Science.gov (United States)

    Teeter, Matthew G; Goyal, Prateek; Yuan, Xunhua; Howard, James L; Lanting, Brent A

    2018-01-01

    The purpose of this study is to measure acetabular cup position and wear of the highly crosslinked polyethylene liner in the supine and standing position for patients at a minimum of 10 years after the operation. A total of 38 patients were recruited at a mean of 12.5 years after the operation. All patients received a single acetabular cup design with a highly crosslinked liner and a 28-mm cobalt-chromium femoral head. Patients underwent supine and standing radiostereometric examinations in which the X-ray sources and detectors were positioned to obtain an anterior-posterior and cross-table lateral radiograph. Acetabular cup position and the three-dimensional wear rate were measured from the radiographs, and outcome scores were recorded for each patient. Anteversion significantly increased (P cup orientation and wear rate in either position. Highly crosslinked polyethylene is a forgiving bearing material. Although adherence to the traditional acetabular position target zone is recommended, ensuring hip stability and consideration of the patient's functional position are also important objectives to consider for the acetabular position. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Ultrasonography as a diagnostic tool in assessing deltoid ligament injury in supination external rotation fractures of the ankle.

    LENUS (Irish Health Repository)

    Henari, Shwan

    2011-10-01

    The medial deltoid ligament is the primary stabilizing structure in the ankle joint following lateral malleolar fracture. However, medial deltoid ligament ruptures are difficult to diagnose using current imaging modalities. We hypothesized that ultrasonography can be used to accurately allow early clinical assessment of ankle fracture stability, thereby negating the need to perform plain film stress views of the acutely injured ankle. This prospective study included 12 patients (age range, 18-72) with supination external rotation fractures requiring operative fixation. Following induction of anesthesia, ultrasonography examination was performed, followed by an arthrogram under fluoroscopic screening. Radiographs, ultrasonography, and arthrographic findings were compared. There was 100% correlation between ultrasonography and arthrogram findings. Ultrasonography accurately diagnosed medial deltoid rupture with a sensitivity of 100% and specificity of 100%. Plain film radiographs of the ankle had a sensitivity of 57.1% and a specificity of 60%. The difference between these was significant (χ(2)=.0091). This study demonstrates diagnostic ultrasonography to be an accurate diagnostic modality in assessing medial deltoid ligament integrity in patients with supination external rotation fractures. It offers the same sensitivity and specificity as arthrography without the need for additional invasive procedures. Its relative ease of use and lack of ionizing radiation make it a potentially useful tool, particularly in a busy trauma service.

  17. Effect of Lumbar Disc Degeneration and Low-Back Pain on the Lumbar Lordosis in Supine and Standing

    DEFF Research Database (Denmark)

    Hansen, Bjarke B; Bendix, Tom; Grindsted, Jacob

    2015-01-01

    STUDY DESIGN: Cross-sectional study. OBJECTIVE: To examine the influence of low-back pain (LBP) and lumbar disc degeneration (LDD) on the lumbar lordosis in weight-bearing positional magnetic resonance imaging (pMRI). SUMMARY OF BACKGROUND DATA: The lumbar lordosis increases with a change...... of position from supine to standing and is known as an essential contributor to dynamic changes. However, the lordosis may be affected by disc degeneration and pain. METHODS: Patients with LBP >40 on a 0 to 100 mm Visual Analog Scale (VAS) both during activity and rest and a sex and age-decade matching...... control group without LBP were scanned in the supine and standing position in a 0.25-T open MRI unit. LDD was graded using Pfirrmann's grading-scale. Subsequently, the L2-to-S1 lumbar lordosis angle (LA) was measured. RESULTS: Thirty-eight patients with an average VAS of 58 (±13.8) mm during rest and 75...

  18. Supine MRI for regional breast radiotherapy: imaging axillary lymph nodes before and after sentinel-node biopsy

    Science.gov (United States)

    van Heijst, Tristan C. F.; Eschbach-Zandbergen, Debora; Hoekstra, Nienke; van Asselen, Bram; Lagendijk, Jan J. W.; Verkooijen, Helena M.; Pijnappel, Ruud M.; de Waard, Stephanie N.; Witkamp, Arjen J.; van Dalen, Thijs; Desirée van den Bongard, H. J. G.; Philippens, Marielle E. P.

    2017-08-01

    Regional radiotherapy (RT) is increasingly used in breast cancer treatment. Conventionally, computed tomography (CT) is performed for RT planning. Lymph node (LN) target levels are delineated according to anatomical boundaries. Magnetic resonance imaging (MRI) could enable individual LN delineation. The purpose was to evaluate the applicability of MRI for LN detection in supine treatment position, before and after sentinel-node biopsy (SNB). Twenty-three female breast cancer patients (cTis-3N0M0) underwent 1.5 T MRI, before and after SNB, in addition to CT. Endurance for MRI was monitored. Axillary levels were delineated. LNs were identified and delineated on MRI from before and after SNB, and on CT, and compared by Wilcoxon signed-rank tests. LN locations and LN-based volumes were related to axillary delineations and associated volumes. Although postoperative effects were visible, LN numbers on postoperative MRI (median 26 LNs) were highly reproducible compared to preoperative MRI when adding excised sentinel nodes, and higher than on CT (median 11, p  <  0.001). LN-based volumes were considerably smaller than respective axillary levels. Supine MRI of LNs is feasible and reproducible before and after SNB. This may lead to more accurate RT target definition compared to CT, with potentially lower toxicity. With the MRI techniques described here, initiation of novel MRI-guided RT strategies aiming at individual LNs could be possible.

  19. Influence of heart rate in nonlinear HRV indices as a sampling rate effect evaluated on supine and standing

    Directory of Open Access Journals (Sweden)

    Juan Bolea

    2016-11-01

    Full Text Available The purpose of this study is to characterize and attenuate the influence of mean heart rate (HR on nonlinear heart rate variability (HRV indices (correlation dimension, sample and approximate entropy as a consequence of being the HR the intrinsic sampling rate of HRV signal. This influence can notably alter nonlinear HRV indices and lead to biased information regarding autonomic nervous system (ANS modulation.First, a simulation study was carried out to characterize the dependence of nonlinear HRV indices on HR assuming similar ANS modulation. Second, two HR-correction approaches were proposed: one based on regression formulas and another one based on interpolating RR time series. Finally, standard and HR-corrected HRV indices were studied in a body position change database.The simulation study showed the HR-dependence of non-linear indices as a sampling rate effect, as well as the ability of the proposed HR-corrections to attenuate mean HR influence. Analysis in a body position changes database shows that correlation dimension was reduced around 21% in median values in standing with respect to supine position (p < 0.05, concomitant with a 28% increase in mean HR (p < 0.05. After HR-correction, correlation dimension decreased around 18% in standing with respect to supine position, being the decrease still significant. Sample and approximate entropy showed similar trends.HR-corrected nonlinear HRV indices could represent an improvement in their applicability as markers of ANS modulation when mean HR changes.

  20. [Treatment compliance with continuous positive airway pressure device among adults with obstructive sleep apnea (OSA): how many adhere to treatment?].

    Science.gov (United States)

    Sarrell, E Michael; Chomsky, Ofer; Shechter, Dalia

    2013-03-01

    Obstructive sleep apnea syndrome (OSA) afflicts approximately 5% of the adult population and increases with age. The gold standard treatment is with the Continuous Positive Airways Pressure (CPAP) machine. Well-designed prospective trials to elucidate long term compliance with CPAP machine are rare. Assessing compliance and long-term use of CPAP machines among patients with OSA who were referred for treatment with this machine. A 4 years prospective cohort observational study was conducted using telephone interviews of 371 newly diagnosed patients with moderate to severe OSA, who received a specialist recommendation to use the CPAP machine which was bought and adjusted to their use. At the end of the first year, 126 (34%) of the OSA patients used the CPAP machine on a nightly basis (regular users), 120 (32.3%) had not used it at all, and 125 (33.7%) had used it only intermittently. The number of regular users increased between the 1st and 2nd year from 126 (34%), to 163 (44%) (p < 0.07) due to additions from the intermittent users group. The non-users group grew from 120 (32.3%) in the first year, and every year afterwards, up to 221 (59.6%) in the fourth year (p < 0.02). In contrast, there was a significant decrease in the intermittent users group, which declined from 125 (33.7%) in the first year to only 18 (4.8%) in the 4th year (p < 0.005). Most of the patients (92.9%) were males. The average age of the regular users was 59.6 years (+/- 11), which was higher in comparison to 55.9 years (+/- 10.3) for the non-users or 58.9 years (+/- 12.6) among the intermittent users (p = 0.064). There were no statistical differences in co-morbidities or demographics between the three groups. However, the regular users were found to have a higher score in the Epworth Sleepiness Scale (ESS) and a minimal arterial oxygen saturation (SaO2) level lower than the patients in the non-users and intermittent users groups (p = 0.019 and p = 0.03 respectively). Four years follow

  1. Improving PTSD Symptoms and Preventing Progression of Subclinical PTSD to an Overt Disorder by Treating Comorbid OSA With CPAP.

    Science.gov (United States)

    Ullah, M I; Campbell, Douglas G; Bhagat, Rajesh; Lyons, Judith A; Tamanna, Sadeka

    2017-10-15

    Obstructive sleep apnea (OSA) and posttraumatic stress disorder (PTSD) are common in United States veterans. These conditions often coexist and symptoms overlap. Previous studies reported improvement in PTSD symptoms with continuous positive airway pressure (CPAP) therapy for comorbid OSA but its effect has not been assessed in a non-PTSD cohort. We have prospectively assessed the effect of CPAP therapy on clinical symptom improvement as a function of CPAP compliance levels among PTSD and non-PTSD veterans. Veterans in whom OSA was newly diagnosed were enrolled in our study (n = 192). Assignment to PTSD and non-PTSD cohorts was determined by chart review. Each patient completed the military version of the PTSD Checklist (PCL), Epworth Sleepiness Scale (ESS), and reported nightmare frequency (NMF) at baseline and 6 months after CPAP therapy. CPAP adherence was objectively documented from machine compliance data. We had complete data for 177 veterans (PTSD n = 59, non-PTSD n = 118) for analysis. The mean ages were 51.24 years in the PTSD cohort and 52.36 years in the non-PTSD cohort ( P = .30). In the PTSD cohort, the mean total PCL score (baseline = 66.06, post-CPAP = 61.27, P = .004, d = -0.34) and NMF (baseline = 4.61, post-CPAP = 1.49, P = .0001, d = -0.51) decreased after 6 months of CPAP treatment. Linear regression analysis showed that the CPAP compliance was the only significant predictor for these changes among veterans with PTSD (PCL score: P = .033, R 2 = .65; NMF; P = .03, R 2 = .61). Further analysis by CPAP compliance quartiles in this cohort (Q1 = 0% to 25%, Q2 = 26% to 50%, Q3 = 51% to 75%, Q4 > 75%) revealed that mean total PCL score declined in Q2 (change = -3.91, P = .045, d = 0.43), Q3 (change = -6.6, P = .002, d = 0.59), and Q4 (change = -7.94, P = .037, d = 0.49). In the non-PTSD cohort, the PCL score increased despite CPAP therapy in lower CPAP compliance quartiles Q1 (change = 8.71, P = .0001, d = 0.46) and Q2 (change = 4.51, P = .046, d = 0

  2. Inverse correlation between the standard deviation of R-R intervals in supine position and the simplified menopausal index in women with climacteric symptoms.

    Science.gov (United States)

    Yanagihara, Nobuyuki; Seki, Meikan; Nakano, Masahiro; Hachisuga, Toru; Goto, Yukio

    2014-06-01

    Disturbance of autonomic nervous activity has been thought to play a role in the climacteric symptoms of postmenopausal women. This study was therefore designed to investigate the relationship between autonomic nervous activity and climacteric symptoms in postmenopausal Japanese women. The autonomic nervous activity of 40 Japanese women with climacteric symptoms and 40 Japanese women without climacteric symptoms was measured by power spectral analysis of heart rate variability using a standard hexagonal radar chart. The scores for climacteric symptoms were determined using the simplified menopausal index. Sympathetic excitability and irritability, as well as the standard deviation of mean R-R intervals in supine position, were significantly (P standard deviation of mean R-R intervals in supine position and the simplified menopausal index score. The lack of control for potential confounding variables was a limitation of this study. In climacteric women, the standard deviation of mean R-R intervals in supine position is negatively correlated with the simplified menopausal index score.

  3. Slice-based supine to standing postured deformation for chinese anatomical models and the dosimetric results by wide band frequency electromagnetic field exposure: Morphing

    International Nuclear Information System (INIS)

    Wu, T.; Tan, L.; Shao, Q.; Li, Y.; Yang, L.; Zhao, C.; Xie, Y.; Zhang, S.

    2013-01-01

    Digital human models are frequently obtained from supine-postured medical images or cadaver slices, but many applications require standing models. This paper presents the work of reconstructing standing Chinese adult anatomical models from supine postured slices. Apart from the previous studies, the deformation works on 2-D segmented slices. The surface profile of the standing posture is adjusted by population measurement data. A non-uniform texture amplification approach is applied on the 2-D slices to recover the skin contour and to redistribute the internal tissues. Internal organ shift due to postures is taken into account. The feet are modified by matrix rotation. Then, the supine and standing models are utilised for the evaluation of electromagnetic field exposure over wide band frequency and different incident directions. . (authors)

  4. A randomised trial of Supine versus Prone breast radiotherapy (SuPr study): Comparing set-up errors and respiratory motion

    International Nuclear Information System (INIS)

    Kirby, Anna M.; Evans, Philip M.; Helyer, Sarah J.; Donovan, Ellen M.; Convery, Helen M.; Yarnold, John R.

    2011-01-01

    Purpose: To test a prone position against the international-standard supine position in women undergoing whole-breast-radiotherapy (WBRT) after wide-local-excision (WLE) of early breast cancer (BC) in terms of feasibility, set-up errors, and respiratory motion. Methods: Following WLE of BC with insertion of tumour-bed clips, patients underwent 4D-CT for WBRT-planning in supine and prone positions (the latter using an in-house-designed platform). Patients were randomised to undergo WBRT fractions 1-7 in one position, switching to the alternate position for fractions 8-15 (40 Gy/15-fractions total). Cone-beam CT-images (CBCT) were acquired prior to fractions 1, 4, 7, 8, 11 and 14. CBCT data were matched to planning-CT data using (i) chest-wall and (ii) clips. Systematic and random errors were calculated. Maximal displacement of chest-wall and clips with respiration was measured on 4D-CT. Clinical- to planning-target-volume (CTV-PTV) margins were calculated. Patient-comfort-scores and treatment-times were evaluated. Results: Twenty-five patients were randomized. 192/192 (100%) planned supine fractions and 173/192 (90%) prone fractions were completed. 3D population systematic errors were 1.3-1.9 mm (supine) and 3.1-4.3 mm (prone) (p = 0.02) and random errors 2.6-3.2 mm (supine) and 3.8-5.4 mm (prone) (p = 0.02). Prone positioning reduced chest-wall and clip motion (0.5 ± 0.2 mm (prone) versus 2.7 ± 0.5 mm (supine) (p < 0.001)) with respiration. Calculated CTV-PTV margins were greater for prone (12-16 mm) than for supine treatment (10 mm). Patient-comfort-scores and treatment times were comparable (p = 0.06). Conclusions: Set-up errors were greater using our prone technique than for our standard supine technique, resulting in the need for larger CTV-PTV margins in the prone position. Further work is required to optimize the prone treatment-platform and technique before it can become a standard treatment option at our institution.

  5. Rupture of the Distal Biceps Tendon Combined with a Supinator Muscle Tear in a 51-Year-Old Woman: A Case Report

    Directory of Open Access Journals (Sweden)

    Samir Nayyar

    2011-01-01

    Full Text Available Distal biceps tendon rupture is a relatively uncommon occurrence in the general female population, and to our knowledge, has not been reported in association with a supinator muscle tear. We report a case of 51-year-old woman who experienced sharp pain in her forearm and elbow after lifting a heavy object. History and physical examination raised suspicion for a distal biceps tendon rupture. MRI imaging determined a combined distal biceps tendon tear with a supinator muscle tear with subsequent confirmation at surgery. Surgical repair was performed for the distal biceps tendon only through a single incision approach using the Endobutton technique.

  6. Comparison of Lumbar Lordosis in Lateral Radiographs in Standing Position with supine MR Imaging in consideration of the Sacral Slope.

    Science.gov (United States)

    Benditz, Achim; Boluki, Daniel; Weber, Markus; Zeman, Florian; Grifka, Joachim; Völlner, Florian

    2017-03-01

    Purpose  To investigate the influence of sacral slope on the correlation between measurements of lumbar lordosis obtained by standing radiographs and magnetic resonance images in supine position (MRI). Little information is available on the correlation between measurements of lumbar lordosis obtained by radiographic and MR images. Most relevant studies have shown correlations for the thoracic spine, but detailed analyses on the lumbar spine are lacking. Methods  MR images and standing lateral radiographs of 63 patients without actual low back pain or radiographic pathologies of the lumbar spine were analyzed. Standing radiographic measurements included the sagittal parameters pelvic incidence (PI) pelvic tilt (PT), and sacral slope (SS); MR images were used to additionally measure lumbar L1-S1 lordosis and single level lordosis. Differences between radiographic and MRI measurements were analyzed and divided into 4 subgroups of different sacral slope according to Roussouly's classification. Results  Global lumbar lordosis (L1-S1) was 44.99° (± 10 754) on radiographs and 47.91° (± 9.170) on MRI, yielding a clinically relevant correlation (r = 0.61, p lordosis only showed minor differences. At all levels except for L5 / S1, lordosis measured by means of standing radiographs was higher than that measured by MRI. The difference in global lumbar L1-S1 lordosis was -2.9°. Analysis of the Roussouly groups showed the largest difference for L1-S1 (-8.3°) in group 2. In group 4, when measured on MRI, L5 / S1 lordosis (25.71°) was lower than L4 / L5 lordosis (27.63°) compared to the other groups. Conclusions  Although measurements of global lumbar lordosis significantly differed between the two scanning technologies, the mean difference was just 2.9°. MRI in supine position may be used for estimating global lumbar lordosis, but single level lordosis should be determined by means of standing radiographs. Key Points   · Large

  7. Treatment of Medial Malleolus or Pure Deltoid Ligament Injury in Patients with Supination-External Rotation Type IV Ankle Fractures.

    Science.gov (United States)

    Wang, Xu; Zhang, Chao; Yin, Jian-Wen; Wang, Chen; Huang, Jia-Zhang; Ma, Xin; Wang, Cheng-Wei; Wang, Xue

    2017-02-01

    To investigate the effect of internal fixation on postoperative ankle function in patients with supination-external rotation type IV ankle fractures, including medial malleolus fractures and deltoid ligament injury. Between January 2012 and June 2014, patients with medial structure injuries were enrolled in this study and assigned to the medial malleolus fracture group or the deltoid ligament group. The surgical procedures for the two groups were documented. The follow-up endpoint was the time point when the steel plate or screw was removed from the lateral ankle. The Olerud-Molander ankle scoring system was used to assess ankle function. A total of 84 patients with supination-external rotation type IV ankle fractures had complete medical records and were included in this study. The average age of the patients was 44.16 years (range, 15-75). The patient sample included 39 males and 45 females. Overall, 49 patients (19 males and 30 females) suffered a medial malleolus fracture. The average age of these patients was 40.20 years (range, 15-75). Patients with a posterior malleolar fracture fragment >25% of the articular surface accounted for 81.6% (40 patients) of these patients. Overall, 35 patients (20 males and 15 females) experienced a deltoid ligament injury. The average age of these patients was 44.21 years (range, 17-73). Patients with a posterior malleolar fracture fragment >25% of the articular surface accounted for 11.5% (four patients) of these patients. Open reduction was performed in patients with medial malleolus fractures, and two 4.0-mm cannulated screws were used to fixate the posterior malleolus and the medial malleolus. The suture-anchor technique was used to repair the ligaments in patients with deltoid ligament injuries. The follow-up endpoint was the time point when the steel plate and screws were removed from the lateral ankle in patients. The average follow-up period was 13.4 months (range, 11-17). The Olerud-Molander ankle scoring system was

  8. Assessment and characterization of joineries in the city of Viçosa, MG/ Diagnóstico e caracterização das marcenarias na cidade de Viçosa, MG

    Directory of Open Access Journals (Sweden)

    José de Castro Silva

    2008-07-01

    Full Text Available The forestry sector is not only formed by large companies, such as pulp and paper or reconstituted panels, but also by small businesses, and often strictly family businesses, as joineries. This study aimed to identify, assess and characterize joineries in Viçosa, Minas Gerais. The object of study was limited to the city’s joinery businesses, mainly the ones belonging to the former Joiner’s Association. A questionnaire was drawn up to obtain information on the used wood, internal management and employee training, machinery, products, market, product advertising and prospects for the sector. It was found that both entrepreneurs and workers have low educational level and lack their own product design. They were producing only ordered products with intensive use of solid wood particularly from native forests. Products were heterogeneous, ranging from furniture to farm utilities. Competition, mainly the informal, represented the biggest obstacle to sector development, as well as serialized products from other locations sold in shops at lower prices. It was concluded that the joinery sector in Viçosa needs greater skill levels, both technical and managerial, to improve the activity. Moreover, the sector needs better organization through associations and support of agencies such as local Sebrae, and wider product advertising targeting consumers in the region.O setor florestal não é constituído apenas por grandes empresas, como as de celulose e papel ou de painéis reconstituídos, mas também por pequenas empresas, muitas das vezes estritamente familiares, como as marcenarias. O presente trabalho teve por objetivo a identificação, diagnóstico e caracterização das marcenarias de Viçosa, Estado de Minas Gerais. Delimitaram-se, como objeto de estudo, as empresas de marcenaria da cidade, principalmente, pertencentes ao antigo Núcleo de Marceneiros. Elaborou-se um questionário para buscar informações sobre a madeira utilizada

  9. Communication Apprehension among Black Students on Predominantly White Campuses.

    Science.gov (United States)

    Byrd, Marquita L.; Sims, Anntarie L.

    1987-01-01

    A study of 114 Black undergraduates in two predominantly White midwestern universities demonstrates that communication apprehension (CA) among Blacks appears to be an audience-based phenomenon. Black females scored lower than Black males on the Personal Report of Communication Apprehension-24 (PRCA-24). The higher the CA score, the higher the…

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

    Science.gov (United States)

    Kris, M G; Yeh, S D; Gralla, R J; Young, C W

    1986-01-01

    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.

  11. Genome-Wide Association Study of Orthostatic Hypotension and Supine-Standing Blood Pressure Changes in Two Korean Populations

    Directory of Open Access Journals (Sweden)

    Kyung-Won Hong

    2013-09-01

    Full Text Available Orthostatic hypotension (OH is defined by a 20-mm Hg difference of systolic blood pressure (dtSBP and/or a 10-mm Hg difference of diastolic blood pressure (dtDBP between supine and standing, and OH is associated with a failure of the cardiovascular reflex to maintain blood pressure on standing from a supine position. To understand the underlying genetic factors for OH traits (OH, dtSBP, and dtDBP, genome-wide association studies (GWASs using 333,651 single nucleotide polymorphisms (SNPs were conducted separately for two population-based cohorts, Ansung (n = 3,173 and Ansan (n = 3,255. We identified 8 SNPs (5 SNPs for dtSBP and 3 SNPs for dtDBP that were repeatedly associated in both the Ansung and Ansan cohorts and had p-values of <1 × 10-5 in the meta-analysis. Unfortunately, the SNPs of the OH case control GWAS did not pass our p-value criteria. Four of 8 SNPs were located in the intergenic region of chromosome 2, and the nearest gene (CTNNA2 was located at 1 Mb of distance. CTNNA2 is a linker between cadherin adhesion receptors and the actin cytoskeleton and is essential for stabilizing dendritic spines in rodent hippocampal neurons. Although there is no report about the function in blood pressure regulation, hippocampal neurons interact primarily with the autonomic nervous system and might be related to OH. The remaining SNPs, rs7098785 of dtSBP trait and rs6892553, rs16887217, and rs4959677 of dtDBP trait were located in the PIK3AP1 intron, ACTBL2-3' flanking, STAR intron, and intergenic region, respectively, but there was no clear functional link to blood pressure regulation.

  12. Comparison of lumbar lordosis in lateral radiographs in standing position with supine MR imaging in consideration of the sacral slope

    International Nuclear Information System (INIS)

    Benditz, Achim; Boluki, Daniel; Weber, Markus; Grifka, Joachim; Voellner, Florian; Zeman, Florian

    2017-01-01

    To investigate the influence of sacral slope on the correlation between measurements of lumbar lordosis obtained by standing radiographs and magnetic resonance images in supine position (MRI). Little information is available on the correlation between measurements of lumbar lordosis obtained by radiographic and MR images. Most relevant studies have shown correlations for the thoracic spine, but detailed analyses on the lumbar spine are lacking. MR images and standing lateral radiographs of 63 patients without actual low back pain or radiographic pathologies of the lumbar spine were analyzed. Standing radiographic measurements included the sagittal parameters pelvic incidence (PI) pelvic tilt (PT), and sacral slope (SS); MR images were used to additionally measure lumbar L1-S1 lordosis and single level lordosis. Differences between radiographic and MRI measurements were analyzed and divided into 4 subgroups of different sacral slope according to Roussouly's classification. Global lumbar lordosis (L1-S1) was 44.99 (± 10754) on radiographs and 47.91 (±9.170) on MRI, yielding a clinically relevant correlation (r = 0.61, p < 0.01). Measurements of single level lordosis only showed minor differences. At all levels except for L5 / S1, lordosis measured by means of standing radiographs was higher than that measured by MRI. The difference in global lumbar L1-S1 lordosis was -2.9 . Analysis of the Roussouly groups showed the largest difference for L1-S1 (-8.3 ) in group 2. In group 4, when measured on MRI, L5 / S1 lordosis (25.71 ) was lower than L4 / L5 lordosis (27.63 ) compared to the other groups. Although measurements of global lumbar lordosis significantly differed between the two scanning technologies, the mean difference was just 2.9 . MRI in supine position may be used for estimating global lumbar lordosis, but single level lordosis should be determined by means of standing radiographs.

  13. Comparison of lumbar lordosis in lateral radiographs in standing position with supine MR imaging in consideration of the sacral slope

    Energy Technology Data Exchange (ETDEWEB)

    Benditz, Achim; Boluki, Daniel; Weber, Markus; Grifka, Joachim; Voellner, Florian [Regensburg Univ. Medical Center (Germany). Orthopedic Surgery; Zeman, Florian [Regensburg Univ. Medical Center (Germany). Center for Clinical Studies

    2017-03-15

    To investigate the influence of sacral slope on the correlation between measurements of lumbar lordosis obtained by standing radiographs and magnetic resonance images in supine position (MRI). Little information is available on the correlation between measurements of lumbar lordosis obtained by radiographic and MR images. Most relevant studies have shown correlations for the thoracic spine, but detailed analyses on the lumbar spine are lacking. MR images and standing lateral radiographs of 63 patients without actual low back pain or radiographic pathologies of the lumbar spine were analyzed. Standing radiographic measurements included the sagittal parameters pelvic incidence (PI) pelvic tilt (PT), and sacral slope (SS); MR images were used to additionally measure lumbar L1-S1 lordosis and single level lordosis. Differences between radiographic and MRI measurements were analyzed and divided into 4 subgroups of different sacral slope according to Roussouly's classification. Global lumbar lordosis (L1-S1) was 44.99 (± 10754) on radiographs and 47.91 (±9.170) on MRI, yielding a clinically relevant correlation (r = 0.61, p < 0.01). Measurements of single level lordosis only showed minor differences. At all levels except for L5 / S1, lordosis measured by means of standing radiographs was higher than that measured by MRI. The difference in global lumbar L1-S1 lordosis was -2.9 . Analysis of the Roussouly groups showed the largest difference for L1-S1 (-8.3 ) in group 2. In group 4, when measured on MRI, L5 / S1 lordosis (25.71 ) was lower than L4 / L5 lordosis (27.63 ) compared to the other groups. Although measurements of global lumbar lordosis significantly differed between the two scanning technologies, the mean difference was just 2.9 . MRI in supine position may be used for estimating global lumbar lordosis, but single level lordosis should be determined by means of standing radiographs.

  14. The possibility of access to the kidneys from posterior axillary line in supine position for percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Ali Tabibi

    2013-11-01

    Full Text Available Please cite this article as: Tabibi A, Kashi AH, Mirjalili SAM, Mahmoudnejad N, Kashani P, Salavatipour B, Soltani MH. The possibility of access to the kidneys from posterior axillary line in supine position for percutaneous nephrolithotomy. Novel Biomed 2013;1(2:43-47.Objectives: To evaluate the possibility of access to the kidneys from posterior axillary line (PAL in supine position for percutaneous nephrolithotomy.Materials and Methods: 102 consecutive patients who were candidated for abdominal CT scan, enrolled in this study. In cases of impossible access, the point on the posterior surface of body which permitted safe access was determined and the percent of movement toward body midline (relative to PAL was calculated (M.PER.Results: Percutaneous access was simulated from upper and middle calyces of the kidney in 13% and 75% of cases, respectively. Access to the lower region was possible in 90% of right and 79% of left lower calyces, respectively (p=0.03. In cases with impossible access from PAL, the M.PER for a safe access was 46-47% for upper region and 34- 38% for middle and lower calyces of the kidney (P = 0.0001.Conclusions: Access to upper calyces from PAL was limited in some cases regarding to the presence of solid organs. Presence of colon made access impossible in the lower right and left calyces in about 10% and 20% of cases, respectively. In upper region, more deviation toward midline was necessary to establish a safe access compared with middle and lower calyces.

  15. Comparison of the outcomes of complete supine percutaneous nephrolithotomy in patients with radiopaque and radiolucent kidney stones.

    Science.gov (United States)

    Falahatkar, Siavash; Mokhtari, Gholamreza; Amin, Atiyeh; Kazemnezhad, Ehsan; Esmaeili, Samaneh; Herfeh, Nadia Rastjou; Falahatkar, Reza

    2017-12-01

    This study compared the stone opacity effect in patients who had radiopaque and radiolucent stones in percutaneous nephrolithotomy (PCNL) results. The medical records of 171 complete supine PCNL procedures were gathered. Patients were categorized into two groups: those with radiopaque (n=141) and those with radiolucent (n=30) stones. Kidney, ureter and bladder x-ray was done a day after PCNL and Ultrasound imaging was done two weeks later to evaluate the stone free rate. A stone free result was defined as having less than 4 mm residual stone size. Outcome parameters were compared by univariate analysis and those which were significantly different between the two groups were assessed by multivariate binary logistic regression analysis. There were no significant differences in age, sex, body mass index, hypertension, diabetes mellitus, pre-surgery hemoglobin, pre-surgery serum creatinine, stone and also surgery-related parameters between the two groups. Stone free rate, surgery time, complication-related parameters, hemoglobin drop, serum creatinine and glomerular filtration rate (GFR) changes were similar in both groups based on univariate analysis. The radiopaque group had higher post-surgery GFR (p=0.04) and longer hospital stay (p=0.009). However, opacity had no effect on these outcomes after multivariate analysis. Higher post-surgery GFR was seen in patient with higher GFR before surgery (p<0.0001). Also, higher hemoglobin before surgery was correlated with less hospital stay (p=0.001). The complete supine percutaneous nephrolithotomy outcomes are similar in patients with radiopaque and radiolucent stones.

  16. Consideration of Shoulder Joint's Image with the Changed Tube Angle of the Shoulder Oblique Projection in Supine Position

    International Nuclear Information System (INIS)

    Seo, Jae Hyun; Choi, Nam Gil

    2008-01-01

    There is a standard shoulder oblique method (Grashey method) available to view the shoulder joint. This method projects AP view of the shoulder joint so that the Humerus head's subuxation or joint degeneration can be easily visualized. However, in this view, the patients, with supine or sitting or erect position, have to keep their body obliquely. Whereas, the patients who are not well or operated, usually feel very uncomfortable to keep their body in this position and hence, we need other persons' help and much efforts will be needed to get the good quality shoulder joint view. Therefore, we thought of examining a method which shows the joint well by angling the tube to Medio-Lateral direction and without keeping the patients' one side upward in supine position. For this study, total 15 subjects with no history of neurological or psychiatric illness, were recruited for examinations. They consisted of 9 males and 6 females. Statistic group analysis was performed with ANOVA test. Scores of the evaluation of the experts were 1.01±0.54 at 25 degrees, 2.50±0.50 at 30 degrees, 2.85±0.36 at 35 degrees and 2.33±0.47 at 40 degrees, respectively, and they were significant(p<0.05, Table 1). Joint space of the Humerus head and Scapula were well distinguished at 35 degrees, 30 degrees and 40 degrees with the almost same score. However, the degree of distortion at 40 degrees was more severe than that at 30 degrees. Ultimately, 30-35 degrees views were shown to yield good quality shoulder oblique images. In conclusion, this method may be very useful for the patients who are uncomfortable and for the emergency patients. In order to get similar or comparable view, the same X-tube angle is recommended to be used before and after the operation. Therefore, we hope that this new angled method seems to be efficient.

  17. Genetics of Euglossini bees (Hymenoptera in fragments of the Atlantic Forest in the region of Viçosa, MG

    Directory of Open Access Journals (Sweden)

    A. M. Waldschmidt

    Full Text Available With uncontrolled deforestation, forest fragments remain, which in most cases are in different stages of regeneration and present isolated populations. In the present study we analyzed the genetic patterns of Eulaema nigrita populations in seven Atlantic Forest fragments of different sizes and successional stages in the region of Viçosa, MG. This was done by RAPD molecular markers. We observed that the area of the fragments had no effect on the genetic variability of E. nigrita in the direction predicted by meta-population models. Medium-sized well-preserved woods presented the lowest variability, whereas large and small woods were statistically identical. The evidence supports the notion that rural areas present greater dispersal among fragments, implying greater similarity between the populations of fragments located in rural areas when compared to fragments in urban areas.

  18. A mast fruiting episode of the tropical tree Peltogyne purpurea(Caesalpinaceaein the Osa Peninsula, Costa Rica

    Directory of Open Access Journals (Sweden)

    Oscar J Rocha

    2006-12-01

    Full Text Available Se describe un episodio de fructificación en masa en una población de Peltogyne purpurea de la Península de Osa, Costa Rica. En febrero y marzo de 2000, la mayor parte de los árboles de esta especie tuvo una gran cosecha de frutos. En los años anteriores, desde 1995, ninguno o muy pocos árboles produjeron frutos y la producción por árbol fue escasa. La cosecha del año 2000 fue masiva y todos los árboles examinados produjeron frutos abundantes. Este patrón reproductivo podría producir extinciones locales si la extracción maderera no lo toma en cuenta

  19. Initiation of CPAP therapy for OSA: does prophylactic humidification during CPAP pressure titration improve initial patient acceptance and comfort?

    Science.gov (United States)

    Wiest, G H; Harsch, I A; Fuchs, F S; Kitzbichler, S; Bogner, K; Brueckl, W M; Hahn, E G; Ficker, J H

    2002-01-01

    Heated humidifiers (HH) enable effective treatment of upper airway dryness during nasal continuous positive airway pressure (nCPAP) therapy for obstructive sleep apnoea (OSA), but the role of prophylactic use of HH during the initiation of nCPAP treatment has not been studied so far. The aim of the present study was to investigate whether prophylactic HH during the initiation of CPAP would result in improved initial patient comfort and acceptance. In 44 consecutive, previously untreated OSA patients with no history of upper airway dryness, CPAP titration with and without HH was performed on two consecutive nights in a randomised order. The patients were interviewed after each treatment night in order to establish the comfort of the treatment, and, after the second treatment, they were asked which of the two nights they considered more pleasant, and which treatment they would prefer for long-term use. Following CPAP titration with HH, 32 patients (73%) claimed to have had a better night's sleep than usual (i.e. without CPAP treatment) compared with 33 patients (75%) saying the same following CPAP treatment without HH. For 21 patients (47.7%) treatment with HH was more pleasant, 23 (52.3%) saw no difference or said that treatment without HH was more pleasant. Nineteen patients (43.2%) gave preference to treatment with HH for long-term use, while 25 patients (56.8%) had no preference or said they would prefer treatment without HH. The use of HH during the initiation phase of CPAP treatment was associated neither with an initial improvement in comfort nor with greater initial treatment acceptance. Copyright 2002 S. Karger AG, Basel

  20. A mast fruiting episode of the tropical tree Peltogyne purpurea(Caesalpinaceaein the Osa Peninsula, Costa Rica

    Directory of Open Access Journals (Sweden)

    Oscar J Rocha

    2006-12-01

    Full Text Available Se describe un episodio de fructificación en masa en una población de Peltogyne purpurea de la Península de Osa, Costa Rica. En febrero y marzo de 2000, la mayor parte de los árboles de esta especie tuvo una gran cosecha de frutos. En los años anteriores, desde 1995, ninguno o muy pocos árboles produjeron frutos y la producción por árbol fue escasa. La cosecha del año 2000 fue masiva y todos los árboles examinados produjeron frutos abundantes. Este patrón reproductivo podría producir extinciones locales si la extracción maderera no lo toma en cuentaThe existence of mast fruiting has not been well documented in the Neotropics. The occurrence of a mast fruiting episode in the population of the tree Peltogyne purpurea in the Osa Peninsula of Costa Rica is described. In February and March of 2000 most of the trees of this species produced a large fruit crop, compared with 1995-1999, when the number of fruit producing trees was very low or zero and those that did bear fruit, did so at a low intensity. In contrast, the fruit crop of 2000 was massive, all trees examined produced fruits and the intensity of fruiting was maximal. There is not enough information on the event for a hypothesis to be formed because the climatic or biological cues that triggered this sporadic flowering are unknown and there is no meteorological data available for this area. Populations with this mode of reproduction may experience local extinction bacause of logging operations. Rev. Biol. Trop. 54 (4: 1151-1155. Epub 2006 Dec. 15

  1. Translation of Berlin Questionnaire to Portuguese language and its application in OSA identification in a sleep disordered breathing clinic

    Directory of Open Access Journals (Sweden)

    A.P. Vaz

    2011-03-01

    Full Text Available Background: Berlin Questionnaire (BQ, an English language screening tool for obstructive sleep apnea (OSA in primary care, has been applied in tertiary settings, with variable results. Aims: Development of BQ Portuguese version and evaluation of its utility in a sleep disordered breathing clinic (SDBC. Material and methods: BQ was translated using back translation methodology and prospectively applied, previously to cardiorespiratory sleep study, to 95 consecutive subjects, referred to a SDBC, with OSA suspicion. OSA risk assessment was based on responses in 10 items, organized in 3 categories: snoring and witnessed apneas (category 1, daytime sleepiness (category 2, high blood pressure (HBP/obesity (category 3. Results: In the studied sample, 67.4% were males, with a mean age of 51 ± 13 years. Categories 1, 2 and 3 were positive in 91.6, 24.2 and 66.3%, respectively. BQ identified 68.4% of the patients as being in the high risk group for OSA and the remaining 31.6% in the low risk. BQ sensitivity and specificity were 72.1 and 50%, respectively, for an apnea-hipopnea index (AHI > 5, 82.6 and 44.8% for AHI > 15, 88.4 and 39.1% for AHI > 30. Being in the high risk group for OSA did not infl uence significantly the probability of having the disease (positive likelihood ratio [LR] between 1.44-1.49. Only the items related to snoring loudness, witnessed apneas and HBP/obesity presented a statistically positive association with AHI, with the model constituted by their association presenting a greater discrimination capability, especially for an AHI > 5 (sensitivity 65.2%, specificity 80%, positive LR 3.26. Conclusions: The BQ is not an appropriate screening tool for OSA in a SDBC, although snoring loudness, witnessed apneas, HBP/obesity have demonstrated being significant questionnaire elements in this population. Resumo: Introdução: O Questionário de Berlim (QB, originalmente desenvolvido em língua inglesa como um instrumento de

  2. A randomized clinical trial to compare the immediate effects of seated thoracic manipulation and targeted supine thoracic manipulation on cervical spine flexion range of motion and pain.

    Science.gov (United States)

    Karas, Steve; Olson Hunt, Megan J

    2014-05-01

    Randomized clinical trial. To determine the effectiveness of seated thoracic manipulation versus targeted supine thoracic manipulation on cervical spine pain and flexion range of motion (ROM). There is evidence that thoracic spine manipulation is an effective treatment for patients with cervical spine pain. This evidence includes a variety of techniques to manipulate the thoracic spine. Although each of them is effective, no research has compared techniques to determine which produces the best outcomes. A total of 39 patients with cervical spine pain were randomly assigned to either a seated thoracic manipulation or targeted supine thoracic manipulation group. Pain and flexion ROM measures were taken before and after the intervention. Pain reduction (post-treatment-pre-treatment) was significantly greater in those patients receiving the targeted supine thoracic manipulation compared to the seated thoracic manipulation (Pmanipulation group. The results of this study indicate that a targeted supine thoracic manipulation may be more effective in reducing cervical spine pain and improving cervical flexion ROM than a seated thoracic manipulation. Future studies should include a variety of patients and physical therapists (PTs) to validate our findings.

  3. Is the modified Tardieu scale in semi-standing position better associated with knee extension and hamstring activity in terminal swing than the supine Tardieu?

    NARCIS (Netherlands)

    Faber, I.R.; Nienhuis, B.; Rijs, N.P.; Geurts, A.C.H.; Duysens, J.E.J.

    2008-01-01

    The aim of this study was to investigate whether the modified Tardieu scale (MTS) in a semi-standing position, used for the assessment of hamstrings spasticity, was better associated with knee extension and hamstrings activity in terminal swing than the MTS in a supine position in children with

  4. Postural change from lateral to supine is an important mechanism enhancing cephalic spread after injection of intrathecal 0.5% plain bupivacaine for cesarean section.

    Science.gov (United States)

    Xu, F; Qian, M; Wei, Y; Wang, Y; Wang, J; Li, M; Zhang, Y; Zhao, Y; Guo, X

    2015-11-01

    Spinal anesthesia is widely used for cesarean section, but the factors that affect the spread of the block in pregnant patients are still not fully explained. This study was designed to investigate the effect of postural changes on sensory block level. Thirty patients scheduled for elective cesarean section under combined spinal-epidural anesthesia were randomly allocated into three groups. After intrathecal injection of 0.5% plain bupivacaine 7.5mg, patients in group S were immediately placed in the supine position with left tilt, patients in group L5 were kept lateral for 5 min and then turned to the supine position with left tilt, and patients in group L10 were kept lateral for 10 min and then turned to the supine position with left tilt. At 5 min, median cephalad level of sensory block was lower in groups L5 and L10 compared with group S (corrected Ppostural change from the lateral position to the supine position is an important mechanism enhancing cephalic spread of spinal anesthesia during late pregnancy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Does the Supine Position Affect the Nasal Profile in Rhinoplasty Patients? A Comparison of Nasal Anthropometric Measurements in Different Body Positions.

    Science.gov (United States)

    Kim, Su Jin; Ryu, In Yong; Kim, Sung Wan; Lee, Kun Hee

    2017-10-16

    Rhinoplasty surgeons are aware that the nasal profile differs according to body position, namely, the erect position in the consultation room vs the supine position on the operating table. It is not clear whether this difference is caused by an optical illusion or skin laxity due to positional change. To evaluate anthropometric measurements of the nose with different body positions and determine whether the supine position affects the nasal profile. In this retrospective study, 103 patients who underwent primary rhinoplasty were enrolled. Preoperatively, all patients underwent lateral cephalography in the erect position, and facial computed tomography (CT), in the supine position. We measured four nasal anthropometric parameters (the nasofrontal, nasolabial, and nasomental angles, and Simon's ratio) on lateral cephalograms and facial CT images, and compared these parameters between the two body positions. The nasofrontal angle was greater on facial CT than on cephalograms (P sex, or body mass index (P > 0.05 each). We found no significant difference (P > 0.05) between the two positions in the nasolabial angle, nasomental angle, or Simon's ratio. The supine position does affect the nasal profile, especially in the radix area. Surgeons need to consider this difference in patients undergoing rhinoplasty. 2. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

  6. A Dosimetric Comparison of Accelerated Partial Breast Irradiation Techniques: Multicatheter Interstitial Brachytherapy, Three-Dimensional Conformal Radiotherapy, and Supine Versus Prone Helical Tomotherapy

    International Nuclear Information System (INIS)

    Patel, Rakesh R.; Becker, Stewart J.; Das, Rupak K.; Mackie, Thomas R.

    2007-01-01

    Purpose: To compare dosimetrically four different techniques of accelerated partial breast irradiation (APBI) in the same patient. Methods and Materials: Thirteen post-lumpectomy interstitial brachytherapy (IB) patients underwent imaging with preimplant computed tomography (CT) in the prone and supine position. These CT scans were then used to generate three-dimensional conformal radiotherapy (3D-CRT) and prone and supine helical tomotherapy (PT and ST, respectively) APBI plans and compared with the treated IB plans. Dose-volume histogram analysis and the mean dose (NTD mean ) values were compared. Results: Planning target volume coverage was excellent for all methods. Statistical significance was considered to be a p value mean dose of 1.3 Gy 3 and 1.2 Gy 3 , respectively. Both of these methods were statistically significantly lower than the supine external beam techniques. Overall, all four methods yielded similar low doses to the heart. Conclusions: The use of IB and PT resulted in greater normal tissue sparing (especially ipsilateral breast and lung) than the use of supine external beam techniques of 3D-CRT or ST. However, the choice of APBI technique must be tailored to the patient's anatomy, lumpectomy cavity location, and overall treatment goals

  7. Assessment of the effective dose in supine, prone, and oblique positions in the maxillofacial region using a novel combined extremity and maxillofacial cone beam computed tomography scanner

    NARCIS (Netherlands)

    Koivisto, J.; Wolff, J.; Järnstedt, J.; Dastidar, P.; Kortesniemi, M.

    2014-01-01

    Objective The objectives of this study were to assess the organ and effective doses (International Commission on Radiological Protection [ICRP] 103 standard) resulting from supine, prone, and oblique phantom positions in the maxillofacial region using a novel cone beam computed tomography (CBCT)

  8. Heart-Rate Variability During Deep Sleep in World-Class Alpine Skiers: A Time-Efficient Alternative to Morning Supine Measurements.

    Science.gov (United States)

    Herzig, David; Testorelli, Moreno; Olstad, Daniela Schäfer; Erlacher, Daniel; Achermann, Peter; Eser, Prisca; Wilhelm, Matthias

    2017-05-01

    It is increasingly popular to use heart-rate variability (HRV) to tailor training for athletes. A time-efficient method is HRV assessment during deep sleep. To validate the selection of deep-sleep segments identified by RR intervals with simultaneous electroencephalography (EEG) recordings and to compare HRV parameters of these segments with those of standard morning supine measurements. In 11 world-class alpine skiers, RR intervals were monitored during 10 nights, and simultaneous EEGs were recorded during 2-4 nights. Deep sleep was determined from the HRV signal and verified by delta power from the EEG recordings. Four further segments were chosen for HRV determination, namely, a 4-h segment from midnight to 4 AM and three 5-min segments: 1 just before awakening, 1 after waking in supine position, and 1 in standing after orthostatic challenge. Training load was recorded every day. A total of 80 night and 68 morning measurements of 9 athletes were analyzed. Good correspondence between the phases selected by RR intervals vs those selected by EEG was found. Concerning root-mean-squared difference of successive RR intervals (RMSSD), a marker for parasympathetic activity, the best relationship with the morning supine measurement was found in deep sleep. HRV is a simple tool for approximating deep-sleep phases, and HRV measurement during deep sleep could provide a time-efficient alternative to HRV in supine position.

  9. Changes of plasma IL-6 and TNF-α levels after CPAP treatment in patients with obstructive sleep apnea syndrome (OSAS)

    International Nuclear Information System (INIS)

    Cao Zhuo; Wang Liangxing

    2009-01-01

    Objective: To investigate the changes of plasma IL-6 and TNF-α levels after continuous positive airway pressure (CPAP) therapy in patients with obstructive sleep apnea syndrome (OSAS). Methods: Plasma IL-6 and TNF-α levels were measured with RIA in 60 patients with OSAS both before and after CPAS therapy as well as in 30 controls. Results: Before CPAP therapy, the plasma IL-6 and TNF-α levels in patients with OSAS were significantly higher than those in controls (25.92 ± 4.48pg/ ml and 11.27 ± 2.60pg/ml vs 13.21 ± 1.97pg/ml and 5.83±0.99pg/mi, P 2 level (r=-0.495, 0.483, P<0.05). After treatment with CPAP for three months, the plasma IL-6 and TNF-α levels were significantly decreased (15.37±1.78pg/ml and 6.79±0.87pg/ml, vs pre-treatment levels, P<0.05, P<0.01). Conclusion: CPAP therapy could effectively decrease the plasma IL-6 and TNF-α levels in patients with OSAS. (authors)

  10. Oronasal mask may compromise the efficacy of continuous positive airway pressure on OSA treatment: is there evidence for avoiding the oronasal route?

    Science.gov (United States)

    Andrade, Rafaela Garcia Santos; Madeiro, Fernanda; Genta, Pedro Rodrigues; Lorenzi-Filho, Geraldo

    2016-11-01

    Continuous positive airway pressure (CPAP) delivered by nasal mask is the gold standard treatment for obstructive sleep apnea (OSA). However, oral and oronasal masks are also available. We considered experimental evidence and reviewed clinical trials that evaluated the impact of oral and oronasal mask on OSA treatment. One recent study in 18 OSA patients that slept with a customized oronasal mask with two sealed compartments showed that the change of CPAP flow from nasal to oronasal and oral caused upper airway obstruction because of posterior displacement of the tongue demonstrated by nasoendoscopy. Oral masks use a mouthpiece that may stabilize the jaw and the tongue and have shown to be effective. However, oral masks are not widely used in clinical practice. Four out of five observational studies and all five reviewed randomized studies showed a worse performance of oronasal when compared with nasal masks. Oronasal masks were associated with higher residual apnea-hypopnea index, lower adherence, more leaks, and less satisfaction than nasal mask in the majority of the studies. Nasal CPAP must be the first choice to treat OSA. Patients on oronasal mask should be carefully followed. VIDEO ABSTRACT.

  11. Indicadores de campo para solos hidromórficos na região de Viçosa (MG Field indicators for the identification of hydromorphic soils in the region of Viçosa, Minas Gerais - Brazil

    Directory of Open Access Journals (Sweden)

    C. E. B. Campos

    2003-12-01

    Full Text Available Indicadores locais são úteis para a identificação de ambientes. Na região de Viçosa, embora os solos encharcados ocorram sob vegetação de taboa (Thypha dominguensis, Gleissolos, de coloração típica acinzentada, são incomuns. A maioria dos solos com lençol freático alto é coberta pela taboa e as características gleizadas do solo são pouco pronunciadas, especialmente nos solos com mais altos teores de ferro. Não há clara conexão entre altura do lençol freático e deficiência de oxigênio. Como as relações entre altura do lençol freático, deficiência de oxigênio e cor do solo não são claras o bastante, hipotetizou-se que outros indicadores para as condições de redução poderiam ser encontrados nesses ambientes. Neste propósito, caracterizou-se o solo e trabalhou-se na sua relação com a vegetação. Estudaram-se os solos com várias intensidades de condições de drenagem em três áreas: Cajuri (Área 1, Viçosa (Área 2 e Coimbra (Área 3, todas pertencentes ao Planalto de Viçosa. Na avaliação das condições de redox dos solos (pH e pE a campo, utilizou-se um medidor digital adaptado a uma sonda de aço. Conquanto importante na identificação de indicadores de ambientes, a caracterização morfológica não se mostrou precisa o bastante para evidenciar o que os solos encharcados têm mais em comum: a deficiência de oxigênio por longos períodos. A cor, embora seja um bom e útil indicador para muitas das condições de drenagem do solo, não se mostrou também eficiente nessas áreas. De modo geral, os Gleissolos estudados apresentaram cromas maiores do que dois, o que supera o limite do critério para identificar horizonte glei no Sistema Brasileiro de Classificação de Solos, embora o teste indicador da presença de Fe2+ com alfa,alfa'-dipiridil tenha sido positivo. Por outro lado, a presença da taboa foi um bom indicador das condições de má drenagem. Nos locais dos povoamentos puros de taboa, os

  12. [Usefulness of a protocol for carotid sinus massage in supine and erect postures in patients with syncope without other cardiovascular or neurological diseases].

    Science.gov (United States)

    Bocchiardo, M; Alciati, M; Buscemi, A; Cravetto, A; Richiardi, E; Gaita, F

    1995-05-01

    Carotid sinus massage is a first level test when investigating the cause of syncope. It is normally performed in the supine and erect positions. However, there is no standard complete protocol. So we have devised a new protocol to evaluate the utility of carotid sinus massage in different postures and the influence of patients age on the response. Two groups of subjects were selected: a group of 167 patients (mean age 50 ys +/- 18, 105 males, 62 females) with a history of syncope without cardiovascular and neurological disease and 20 asymptomatic control subjects (mean age 52 ys +/- 13, 11 males, 9 females). Carotid sinus massage was performed supine, just after passive tilt, after 5 minutes of tilt and just after passive return to supine. If a pause > 3" was detected, the protocol was repeated after atropine i.v. injection. Borderline vasodepressor: blood pressure reduction > 30 but blood pressure reduction > 50 mm Hg or > 30 mm Hg with symptoms like dizziness, vertigo or syncope; cardioinhibitory: pause > 3"; mixed: cardioinhibitory with blood pressure reduction > 30 mm Hg after atropine. Carotid sinus massage gave all informations in the supine position in 14 (12%) patients, after passive tilt in 67 (57%), after 5 minutes of tilt in 30 (26%), and after return to supine in 6 (5%). The responses were: 13 (8%) borderline vasodepressor, 32 (19%) vasodepressor, 2 (1%) cardioinhibitory, 70 (42%) mixed, 50 (30%) negative. Positive responses were more frequent in patients over 45 years (90% versus 43%). In the control group only 3 (15%) positive responses were elicited (2 borderline vasodepressor, and 1 vasodepressor, all in subjects over 45). This protocol for carotid sinus massage evidenced positive responses in 70% of patients with syncope without cardiovascular and neurological disease; cardioinhibitory responses are rare (2%); positive responses are more frequent in patients over 45 years; the protocol specificity was 85%.

  13. Semi-recumbent position versus supine position for the prevention of ventilator-associated pneumonia in adults requiring mechanical ventilation.

    Science.gov (United States)

    Wang, Li; Li, Xiao; Yang, Zongxia; Tang, Xueli; Yuan, Qiang; Deng, Lijing; Sun, Xin

    2016-01-08

    Ventilator-associated pneumonia (VAP) is associated with increased mortality, prolonged length of hospital stay and increased healthcare costs in critically ill patients. Guidelines recommend a semi-recumbent position (30º to 45º) for preventing VAP among patients requiring mechanical ventilation. However, due to methodological limitations in existing systematic reviews, uncertainty remains regarding the benefits and harms of the semi-recumbent position for preventing VAP. To assess the effectiveness and safety of semi-recumbent positioning versus supine positioning to prevent ventilator-associated pneumonia (VAP) in adults requiring mechanical ventilation. We searched CENTRAL (2015, Issue 10), which includes the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE (1946 to October 2015), EMBASE (2010 to October 2015), CINAHL (1981 to October 2015) and the Chinese Biomedical Literature Database (CBM) (1978 to October 2015). We included randomised controlled trials (RCTs) comparing semi-recumbent versus supine positioning (0º to 10º), or RCTs comparing alternative degrees of positioning in mechanically ventilated patients. Our outcomes included clinically suspected VAP, microbiologically confirmed VAP, intensive care unit (ICU) mortality, hospital mortality, length of ICU stay, length of hospital stay, duration of ventilation, antibiotic use and any adverse events. Two review authors independently and in duplicate screened titles, abstracts and full texts, assessed risk of bias and extracted data using standardised forms. We calculated the mean difference (MD) and 95% confidence interval (95% CI) for continuous data and the risk ratio (RR) and 95% CI for binary data. We performed meta-analysis using the random-effects model. We used the grading of recommendations, assessment, development and evaluation (GRADE) approach to grade the quality of evidence. We included 10 trials involving 878 participants, among which 28 participants in two

  14. Estado nutricional e fatores associados em idosos do Município de Viçosa, Minas Gerais, Brasil Nutritional status and associated factors among the elderly in Viçosa, Minas Gerais State, Brazil

    Directory of Open Access Journals (Sweden)

    Clarissa de Matos Nascimento

    2011-12-01

    Full Text Available Investigaram-se as prevalências de baixo peso e excesso de peso, bem como os fatores associados em idosos. Trata-se de um estudo transversal, com 621 idosos residentes no Município de Viçosa, Minas Gerais, Brasil, realizado em 2009. As informações foram obtidas por meio de entrevistas domiciliares e se referiam à avaliação do estado nutricional, condições sociodemográficas e de saúde. Do total de pessoas estudadas, 53,3% eram do gênero feminino. A mediana do IMC foi de 26,40kg/m² (mínima 15,20 e máxima 46,82 e foi menor para os homens do que para as mulheres. A prevalência de excesso de peso foi elevada (45%; IC95%: 40%-49%, diminuiu com a idade, associou-se positivamente ao gênero feminino e história de artrite/artrose, e negativamente à faixa etária de 80 anos ou mais e ao tabagismo. A prevalência de baixo peso foi maior no gênero masculino (18,2%, aumentou com o avanço da idade e associou-se positivamente à pior percepção de saúde. O conjunto dos resultados salientam a importância de estratégias em saúde que favoreçam mudanças no estilo de vida e hábitos alimentares saudáveis.This cross-sectional study in 2009 focused on the prevalence of underweight and overweight and associated factors in a sample of 621 elderly individuals in Viçosa, Minas Gerais State, Brazil. Data were obtained through home interviews on nutritional status and socio-demographic and health conditions. Of the total sample, 53.3% were females. Median BMI was 26.40kg/m² (range = 15.20-46.82 and was lower for men than for women. Prevalence of overweight was high (45%; 95%CI: 40%-49%, decreased with age, was positively associated with female gender and history of arthritis/arthrosis, and was negatively associated with age 80 years or older and smoking. Prevalence of underweight was high in men (18.2%, increased with age, and was positively associated with worse self-rated health. The findings highlight the importance of health strategies

  15. [Application of lateral malleolus hook-plate in treatment of stage II supination-adduction type medial malleolus fracture].

    Science.gov (United States)

    Chen, Yu; Zhang, Hui; Huang, Fuguo; Xiang, Zhuo; Fang, Yue; Liu, Lei; Cen, Shiqiang

    2014-09-01

    To investigate the application of lateral malleolus hook-plate for the treatment of stage II supination-adduction type medial malleolus fractures. Between January 2011 and June 2013, 21 patients with stage II supination-adduction type ankle fractures were treated with lateral malleolus hook-plate, including 12 males and 9 females with an average age of 55.5 years (range, 27-65 years). The injury causes were sprain in 17 cases and traffic accident in 4 cases. The mean time between injury and admission was 12.4 hours (range, 2-72 hours). The tibial distal medial articular surface collapse was found in 7 cases by CT examination and in 3 cases by X-ray film. Of 21 cases, there were 12 cases of low transverse fractures of lateral malleolus, 7 cases of short oblique fractures of lateral malleolus, and 2 cases of ankle joint lateral collateral ligament injury without fractures of lateral malleolus. After operation, the clinical outcome was evaluated according to the talus-leg angle, the recovery of Coin-sign continuity, inside-outside and top ankle gap, talus slope, American Orthopedic Foot and Ankle Society (AOFAS) score, Olerud-Molander score, Kofoed evaluation standards, and patient satisfaction. Seventeen cases were followed up 18.7 months on average (range, 12-25 months). Primary healing was obtained in 16 cases except 1 case of delayed healing. Fracture healed at an average of 14.6 weeks (range, 12-16 weeks). All cases achieved anatomical reduction, the continuity of Coin-sign, and consistency of inside and outside joint gap; no talus tilt occurred. There was no complication of reduction loss, loosening or breakage of internal fixation, or osteoarthritis during follow-up. The talus-leg angle of the affected side was significantly improved to (83.4 ± 1.8)° at 1 week after operation from preoperative (74.8 ± 7.1)° (t = 5.370, P = 0.000), but no significant difference was found when compared with normal side (83.8 ± 2.3)° (t = 0.676, P = 0.509). The AOFAS score

  16. Prone versus supine positioning for whole and partial-breast radiotherapy: A comparison of non-target tissue dosimetry

    International Nuclear Information System (INIS)

    Kirby, Anna M.; Evans, Philip M.; Donovan, Ellen M.; Convery, Helen M.; Haviland, Joanna S.; Yarnold, John R.

    2010-01-01

    Purpose: To compare non-target tissue (including left-anterior-descending coronary-artery (LAD)) dosimetry of prone versus supine whole (WBI) and partial-breast irradiation (PBI). Methods and materials: Sixty-five post-lumpectomy breast cancer patients underwent CT-imaging supine and prone. On each dataset, the whole-breast clinical-target-volume (WB-CTV), partial-breast CTV (tumour-bed + 15 mm), ipsilateral-lung and chest-wall were outlined. Heart and LAD were outlined in left-sided cases (n = 30). Tangential-field WBI and PBI plans were generated for each position. Mean LAD, heart, and ipsilateral-lung doses (x mean ), maximum LAD (LAD max ) doses, and the volume of chest-wall receiving 50 Gy (V 50Gy ) were compared. Results: Two-hundred and sixty plans were generated. Prone positioning reduced heart and LAD doses in 19/30 WBI cases (median reduction in LAD mean = 6.2 Gy) and 7/30 PBI cases (median reduction in LAD max = 29.3 Gy) (no difference in 4/30 cases). However, prone positioning increased cardiac doses in 8/30 WBI (median increase in LAD mean = 9.5 Gy) and 19/30 PBI cases (median increase in LAD max = 22.9 Gy) (no difference in 3/30 cases). WB-CTV > 1000cm 3 was associated with improved cardiac dosimetry in the prone position for WBI (p = 0.04) and PBI (p = 0.04). Prone positioning reduced ipsilateral-lung mean in 65/65 WBI and 61/65 PBI cases, and chest-wall V 50Gy in all WBI cases. PBI reduced normal-tissue doses compared to WBI in all cases, regardless of the treatment position. Conclusions: In the context of tangential-field WBI and PBI, prone positioning is likely to benefit left-breast-affected women of larger breast volume, but to be detrimental in left-breast-affected women of smaller breast volume. Right-breast-affected women are likely to benefit from prone positioning regardless of breast volume.

  17. Total and regional deposition of inhaled aerosols in supine healthy subjects and subjects with mild-to-moderate COPD

    Energy Technology Data Exchange (ETDEWEB)

    Darquenne, Chantal; Lamm, Wayne J.; Fine, Janelle M.; Corley, Richard A.; Glenny, Robb W.

    2016-09-01

    Despite substantial development of sophisticated subject-specific computational models of aerosol transport and deposition in human lungs, experimental validation of predic- tions from these new models is sparse. We collected aerosol retention and exhalation profiles in seven healthy volunteers and six subjects with mild-to-moderate COPD (FEV1 ¼ 50–80%predicted) in the supine posture. Total deposition was measured during continuous breathing of 1 and 2.9 mm-diameter particles (tidal volume of 1 L, flow rate of 0.3 L/s and 0.75 L/s). Bolus inhalations of 1 mm particles were performed to penetration volumes of 200, 500 and 800 mL (flow rate of 0.5 L/s). Aerosol bolus dispersion (H), deposition, and mode shift (MS) were calculated from these data. There was no significant difference in total deposition between healthy subjects and those with COPD. Total deposition increased with increasing particle size and also with increasing flow rate. Similarly, there was no significant difference in aerosol bolus deposition between subject groups. Yet, the rate of increase in dispersion and of decrease in MS with increasing penetration volume was higher in subjects with COPD than in healthy volunteers (H: 0.79870.205 vs. 0.52770.122 mL/mL, p¼ 0.01; MS: - 0.27170.129 vs. - 0.145 70.076 mL/mL, p¼ 0.05) indicating larger ventilation inhomogeneities (based on H) and increased flow sequencing (based on MS) in the COPD than in the healthy group. In conclusion, in the supine posture, deposition appears to lack sensitivity for assessing the effect of lung morphology and/or ventilation distribution alteration induced by mild-to- moderate lung disease on the fate of inhaled aerosols. However, other parameters such as aerosol bolus dispersion and mode shift may be more sensitive parameters for evaluating models of lungs with moderate disease.

  18. Targeted therapies for diarrhea-predominant irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Olden KW

    2012-05-01

    Full Text Available Kevin W OldenDepartment of Medicine, St Joseph's Hospital and Medical Center, Phoenix, AZ, USAAbstract: Irritable bowel syndrome (IBS causes gastrointestinal symptoms such as abdominal pain, bloating, and bowel pattern abnormalities, which compromise patients' daily functioning. Common therapies address one or two IBS symptoms, while others offer wider symptom control, presumably by targeting pathophysiologic mechanisms of IBS. The aim of this targeted literature review was to capture clinical trial reports of agents receiving the highest recommendation (Grade 1 for treatment of IBS from the 2009 American College of Gastroenterology IBS Task Force, with an emphasis on diarrhea-predominant IBS. Literature searches in PubMed captured articles detailing randomized placebo-controlled trials in IBS/diarrhea-predominant IBS for agents receiving Grade I (strong 2009 American College of Gastroenterology IBS Task Force recommendations: tricyclic antidepressants, nonabsorbable antibiotics, and the 5-HT3 receptor antagonist alosetron. Studies specific for constipation-predominant IBS were excluded. Tricyclic antidepressants appear to improve global IBS symptoms but have variable effects on abdominal pain and uncertain tolerability; effects on stool consistency, frequency, and urgency were not adequately assessed. Nonabsorbable antibiotics show positive effects on global symptoms, abdominal pain, bloating, and stool consistency but may be most efficacious in patients with altered intestinal microbiota. Alosetron improves global symptoms and abdominal pain and normalizes bowel irregularities, including stool frequency, consistency, and fecal urgency. Both the nonabsorbable antibiotic rifaximin and the 5-HT3 receptor antagonist alosetron improve quality of life. Targeted therapies provide more complete relief of IBS symptoms than conventional agents. Familiarization with the quantity and quality of evidence of effectiveness can facilitate more individualized

  19. Targeted therapies for diarrhea-predominant irritable bowel syndrome

    Science.gov (United States)

    Olden, Kevin W

    2012-01-01

    Irritable bowel syndrome (IBS) causes gastrointestinal symptoms such as abdominal pain, bloating, and bowel pattern abnormalities, which compromise patients’ daily functioning. Common therapies address one or two IBS symptoms, while others offer wider symptom control, presumably by targeting pathophysiologic mechanisms of IBS. The aim of this targeted literature review was to capture clinical trial reports of agents receiving the highest recommendation (Grade 1) for treatment of IBS from the 2009 American College of Gastroenterology IBS Task Force, with an emphasis on diarrhea-predominant IBS. Literature searches in PubMed captured articles detailing randomized placebo-controlled trials in IBS/diarrhea-predominant IBS for agents receiving Grade I (strong) 2009 American College of Gastroenterology IBS Task Force recommendations: tricyclic antidepressants, nonabsorbable antibiotics, and the 5-HT3 receptor antagonist alosetron. Studies specific for constipation-predominant IBS were excluded. Tricyclic antidepressants appear to improve global IBS symptoms but have variable effects on abdominal pain and uncertain tolerability; effects on stool consistency, frequency, and urgency were not adequately assessed. Nonabsorbable antibiotics show positive effects on global symptoms, abdominal pain, bloating, and stool consistency but may be most efficacious in patients with altered intestinal microbiota. Alosetron improves global symptoms and abdominal pain and normalizes bowel irregularities, including stool frequency, consistency, and fecal urgency. Both the nonabsorbable antibiotic rifaximin and the 5-HT3 receptor antagonist alosetron improve quality of life. Targeted therapies provide more complete relief of IBS symptoms than conventional agents. Familiarization with the quantity and quality of evidence of effectiveness can facilitate more individualized treatment plans for patients with this heterogeneous disorder. PMID:22754282

  20. Lymphocyte-predominant Hodgkin disease: a comprehensive overview.

    Science.gov (United States)

    Bose, Sumit; Ganesan, Chitra; Pant, Manish; Lai, Catherine; Tabbara, Imad A

    2013-02-01

    Lymphocyte-predominant Hodgkin disease is a rare form of Hodgkin lymphoma that is recognized as a separate histopathological entity. This disease tends to have multiple relapses, but has an overall good prognosis. Owing to its rarity, and the prolonged time period between recurrence and transformation events, there is no consensus regarding optimal management. However, the National Comprehensive Cancer Network guidelines indicate that for early stages, appropriate treatment is radiotherapy. Several management options have been reported including observation, radiation, chemotherapy, combined chemoradiotherapy, and anti-CD20 antibody therapy. Salvage therapy remains effective in inducing prolonged remission in patients with relapsed/refractory disease.

  1. The "DOC" screen: Feasible and valid screening for depression, Obstructive Sleep Apnea (OSA) and cognitive impairment in stroke prevention clinics.

    Science.gov (United States)

    Swartz, Richard H; Cayley, Megan L; Lanctôt, Krista L; Murray, Brian J; Cohen, Ashley; Thorpe, Kevin E; Sicard, Michelle N; Lien, Karen; Sahlas, Demetrios J; Herrmann, Nathan

    2017-01-01

    Post-stroke Depression, Obstructive sleep apnea (OSA) and Cognitive impairment ("DOC") are associated with greater mortality, worse recovery and poorer quality of life. Best practice recommendations endorse routine screening for each condition; yet, all are under-assessed, diagnosed and treated. We seek to determine the feasibility and validity of an integrated tool ("DOC" screen) to identify stroke clinic patients at high-risk of depression, OSA, and cognitive impairment. All consecutive new referrals to a regional Stroke Prevention Clinic who were English-speaking and non-aphasic were eligible to be screened. Time for screen completion was logged. DOC screen results were compared to the neuropsychological battery and polysomnogram assessments using a modified receiver operator characteristic and area under the curve analysis. Data is reported to conform to STARD guidelines. 1503 people were screened over 2 years. 89% of eligible patients completed the screen in 5 minutes or less (mean 4.2 minutes), less than half the time it takes to complete the Montreal Cognitive Assessment (MoCA). 437 people consented to detailed testing. Of those, 421 completed the Structured Clinical Interview for Depression within 3 months of screening, 387 completed detailed neuropsychological testing within 3 months, and 88 had overnight polysomnograms. Screening scores combined with demographic variables (age, sex, education, body mass index), had excellent validity compared to gold standard diagnoses: DOC-Mood AUC 0.90; DOC-Apnea AUC 0.80; DOC-Cog AUC 0.81. DOC screen scores can reliably categorize patients in to low-, intermediate- or high-risk groups for further action and can do so with comparable accuracy to more time-consuming screens. Systematic screening of depression, obstructive sleep apnea, and cognitive impairment in 5 minutes or less is feasible and valid in a high volume stroke clinic using the DOC screen. The DOC screen may facilitate improved identification and treatment

  2. Carotene and provitamin A content of vegetables sold in Viçosa, MG, Brazil, during spring and winter

    Directory of Open Access Journals (Sweden)

    Pollyanna Costa Cardoso

    2009-09-01

    Full Text Available This study investigated the α- and β-carotene content and provitamin A value of four leafy vegetables sold at local and street markets in Viçosa, MG, Brazil, in the spring and winter of 2002. Carotenoids were analyzed by high-performance liquid chromatography. α-Carotene was detected in all samples sold during spring, but was only present in a few samples of smooth and curly lettuce and kale in winter. β-Carotene was found in marked quantities in all leafy vegetables analyzed. Duncan's test (α = 5% showed significantly higher α-carotene content in curly lettuce and vitamin A value in large-leaved watercress in the spring. Mean β-carotene content and vitamin A value were 7544, 8751, 2584, 2792, 8193, and 5338 μg/100 g and 666, 760, 227, 238, 698, and 460 μg RAE/100 g in large-leaved and hydroponic watercress, smooth and curly lettuce, kale and spinach, respectively. All leafy vegetables analyzed represent important sources of provitamin A and supply an important part of the daily requirements of children and adults.Investigou-se o conteúdo de α e β-caroteno e avaliou-se o valor pro-vitamínico A de quatro hortaliças folhosas comercializadas em mercados locais e feira- livre de Viçosa, MG durante a primavera e o inverno de 2002. Os carotenóides foram analisados por Cromatografia Líquida de Alta Eficiência (CLAE. O α-caroteno foi detectado em todas as amostras analisadas na primavera, porém no inverno, somente algumas amostras de alface crespa e lisa, e couve apresentaram tal carotenóide. O β-caroteno foi encontrado, em quantidades apreciáveis, em todas as hortaliças folhosas analisadas. O teste de Duncan (α=5% detectou que o conteúdo de α-caroteno em alface crespa e o valor de vitamina A em agrião de folha larga foram estatisticamente superiores na primavera. Os teores médios de β-caroteno e de valor de vitamina A para agrião de folha larga e hidropônico, alface crespa e lisa, couve e espinafre foram: 7544; 8751

  3. Survey report. New energy vision formulation project for Osa Town, Okayama Prefecture; 2001 nendo Osa cho shin energy vision sakutei tou jigyo chosa hokokusho. Chiiki shin energy vision sakutei tou jigyo

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-02-01

    A New Energy Vision was formulated for Osa Town after investigations about energy demand, new energy reserves, and their available amounts. The town consumes approximately 50.6-billion kcal in total, with automobiles consuming a half thereof as fuel. Studies were made about new energy reserves and recoverable amounts in the town, and then an estimation was made that 16.2 times 10{sup 5} kWh/year would be recoverable from photovoltaic energy, 1.58 times 10{sup 5} kWh from small-scale hydropower, 8.79 times 10{sup 6} kWh from ligneous biomass, and 1.96 times 10{sup 5} kWh from livestock biomass, and that 40 MW, for example, would come from wind power, subject to change depending on the wind power generator system to be built. Projects for new energy introduction were discussed, which involved the use of biodiesel fuel for official vehicles, installation of solar hot water showers in primary and junior high schools, application of photovoltaic/wind power to crime prevention lights and street lamps, snow melting systems for roads utilizing geothermal energy, use of heat from thinnings and ligneous waste, wind power facilities, small-scale hydropower facilities, introduction of new energy appliances into sightseeing facilities, and the introduction of photovoltaic power or the like into public facilities. (NEDO)

  4. Contaminación fecal en varios ríos de la Gran Área Metropolitana y la Península de Osa Fecal contamination in several rivers of the Greater Metropolitan Area and the Osa Peninsula

    Directory of Open Access Journals (Sweden)

    Guillermo Calvo Brenes

    2012-12-01

    Full Text Available La contaminación en los ríos de Costa Rica es un problema que merece especial atención. El concepto “contaminación del agua” implica la incorporación de materias extrañas a esta, tales como microorganis- mos (coliformes totales y fecales, productos quími- cos (jabones, fer tilizantes, pesticidas, metales pesados (cromo, plomo, mercurio, etc. o materia orgánica proveniente de los suelos a través de la escorrentía superficial y de las aguas residuales domésticas. Estas materias deterioran la calidad del agua y reducen los diferentes usos que podría tener un río. El recurso hídrico es importante tanto para la preservación de la vida humana como para la conservación de la flora y fauna. Costa Rica se ha caracterizado por ser un país poseedor de una rica biodiversidad. Sin embargo, muchos de los ríos de la Gran Área Metropolitana ya presentan una contaminación severa, según el Índice holandés de clasificación de la calidad del agua. En este estudio se analizó el contenido de colifor- mes fecales en 10 ríos de las provincias de San José, Alajuela, Heredia y Car tago, así como de la Península de Osa. Para correlacionar el contenido de colifor- mes fecales con la densidad poblacional, además, se muestrearon tres puntos en cada río: la zona alta cercana a la naciente, la zona media y la zona baja cercana a su desembocadura. Se encontró que los puntos de muestreo con densi- dades poblacionales medias o altas están altamente contaminados con coliformes fecales.Varios de ellos superan el límite máximo permisible en el contenido de coliformes fecales establecido por los reglamen- tos nacionales para el uso de los ríos en actividades de recreación de contacto primario. También se determinó que las zonas con menor pobla- ción, tales como los ríos Tigre y Rincón en la Península de Osa, el río Poás en Alajuela en todo su recorrido y los ríos Purires y Birrís en Cartago, en sus zonas medias y altas, están menos

  5. Three-dimensional intrafractional movement of prostate measured during real-time tumor-tracking radiotherapy in supine and prone treatment positions

    International Nuclear Information System (INIS)

    Kitamura, Kei; Shirato, Hiroki; Seppenwoolde, Yvette; Onimaru, Rikiya; Oda, Makoto; Fujita, Katsuhisa; Shimizu, Shinichi; Shinohara, Nobuo; Harabayashi, Toru; Miyasaka, Kazuo

    2002-01-01

    Purpose: To quantify three-dimensional (3D) movement of the prostate gland with the patient in the supine and prone positions and to analyze the movement frequency for each treatment position. Methods and Materials: The real-time tumor-tracking radiotherapy (RTRT) system was developed to identify the 3D position of a 2-mm gold marker implanted in the prostate 30 times/s using two sets of fluoroscopic images. The linear accelerator was triggered to irradiate the tumor only when the gold marker was located within the region of the planned coordinates relative to the isocenter. Ten patients with prostate cancer treated with RTRT were the subjects of this study. The coordinates of the gold marker were recorded every 0.033 s during RTRT in the supine treatment position for 2 min. The patient was then moved to the prone position, and the marker was tracked for 2 min to acquire data regarding movement in this position. Measurements were taken 5 times for each patient (once a week); a total of 50 sets for the 10 patients was analyzed. The raw data from the RTRT system were filtered to reduce system noise, and the amplitude of movement was then calculated. The discrete Fourier transform of the unfiltered data was performed for the frequency analysis of prostate movement. Results: No apparent difference in movement was found among individuals. The amplitude of 3D movement was 0.1-2.7 mm in the supine and 0.4-24 mm in the prone positions. The amplitude in the supine position was statistically smaller in all directions than that in the prone position (p < 0.0001). The amplitude in the craniocaudal and AP directions was larger than in the left-right direction in the prone position (p < 0.0001). No characteristic movement frequency was detected in the supine position. The respiratory frequency was detected for all patients regarding movement in the craniocaudal and AP directions in the prone position. The results of the frequency analysis suggest that prostate movement is

  6. A comparative study of set up variations and bowel volumes in supine versus prone positions of patients treated with external beam radiation for carcinoma rectum.

    Science.gov (United States)

    Rajeev, K R; Menon, Smrithy S; Beena, K; Holla, Raghavendra; Kumar, R Rajaneesh; Dinesh, M

    2014-01-01

    A prospective study was undertaken to evaluate the influence of patient positioning on the set up variations to determine the planning target volume (PTV) margins and to evaluate the clinical relevance volume assessment of the small bowel (SB) within the irradiated volume. During the period of months from December 2011 to April 2012, a computed tomography (CT) scan was done either in supine position or in prone position using a belly board (BB) for 20 consecutive patients. All the patients had histologically proven rectal cancer and received either post- or pre-operative pelvic irradiation. Using a three-dimensional planning system, the dose-volume histogram for SB was defined in each axial CT slice. Total dose was 46-50 Gy (2 Gy/fraction), delivered using the 4-field box technique. The set up variation of the study group was assessed from the data received from the electronic portal imaging device in the linear accelerator. The shift along X, Y, and Z directions were noted. Both systematic and random errors were calculated and using both these values the PTV margin was calculated. The systematic errors of patients treated in the supine position were 0.87 (X-mm), 0.66 (Y-mm), 1.6 (Z-mm) and in the prone position were 1.3 (X-mm), 0.59 (Y-mm), 1.17 (Z-mm). The random errors of patients treated in the supine positions were 1.81 (X-mm), 1.73 (Y-mm), 1.83 (Z-mm) and in prone position were 2.02 (X-mm), 1.21 (Y-mm), 3.05 (Z-mm). The calculated PTV margins in the supine position were 3.45 (X-mm), 2.87 (Y-mm), 5.31 (Z-mm) and in the prone position were 4.91 (X-mm), 2.32 (Y-mm), 5.08 (Z-mm). The mean volume of the peritoneal cavity was 648.65 cm 3 in the prone position and 1197.37 cm 3 in the supine position. The prone position using BB device was more effective in reducing irradiated SB volume in rectal cancer patients. There were no significant variations in the daily set up for patients treated in both supine and prone positions.

  7. Going to sleep in the supine position is a modifiable risk factor for late pregnancy stillbirth; Findings from the New Zealand multicentre stillbirth case-control study.

    Directory of Open Access Journals (Sweden)

    Lesley M E McCowan

    Full Text Available Our objective was to test the primary hypothesis that maternal non-left, in particular supine going-to-sleep position, would be a risk factor for late stillbirth (≥28 weeks of gestation.A multicentre case-control study was conducted in seven New Zealand health regions, between February 2012 and December 2015. Cases (n = 164 were women with singleton pregnancies and late stillbirth, without congenital abnormality. Controls (n = 569 were women with on-going singleton pregnancies, randomly selected and frequency matched for health region and gestation. The primary outcome was adjusted odds of late stillbirth associated with self-reported going-to-sleep position, on the last night. The last night was the night before the late stillbirth was thought to have occurred or the night before interview for controls. Going-to-sleep position on the last night was categorised as: supine, left-side, right-side, propped or restless. Multivariable logistic regression adjusted for known confounders.Supine going-to-sleep position on the last night was associated with increased late stillbirth risk (adjusted odds ratios (aOR 3.67, 95% confidence interval (CI 1.74 to 7.78 with a population attributable risk of 9.4%. Other independent risk factors for late stillbirth (aOR, 95% CI were: BMI (1.04, 1.01 to 1.08 per unit, maternal age ≥40 (2.88, 1.31 to 6.32, birthweight <10th customised centile (2.76, 1.59 to 4.80, and <6 hours sleep on the last night (1.81, 1.14 to 2.88. The risk associated with supine-going-to-sleep position was greater for term (aOR 10.26, 3.00 to 35.04 than preterm stillbirths (aOR 3.12, 0.97 to 10.05.Supine going-to-sleep position is associated with a 3.7 fold increase in overall late stillbirth risk, independent of other common risk factors. A public health campaign encouraging women not to go-to-sleep supine in the third trimester has potential to reduce late stillbirth by approximately 9%.

  8. O tratamento dos doentes insanos de Vila Viçosa no hospital de Rilhafoles (segunda metade do século XIX

    Directory of Open Access Journals (Sweden)

    Lobo de Araújo, Maria Marta

    2014-12-01

    Full Text Available In this work we examined the procedural requirements related to the sending of insane patients of Vila Viçosa to the hospital of Rilhafoles, in the second half of the 19th century, and the relationships established with the hospital of this Alentejo town relating to the payment of treatment. Faced with a severe financial crisis, the hospital of Vila Viçosa systematically refused the responsibility to send the insane patients to the Rilhafoles hospital in an attempt to pass this burden on the administration of the county, being very reluctant to pay the bills that came to him from the hospital of São José. The conflict between the two institutions came to the monarch with no other alternative than the payment, the hospital of village of the Alentejo region proceeded to sending parcels of money, albeit way too late. For the realization of this work we use the books of the Misericórdia and the documents of the Civil Governor found of the city of Évora under the custody of the Distrital Archive of the same city. This documents results, basically, from the correspondence between the Misericórdia of Vila Viçosa, the council administrator and the civil governor of Évora.[pt] Neste trabalho analisamos os trâmites processuais respeitantes ao envio de doentes insanos de Vila Viçosa para o hospital de Rilhafoles, na segunda metade do século XIX, e as relações estabelecidas com o hospital desta vila alentejana relativamente ao pagamento do tratamento. A braços com uma grave crise financeira, o hospital de Vila Viçosa recusava sistematicamente a responsabilidade de enviar os alienados para Rilhafoles, numa tentativa de passar esse ónus para a administração do concelho, mostrando-se muito renitente no pagamento das faturas que lhe chegavam do hospital de São José. O conflito entre as duas instituições chegou ao monarca e sem outra alternativa que a do pagamento, o hospital da vila alentejana procedeu ao envio de parcelas de dinheiro

  9. Prevention of supine hypotensive syndrome in pregnant women undergoing computed tomography - A national survey of current practice

    International Nuclear Information System (INIS)

    McMahon, Michelle A.; Fenwick, Alison; Banks, Amelia; Dineen, Robert A.

    2009-01-01

    Aim: Supine hypotensive syndrome (SHS) can occur in women in the second half of pregnancy due to compression of the aorta and inferior vena cava by the gravid uterus. This results in a decrease in cardiac output with effects ranging from transient asymptomatic hypotension to cardiovascular collapse. SHS can be easily avoided by left lateral tilt positioning. We undertook a nationwide survey to assess the awareness amongst senior computed tomography (CT) radiographers of the potential risk of SHS in women in this patient group, and to identify the extent to which preventative practices and protocols are in place. Methods and materials: A questionnaire was sent to superintendent CT radiographers at all acute NHS Trusts in England and Wales examining awareness of the risk of SHS and the preventative practices and protocols currently used. Results: Completed questionnaires were received from 64% institutions. Of respondents who scan women in this patient group, only 44% were aware of the risk of SHS. No institution had a written protocol specifying positioning of women in this patient group. Seventy-five percent of institutions never employed oblique positioning. Eighty-five percent felt that specific guidelines from the Society of Radiographers or Royal College of Radiologists would be helpful. Conclusion: Current awareness and practices for preventing this easily avoidable but potentially harmful condition are inadequate. Central guidance would be welcomed by a large majority of respondents.

  10. Cerclage wire and lag screw fixation of the lateral malleolus in supination and external rotation fractures of the ankle.

    Science.gov (United States)

    Bajwa, Amarjit S; Gantz, D E

    2005-01-01

    Wound dehiscence and exposed lateral hardware can occur after open reduction internal fixation of lateral malleolus. The bulk of a lateral plate and the minimum soft tissue over the lateral malleolus may contribute to this situation. The objective of this study was to evaluate a series of patients with lateral malleolar fractures treated with operative reduction using minimal hardware. We wanted to observe whether there was any loss of reduction and whether there were any incidences of soft tissue disruption. Fifty-two patients with long spiral fracture of the lateral malleolus in a supination-external rotation injury were treated with two or three 3.5-mm lag screws inserted 1 cm apart and 1 or 2 circlage wires. Less rigid fixation was supplemented with a below-the-knee plaster cast. All patients were followed up until clinical and radiological evidence of fracture healing at 6, 10, and 14 weeks postoperatively. By 10 weeks, all patients were full weight bearing, although most patients still limped. At 14 weeks' follow-up, there were no infections or wound dehiscences. All patients were able to return to their activities of daily living. All the fractures had united without loss of original position. Two fractures of the posterior bone spikes seen during surgery united uneventfully. Long spiral fractures of the lateral malleolus of the ankle can be treated successfully with 2 or 3 lag screws and circlage wires without compromising the outcome of the fracture healing.

  11. Finite element modeling for predicting the contact pressure between a foam mattress and the human body in a supine position.

    Science.gov (United States)

    Lee, Wookjin; Won, Byeong Hee; Cho, Seong Wook

    2017-01-01

    In this paper, we generated finite element (FE) models to predict the contact pressure between a foam mattress and the human body in a supine position. Twenty-year-old males were used for three-dimensional scanning to produce the FE human models, which was composed of skin and muscle tissue. A linear elastic isotropic material model was used for the skin, and the Mooney-Rivlin model was used for the muscle tissue because it can effectively represent the nonlinear behavior of muscle. The contact pressure between the human model and the mattress was predicted by numerical simulation. The human models were validated by comparing the body pressure distribution obtained from the same human subject when he was lying on two different mattress types. The experimental results showed that the slope of the lower part of the mattress caused a decrease in the contact pressure at the heels, and the effect of bone structure was most pronounced in the scapula. After inserting a simple structure to function as the scapula, the contact pressure predicted by the FE human models was consistent with the experimental body pressure distribution for all body parts. These results suggest that the models proposed in this paper will be useful to researchers and designers of products related to the prevention of pressure ulcers.

  12. Prevention of supine hypotensive syndrome in pregnant women undergoing computed tomography - A national survey of current practice

    Energy Technology Data Exchange (ETDEWEB)

    McMahon, Michelle A.; Fenwick, Alison [Department of Diagnostic Imaging, Queen' s Medical Centre Campus, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH (United Kingdom); Banks, Amelia [Department of Anaesthesia, City Hospital Campus, Nottingham University Hospitals NHS Trust, Hucknall Road, Nottingham, NG5 1PB (United Kingdom); Dineen, Robert A. [Department of Diagnostic Imaging, Queen' s Medical Centre Campus, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH (United Kingdom)], E-mail: Robert.dineen@nhs.net

    2009-05-15

    Aim: Supine hypotensive syndrome (SHS) can occur in women in the second half of pregnancy due to compression of the aorta and inferior vena cava by the gravid uterus. This results in a decrease in cardiac output with effects ranging from transient asymptomatic hypotension to cardiovascular collapse. SHS can be easily avoided by left lateral tilt positioning. We undertook a nationwide survey to assess the awareness amongst senior computed tomography (CT) radiographers of the potential risk of SHS in women in this patient group, and to identify the extent to which preventative practices and protocols are in place. Methods and materials: A questionnaire was sent to superintendent CT radiographers at all acute NHS Trusts in England and Wales examining awareness of the risk of SHS and the preventative practices and protocols currently used. Results: Completed questionnaires were received from 64% institutions. Of respondents who scan women in this patient group, only 44% were aware of the risk of SHS. No institution had a written protocol specifying positioning of women in this patient group. Seventy-five percent of institutions never employed oblique positioning. Eighty-five percent felt that specific guidelines from the Society of Radiographers or Royal College of Radiologists would be helpful. Conclusion: Current awareness and practices for preventing this easily avoidable but potentially harmful condition are inadequate. Central guidance would be welcomed by a large majority of respondents.

  13. Environmental service payments: evaluating biodiversity conservation trade-offs and cost-efficiency in the Osa Conservation Area, Costa Rica.

    Science.gov (United States)

    Barton, D N; Faith, D P; Rusch, G M; Acevedo, H; Paniagua, L; Castro, M

    2009-02-01

    The cost-efficiency of payments for environmental services (PES) to private landowners in the Osa Conservation Area, Costa Rica, is evaluated in terms of the trade-off between biodiversity representation and opportunity costs of conservation to agricultural and forestry land-use. Using available GIS data and an 'off-the-shelf' software application called TARGET, we find that the PES allocation criteria applied by authorities in 2002-2003 were more than twice as cost-efficient as criteria applied during 1999-2001. Results show that a policy relevant assessment of the cost-effectiveness of PES relative to other conservation policies can be carried out at regional level using available studies and GIS data. However, there are a number of data and conceptual limitations to using heuristic optimisation algorithms in the analysis of the cost-efficiency of PES. Site specific data on probabilities of land-use change, and a detailed specification of opportunity costs of farm land, labour and capital are required to use algorithms such as TARGET for ranking individual sites based on cost-efficiency. Despite its conceptual soundness for regional conservation analysis, biodiversity complementarity presents a practical challenge as a criterion for PES eligibility at farm level because it varies depending on the set of areas under PES contracts at any one time.

  14. Scarlet Macaw (Ara macao, Psittaciformes: Psittacidae Nest Characteristics in the Osa Peninsula Conservation Area (ACOSA, Costa Rica

    Directory of Open Access Journals (Sweden)

    John L Guittar

    2009-06-01

    Full Text Available The Scarlet Macaw (Ara macao is an endangered species. In Costa Rica, the Scarlet Macaw population of the Central Pacific Conservation Area (ACOPAC, n =432 individuals has undergone considerable study and has been used effectively as a flagship species for regional conservation. Costa Rica’s only other viable Scarlet Macaw population, located in the Osa Peninsula Conservation Area (ACOSA, n=800-1200 individuals, remains virtually unstudied. We studied ACOSA Scarlet Macaw nest cavities from February 19th to March 22nd 2006. Through informal interviews with park guards and residents, we found a total of 57 potential nests in 52 trees. Eleven nests were reported as frequently poached. Scarlet Macaws used 14 identified tree species, ten of which are unrecorded in Costa Rica. The most common nesting trees were Caryocar costaricense (n=12, 24%, Schizolobium parahyba (n=9, 18.0%, Ceiba pentandra (n=7, 14.0% and Ficus sp. (n=5, 10.0%. We compare nesting characteristics to those recorded in ACOPAC. A combination of bottom-up and top-down strategies are necessary to ensure the Scarlet Macaw’s long-term success, including environmental education in local schools, community stewardship of active nests, and the advertisement of stricter penalties for poaching. Rev. Biol. Trop. 57 (1-2: 387-393. Epub 2009 June 30.

  15. Epidemiological survey of the taeniasis/cysticercosis complex in cattle farms in Viçosa County, Minas Gerais, Brazil

    Directory of Open Access Journals (Sweden)

    Tatiane O. Santos

    2013-04-01

    Full Text Available Despite the importance of human taeniasis/bovine cysticercosis for public and animal health and the economy, its actual epidemiological status in Brazil is not well-studied. We sought to assess the epidemiological profile of this zoonosis in the rural area of Viçosa County, Minas Gerais, Brazil. The prevalence of bovine cysticercosis was 0.42%, whereas no case of human taeniasis was diagnosed. Factors favoring the persistence of zoonosis were identified. These included the supply of untreated water to animals, animals raised for slaughter without sanitary supervision, poor mechanization of raising techniques, and the use of untreated water for human consumption. Bovine meat for human consumption acquired in the city or from the farm itself was characterized as a risk factor for bovine cysticercosis (Odds Ratio (OR =16.77; p<0.05. Nevertheless, the families on the investigated farms did apply several appropriate measures to control this disease, such as the virtual lack of open sewers and the consumption of well-cooked meat. The presence of bovine cysticercosis cases, and the factors favoring its persistence, point to the need for constant epidemiological and sanitary surveillance in this county.

  16. Rice microRNA osa-miR1848 targets the obtusifoliol 14α-demethylase gene OsCYP51G3 and mediates the biosynthesis of phytosterols and brassinosteroids during development and in response to stress.

    Science.gov (United States)

    Xia, Kuaifei; Ou, Xiaojing; Tang, Huadan; Wang, Ren; Wu, Ping; Jia, Yongxia; Wei, Xiaoyi; Xu, Xinlan; Kang, Seung-Hye; Kim, Seong-Ki; Zhang, Mingyong

    2015-11-01

    Phytosterols are membrane components or precursors for brassinosteroid (BR) biosynthesis. As they cannot be transported long distances, their homeostasis is tightly controlled through their biosynthesis and metabolism. However, it is unknown whether microRNAs are involved in their homeostatic regulation. Rice (Oryza sativa) plants transformed with microRNA osa-miR1848 and its target, the obtusifoliol 14α-demethylase gene, OsCYP51G3, were used to investigate the role of osa-miR1848 in the regulation of phytosterol biosynthesis. osa-miR1848 directs OsCYP51G3 mRNA cleavage to regulate phytosterol and BR biosynthesis in rice. The role of OsCYP51G3 as one of the osa-miR1848 targets is supported by the opposite expression patterns of osa-miR1848 and OsCYP51G3 in transgenic rice plants, and by the identification of OsCYP51G3 mRNA cleavage sites. Increased osa-miR1848 and decreased OsCYP51G3 expression reduced phytosterol and BR concentrations, and caused typical phenotypic changes related to phytosterol and BR deficiency, including dwarf plants, erect leaves, semi-sterile pollen grains, and shorter cells. Circadian expression of osa-miR1848 regulated the diurnal abundance of OsCYP51G3 transcript in developing organs, and the response of OsCYP51G3 to salt stress. We propose that osa-miR1848 regulates OsCYP51G3 expression posttranscriptionally, and mediates phytosterol and BR biosynthesis. osa-miR1848 and OsCYP51G3 might have potential applications in rice breeding to modulate leaf angle, and the size and quality of seeds. © 2015 The Authors. New Phytologist © 2015 New Phytologist Trust.

  17. Effect of the supine position on uterine and umbilical blood flow during the third trimester of uncomplicated pregnancies in multiparous patients.

    Science.gov (United States)

    Jaffa, A J; Gull, I; Amster, R; Lessing, J B; Wolman, I

    2001-01-01

    We established the effects of the supine position on umbilical blood flow when measured during the third trimester in 30 multiparous, normotensive patients. Blood flow in the umbilical and uterine arteries and blood pressure in the brachial and popliteal arteries were blindly taken by two different observers: first in the lateral and 5 min later in the supine position. There was a significant difference in mean blood pressure between the two postures. However, there was no statistical difference in the pulse pressure or in systolic/diastolic ratio in the umbilical and uterine arteries between the two positions. Postural changes in normotensive multiparous patients do not affect uterine and umbilical blood flow during the third trimester of uncomplicated pregnancies. Copyright 2001 S. Karger AG, Basel

  18. Analysis of the effects of non-supine sleeping positions on the stress, strain, deformation and intraocular pressure of the human eye

    Science.gov (United States)

    Volpe, Peter A.

    This thesis presents analytical models, finite element models and experimental data to investigate the response of the human eye to loads that can be experienced when in a non-supine sleeping position. The hypothesis being investigated is that non-supine sleeping positions can lead to stress, strain and deformation of the eye as well as changes in intraocular pressure (IOP) that may exacerbate vision loss in individuals who have glaucoma. To investigate the quasi-static changes in stress and internal pressure, a Fluid-Structure Interaction simulation was performed on an axisymmetrical model of an eye. Common Aerospace Engineering methods for analyzing pressure vessels and hyperelastic structural walls are applied to developing a suitable model. The quasi-static pressure increase was used in an iterative code to analyze changes in IOP over time.

  19. Acute Infantile Encephalopathy Predominantly Affecting The Frontal Lobes (AIEF).

    Science.gov (United States)

    Raha, Sarbani; Udani, Vrajesh

    2012-12-01

    Acute Infantile Encephalopathy Predominantly Affecting the Frontal Lobes (AIEF) is a relatively recent described entity. This article includes case reports of two patients who had bifrontal involvement during acute febrile encephalopathy. Case 1 describes a 1-y-old boy who presented with hyperpyrexia and dialeptic seizures. Imaging revealed significant bilateral frontal lobe involvement while serology proved presence of Influenza B infection. Over a period of one wk, he recovered with significant cognitive decline and perseveratory behavior. Another 6-y-old boy presented with language and behavioral problems suggestive of frontal dysfunction after recovering from prolonged impairment of consciousness following a convulsive status epilepticus. Bilateral superior frontal lesions with gyral swelling was evident on neuroimaging. These cases are among the very few cases of AIEF described in recent literature and the article also reviews this unique subtype of acute encephalopathy.

  20. Predominant Nearshore Sediment Dispersal Patterns in Manila Bay

    Directory of Open Access Journals (Sweden)

    Fernando Siringan

    1997-12-01

    Full Text Available Net nearshore sediment drift patterns in Manila Bay were determined by combining the coastal geomorphology depicted in 1 : 50,000scale topographic maps and Synthetic Aperture Radar (SAR images, with changes in shoreline position and predominant longshore current directions derived from the interaction of locally generated waves and bay morphology.Manila Bay is fringed by a variety of coastal subenvironments that reflect changing balances of fluvial, wave, and tidal processes. Along the northern coast, a broad tidal-river delta plain stretching from Bataan to Bulacan indicates the importance of tides, where the lateral extent of tidal influences is amplified by the very gentle coastal gradients. In contrast, along the Cavite coast sandy strandplains, spits, and wave-dominated deltas attest to the geomorphic importance of waves that enter the bay from the South China Sea.The estimates of net sediment drift derived from geomorphological, shoreline-change, and meteorological information are generally in good agreement. Sediment drift directions are predominantly to the northeast along Cavite, to the northwest along Manila and Bulacan, and to the north along Bataan. Wave refraction and eddy formation at the tip of the Cavite Spit cause southwestward sediment drift along the coast from Zapote to Kawit. Geomorphology indicates that onshore-offshore sediment transport is probably more important than alongshore transport along the coast fronting the tidal delta plain of northern Manila Bay. Disagreements between the geomorphic-derived and predicted net sediment drift directions may be due to interactions of wave-generated longshore currents with wind- and tide-generated currents.

  1. Nonalbumin proteinuria predominates in biopsy-proven tenofovir nephrotoxicity.

    Science.gov (United States)

    Sise, Meghan E; Hirsch, Jamie S; Canetta, Pietro A; Herlitz, Leal; Mohan, Sumit

    2015-05-15

    Tenofovir disoproxil fumarate (TDF) nephrotoxicity is characterized by proximal renal tubular injury and dysmorphic mitochondria resulting in proteinuria, orthoglycemic glycosuria, and other markers of proximal tubular dysfunction. The objective of this study was to determine the pattern of proteinuria in patients with biopsy-proven TDF nephrotoxicity. Retrospective chart review. Patients with biopsy-proven TDF nephrotoxicity were identified and their medical charts and biopsy reports were reviewed. Comparison was made with HIV-infected patients not on TDF who underwent kidney biopsy. We identified 43 biopsy-proven cases of TDF nephrotoxicity; mean age 54.7 ± 0.4 years, 53% men, 42% whites. Thirty-seven cases reported proteinuria by dipstick of which only 60% had at least 2+ proteinuria. Twenty-seven patients had urine protein quantified by either 24-h collection or spot urine protein-to-creatinine ratio; median proteinuria was 1742 mg/day [interquartile range (IQR) 1200-2000 mg] and 1667 mg/g creatinine (IQR 851-1967 mg/g), respectively. Ten patients had concurrent urinary albumin measured, with a median 236 mg/g creatinine (IQR 137-343 mg/g). The mean urine albumin-to-urine protein ratio (uAPR) was 0.17 (IQR 0.14-0.19), confirming that TDF nephrotoxicity is primarily associated with nonalbumin proteinuria. Control cases had a uAPR of 0.65 (IQR 0.55-0.79) P < 0.001. Histopathology showed the predominance of proximal tubular injury with characteristic mitochondrial abnormalities. In the largest published cohort of patients with biopsy-proven TDF nephrotoxicity, we show that low uAPR is a reliable feature of this disease. Because of the predominance of nonalbumin proteinuria, dipstick urinalysis may be unreliable in TDF nephrotoxicity.

  2. Perfil socioeconômico, nutricional e de antioxidantes de jovens fumantes, do município de Viçosa-MG

    OpenAIRE

    Batista, Ellencristina da Silva

    2006-01-01

    Com o objetivo de comparar o perfil socieconômico, nutricional e de antioxidantes de indivíduos jovens fumantes e não fumantes de Viçosa-MG, conduziu-se um estudo transversal controlado. Foram selecionados indivíduos fumantes e não fumantes de instituições de ensino da cidade de Viçosa-MG. Considerou-se como fumante o indivíduo que fumava pelo menos um cigarro diariamente, por pelo menos 30 dias antes do inicio do estudo, e não fumante o que nunca fumou e/ou não fumava esporadicamente. Os fum...

  3. Quantitative cardiovascular magnetic resonance in pregnant women: cross-sectional analysis of physiological parameters throughout pregnancy and the impact of the supine position.

    Science.gov (United States)

    Rossi, Alexia; Cornette, Jerome; Johnson, Mark R; Karamermer, Yusuf; Springeling, Tirza; Opic, Petra; Moelker, Adriaan; Krestin, Gabriel P; Steegers, Eric; Roos-Hesselink, Jolien; van Geuns, Robert-Jan M

    2011-06-27

    There are physiological reasons for the effects of positioning on hemodynamic variables and cardiac dimensions related to altered intra-abdominal and intra-thoracic pressures. This problem is especially evident in pregnant women due to the additional aorto-caval compression by the enlarged uterus. The purpose of this study was to investigate the effect of postural changes on cardiac dimensions and function during mid and late pregnancy using cardiovascular magnetic resonance (CMR). Healthy non-pregnant women, pregnant women at 20th week of gestation and at 32nd week of gestation without history of cardiac disease were recruited to the study and underwent CMR in supine and left lateral positions. Cardiac hemodynamic parameters and dimensions were measured and compared between both positions. Five non-pregnant women, 6 healthy pregnant women at mid pregnancy and 8 healthy pregnant women at late pregnancy were enrolled in the study. In the group of non-pregnant women left ventricular (LV) cardiac output (CO) significantly decreased by 9% (p=0.043) and right ventricular (RV) end-diastolic volume (EDV) significantly increased by 5% (p=0.043) from the supine to the left lateral position. During mid pregnancy LV ejection fraction (EF), stroke volume (SV), left atrium lateral diameter and left atrial supero-inferior diameter increased significantly from the supine position to the left lateral position: 8%, 27%, 5% and 11%, respectively (ppregnancy a significant increment of LV EF, EDV, SV and CO was observed in the left lateral position: 11%, 21%, 35% and 24% (ppregnancy positional changes affect significantly cardiac hemodynamic parameters and dimensions. Pregnant women who need serial studies by CMR should be imaged in a consistent position. From as early as 20 weeks the left lateral position should be preferred on the supine position because it positively affects venous return, SV and CO.

  4. Quantitative cardiovascular magnetic resonance in pregnant women: cross-sectional analysis of physiological parameters throughout pregnancy and the impact of the supine position

    Directory of Open Access Journals (Sweden)

    Moelker Adriaan

    2011-06-01

    Full Text Available Abstract Background There are physiological reasons for the effects of positioning on hemodynamic variables and cardiac dimensions related to altered intra-abdominal and intra-thoracic pressures. This problem is especially evident in pregnant women due to the additional aorto-caval compression by the enlarged uterus. The purpose of this study was to investigate the effect of postural changes on cardiac dimensions and function during mid and late pregnancy using cardiovascular magnetic resonance (CMR. Methods Healthy non-pregnant women, pregnant women at 20th week of gestation and at 32nd week of gestation without history of cardiac disease were recruited to the study and underwent CMR in supine and left lateral positions. Cardiac hemodynamic parameters and dimensions were measured and compared between both positions. Results Five non-pregnant women, 6 healthy pregnant women at mid pregnancy and 8 healthy pregnant women at late pregnancy were enrolled in the study. In the group of non-pregnant women left ventricular (LV cardiac output (CO significantly decreased by 9% (p = 0.043 and right ventricular (RV end-diastolic volume (EDV significantly increased by 5% (p = 0.043 from the supine to the left lateral position. During mid pregnancy LV ejection fraction (EF, stroke volume (SV, left atrium lateral diameter and left atrial supero-inferior diameter increased significantly from the supine position to the left lateral position: 8%, 27%, 5% and 11%, respectively (p Conclusions During pregnancy positional changes affect significantly cardiac hemodynamic parameters and dimensions. Pregnant women who need serial studies by CMR should be imaged in a consistent position. From as early as 20 weeks the left lateral position should be preferred on the supine position because it positively affects venous return, SV and CO.

  5. Estaquillas leñosas de fácil enraizamiento: Estudio del Esclerenquima Estaquillas leñosas de fácil enraizamiento: Estudio del Esclerénquima

    Directory of Open Access Journals (Sweden)

    González Elena

    1986-12-01

    Full Text Available An anatomy study was made of following wood easy-to-root species: Aucuba japonica Thunb., Buddleja  japonica Hemsley,  Buxus sempervirens L., Citrus aurantium.  L., Citrus limon (L. Burm. fil.,  Cvdonia oblonga Miller,  Erica arborea L., Escallonia rubra (Ruiz & Pavón Pers., Euonymus japonicus L. fil., Forsythia viridissima Lindl., Hydrangea macrophylla Ser., Morus alba L., Populus nigra L.,  Rhododendron ponticum L., Salix atrocinerea Brot., Salix  viminalis L., Sambucus nigra L. and Symphoricarpos albus (L. S. F. Blake.  It was observed the presence or absence of a discontinous sclerenchyma ring so the species studied had not a mechanical barrier to the emergence of adventitious roots. Se realizó un estudio histológico de las siguientes especies leñosas de fácil enraizamiento: Aucuba japonica Thumb, Buddleja japonica Hemsley, Buxus sempervirens L., Citrus aurantium L., Citrus limon (L. Burm, fil., Cydonia oblonga Miller, Erica arborea L., Escallonia rubra (Ruiz & Pavón Pers., Euonymus japonicus L. fil., Forsythia viridissima Lindl., Hydrangea macrophylla Ser., Morus alba L. Populus nigra L., Rhododendron ponticum L., Salix atrocinerea Brot., Salix viminalis L., Sambucus nigra L. y Syrnphoricarpos albus (L. S. F. Blake. Se observó la presencia o ausencia de un anillo discontinuo de esclerénquima, por lo tanto dichas especies no poseen ningún impedimento mecánico para la emergencia de las raíces adventicias.

  6. Perfil cualitativo de metabolitos secundarios en la fracción comestible de especies leñosas seleccionadas por vacunos en un bosque semicaducifolio

    Directory of Open Access Journals (Sweden)

    Á Ojeda

    Full Text Available Con el fin de caracterizar cualitativamente el perfil de metabolitos secundarios de la fracción comestible de plantas leñosas seleccionadas por vacunos en silvopastoreo, las cuales se encuentran en un bosque tropófilo semicaducifolio de Venezuela, se utilizaron 14 vacunos machos Brahman x Holstein de 390,4 ± 18,0 kg de PV. Estos fueron manejados en pastoreo continuo en una superficie de 81 ha, de las cuales 50 ha correspondían a un bosque semicaducifolio y el resto, a vegetación herbácea natural (Cynodon nlemfuensis, Sporobolus indicus, Axonopus sp., Mimosa pudica e Hyptis suaveolens. La composición de la biomasa leñosa seleccionada por los animales se estudió mediante la evaluación de los fragmentos epidérmicos presentes en las heces colectadas por vía transrectal, cada 15 días. A partir de estos resultados, se tomaron muestras de cinco plantas por especie leñosa, en los periodos seco y lluvioso. Se determinaron 15 grupos de metabolitos: alcaloides, á-aminos, carbohidratos solubles, cardenólidos, cianógenos, esteroles, fenoles totales, flavonoides, lectinas, mucílagos, quinonas, saponinas, taninos extractables (totales y condensados y terpenoides. La mayoría de la biomasa correspondió a especies de la familia Fabaceae, las cuales presentaron todos los metabolitos evaluados. En ambos periodos se detectaron niveles de esteroles, terpenoides, fenoles totales y taninos extractables que variaron desde leves hasta cuantiosos. Con independencia del periodo, el 66,7 % de las especies presentó entre 10-11 metabolitos secundarios en su biomasa comestible. Se recomienda realizar estudios para la cuantificación de los metabolitos secundarios presentes en plantas leñosas de valor forrajero, para este sistema silvopastoril

  7. The importance of neck circumference to thyromental distance ratio (NC/TM) as a predictor of difficult intubation in obstructive sleep apnea (OSA) patients

    OpenAIRE

    Hala Ezzat Abdel Naim; Sabah Abdel Raouf Mohamed; Sherif Mohamed Soaida; Haitham Hassan Awad Eltrabily

    2014-01-01

    Background: The trial to find a bedside examination that is helpful for foreseeing difficult intubation is quite inspiring. It was reported that thyromental distance (TM), body mass index (BMI), neck circumference (NC) and a Mallampati score >3 were the only helpful bedside test predictors. By using magnetic resonance imaging, it was established that more fat was present in areas around the collapsible parts of the pharynx in OSA patients. So distribution of fat may provide a better suggestio...

  8. Control of OSA during automatic positive airway pressure titration in a clinical case series: predictors and accuracy of device download data.

    Science.gov (United States)

    Huang, Hsin-Chia Carol; Hillman, David R; McArdle, Nigel

    2012-09-01

    To investigate the factors associated with physiologic control of obstructive sleep apnea (OSA) during automatic positive airway pressure (APAP) titration in a clinical series. To also assess the usefulness of apnea-hypopnea index (AHI) data downloaded from the APAP device (Dev AHI). Retrospective review of a consecutive series of patients with OSA who underwent APAP titration (Autoset Spirit, ResMed, Bella Vista, New South Wales, Australia ) with simultaneous polysomnographic (PSG) monitoring in the sleep laboratory. Tertiary sleep clinic. There were 190 consecutive patients with OSA referred for APAP titration. There were 58% of patients who achieved optimal or good control of OSA (titration PSG AHI titration. The independent predictors of titration PSG AHI were a history of cardiac disease and elevated central apnea and arousal indices during the diagnostic study. Although the median and interquartile range (IQR) AHI from the device (7.0, 3.9-11.6 events/hr) was only slightly less than the PSG AHI (7.8, 3.9-14.4 events/hr, P = 0.04) during titration, case-by-case agreement between the two measures was poor (chi-square titration is often poor, and close clinical follow-up is particularly needed in patients with a history of cardiac disease or with high arousal or central apnea indices on the diagnostic study. Device AHI does not reliably assess control during APAP titration, and PSG assessment may be required if clinical response to treatment is poor. The findings relate to the ResMed AutoSet device and may not apply to other devices.

  9. Pulmonary atelectasis in patients with neurological or muscular disease. Gravity-related lung compression by the heart and intra-abdominal organs on persistent supine position

    International Nuclear Information System (INIS)

    Toyoshima, Mitsuo; Maeoka, Yukinori; Kawahara, Hitoshi; Maegaki, Yoshihiro; Ohno, Kousaku

    2006-01-01

    We report 10 cases of pulmonary atelectasis diagnosed by chest computed tomography in patients with neurological or muscular disease. Atelectasis was frequently seen in hypotonic patients who could not roll over on their own. The atelectases located mostly in the dorsal bronchopulmonary segments, adjacent to the heart or diaphragm. Atelectasis diminished in two patients after they became able to roll themselves over. Gravity-related lung compression by the heart and intra-abdominal organs on persistent supine position can cause pulmonary atelectasis in patients with neurological or muscular disease who can not roll over by their own power. To confirm that the prone position reduces compression of the lungs, chest computed tomography was performed in both the supine and the prone position in three patients. Sagittal images with three-dimensional computed tomographic reconstruction revealed significant sternad displacements of the heart and caudal displacements of the dorsal portion of the diaphragm on prone position compared with supine position. The prone position, motor exercises for rolling over, and biphasic cuirass ventilation are effective in reducing gravity-related lung compression. Some patients with intellectual disabilities were also able to cooperate in chest physiotherapy. Chest physiotherapy is useful in preventing atelectasis in patients with neurological or muscular disease. (author)

  10. Comparison of effect of body position, prone or supine, on the result of extracorporeal shock wave lithotripsy in patients with stones in the proximal ureter

    International Nuclear Information System (INIS)

    Zomorrodi, A.; Elahian, A.; Ghorbani, N.; Tavoosi, A.

    2007-01-01

    The aim of this study was to determine whether positioning of patient, prone or supine, plays a significant role on the treatment of stones in the proximal ureter with extracorporeal shock wave lithotripsy (ESWL). 68 patients with proximal ureteric stones underwent ESWL. The procedure was performed in the supine position in 35 (Group1) and the prone position in 33 patients (Group2). Stone-free rates, repeat ESWL rates, shocks per patient and shocks per session were compared in both groups. The mean session number per patient was 1.93+-0.82 in Group 1 and 1.88+-0.79 in Group 2 (P=0.786). The stone free rates, three months after ESWL, were 81.8% in group 1 and 82.9% in Group 2 (P=>0.05). Thus these two parameters were similar in both groups. Also, the number of shocks per session was 3066.1 +- 346.3 in Group 1 and 3148+-621.0 in Group 2. This difference was no significant (P=0.49). Our study suggests that the treatment of proximal ureteric stones with ESWL in the prone position is a safe and effective as when the patient is placed in the supine position. (author)

  11. Age-related differences in the response of leg muscle cross-sectional area and water diffusivity measures to a period of supine rest.

    Science.gov (United States)

    Lorbergs, Amanda L; Noseworthy, Michael D; MacIntyre, Norma J

    2015-06-01

    The object was to assess whether cross-sectional area (CSA) and water diffusion properties of leg muscles in young and older women change with increased time spent in supine rest. Healthy young (n = 9, aged 20-30 years) and older (n = 9, aged 65-75 years) women underwent MRI scanning of the right leg at baseline, 30 and 60 min of supine rest. Muscle CSA was derived from proton density images. Water diffusion properties [apparent diffusion coefficient (ADC) and fractional anisotropy (FA)] of the tibialis anterior and posterior, soleus, and medial and lateral heads of the gastrocnemius were derived from diffusion tensor imaging (DTI). Repeated measures ANOVAs and Bonferroni post hoc tests determined the effects of time and group on each muscle outcome. In both groups, muscle CSA and FA did not significantly change over time, whereas ADC significantly decreased. A greater decline at 30 min for young women was only observed for ADC in the medial gastrocnemius. Regardless of age, ADC values decreased with fluid shift associated with time spent supine, whereas CSA and FA were not affected. For leg muscle assessment in young and older women, DTI scanning protocols should consider the amount of time spent in a recumbent position.

  12. Weightbearing vs Gravity Stress Radiographs for Stability Evaluation of Supination-External Rotation Fractures of the Ankle.

    Science.gov (United States)

    Seidel, Angela; Krause, Fabian; Weber, Martin

    2017-07-01

    Isolated lateral malleolar fractures may result from a supination-external rotation (SER) injury of the ankle. Stable fractures maintain tibiotalar congruence due to competent medial restraints and can be treated nonoperatively with excellent functional results and long-term prognosis. Stability might be assessed with either stress radiographs or weightbearing radiographs. A consecutive series of patients with closed SER fractures (presumed AO 44-B1) were prospectively enrolled from 2008 to 2015. Patients with clearly unstable fractures (medial clear space more than 7 mm) on the initial nonweightbearing radiograph were excluded and operated on. All other patients were examined with a gravity stress and a weightbearing anteroposterior radiograph. Borderline instability of the fracture was assumed when the medial clear space was 4 to 7 mm. Those were treated nonoperatively. Of 104 patients with isolated lateral malleolar fractures of the SER type, 14 patients were treated operatively because of clear instability (displacement) on the initial radiographs. Of the nonoperative patients, 44 patients demonstrated borderline instability on the gravity stress but stability on the weightbearing radiograph ("gravity borderline"); the remaining 46 were stable in both tests ("gravity stable"). At an average follow-up of 23 months, no significant differences were seen in the American Orthopaedic Foot & Ankle Society hindfoot score (92 points gravity-borderline group vs 93 points gravity-unstable group), the Foot Functional Index score (11 vs 10 points), the Short Form 36 (SF-36) physical component (86 vs 85 points), and SF-36 mental component (84 vs 81 points). Radiographically, all fractures had healed with anatomic congruity of the ankle. Weightbearing radiographs provided a reliable basis to decide about stability and nonoperative treatment in isolated lateral malleolar fractures of the SER type with excellent clinical and radiographic outcome at short-term follow-up. Gravity

  13. Venoconstrictor agents mobilize blood from different sources and increase intrathoracic filling during epidural anesthesia in supine humans

    International Nuclear Information System (INIS)

    Stanton-Hicks, M.; Hoeck, A.S.; Stuehmeier, K.D.A.; Arndt, J.O.

    1987-01-01

    The authors studied the effects of dihydroergotamine (DHE) and etilefrine hydrochloride (E) on the regional distribution of /sup 99m/Tc-marked erythrocytes during epidural anesthesia in eight supine men to determine if vasoactive agents with venoconstrictor action would enhance cardiac filling during epidural anesthesia. Radioactivity was recorded with a gamma camera, and its distribution determined in the thorax, abdomen, and limbs. Arterial and central venous pressure, heart rate, and calf volume by plethysmography were measured. During epidural anesthesia with a sensory block up to T4/5, DHE (7.5 micrograms/kg) reduced the radioactivity, i.e., blood volume, in both the innervated (-5.9 +/- 3.5%) and denervated muscle/skin (-16.9 +/- 7%) regions, and increased it in both the intrathoracic (+7.0 +/- 2.3%), and splanchnic vasculature (+4.2 +/- 3.2). In contrast, E (6 micrograms X kg-1 X min-1) decreased the blood volume most markedly in the splanchnic region (-5.4 +/- 0.7%) and increased it in the thorax (+2 +/- 0.6%). All these changes were statistically significant. The combined effects were estimated to be equivalent to a transfusion of nearly 1.01 of blood. Both drugs reversed the hypotensive action of epidural anesthesia. During epidural anesthesia, DHE preferentially constricted the capacitance vessels in skeletal muscle and skin irrespective of the state of innervation, whereas E preferentially constricted the splanchnic vasculature. In the doses used, the two agents replenished in an additive fashion the central circulation during epidural anesthesia

  14. Dynamic Stress Testing Is Unnecessary for Unimalleolar Supination-External Rotation Ankle Fractures with Minimal Fracture Displacement on Lateral Radiographs.

    Science.gov (United States)

    Nortunen, Simo; Leskelä, Hannu-Ville; Haapasalo, Heidi; Flinkkilä, Tapio; Ohtonen, Pasi; Pakarinen, Harri

    2017-03-15

    This study aimed to identify factors from standard radiographs that contributed to the stability of the ankle mortise in patients with isolated supination-external rotation fractures of the lateral malleolus (OTA/AO 44-B). Non-stress radiographs of the mortise and lateral views, without medial clear space widening or incongruity, were prospectively collected for 286 consecutive patients (mean age, 45 years [range, 16 to 85 years]), including 144 female patients (mean age, 50 years [range, 17 to 85 years]) and 142 male patients (mean age, 40 years [range, 16 to 84 years]) from 2 trauma centers. The radiographs were analyzed for fracture morphology by 2 orthopaedic surgeons, who were blinded to each other's measurements and to the results of external rotation stress radiographs (the reference for stability). Factors significantly associated with ankle mortise stability were tested in multiple logistic regression. Receiver operating characteristic analyses were performed for continuous variables to determine optimal thresholds. A sensitivity of >90% was used as the criterion for an optimal threshold. According to external rotation stress radiographs, 217 patients (75.9%) had a stable injury, defined as that with a medial clear space of ankle mortise were female sex (odds ratio [OR], 2.5 [95% confidence interval (CI), 1.4 to 4.6]), a posterior diastasis of fracture fragments (OR, 7.3 [95% CI, 2.1 to 26.3]). When the posterior diastasis was fracture fragments were present, the probability of a stable ankle mortise was 0.98 for 48 female patients (16.8%) and 0.94 for 37 male patients (12.9%). Patients with noncomminuted lateral malleolar fractures (85 patients [29.7%]) could be diagnosed with a stable ankle mortise without further stress testing, when the fracture line widths were <2 mm on lateral radiographs. Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  15. Rapid intravenous infusion of 20 mL/kg saline alters the distribution of perfusion in healthy supine humans.

    Science.gov (United States)

    Henderson, A C; Sá, R C; Barash, I A; Holverda, S; Buxton, R B; Hopkins, S R; Prisk, G K

    2012-03-15

    Rapid intravenous saline infusion, a model meant to replicate the initial changes leading to pulmonary interstitial edema, increases pulmonary arterial pressure in humans. We hypothesized that this would alter lung perfusion distribution. Six healthy subjects (29 ± 6 years) underwent magnetic resonance imaging to quantify perfusion using arterial spin labeling. Regional proton density was measured using a fast-gradient echo sequence, allowing blood delivered to the slice to be normalized for density and quantified in mL/min/g. Contributions from flow in large conduit vessels were minimized using a flow cutoff value (blood delivered > 35% maximum in mL/min/cm(3)) in order to obtain an estimate of blood delivered to the capillary bed (perfusion). Images were acquired supine at baseline, after infusion of 20 mL/kg saline, and after a short upright recovery period for a single sagittal slice in the right lung during breath-holds at functional residual capacity. Thoracic fluid content measured by impedance cardiography was elevated post-infusion by up to 13% (pchanges in conduit vessels, there were no significant changes in perfusion in dependent lung following infusion (7.8 ± 1.9 mL/min/g baseline, 7.9 ± 2.0 post, 8.5 ± 2.1 recovery, p=0.36). There were no significant changes in lung density. These data suggest that saline infusion increased perfusion to nondependent lung, consistent with an increase in intravascular pressures. Dependent lung may have been "protected" from increases in perfusion following infusion due to gravitational compression of the pulmonary vasculature. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. Role of spousal involvement in continuous positive airway pressure (CPAP adherence in patients with obstructive sleep apnea (OSA

    Directory of Open Access Journals (Sweden)

    Batool-Anwar S

    2017-05-01

    Full Text Available Introduction: Little is known about the impact of spousal involvement on continuous positive airway pressure (CPAP adherence. The aim of this study was to determine whether spouse involvement affects adherence with CPAP therapy, and how this association varies with gender. Methods: 194 subjects recruited from Apnea Positive Pressure Long Term Efficacy Study (APPLES completed the Dyadic Adjustment Scale (DAS. The majority of participants were Caucasian (83%, and males (73%, with mean age of 56 years, mean BMI of 31 kg/m2. & 62% had severe OSA. The DAS is a validated 32-item self-report instrument measuring dyadic consensus, satisfaction, cohesion, and affectional expression. A high score in the DAS is indicative of a person’s adjustment to the marriage. Additionally, questions related to spouse involvement with general health and CPAP use were asked. CPAP use was downloaded from the device and self-report, and compliance was defined as usage > 4 h per night. Results: There were no significant differences in overall marital quality between the compliant and noncompliant subjects. However, level of spousal involvement was associated with increased CPAP adherence at 6 months (p=0.01. After stratifying for gender these results were significant only among males (p=0.03. Three years after completing APPLES, level of spousal involvement was not associated with CPAP compliance even after gender stratification. Conclusion: Spousal involvement is important in determining CPAP compliance in males in the 1st 6 months after initiation of therapy but is not predictive of longer-term adherence. Involvement of the spouse should be considered an integral part of CPAP initiation procedures.

  17. Mapping Tropical Forest Mosaics with C- and L-band SAR: First Results from Osa Peninsula, Costa Rica

    Science.gov (United States)

    Pinto, N.; Hensley, S.; Aguilar-Amuchastegui, N.; Broadbent, E. N.; Ahmed, R.

    2016-12-01

    In tropical countries, economic incentives and improved infrastructure are creating forest mosaics where small-scale farming and industrial plantations are embedded within and potentially replacing native ecosystems. Practices such as agroforestry, slash-and-burn cultivation, and oil palm monocultures bring widely different impacts on carbon stocks. Characterizing these production systems is not only critical to ascribe deforestation to particular drivers, but also essential to understand the impact of macroeconomic scenarios, national policies, and land tenure schemes on carbon fluxes. The last decade has experienced a dramatic improvement in the extent and consistency of tree cover and gross deforestation products from optical imagery. At the same time, recent work shows that Synthetic Aperture Radar (SAR) can complement optical data and reveal structural types that cannot be easily resolved with reflectance measurements alone. While these results demonstrate the validity of sensor fusion methodologies, they typically rely on local classifications or even manual delineation and as such they cannot support large-scale investigations. Furthermore, there have been few attempts to exploit PolInSAR or multiple wavelengths that can provide critical information to resolve natural and anthropogenic land cover types. We report results from our research at Costa Rica's Osa Peninsula. This site is ideal for algorithm development as it includes a highly diverse tropical forest within Corcovado National Park, as well as agroforestry zones, mangroves, and palm plantations. We first integrate SAR backscatter and coherence data from NASA's L-band UAVSAR, JAXA's ALOS/PALSAR, and ESA's Sentinel to produce a map of structural types. Second, we assess whether coherence measurements and PolInSAR retrievals can be used to resolve forest stand differences at 30m resolution and disitinguish between primary and secondary forest sites.

  18. SU-E-J-21: Setup Variability of Colorectal Cancer Patients Treated in the Prone Position and Dosimetric Comparison with the Supine Position

    Energy Technology Data Exchange (ETDEWEB)

    Kim, A; Foster, J; Chu, W; Karotki, A [Sunnybrook Health Sciences Centre/Odette Cancer Centre, Toronto, Ontario (Canada)

    2015-06-15

    Purpose: Many cancer centers treat colorectal patients in the prone position on a belly board to minimize dose to the small bowel. That may potentially Result in patient setup instability with corresponding impact on dose delivery accuracy for highly conformal techniques such as IMRT/VMAT. Two aims of this work are 1) to investigate setup accuracy of rectum patients treated in the prone position on a belly board using CBCT and 2) to evaluate dosimetric impact on bladder and small bowel of treating rectum patients in supine vs. prone position. Methods: For the setup accuracy study, 10 patients were selected. Weekly CBCTs were acquired and matched to bone. The CBCT-determined shifts were recorded. For the dosimetric study, 7 prone-setup patients and 7 supine-setup patients were randomly selected from our clinical database. Various clinically relevant dose volume histogram values were recorded for the small bowel and bladder. Results: The CBCT-determined rotational shifts had a wide variation. For the dataset acquired at the time of this writing, the ranges of rotational setup errors for pitch, roll, and yaw were [−3.6° 4.7°], [−4.3° 3.2°], and [−1.4° 1.4°]. For the dosimetric study: the small bowel V(45Gy) and mean dose for the prone position was 5.6±12.1% and 18.4±6.2Gy (ranges indicate standard deviations); for the supine position the corresponding dose values were 12.9±15.8% and 24.7±8.8Gy. For the bladder, the V(30Gy) and mean dose for prone position were 68.7±12.7% and 38.4±3.3Gy; for supine position these dose values were 77.1±13.7% and 40.7±3.1Gy. Conclusion: There is evidence of significant rotational instability in the prone position. The OAR dosimetry study indicates that there are some patients that may still benefit from the prone position, though many patients can be safely treated supine.

  19. In patients with minimally symptomatic OSA can baseline characteristics and early patterns of CPAP usage predict those who are likely to be longer-term users of CPAP.

    Science.gov (United States)

    Turnbull, Christopher D; Bratton, Daniel J; Craig, Sonya E; Kohler, Malcolm; Stradling, John R

    2016-02-01

    Long-term continuous positive airway pressure (CPAP) usage varies between individuals. It would be of value to be able to identify those who are likely to benefit from CPAP (and use it long term), versus those who would not, and might therefore benefit from additional help early on. First, we explored whether baseline characteristics predicted CPAP usage in minimally symptomatic obstructive sleep apnoea (OSA) patients, a group who would be expected to have low usage. Second, we explored if early CPAP usage was predictive of longer-term usage, as has been shown in more symptomatic OSA patients. The MOSAIC trial was a multi-centre randomised controlled trial where minimally symptomatic OSA patients were randomised to CPAP, or standard care, for 6 months. Here we have studied only those patients randomised to CPAP treatment. Baseline characteristics including symptoms, questionnaires [including the Epworth sleepiness score (ESS)] and sleep study parameters were recorded. CPAP usage was recorded at 2-4 weeks after initiation and after 6 months. The correlation and association between baseline characteristics and 6 months CPAP usage was assessed, as was the correlation between 2 and 4 weeks CPAP usage and 6 months CPAP usage. One hundred and ninety-five patients randomised to CPAP therapy had median [interquartile range (IQR)] CPAP usage of 2:49 (0:44, 5:13) h:min/night (h/n) at the 2-4 weeks visit, and 2:17 (0:08, 4:54) h/n at the 6 months follow-up visit. Only male gender was associated with increased long-term CPAP use (male usage 2:56 h/n, female 1:57 h/n; P=0.02). There was a moderate correlation between the usage of CPAP at 2-4 weeks and 6 months, with about 50% of the variability in long-term use being predicted by the short-term use. In patients with minimally symptomatic OSA, our study has shown that male gender (and not OSA severity or symptom burden) is associated with increased long-term use of CPAP at 6 months. Although, in general, early patterns of CPAP

  20. Identification of the predominant volatile compounds produced by Aspergillus flavus.

    Science.gov (United States)

    Kamiński, E; Libbey, L M; Stawicki, S; Wasowicz, E

    1972-11-01

    A culture of Aspergillus flavus grown on moistened wheat meal was homogenized with a blendor, and the resulting slurry was vacuum-distilled at 5 mm of Hg and 35 C. The aqueous distillate was collected in traps cooled to -10 to -80 C. The culture volatiles were extracted from the distillate with CH(2)Cl(2), and, after removal of the bulk of the solvent, the concentrated volatiles were examined by packed-column gas chromatography. Nineteen peaks were observed, and coupled gas chromatography-mass spectrometry was employed to identify the larger components. The compounds identified were: 3-methyl-butanol, 3-octanone, 3-octanol, 1-octen-3-ol, 1-octanol, and cis-2-octen-1-ol. The two octenols were the predominant compounds, and sufficient sample was trapped from the gas chromatograph for infrared analyses; this confirmed the mass spectral identifications and permitted the assignment of the cis designation to 2-octen-1-ol. Both oct-1-en-3-ol and cis-2-octen-1-ol are thought to be responsible for the characteristic musty-fungal odor of certain fungi; the latter compound may be a useful chemical index of fungal growth.

  1. Predominantly elastic crack growth under combined creep-fatigue cycling

    International Nuclear Information System (INIS)

    Lloyd, G.J.

    1979-01-01

    A rationalization of the various observed effects of combined creep-fatigue cycling upon predominantly elastic fatigue-crack propagation in austenitic steel is presented. Existing and new evidence is used to show two main groups of behaviour: (i) material and cycling conditions which lead to modest increases (6-8 times) in the rate of crack growth are associated with relaxation-induced changes in the material deformation characteristics, and (ii) material and cycling conditions severe enough to generate internal fracture damage lead to significant (up to a factor of 30) increases in crack growth rate when compared with fast-cycling crack propagation rates at the same temperature. A working hypothesis is presented to show that the boundary between the two groups occurs when the scale of the nucleated creep damage is of the same magnitude as the crack tip opening displacement. This leads to the possibility of unstable crack advance. Creep crack growth rates are shown to provide an upper bound to creep-fatigue crack growth rates when crack advance is unstable. If the deformation properties only are affected by the creep-fatigue cycling then creep crack growth rates provide a lower bound. The role of intergranular oxygen corrosion in very low frequency crack growth tests is also briefly discussed. (author)

  2. Ureter smooth muscle cell orientation in rat is predominantly longitudinal.

    Science.gov (United States)

    Spronck, Bart; Merken, Jort J; Reesink, Koen D; Kroon, Wilco; Delhaas, Tammo

    2014-01-01

    In ureter peristalsis, the orientation of the contracting smooth muscle cells is essential, yet current descriptions of orientation and composition of the smooth muscle layer in human as well as in rat ureter are inconsistent. The present study aims to improve quantification of smooth muscle orientation in rat ureters as a basis for mechanistic understanding of peristalsis. A crucial step in our approach is to use two-photon laser scanning microscopy and image analysis providing objective, quantitative data on smooth muscle cell orientation in intact ureters, avoiding the usual sectioning artifacts. In 36 rat ureter segments, originating from a proximal, middle or distal site and from a left or right ureter, we found close to the adventitia a well-defined longitudinal smooth muscle orientation. Towards the lamina propria, the orientation gradually became slightly more disperse, yet the main orientation remained longitudinal. We conclude that smooth muscle cell orientation in rat ureter is predominantly longitudinal, though the orientation gradually becomes more disperse towards the proprial side. These findings do not support identification of separate layers. The observed longitudinal orientation suggests that smooth muscle contraction would rather cause local shortening of the ureter, than cause luminal constriction. However, the net-like connective tissue of the ureter wall may translate local longitudinal shortening into co-local luminal constriction, facilitating peristalsis. Our quantitative, minimally invasive approach is a crucial step towards more mechanistic insight into ureter peristalsis, and may also be used to study smooth muscle cell orientation in other tube-like structures like gut and blood vessels.

  3. Abdominal Pain-predominant Functional Gastrointestinal Disorders in Adolescent Nigerians.

    Science.gov (United States)

    Udoh, Ekong; Devanarayana, Niranga Manjuri; Rajindrajith, Shaman; Meremikwu, Martin; Benninga, Marc Alexander

    2016-04-01

    To determine the prevalence, pattern, and predisposing factors of abdominal pain-predominant functional gastrointestinal disorders (AP-FGIDs) in adolescent Nigerians. A cross-sectional study was conducted in 2 states in the southern part of Nigeria in June 2014. Adolescents of age 10 to 18 years were recruited from 11 secondary schools using a stratified random sampling technique. A validated self-administered questionnaire on Rome III criteria for diagnosing AP-FGIDs and its determinants were filled by the participants in a classroom setting. A total of 874 participants filled the questionnaire. Of this, 818 (93.4%) filled it properly and were included in the final analysis. The mean age of the participants was 14.6 ± 2.0 years with 409 (50.0%) being boys. AP-FGIDs were present in 81 (9.9%) participants. Forty six (5.6%) of the study participants had irritable bowel syndrome (IBS), 21 (2.6%) functional abdominal pain, 15 (1.8%) abdominal migraine while 3 (0.4%) had functional dyspepsia. The difference in AP-FGIDs between adolescents residing in rural and urban areas was not statistically significant (P = 0.22). Intestinal and extra-intestinal symptoms occurred more frequently in those with AP-FGIDs. Nausea was the only symptom independently associated with AP-FGIDs (p = 0.015). Multiple regression analysis showed no significant association between stressful life events and AP-FGIDs. AP-FGIDs are a significant health problem in Nigerian adolescents. In addition to the intestinal symptoms, most of the affected children and others also had extraintestinal symptoms. None of the stressful life events evaluated was significantly associated with FGIDs.

  4. Ureter smooth muscle cell orientation in rat is predominantly longitudinal.

    Directory of Open Access Journals (Sweden)

    Bart Spronck

    Full Text Available In ureter peristalsis, the orientation of the contracting smooth muscle cells is essential, yet current descriptions of orientation and composition of the smooth muscle layer in human as well as in rat ureter are inconsistent. The present study aims to improve quantification of smooth muscle orientation in rat ureters as a basis for mechanistic understanding of peristalsis. A crucial step in our approach is to use two-photon laser scanning microscopy and image analysis providing objective, quantitative data on smooth muscle cell orientation in intact ureters, avoiding the usual sectioning artifacts. In 36 rat ureter segments, originating from a proximal, middle or distal site and from a left or right ureter, we found close to the adventitia a well-defined longitudinal smooth muscle orientation. Towards the lamina propria, the orientation gradually became slightly more disperse, yet the main orientation remained longitudinal. We conclude that smooth muscle cell orientation in rat ureter is predominantly longitudinal, though the orientation gradually becomes more disperse towards the proprial side. These findings do not support identification of separate layers. The observed longitudinal orientation suggests that smooth muscle contraction would rather cause local shortening of the ureter, than cause luminal constriction. However, the net-like connective tissue of the ureter wall may translate local longitudinal shortening into co-local luminal constriction, facilitating peristalsis. Our quantitative, minimally invasive approach is a crucial step towards more mechanistic insight into ureter peristalsis, and may also be used to study smooth muscle cell orientation in other tube-like structures like gut and blood vessels.

  5. Assessing roles of vocabulary knowledge predominating in contextual clues

    Directory of Open Access Journals (Sweden)

    Patcharawadee Promduang

    2016-07-01

    Full Text Available The purpose of this study is to investigate the relationship between vocabulary knowledge and the use of contextual clues and whether EFL learners who are well-equipped with reading skills are able to comprehend the text despite a low level of vocabulary knowledge. Therefore, the study focused on which vocabulary dimensions help students guess unfamiliar words. The study was carried out at Hatyai University in Thailand. The population of this study consisted of 34 undergraduates who were studying International Business English and had taken a course in reading techniques. The present study was conducted to conceptually validate the roles of breadth and depth of vocabulary knowledge to improve skills by contextual clue. Vocabulary Depth was specially employed to evaluate two dimensions namely Paradigmatic and Syntagmatic. The Schmitt and Clapham Vocabulary Level Test was used to test vocabulary breadth, while the vocabulary depth was implemented by Read’s Vocabulary Depth Test. Reading parts of the TOEFL were adopted for contextual clue items. There were two statistical analysis tools also implemented in this study: paired-sample t-test and bivariate correlation. First, in an attempt to find which vocabulary dimension predominates in guessing word meaning from the text, a paired-sample t-test was utilized to compare the difference of two vocabulary dimensions in reading part: vocabulary depth and contextual clues, and vocabulary breadth and contextual clues. Second, a bivariate correlation was used to find the degree of relationship between vocabulary knowledge and contextual clues. The consequences of this study identified empirical results that 1 there was a positive relationship between contextual clues and vocabulary depth, the reverse is true in vocabulary breadth. Moreover, vocabulary depth is more significantly crucial than breadth to enhance student’s ability to guess words’ meaning from the context.

  6. Murdelisest tegelaskõnest "Tõe ja õiguse" I osas / Dialect in the Speech of Characters in A. H. Tammsaare’s Truth and Justice Part I

    Directory of Open Access Journals (Sweden)

    Maria Mandri

    2015-06-01

    Full Text Available Teesid: Artikkel keskendub A. H. Tammsaare „Tõe ja õiguse“ pentaloogia I osas leiduvale murdelisele tegelaskõnele. Murdeline tegelaskõne on ilukirjanduslik võte, mis lähtub autori loomingulistest taotlustest ning on seega lahutamatu teose sisust. Keele- ja kirjandusteadust ühendades pakub artikkel seni puudu nud kontekstisidusa käsitluse „Tõe ja õiguse“ I osa tegelaskõnes kasutatud murdepärasuste omadustest ning funktsioonist teose sisu ja kompositsiooni toetamisel. Murdeline tegelaskõne osutab geograafiliselt kesk- ja läänemurde alale, iseloomustab tegelasi kui talurahva hulka kuulujaid, taotleb külaühiskonna realistlikku esitlust, toetab keeleliselt Vargamäe Ees- ja Tagapere ning vanade ja noorte vastandust.    SU M M A R Y   The use of language in Part I of A. H. Tammsaare’s five-volume novel Truth and Justice (Tõde ja Õigus has received quite a bit of scholarly attention. However, up till now there have been few treatments of dialect in characters’ speech that also take into account the coherence of context and the writer’s aesthetic goals. Features of dialect in characters’ speech have been noticed by many researchers, but they mostly limited themselves to giving descriptive accounts of dialect words. These earlier accounts often approached these passages as authentic specimens of dialect, and did not interpret them in context or as aspects of literary form. This article is based on the literary dialect theory of linguist and literary scholar Sumner Ives, who argues from the principle that dialect phenomena in literature cannot be studied as authentic specimens of dialect. In literature, when characters speak in dialect, this serves goals related to the content and composition of the work, and does not attempt to be a precise representation of real dialect speech. In this spirit, I will examine dialect in the characters’ speech in the first volume of Tammsaare’s cycle of novels Truth and Justice

  7. Effects of head-up vs. supine CPR on cerebral oxygenation and cerebral metabolism - a prospective, randomized porcine study.

    Science.gov (United States)

    Putzer, Gabriel; Braun, Patrick; Martini, Judith; Niederstätter, Ines; Abram, Julia; Lindner, Andrea Katharina; Neururer, Sabrina; Mulino, Miriam; Glodny, Bernhard; Helbok, Raimund; Mair, Peter

    2018-05-01

    Recent studies have shown that during cardiopulmonary resuscitation (CPR) head-up position (HUP) as compared to standard supine position (SUP) decreases intracranial pressure (ICP) and increases cerebral perfusion pressure (CPP). The impact of this manoeuvre on brain oxygenation and metabolism is not clear. We therefore investigated HUP as compared to SUP during basic life support (BLS) CPR for their effect on brain oxygenation and metabolism. Twenty pigs were anaesthetized and instrumented. After 8 min of cardiac arrest (CA) pigs were randomized to either HUP or SUP and resuscitated mechanically for 20 min. Mean arterial pressure (MAP), ICP, CPP, cerebral regional oxygen saturation (rSO 2 ) and brain tissue oxygen tension (P bt O 2 ) were measured at baseline, after CA and every 5 min during CPR. Cerebral venous oxygen saturation (S cv O 2 ) was measured at baseline, after CA and after 20 min of CPR. Cerebral microdialysis parameters, e.g. lactate/pyruvate ratio (L/P ratio) were taken at baseline and the end of the experiment. ICP was significantly lower in HUP compared to SUP animals after 5 min (18.0 ± 4.5 vs. 24.1 ± 5.2 mmHg; p = 0.033) and 20 min (12.0 ± 3.4 vs. 17.8 ± 4.3 mmHg; p = 0.023) of CPR. Accordingly, CPP was significantly higher in the HUP group after 5 min (11.2 ± 9.5 vs. 1.0 ± 9.2 mmHg; p = 0.045) and 20 min (3.4 ± 6.4 vs. -3.8 ± 2.8 mmHg; p = 0.023) of CPR. However, no difference was found in rSO 2 , P bt O 2 , S cv O 2 and L/P ratio between groups after 20 min of CPR. In this animal model of BLS CPR, HUP as compared to SUP did not improve cerebral oxygenation or metabolism. Copyright © 2018. Published by Elsevier B.V.

  8. Preoperative Radiographic and CT Findings Predicting Syndesmotic Injuries in Supination-External Rotation-Type Ankle Fractures.

    Science.gov (United States)

    Choi, Young; Kwon, Soon-Sun; Chung, Chin Youb; Park, Moon Seok; Lee, Seung Yeol; Lee, Kyoung Min

    2014-07-16

    The Lauge-Hansen classification system does not provide sufficient data related to syndesmotic injuries in supination-external rotation (SER)-type ankle fractures. The aim of the present study was to investigate factors helpful for the preoperative detection of syndesmotic injuries in SER-type ankle fractures using radiographs and computed tomography (CT). A cohort of 191 consecutive patients (104 male and eighty-seven female patients with a mean age [and standard deviation] of 50.7 ± 16.4 years) with SER-type ankle fractures who had undergone operative treatment were included. Preoperative ankle radiographs and CT imaging scans were made for all patients, and clinical data, including age, sex, and mechanism of injury (high or low-energy trauma), were collected. Patients were divided into two groups: the stable syndesmotic group and the unstable syndesmotic group, with a positive intraoperative lateral stress test leading to syndesmotic screw fixation. Fracture height, fracture length, medial joint space, extent of fracture, and bone attenuation were measured on radiographs and CT images and were compared between the groups. Binary logistic regression analysis was performed to identify the factors that significantly contributed to unstable syndesmotic injuries. Receiver operating characteristic curves were calculated, and cutoff values were suggested to predict unstable syndesmotic injuries on preoperative imaging measurements. Of the 191 patents with a SER-type ankle fracture, thirty-eight (19.9%) had a concurrent unstable syndesmotic injury. Age, sex, mechanism of injury, fracture height, medial joint space, and bone attenuation were significantly different between the two groups. In the binary logistic analysis, fracture height, medial joint space, and bone attenuation were found to be significant factors contributing to unstable syndesmotic injuries. The cutoff values for predicting unstable syndesmotic injuries were a fracture height of >3 mm and a medial

  9. Optimal Patient Positioning (Prone Versus Supine) for VMAT in Gynecologic Cancer: A Dosimetric Study on the Effect of Different Margins

    Energy Technology Data Exchange (ETDEWEB)

    Heijkoop, Sabrina T., E-mail: s.heijkoop@erasmusmc.nl [Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam (Netherlands); Westerveld, Henrike; Bijker, Nina [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands); Feije, Raphael; Sharfo, Abdul W. [Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam (Netherlands); Wieringen, Niek van [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands); Mens, Jan Willem M. [Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam (Netherlands); Stalpers, Lukas J.A. [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands); Hoogeman, Mischa S. [Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam (Netherlands)

    2016-10-01

    Purpose/Objective: It is unknown whether the historically found dosimetric advantages of treating gynecologic cancer with the patient in a prone position with use of a small-bowel displacement device (belly-board) remain when volumetric arc therapy (VMAT) is used and whether these advantages depend on the necessary margin between clinical target volume (CTV) and planning target volume (PTV). The aim of this study is to determine the best patient position (prone or supine) in terms of sparing organs at risk (OAR) for various CTV-to-PTV margins and VMAT dose delivery. Methods and Materials: In an institutional review board—approved study, 26 patients with gynecologic cancer scheduled for primary (9) or postoperative (17) radiation therapy were scanned in a prone position on a belly-board and in a supine position on the same day. The primary tumor CTV, nodal CTV, bladder, bowel, and rectum were delineated on both scans. The PTVs were created each with a different margin for the primary tumor and nodal CTV. The VMAT plans were generated with our in-house system for automated treatment planning. For all margin combinations, the supine and prone plans were compared with consideration of all OAR dose-volume parameters but with highest priority given to bowel cavity V{sub 45Gy} (cm{sup 3}). Results: For both groups, the prone position reduced the bowel cavity V{sub 45Gy}, in particular for nodal margins ≥10 mm (ΔV{sub 45Gy} = 23.9 ± 10.6 cm{sup 3}). However, for smaller margins, the advantage was much less pronounced (ΔV{sub 45Gy} = 6.5 ± 3.0 cm{sup 3}) and did not reach statistical significance. The rectum mean dose (D{sub mean}) was significantly lower (ΔD{sub mean} = 2.5 ± 0.3 Gy) in the prone position for both patient groups and for all margins, and the bladder D{sub mean} was significantly lower in the supine position (ΔD{sub mean} = 2.6 ± 0.4 Gy) only for the postoperative group. The advantage of the prone position was not present if it

  10. Effect of Temperature-Sensitive Poloxamer Solution/Gel Material on Pericardial Adhesion Prevention: Supine Rabbit Model Study Mimicking Cardiac Surgery.

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    Hyun Kang

    Full Text Available We investigated the mobility of a temperature-sensitive poloxamer/Alginate/CaCl2 mixture (PACM in relation to gravity and cardiac motion and the efficacy of PACM on the prevention of pericardial adhesion in a supine rabbit model.A total of 50 rabbits were randomly divided into two groups according to materials applied after epicardial abrasion: PACM and dye mixture (group PD; n = 25 and saline as the control group (group CO; n = 25. In group PD, rabbits were maintained in a supine position with appropriate sedation, and location of mixture of PACM and dye was assessed by CT scan at the immediate postoperative period and 12 hours after surgery. The grade of adhesions was evaluated macroscopically and microscopically two weeks after surgery.In group PD, enhancement was localized in the anterior pericardial space, where PACM and dye mixture was applied, on immediate post-surgical CT scans. However, the volume of the enhancement was significantly decreased at the anterior pericardial space 12 hours later (P < .001. Two weeks after surgery, group PD had significantly lower macroscopic adhesion score (P = .002 and fibrosis score (P = .018 than did group CO. Inflammation score and expression of anti-macrophage antibody in group PD were lower than those in group CO, although the differences were not significant.In a supine rabbit model study, the anti-adhesion effect was maintained at the area of PACM application, although PACM shifted with gravity and heart motion. For more potent pericardial adhesion prevention, further research and development on the maintenance of anti-adhesion material position are required.

  11. SU-F-T-515: Increased Skin Dose in Supine Craniospinal Irradiation Due to Carbon Fiber Couch and Vacuum Bag Immobilization Device

    Energy Technology Data Exchange (ETDEWEB)

    Robertson, D; Zhao, Z; Wang, X; Yang, J [UT MD Anderson Cancer Center, Houston, TX (United States)

    2016-06-15

    Purpose: To measure the surface dose for supine craniospinal irradiation employing posterior beams, treating through an imaging couch and BlueBag immobilization device. Methods: The percentage depth dose (PDD) in the buildup region of a clinical 6 MV photon beam was measured using an Advanced Markus parallel plate ionization chamber in a solid water phantom. The PDD from a 10×10 cm{sup 2} anterior beam was measured at 100 cm SSD, simulating a traditional prone craniospinal technique. The measurements were compared to commissioning and treatment planning system data. The PDD was also measured in a posterior setup with the phantom surface laying directly on the Brainlab carbon fiber imaging couch, with the phantom surface 100 cm from the source, simulating a supine craniospinal setup. The posterior measurements were repeated with a BlueBag vacuum immobilization device between the couch and phantom, with thicknesses of 1.7 cm and 5 cm. The PDD from a 10×10 cm{sup 2} field and a typical 6×30 cm{sup 2} craniospinal field were also compared. The PDDs were normalized at 5 cm to reflect typical craniospinal prescription dose normalization. Results: The measured PDD curve from the anterior setup agreed well with commissioning and treatment planning data, with surface doses of 19.9%, 28.8% and 27.7%, respectively. The surface doses of the 10×10 cm{sup 2} and 6×30 cm{sup 2} fields delivered through the imaging couch were both 122.4%. The supine setup yielded surface doses of 122.4%, 121.6%, and 119.6% for the couch only, 1.7 cm bag, and 5 cm bag setups, respectively. Conclusion: Delivering craniospinal irradiation through a carbon fiber couch removes the majority of skin sparing. The addition of a vacuum bag immobilization device restores some skin sparing, but the magnitude of this effect is negligible.

  12. Sensory analysis and volatile compounds of olive oil (cv. Cobrançosa from different irrigation regimes

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    Fernandes-Silva, A. A.

    2013-03-01

    Full Text Available The aim of this study was to assess the effect of different irrigation strategies on the sensory quality of virgin olive oil (VOO from the cv. “cobrançosa” integrated into a protected denomination of origin of “Azeite de Trás-os-Montes” in the Northeast of Portugal. Three irrigation treatments were applied: (T2-full irrigation, which received a seasonal water equivalent of 100% of the estimated crop evapotranspiration (ETc, (T1-continuous deficit irrigation (30% ETc and (T0- rainfed treatment. Data were collected from two consecutive crop years (2005-2006. Olive oil samples were analyzed for volatiles by GC-MS and the results compared with sensory evaluation data. Total volatile compounds tended to decrease with the amount of water applied. The characteristics pungent and bitter were more pronounced in olive oils from T0 and T1, which had higher polyphenolic concentrations, with a strong positive relationship with this variable and the bitter attribute. The Principal Components Analysis clearly separates the three olive oils from 2005, the driest year, and aggregates into a single group the three samples from 2006, suggesting no effect of irrigation on volatile compounds in years with a rainy spring and a marked effect in years with severe drought, suggesting that the effect of the trees’ water status on these variables occurs throughout the crop season and not just during the oil accumulation phase. In general, olive oil from the cv. Cobrançosa is more bitter than pungent and has a typical nutty sensory attribute shown by a strong positive relationship between benzaldehyde and the sensory notes of almonds and nuts.

    Este estudio tiene como objetivo evaluar el efecto de distintas estrategias de riego en la composición relativa de los compuestos volátiles y en la calidad sensorial. El experimento se realizó en el Noreste de Portugal, dentro de la denominación de origen protegida “Azeites de Tr

  13. Diagnosis of health-related physical fitness in office workers of the Federal University of Viçosa

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    Cristiano Diniz da Silva

    2004-06-01

    Full Text Available The behavioral demands and the particularities of the activities performed by the employees from offices at the Federal University of Viçosa can offer a series of negative factors for health. The interface with the computer and task characteristics give a great body and also cognitive demands, that allied to several factors can represent the appearance or worsening repetitive lesions and/or work related problems in the skeletal muscle (Cumulative Trauma Disorders . This study aimed to diagnose the workers’ situation in relation to General Human Factors (GHF and level of Health-Related Fitness (HRFcomponents: cardiorrespiratory; flexibility; strength and percent of body fat. The sample was composed by 46 workers. For both sexes, the GHF variables of higher significance were: “posture perception”; “sensation of local pains and those from some movement or task” in the back, shoulders and arms areas. Referring to HRF, both sexes presented unsatisfactory levels for trunk-hip flexibility “ and great part of men were classified as” below average “ in the push-up test” which are risk factors for CTD. Significant portion of them presented high percent of body fat (25,0% or were “obese” (14,2%. In general terms of HFR, there should be interventions, such as physical activity and/or sports programs for this group of employees at this institution. It is suggested that actions should also be taken in the leisure activity offering, once it was shown that 39,2% of the men and 44,4% of the women have in TV their main leisure activity. RESUMO As exigências comportamentais e as particularidades das atividades desenvolvidas pelos funcionários de alguns setores caracterizados como escritórios da Universidade Federal de Viçosa podem estar potencializando uma série de fatores negativos para a saúde destes. A interface com o computador e a característica da tarefa levam a uma forte exigência física e também cognitiva, que aliadas a

  14. Adaptation and Validation of the Spanish Version of OSA-18, a Quality of Life Questionnaire for Evaluation of Children with Sleep Apnea-Hypopnea Syndrome.

    Science.gov (United States)

    Chiner, Eusebi; Landete, Pedro; Sancho-Chust, José Norberto; Martínez-García, Miguel Ángel; Pérez-Ferrer, Patricia; Pastor, Esther; Senent, Cristina; Arlandis, Mar; Navarro, Cristina; Selma, María José

    2016-11-01

    To analyze the reliability and validity of the Spanish version of the OSA-18 quality of life questionnaire in children with apnea-hypopnea syndrome (SAHS). Children with suspected SAHS were studied with polysomnography (PSG) before and after adenotonsillectomy (AA). Age, gender, clinical data, PSG, anthropometric data, and Mallampati and Brodsky scales were analyzed. OSA-18 was administered at baseline and 3-6months post AA. After translation and backtranslation by bilingual professionals, the internal consistency, reliability, construct validity, concurrent validity, predictive validity and sensitivity to change of the questionnaire was assessed. In total, 45 boys and 15 girls were evaluated, showing BMI 18±4, neck 28±5, Brodsky (0: 7%; 50 to 75%: 6%), AHI 12±7 pre AA. Global Cronbach alpha was 0.91. Correlations between domains were significant except for emotional aspects, although the total scores correlated with all domains (0.50 to 0.90). The factorial analysis was virtually identical to the original structure. The total scores showed good correlation for concurrent validity (0.2-0.45). With regard to predictive validity, the questionnaire adequately differentiated levels of severity according to Mallampati (ANOVA P=.002) and apnea-hypopnea index (ANOVA P=.006). Test-retest reliability was excellent, as was sensitivity to change, both in the total scores (P<.001) and in each domain (P<.001). The Spanish adaptation of the OSA-18 and its psychometric characteristics suggest that the Spanish version is equivalent to the original and can be used in Spanish-speaking countries. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Effect of the left lateral recumbent position compared with the supine and upright positions on placental blood flow in normal late pregnancy.

    Science.gov (United States)

    Suonio, S; Simpanen, A L; Olkkonen, H; Haring, P

    1976-02-01

    The placental blood flow was assessed by the 99mTc accumulation method in 10 normal pregnancies in the left lateral recumbent position accomplished by a 15 degree wedge and in the supine position. The postural change caused a 17% decrease in the mean placental accumulation rate, which was not statistically significant. Ten patients were moved from the left lateral recumbent position to the upright position, which caused a statistically significant 23% decrease in the mean accumulation rate. Other haemodynamic variables studied were the maternal heart rate and the systolic and diastolic blood pressures. The clinical significance of the haemodynamic changes produced by alterations in posture are briefly discussed.

  16. VALIDITY AND REPRODUCIBILITY OF MEASURING THE KINEMATIC COUPLING BEHAVIOR OF CALCANEAL PRONATION/SUPINATION AND SHANK ROTATION DURING WEIGHT BEARING USING AN OPTICAL THREE-DIMENSIONAL MOTION ANALYSIS SYSTEM

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    Masahiro Edo

    2017-12-01

    Full Text Available Background: It’s important to understand the kinematic coupling of calcaneus and shank to optimize the pathological movement of the lower extremity. However, the quantitative indicator to show the kinematic coupling hasn’t been clarified. We measured the angles of calcaneal pronation-to-supination and shank rotation during pronation and supination of both feet in standing position and devised a technique to quantify the kinematic coupling behavior of calcaneal pronation/supination and shank rotation as the linear regression coefficient (kinematic chain ratio: KCR of those measurements. Therefore, we verified the validity and reproducibility of this technique. Methods: This study is a non-comparative cross-sectional study. The KCR, which is an outcome, was measured using an optical three-dimensional motion analysis system in 10 healthy subjects. The coefficient of determination (R² was calculated for the linear regression equation of the angle of calcaneal pronation-to-supination and angle of shank rotation, and the intraclass correlation coefficient (ICC [1,1] was calculated for the KCR during foot pronation and foot supination and for the KCR measured on different days. And also, skin movement artifacts were investigated by measurement of the displacement of bone and body surface markers in one healthy subject. Results: The linear regression equation of calcaneal pronation/supination and the angle of shank rotation included R²≥0.9 for all subjects. The KCR on foot pronation and supination had an ICC(1,1 of 0.95. The KCR measured on different days had an ICC(1,1 of 0.72. Skin movement artifacts were within the allowable range. Conclusion: The validity and reproducibility of this technique were largely good, and the technique can be used to quantify kinematic coupling behavior.

  17. The Soul of Leadership: African American Students' Experiences in Historically Black and Predominantly White Organizations

    Science.gov (United States)

    Hotchkins, Bryan K.

    2013-01-01

    This study addresses African American students' leadership experiences at predominantly White institutions. Findings indicated participants utilized servant leadership in historically Black organizations and transformational leadership in predominantly White organizations. The differences displayed showed that participants' leadership perceptions…

  18. Floristic composition of natural regeneration of tree species in a mountain seasonal semideciduous florest fragment over an eigth year period, in Viçosa, MG, Brazil

    OpenAIRE

    Higuchi, Pedro; Reis, Maria das Graças Ferreira; Reis, Geraldo Gonçalves dos; Pinheiro, Antonio Lelis; Silva, Crodoaldo Telmo da; Oliveira, Carlos Henrique Rodrigues de

    2006-01-01

    A florística da regeneração natural foi estudada em 10 locais, com seis sub-parcelas em cada local, em 1992, 1995 e 2000, em fragmento de Floresta Estacional Semidecidual Montana, em Viçosa, MG. A amostragem da classe 1 de tamanho de planta (até 1 m de altura), classe 2 (1-3 m de altura) e classe 3 (>3 m de altura e 3m and DBH < 5cm). A total of 4,149 individuals were sampled over the inventory period, comprising 42 families and 160 species, being 11.7 % pioneer, 62.1 % early secondary, and ...

  19. The use of endomarketing in credit unions: a case study of the UFVCredi and the Unicred-Viçosa O emprego do endomarketing em cooperativas de crédito: estudo de caso da UFV-Credi e da Unicred-Viçosa

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    Henrique Lopes Dornelas

    2002-11-01

    Full Text Available Endomarketing can be considered as a group of activities concerned with the internal aspects of the organization, whose purpose is to value the human being. In order to become competitive, the Credit Unions should adopt Endomarketing strategies that combine motivation, training and communication elements. The purpose of the present work was to verify how the Credit Union of the Workers of the Federal University of Viçosa Ltd. / UFV-CREDI and the Credit Union of the Doctors and Health-related Professionals of Viçosa Ltd. – UNICRED/VIÇOSA – MG are using the tools offered by Endomarketing. In the methodology, a study concerning the Endomarketing and the Credit Unions war carried out. After that, the employees and the members of the Credit Unions were asked to answer a questionnaire. After the analysis of the obtained data, it was concluded that UFV-CREDI and UNICRED/VIÇOSA-MG have effectively reached their objectives because their Endomarketing strategies have presented positive results, making it possible for them to get new members as well as to keep their members and employees motivated and satisfied with the products and services offered by the Credit Unions.O Endomarketing pode ser conceituado como um conjunto de atividades voltadas para o interior da organização, cuja finalidade é valorizar o ser humano. Para que as cooperativas de crédito sejam competitivas, elas devem adotar estratégias de Endomarketing, que combinem elementos de motivação, treinamento e comunicação. Procurou-se com o presente estudo, verificar como a Cooperativa de Economia e Crédito Mútuo dos Servidores da Universidade Federal de Viçosa – LTDA / UFV-CREDI e a Cooperativa de Economia e Crédito Mútuo dos Médicos e demais Profissionais da Saúde de Viçosa Ltda – UNICRED/VIÇOSA-MG estão utilizando as ferramentas oferecidas pelo Endomarketing. Na metodologia foi realizado um estudo acerca do Endomarketing e das cooperativas de crédito, para

  20. Objective assessment of mastication predominance in healthy dentate subjects and patients with unilateral posterior missing teeth.

    Science.gov (United States)

    Yamasaki, Y; Kuwatsuru, R; Tsukiyama, Y; Oki, K; Koyano, K

    2016-08-01

    We aimed to investigate mastication predominance in healthy dentate individuals and patients with unilateral posterior missing teeth using objective and subjective methods. The sample comprised 50 healthy dentate individuals (healthy dentate group) and 30 patients with unilateral posterior missing teeth (partially edentulous group). Subjects were asked to freely chew three kinds of test foods (peanuts, beef jerky and chewing gum). Electromyographic activity of the bilateral masseter muscles was recorded. The chewing side (right side or left side) was judged by the level of root mean square electromyographic amplitude. Mastication predominance was then objectively assessed using the mastication predominant score and the mastication predominant index. Self-awareness of mastication predominance was evaluated using a modified visual analogue scale. Mastication predominance scores of the healthy dentate and partially edentulous groups for each test food were analysed. There was a significant difference in the distribution of the mastication predominant index between the two groups (P mastication predominant score was weakly correlated with self-awareness of mastication predominance in the healthy dentate group, whereas strong correlation was observed in the partially edentulous group (P mastication predominance and were more aware of mastication predominance than healthy dentate individuals. Our findings suggest that an objective evaluation of mastication predominance is more precise than a subjective method. © 2016 John Wiley & Sons Ltd.

  1. Determinação de resíduos de organoclorados em águas fluviais do município de Viçosa - MG Determination of organochlorinated present in river from the region of Viçosa, MG

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    Cíntia Maria Chagas

    1999-07-01

    Full Text Available In this work the contamination, by organochlorinated, of a drinking water source located in the region of Viçosa, MG, was evaluated. The identification and quantification of the analytes was carried out using a gas-chromatograph equipped with an electron capture detector after liquid-liquid extraction and concentration. Four insecticides, Aldrin, Epoxy heptachloride, Endrin and op'- DDT were detected in concentrations that are higher than the safety limits established in the Brazilian legislation.

  2. El cura y sus hijos osos o el recorrido civilizador de los hijos de un cura y una osa

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    1997-01-01

    Full Text Available LE CURE ET SES ENFANTS OURS OU LE PARCOURS CIVILISATEUR DES ENFANTS D’UN CURE ET D’UNE OURSE. Cet article constitue un essai d’interprétation de deux versions quechuas cuzquéniennes du récit panandin connu comme “Jean de l’Ours” ou “Le fils de l’ours”. A partir d’une analyse du symbolisme du récit, la logique profonde qui l’ordonne est mise en lumière: la société humaine et civilisée ne peut se perpétuer sans établir des échanges et une coopération avec les êtres sauvages de l’au-delà. Les protagonistes, fils d’un curé et d’une ourse, ainsi que le curé lui-même, sont les héros médiateurs d’un récit mythique dont la logique prétend aussi s’appliquer aux relations interethniques dans les Andes. Este artículo presenta un ensayo de interpretación de dos versiones quechuas cuzqueñas del relato panandino conocido como “Juan Oso” o “El hijo del oso”. A partir de un análisis del simbolismo del relato, se saca a luz la lógica profunda que lo ordena: la sociedad humana y civilizada no puede perpetuarse sin establecer un intercambio y una cooperación con los seres salvajes del más allá. Los protagonistas, hijos de un cura y una osa, así como el cura mismo, son los héroes mediadores de un relato mítico cuya lógica pretende también aplicarse a las relaciones interétnicas en los Andes. THE PRIEST AND HIS BEAR CHILDREN OR THE PASSAGE TO CIVILIZATION OF THE CHILDREN OF A PRIEST AND A SHE-BEAR. This article sets out to interpret two Cuzco Quechua versions of the pan-Andean tale known as “Juan Oso” or “The Bear’s Son”. The analysis of the story’s symbolism sheds light on the profound logic on which it is based: human and civilized society cannot survive without establishing interchange and cooperation with wild beings from the other world. The protagonist, the son of the priest and the she-bear, as well as the priest himself, are the mediator heroes of a tale whose logic also applies to interethnic

  3. Banco de sementes do solo de uma Floresta Estacional Semidecidual, em Viçosa, Minas Gerais.

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    Juvenal Pinheiro Batista Neto

    2010-08-01

    Full Text Available Avaliou-se quantitativa e qualitativamente a florística do banco de sementes do solo de um fragmento de Floresta Estacional Semidecidual Montana, no município de Viçosa, MG. No final da estação chuvosa (março/2004, foram coletadas duas amostras de solo de 20 x 15 cm, com 5 cm de profundidade, no centro de seis subparcelas contíguas de 10 x 20 m, em dez parcelas permanentes de 20 x 60 m, em dez locais, totalizando 120 amostras (3,6 m2. As amostras de solo foram colocadas em estruturas de sombreamento de 11,5 % e 60 %, e as sementes germinadas foram identificadas em graminóides, herbáceo-cipós, arbustivas e arbóreas. Foram registradas 3.416 sementes germinadas, sendo 30,2 % graminóides, 29,2 % herbáceo-cipós, 17,5 % arbustivas e 23,1 % arbóreas, estas duas últimas distribuídas em 17 famílias, 25 gêneros e 31 espécies. Melastomataceae, Cecropiaceae e Piperaceae contribuíram com 31,8 %, 10,0 % e 8,8 % do total de espécies, respectivamente, sendo que Miconia cinnamomifolia e Leandra purpurascens foram responsáveis por 59,3 % das sementes arbustivo-arbóreas germinadas. As pioneiras se destacaram com 61,3 % das espécies e 88,5 % das sementes germinadas. Não foram registradas espécies secundárias tardias. A densidade média de sementes germinadas para todos os hábitos e locais foi de 949 sementes/m2. O número de espécies e de sementes germinadas do grupo arbustivo-arbóreo diferiu significativamente pelo teste Kruskal-Wallis (P ≤ 0,05 entre os locais estudados. Esses resultados indicam que, no banco de sementes do solo, há predomínio de espécies pioneiras que são importantes para a sucessão em clareiras ou após o corte da floresta. Porém, esse estoque de sementes não é suficiente para a continuidade do processo de sucessão, que inclui o estabelecimento de maior proporção de espécies secundárias iniciais e tardias. Isso indica que há necessidade de um manejo adequado do banco de pl

  4. Two-View Gravity Stress Imaging Protocol for Nondisplaced Type II Supination External Rotation Ankle Fractures: Introducing the Gravity Stress Cross-Table Lateral View.

    Science.gov (United States)

    Boffeli, Troy J; Collier, Rachel C; Gervais, Samuel J

    Assessing ankle stability in nondisplaced Lauge-Hansen supination external rotation type II injuries requires stress imaging. Gravity stress mortise imaging is routinely used as an alternative to manual stress imaging to assess deltoid integrity with the goal of differentiating type II from type IV injuries in cases without a posterior or medial fracture. A type II injury with a nondisplaced fibula fracture is typically treated with cast immobilization, and a type IV injury is considered unstable and often requires operative repair. The present case series (two patients) highlights a standardized 2-view gravity stress imaging protocol and introduces the gravity stress cross-table lateral view. The gravity stress cross-table lateral view provides a more thorough evaluation of the posterior malleolus owing to the slight external rotation and posteriorly directed stress. External rotation also creates less bony overlap between the tibia and fibula, allowing for better visualization of the fibula fracture. Gravity stress imaging confirmed medial-sided injury in both cases, confirming the presence of supination external rotation type IV or bimalleolar equivalent fractures. Open reduction and internal fixation was performed, and both patients achieved radiographic union. No further treatment was required at 21 and 33 months postoperatively. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Effect of Lumbar Disc Degeneration and Low-Back Pain on the Lumbar Lordosis in Supine and Standing: A Cross-Sectional MRI Study.

    Science.gov (United States)

    Hansen, Bjarke B; Bendix, Tom; Grindsted, Jacob; Bliddal, Henning; Christensen, Robin; Hansen, Philip; Riis, Robert G C; Boesen, Mikael

    2015-11-01

    Cross-sectional study. To examine the influence of low-back pain (LBP) and lumbar disc degeneration (LDD) on the lumbar lordosis in weight-bearing positional magnetic resonance imaging (pMRI). The lumbar lordosis increases with a change of position from supine to standing and is known as an essential contributor to dynamic changes. However, the lordosis may be affected by disc degeneration and pain. Patients with LBP >40 on a 0 to 100 mm Visual Analog Scale (VAS) both during activity and rest and a sex and age-decade matching control group without LBP were scanned in the supine and standing position in a 0.25-T open MRI unit. LDD was graded using Pfirrmann's grading-scale. Subsequently, the L2-to-S1 lumbar lordosis angle (LA) was measured. Thirty-eight patients with an average VAS of 58 (±13.8) mm during rest and 75 (±5.0) mm during activities, and 38 healthy controls were included. MRI findings were common in both groups, whereas, the summation of the Pfirrmann's grades (LDD-score) was significantly higher in the patients [(MD 1.44; 95% confidence intervals (CI) 0.80 to 2.10; P lordosis between the positions may be independent of pain. Decreasing lordosis change seems to be associated with age-related increasing disc degeneration in healthy individuals. 2.

  6. The Effect of the Transition to Home Monitoring for the Diagnosis of OSAS on Test Availability, Waiting Time, Patients’ Satisfaction, and Outcome in a Large Health Provider System

    Directory of Open Access Journals (Sweden)

    Ahmad Safadi

    2014-01-01

    Full Text Available During 2009, the Haifa district of Clalit Health Services (CHS has switched from in-lab polysomnography (PSG to home studies for the diagnosis of obstructive sleep apnea (OSA. We assessed the effects of this change on accessibility, waiting time, satisfaction, costs, and CPAP purchase by the patients. Data regarding sleep studies, CPAP purchase, and waiting times were collected retrospectively from the computerized database of CHS. Patients’ satisfaction was assessed utilizing a telephone questionnaire introduced to a randomized small sample of 70 patients. Comparisons were made between 2007 and 2008 (in-lab PSGs and 2010 and 2011 (when most studies were ambulatory. Of about 650000 insured individuals in the Haifa district of CHS, 1471 sleep studies were performed during 2007-2008 compared to 2794 tests during 2010-2011. The average waiting time was 9.9 weeks in 2007-2008 compared to 1.1 weeks in 2010-2011 (P<0.05. 597 CPAPs were purchased in 2007-2008 compared to 831 in 2010-2011. The overall patients’ satisfaction was similar, but discomfort tended to be higher in the in-laboratory group (4.1 vs 2.7 in a scale of 0–10; P=0.11. Switching to ambulatory diagnosis improved the test accessibility and reduced the waiting times. Patients’ satisfaction remained similarly high. The total direct cost of OSA management was reduced.

  7. Sismos y lluvias, factores detonantes de deslizamientos de laderas en las regiones montañosas de Puebla, México

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    Oscar A. Cuanalo C.

    2006-01-01

    Full Text Available El estado de Puebla ubicado en el centro de la República Mexicana, se ve afectado por sismos producto de la actividad a lo largo del Cinturón Volcánico Mexicano que tienen impacto en el centro y sur del estado, además de lluvias intensas en las regiones montañosas ubicadas al Norte y Nororiente del mismo, originadas por los huracanes y tormentas tropicales procedentes del Golfo de México. El escenario anterior ofrece peculiaridades de tipo geomorfológico y meteorológico que han desencadenado deslizamientos de laderas, los cuales han causado considerables daños económicos y lamentables pérdidas humanas. En este artículo se describe brevemente las características geomorfológicas del estado de Puebla, considerando su clima, el cual tiene impacto en la meteorización de las rocas que conforman la región montañosa; además se incluye su historia sismológica en los últimos 100 años, para eventos mayores de 6° Richter, y las lluvias torrenciales de 1999 y 2005 que han desencadenado deslizamientos de laderas

  8. Atributos vitales de especies leñosas en bordes de bosque altoandino de la Reserva Forestal de Cogua (Colombia

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    Alba Lucía Montenegro

    2008-06-01

    Full Text Available En la Reserva Forestal de Cogua (Colombia, estudiamos mediante transectos la vegetación leñosa en dos parches de bosque altoandino para tres tipos de borde: chusque, paramizado y antiguo (este último denominado así por presentar un estado sucesional más avanzado. Seleccionamos como especies típicas de borde las que tenían mayor abundancia en esta zona, presentes en ambos parches del borde y capaces de colonizar la matriz adyacente. Se obtuvo un conjunto de nueve especies a las cuales se les evaluaron 20 atributos vitales, generando seis grupos mediante un análisis de agrupamiento (cluster: 1 Weinmannia balbisiana-W. tomentosa, 2 Gaiadendron punctatum-Hedyosmum bonplandianum, 3 Miconia ligustrina-M. squamulosa, 4 Macleania rupestris, 5 Pentacalia pulchella y 6 Tibouchina grossa. La amplia variación y plasticidad de las especies estudiadas en cuanto a los atributos analizados, conduce a pensar que los conjuntos obtenidos no obedecen a grupos funcionales claramente diferenciados, sino más bien a estrategias diferentes y que estas especies podrían hacer parte de un solo grupo funcional de gran plasticidad. T. grossa es la especie de borde más exitosa en la reserva, dados sus altos valores de abundancia, tolerancia fisiológica, reproducción vegetativa, producción de hojarasca y producción de semillas pequeñas, numerosas, formadoras de un banco de semillas persistente que evidencian su alta fecundidad.Vital traits of woody species in High Andean forest edges of the Cogua Forest Reserve (Colombia. The Cogua Forest Reserve was studied throughout eight months to detect the existence of functional species-groups associated with edge wood forest. A second goal was to determine which species were the most successful in edge areas and their particular vital traits. The regeneration and growth of the forest patches to the adjacent matrix depends on the establishment of these species and their tolerance to both habitats. Three types of High

  9. A randomised controlled trial in comparing maternal and neonatal outcomes between hands-and-knees delivery position and supine position in China.

    Science.gov (United States)

    Zhang, Hongyu; Huang, Shurong; Guo, Xiaolan; Zhao, Ningning; Lu, Yujing; Chen, Min; Li, Yingxia; Wu, Junqin; Huang, Lihua; Ma, Fenglan; Yang, Yuhong; Zhang, Xiaoli; Zhou, Xiaoyu; Guo, Renfei; Cai, Wenzhi

    2017-07-01

    the supine position is the most frequently offered for birth delivery in China and many other countries, but the hands-and-knees position is now gaining prominence with doctors in China. This study aims to examine the differences in maternal and neonatal outcomes among low-risk women who gave birth either in the hands-and-knees position or the supine position. a randomised controlled trial was conducted in 11 hospitals in China from May to December in 2012. In total, 1400 women were recruited and randomly allocated to either the experimental group (n=700, 446 completed the protocol) who delivered in hands-and-knees position and the control group (n=700, 440 completed the protocol) who delivered in supine position. Women who could not maintain the randomised position during the second stage of labour were allowed to withdraw from the study. The primary maternal outcome measured was rate of episiotomy. Secondary outcomes included degree of perineum laceration, rate of emergency caesarean section, rate of shoulder dystocia, and duration of labour, postpartum bleeding, neonatal Apgar score, and the rate of neonatal asphyxia. Because outcome data were only collected for women who gave birth in the randomised position, per-protocol analyses were used to compare groups. The primary outcome, episiotomy, was also compared between groups using logistic regression adjusting for maternal age,gestational age at birth, whether the woman was primiparous, the process of second stage of labour and birthweight. as compared with the control group, the experimental group had lower rates of episiotomy and second-degree perineum laceration (including episiotomy), and higher rates of intact perineum and first-degree perineum laceration, with a longer duration of second stage of labour. No significant differences were found in the amount of postpartum bleeding, shoulder dystocia, neonatal asphyxia and neonatal Apgar scores at 1minute and 5minutes. Adjusted for maternal age, gestational

  10. Effect of CPAP on Cardiac Function in Minimally Symptomatic Patients with OSA: Results from a Subset of the MOSAIC Randomized Trial.

    Science.gov (United States)

    Craig, Sonya; Kylintireas, Ilias; Kohler, Malcolm; Nicoll, Debby; Bratton, Daniel J; Nunn, Andrew J; Leeson, Paul; Neubauer, Stefan; Stradling, John R

    2015-09-15

    Minimally symptomatic obstructive sleep apnea (OSA) is highly prevalent, and the effects of continuous positive airway pressure (CPAP) on myocardial function in these patients are unknown. The MOSAIC randomized, controlled trial of CPAP for minimally symptomatic OSA assessed the effect of CPAP on myocardial function in a subset of patients. Two centers taking part in the MOSAIC trial randomized 238 patients in parallel to 6 months of CPAP (120) or standard care (118). Of these, 168 patients had echocardiograms, and 68 patients had a cardiac magnetic resonance scan (CMR). A larger group (314) from 4 centers had brain natriuretic peptide (BNP) measured. Mean (SD) baseline oxygen desaturation index (ODI) and Epworth sleepiness score (ESS) were 13.5 (13.2), and 8.4 (4.0), respectively. CPAP significantly reduced ESS and ODI. Baseline LV ejection fraction (LVEF) was well preserved (60.4%). CPAP had no significant effect on echo-derived left atrial (LA) area (-1.0 cm2, 95% CI -2.6 to +0.6, p = 0.23) or early to late left ventricular filling velocity (E/A) ratio (-0.01, 95% CI -0.07 to +0.05, p = 0.79). There was a small change in echo-derived LV end diastolic volume (EDV) with CPAP (-5.9 mL, 95% CI -10.6 to -1.2, p = 0.015). No significant changes were detected by CMR on LV mass index (+1.1 g/m(2), 95% CI -5.9 to +8.0, p = 0.76) or LVEF (+0.8%, 95% CI -1.2 to +2.8, p = 0.41). CPAP did not affect BNP levels (p = 0.16). Six months of CPAP therapy does not change cardiac functional or structural parameters measured by echocardiogram or CMR in patients with minimally symptomatic mild-to-moderate OSA. ISRCTN 34164388 (http://isrctn.org). © 2015 American Academy of Sleep Medicine.

  11. Estructura de una población del árbol Peltogyne purpurea (Cesalpinaceae en un bosque intervenido de la Península de Osa, Costa Rica

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    Braulio Vílchez

    2006-09-01

    Full Text Available Se estudió la regeneración de una población del árbol Peltogyne purpurea Pittier después de una corta selectiva de madera en el bosque lluvioso tropical de Mogos, Península de Osa, Costa Rica. La distribución de los árboles adultos de P. purpurea según el diámetro del tallo a la altura del pecho tiene forma de campana. La categoría con la mayor cantidad de individuos correspondió a los árboles con tallos con diámetros entre 70 y 80 cm. No hubo diferencia significativa en el número de brinzales encontrados en los transectos establecidos siguiendo los cuatro puntos cardinales alrededor de los árboles reproductivos (madre. En general, la mayoría de los brinzales se encontraban en los primeros metros alrededor del árbol madre. Se observó otro pico de abundancia de brinzales a la distancia correspondiente con el final de la copa del árbol. La extracción de madera puede tener un efecto negativo en la regeneración de P. purpurea.Population structure of the tree Peltogyne purpurea (Cesalpinaceae in an altered forest at Osa Peninsula, Costa Rica. The regeneration of the rain forest tree Peltogyne purpurea Pittier after selective logging was studied in Mogos, Osa Península, Costa Rica. The distribution of all adult trees of P. purpurea according to diameter at breath height (dbh categories revealed that the distribution of the adult trees followed a bell-shaped curve. The largest number of individuals was found in the 70 to 80 cm dbh category. We did not find any significant differences in the distribution of saplings around seed-producing trees. There were similar numbers of saplings in the four transects established around each reproductive tree following the four cardinal directions. Overall, the majority of the saplings were found in the first meters around each seed-producing tree. There was another peak in the number of saplings at the distance where the crown of the tree ended. Logging can negatively affect the regeneration

  12. Composição florística da regeneração natural de espécies arbóreas ao longo de oito anosem um fragmento de floresta estacional semidecidual, em Viçosa, MG Floristic composition of natural regeneration of tree species in a mountain seasonal semideciduous florest fragment over an eigth year period, in Viçosa, MG, Brazil

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    Pedro Higuchi

    2006-12-01

    Full Text Available A florística da regeneração natural foi estudada em 10 locais, com seis sub-parcelas em cada local, em 1992, 1995 e 2000, em fragmento de Floresta Estacional Semidecidual Montana, em Viçosa, MG. A amostragem da classe 1 de tamanho de planta (até 1 m de altura, classe 2 (1-3 m de altura e classe 3 (>3 m de altura e The floristic composition of the natural regeneration in a secondary Seasonal Semideciduous Forest fragment in the Atlantic Forest domain, Southeastern Brazil, was studied in the years 1992, 1995 and 2000. The sampling unit sizes were 0.5x10m, 0.5x20m and 1x20m, respectively, for plant size class 1 (height up to 1 m, class 2 (height from 1 to 3 m and class 3 (height > 3m and DBH < 5cm. A total of 4,149 individuals were sampled over the inventory period, comprising 42 families and 160 species, being 11.7 % pioneer, 62.1 % early secondary, and 26.2 % late secondary species. Family number did not change and number of species increased with time. Fabaceae, Myrtaceae, Rubiaceae and Lauraceae were the predominant families. Species ingrowth was higher than mortality. Shannon-Weaver diversity index was significantly lower (P < 0.05 only for the plant size class 1 as compared to the other size classes, in 1992, and it increased significantly from 3.45 (average of all plant size classes, in 1992, to 3.67 and 3.64 in 1995 and 2000, respectively. The Pielou equability index per inventory date varied from 0.71 to 0.74, and it was 0.71; 0. 79 and 0.82 for the size classes 1, 2 and 3, respectively. Overall, the results showed that monitoring the natural regeneration over an age sequence is important to understand the dynamics of the secondary forest fragments.

  13. MR imaging of the major nerves about the elbow: cadaveric study examining the effect of flexion and extension of the elbow and pronation and supination of the forearm

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Sook; Yeh, Lee Ren; Trudell, D.; Resnick, D. [Department of Radiology (114), Veterans Administration Medical Center, San Diego, CA (United States)

    1998-08-01

    Magnetic resonance (MR) imaging provides useful information in the evaluation of peripheral nerves. Recent advances in MR imaging allow for detailed depiction of the soft tissue structures of the elbow joint. Three major nerves are present about the elbow. Six cadaveric elbows were imaged to depict the normal anatomy of these nerves and to determine the best plane and position of the elbow for optimal visualization of each nerve. Axial images of the elbow in full extension with the forearm in supination allow identification of all major nerves. Axial images with the elbow in full flexion allow accurate assessment of the cubital tunnel and the ulner nerve. Axial images of the elbow in full extension with the forearm in pronation are helpful for assessment of the median and radial nerves in the forearm. (orig.) With 11 figs., 20 refs.

  14. MR imaging of the major nerves about the elbow: cadaveric study examining the effect of flexion and extension of the elbow and pronation and supination of the forearm

    International Nuclear Information System (INIS)

    Kim, Young Sook; Yeh, Lee Ren; Trudell, D.; Resnick, D.

    1998-01-01

    Magnetic resonance (MR) imaging provides useful information in the evaluation of peripheral nerves. Recent advances in MR imaging allow for detailed depiction of the soft tissue structures of the elbow joint. Three major nerves are present about the elbow. Six cadaveric elbows were imaged to depict the normal anatomy of these nerves and to determine the best plane and position of the elbow for optimal visualization of each nerve. Axial images of the elbow in full extension with the forearm in supination allow identification of all major nerves. Axial images with the elbow in full flexion allow accurate assessment of the cubital tunnel and the ulner nerve. Axial images of the elbow in full extension with the forearm in pronation are helpful for assessment of the median and radial nerves in the forearm. (orig.)

  15. Habitual coffee and tea drinkers experienced increases in blood pressure after consuming low to moderate doses of caffeine; these increases were larger upright than in the supine posture.

    Science.gov (United States)

    McMullen, Michael K; Whitehouse, Julie M; Shine, Gillian; Towell, Anthony

    2011-04-01

    Caffeine users have been encouraged to consume caffeine regularly to maintain their caffeine tolerance and so avoid caffeine's acute pressor effects. In controlled conditions complete caffeine tolerance to intervention doses of 250 mg develops rapidly following several days of caffeine ingestion, nevertheless, complete tolerance is not evident for lower intervention doses. Similarly complete caffeine tolerance to 250 mg intervention doses has been demonstrated in habitual coffee and tea drinkers' but for lower intervention doses complete tolerance is not evident. This study investigated a group of habitual caffeine users following their self-determined consumption pattern involving two to six servings daily. Cardiovascular responses following the ingestion of low to moderate amounts caffeine (67, 133 and 200 mg) were compared with placebo in a double-blind, randomised design without caffeine abstinence. Pre-intervention and post-intervention (30 and 60 min) 90 s continuous cardiovascular recordings were obtained with the Finometer in both the supine and upright postures. Participants were 12 healthy habitual coffee and tea drinkers (10 female, mean age 36). Doses of 67 and 133 mg increased systolic pressure in both postures while in the upright posture diastolic pressure and aortic impedance increased while arterial compliance decreased. These vascular changes were larger upright than supine for 133 mg caffeine. Additionally 67 mg caffeine increased dp/dt and indexed peripheral resistance in the upright posture. For 200 mg caffeine there was complete caffeine tolerance. Cardiovascular responses to caffeine appear to be associated with the size of the intervention dose. Habitual tea and coffee drinking does not generate complete tolerance to caffeine as has been previously suggested. Both the type and the extent of caffeine induced cardiovascular changes were influenced by posture.

  16. The significance of abnormal systolic blood pressure response during supine ergometer exercise and postexercise in ischemic heart disease, studied by exercise radionuclide ventriculography

    International Nuclear Information System (INIS)

    Ajisaka, Ryuichi; Watanabe, Shigeyuki; Masuoka, Takeshi

    1989-01-01

    Abnormal response to blood pressure (BP) during exercise and postexercise was examined in 169 patients with ischemic heart disease. The patients underwent supine ergometer exercise gated equilibrium radionuclide ventriculography and coronary arteriography. When BP during exercise did not increase by at least 11 mmHg or initially increased but later decreased by more than 10 mmHg, the BP response was defined as abnormal during exercise. A postexercise BP increase of more than 10 mmHg above the peak exercise BP was defined as abnormal during postexercise. Fifteen-one patients (30%) were classified as abnormal (group 1) and the other 118 as normal (group 2). Abnormal BP response fell into three types: (1a) exercise hypotension (n=11), (1b) postexercise hypertension (n=30), and (1c) exercise hypotension with postexercise hypertension (n=10). Both average exercise duration and peak heart rate were significantly lower in groups 1a, 1b, and 1c than group 2. Exercise ST-segment depression was more noticeable in groups 1b and 1c than group 2. However, there was no significant difference in the severitiy of exercise ST-segment depression between groups 1a and 2. A decline in ejection fraction occurred more frequently in groups 1b and 1c than group 2. Patients in groups 1a, 1b, and 1c had more extensive coronary artery disease than did patients in group 2. Medically managed patients having an abnormal BP response had a poorer prognosis than those with a normal BP response. An abnormal BP response during both supine exercise and postexercise was infrequent. The abnormal BP during exercise may be usually associated with impaired exercise tolerance and severe coronary artery disease; and that during postexercise may be closely associated with myocardial ischemia and global left ventricular dysfunction. Postexercise hypertension may be of the same value as exercise hypotension in predicting poor prognosis. (Namekawa, K)

  17. Incremental value of clinical assessment, supine exercise electrocardiography, and biplane exercise radionuclide ventriculography in the prediction of coronary artery disease in men with chest pain

    International Nuclear Information System (INIS)

    Currie, P.J.; Kelly, M.J.; Harper, R.W.; Federman, J.; Kalff, V.; Anderson, S.T.; Pitt, A.

    1983-01-01

    The incremental value of clinical assessment, exercise electrocardiography (ECG) and biplane radionuclide ventriculography (RVG) in the prediction of coronary artery disease (CAD) was assessed in 105 men without myocardial infarction who were undergoing coronary angiography for investigation of chest pain. Independent clinical assessment of chest pain was made prospectively by 2 physicians. Graded supine bicycle exercise testing was symptom-limited. Right anterior oblique ECG-gated first-pass RVG and left anterior oblique ECG-gated equilibrium RVG were performed at rest and exercise. Regional wall motion abnormalities were defined by agreement of 2 of 3 blinded observers. A combined strongly positive exercise ECG response was defined as greater than or equal to 2 mm ST depression or 1.0 to 1.9 mm ST depression with exercise-induced chest pain. A multivariate logistic regression model for the preexercise prediction of CAD was derived from the clinical data and selected 2 variables: chest pain class and cholesterol level. A second model assessed the incremental value of the exercise test in prediction of CAD and found 2 exercise variables that improved prediction: RVG wall motion abnormalities, and a combined strongly positive ECG response. Applying the derived predictive models, 37 of the 58 patients (64%) with preexercise probabilities of 10 to 90% crossed either below the 10% probability threshold or above the 90% threshold and 28 (48%) also moved across the 5 and 95% thresholds. Supine exercise testing with ECG and biplane RVG together, but neither test alone, effectively adds to clinical prediction of CAD. It is most useful in men with atypical chest pain and when the ECG and RVG results are concordant

  18. [Case-control study on bone setting manipulation for the treatment of over degree II supination-eversion fractures of ankle joint].

    Science.gov (United States)

    Qi, Yue-Feng; Chen, Fa-Lin; Bao, Shu-Ren; Li, Cheng-Huan; Zhao, Xing-Wei; Liu, Shi-Ming; Chen, Wen-Xue; Li, Ye; Wang, Peng

    2012-08-01

    To explore therapeutic effects of bone setting manipulation for the treatment of over degree II supination-eversion fractures of ankle,and analyze manipulative reduction mechanism. From 2005 to 2008, 95 patients with over degree II supination-eversion fractures of ankle were treated respectively by manipulation and operation. There were 43 cases [11 males and 32 females with an average age of (44.95 +/- 12.65) years] in manipulation group, and 2 cases were degree II, 11 cases were degree III, and 30 cases were degree IV. There were 52 cases [21 males and 31 females with an average age of (39.96 +/- 13.28) years] in operative group,and 6 cases were degree II, 18 cases were degree III, and 28 cases were degree IV. Bone setting manipulation and hard splint external fixation were applied to manipulative group. Operative reduction internal fixation was performed in operative group. X-ray was used to evaluate reduction of fracture before and after treatment, 2 months after treatment. Ankle joint function was evaluated according to Olerud-Molander scoring system after 6 months treatment. All patients were followed up with good reduction. Three cases occurred wound complication in operative group, but not in manipulative group. In manipulation group, 19 cases got excellent results, 20 cases good and 4 cases fair; while in operative group, 30 cases got excellent results, 20 cases good and 2 cases poor. There were no significant differences in fracture reduction and ankle joint function recovery between two groups (P > 0.05). Efficacy of operative treatment was better than that of manipulative treatment at degree IV fracture (P ankle joint fractures, which has advantages of simple and safe operation, reliable efficacy. For ankle join fracture at degree IV, manipulative reduction should be adopted earlier, and operative treatment also necessary

  19. Consideration of Shoulder Joint's Image with the Changed Tube Angle of the Shoulder Oblique Projection in Supine Position

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jae Hyun; Choi, Nam Gil [Dept. of Radiology, Chonnam National University Hospital, Kwangju (Korea, Republic of)

    2008-06-15

    There is a standard shoulder oblique method (Grashey method) available to view the shoulder joint. This method projects AP view of the shoulder joint so that the Humerus head's subuxation or joint degeneration can be easily visualized. However, in this view, the patients, with supine or sitting or erect position, have to keep their body obliquely. Whereas, the patients who are not well or operated, usually feel very uncomfortable to keep their body in this position and hence, we need other persons' help and much efforts will be needed to get the good quality shoulder joint view. Therefore, we thought of examining a method which shows the joint well by angling the tube to Medio-Lateral direction and without keeping the patients' one side upward in supine position. For this study, total 15 subjects with no history of neurological or psychiatric illness, were recruited for examinations. They consisted of 9 males and 6 females. Statistic group analysis was performed with ANOVA test. Scores of the evaluation of the experts were 1.01{+-}0.54 at 25 degrees, 2.50{+-}0.50 at 30 degrees, 2.85{+-}0.36 at 35 degrees and 2.33{+-}0.47 at 40 degrees, respectively, and they were significant(p<0.05, Table 1). Joint space of the Humerus head and Scapula were well distinguished at 35 degrees, 30 degrees and 40 degrees with the almost same score. However, the degree of distortion at 40 degrees was more severe than that at 30 degrees. Ultimately, 30-35 degrees views were shown to yield good quality shoulder oblique images. In conclusion, this method may be very useful for the patients who are uncomfortable and for the emergency patients. In order to get similar or comparable view, the same X-tube angle is recommended to be used before and after the operation. Therefore, we hope that this new angled method seems to be efficient.

  20. Regeneração pós-fogo em um fragmento de floresta estacional semidecidual no município de Viçosa, MG

    Directory of Open Access Journals (Sweden)

    Sebastião Martins Venâncio

    2002-01-01

    Full Text Available Estudou-se a vegetação colonizadora seis meses após perturbação por fogo, em uma á rea do Campus da Universidade Federal de Viçosa, em Viçosa (20o 45’ S, 42o 51’ W , MG. A á rea total de floresta secundá ria atingida por incê ndio foi de 12 hectares, apresentando níveis diferenciados de destruição da vegetação. O estudo concentrou-se no trecho onde o efeito do fogo foi mais drá stico, com a destruição total da cobertura vegetal. Dentro da á rea de estudo, foram comparadas duas toposseqüê ncias de relevo: côncavo (ravina e convexo (crista. Em cada toposseqüê ncia, foram instaladas dezoito parcelas contíguas de 5x5 m, totalizando 36 parcelas, nas quais foram identificadas todas as plantas vasculares. No total, foram amostradas 75 espécies, pertencentes a 26 famílias. As famílias mais ricas em espécies foram: Asteraceae (14, Poaceae (10, Malvaceae (7 e Fabaceae (6. Na toposseq üê ncia crista as espécies com maior valor de cobertura foram: Sida carpinifolia seguida de Melinis minutiflora, Diodia alata e Eupatorium laevigatum, e na ravina: Melinis minutiflora, Eupatorium laevigatum, Sida carpinifolia e Sidastrum paniculatum. Todas as parcelas apresentaram mais de 90% da á rea coberta por vegetação herbá cea e subarbustiva, destacando a importâ ncia dessa vegetação inicial na proteção do solo contra processos erosivos em relevos acidentados.

  1. Flora de importância polinífera para Apis mellifera (L. na região de Viçosa, MG

    Directory of Open Access Journals (Sweden)

    Anna Frida Hatsue Modro

    2011-10-01

    Full Text Available Procurou-se conhecer a flora de importância polinífera para Apis mellifera (L. na região de Viçosa, MG, em período de entressafra de mel, entre agosto e dezembro de 2005. O experimento foi realizado em dois apiários distintos, cada um com cinco colmeias. As cargas retidas nos coletores de pólen instalados nas colmeias foram analisadas quanto à origem botânica. As plantas em floração no entorno dos apiários foram coletadas e identificadas. A maioria das plantas de importância polinífera para abelhas na região de Viçosa era nativa, localizada em jardins e com hábito arbóreo. Pela análise palinológica, verificou-se que espécies como Anadenanthera colubrina, Arecaceae sp., Baccharis dracunculifolia, B. melastomaefolia, Coffea spp., Emilia sagittata, Eugenia uniflora, Mikania cordifolia, M. hirsutissima, Myrcia fallax, Psidium guajava, Vernonia condensata, V. diffusa, V. lanuginosa e V. mariana são potenciais recursos poliníferos a serem utilizados no período de entressafra do mel. Os resultados indicaram a importância de plantas localizadas em áreas abertas para o forrageamento de pólen por A. mellifera e confirmaram o potencial polinífero da região estudada, durante o período de entressafra do mel.

  2. Adoção sequencial de tecnologia pós-colheita aplicada à cafeicultura em Viçosa (MG

    Directory of Open Access Journals (Sweden)

    Matheus Wemerson Gomes Pereira

    2010-06-01

    Full Text Available O processo de adoção tecnológica na agricultura é de fundamental importância para o aumento da produtividade e a melhoria da qualidade dos produtos agrícolas. O objetivo deste artigo é avaliar os determinantes da adoção da tecnologia pós-colheita na cafeicultura em Viçosa (MG, no ano de 2007. Os resultados sugerem que o modelo sequencial é o mais apropriado à análise e que as variáveis associativismo, rentabilidade, treinamento, crédito, capital próprio e escolaridade são os principais determinantes na adoção de estágios mais elevados de tecnologia pós-colheita aplicada à cafeicultura. Os efeitos marginais mais importantes para adoção de maiores níveis tecnológicos são associativismo, treinamento, crédito e rentabilidade.The process of tecnology adoption in agriculture is fundamentally important for increasing productivity and improving the quality of agricultural products. The objective of this study is to evaluate the factors that determine the technological adoption of post-harvest coffee employed in Viçosa (MG in the year of 2007. The results indicate that the sequential model is more appropriate for the analysis and the most important determinants for the adoption of higher levels of post-harvest technology are association, profitability, training, education, credit, stock of capital, and years at school. The most important marginal effects for the adoption of higher levels of post-harvest technology are association, training, credit and profitability.

  3. Retrospective study comparing breast planning in supine and prone using Acess(Qfix); Estudo retrospectivo comparativo do planejamento de mama em posicao supina e a de prona com acessorio Acess-Qfix

    Energy Technology Data Exchange (ETDEWEB)

    Setti, Marcela C.; Fernandes, Izabela L.S.; Padua, Marcelo L.A.; Cunha, Fredstone R. [Cot - Radioterapia, Uberlandia, MG (Brazil)

    2016-07-01

    Retrospective study comparing breast planning in supine and prone using Acess(Qfix) immobilization accessory. 10 participants were evaluated for the period from November 2015 to April 2016. In the comparative analysis of healthy organs heart, lung and healthy breast, lung had only difference with significance statistics. Regarding the coverage of the tumor volume and gradient there was also no statistically significant difference. (author)

  4. A pilot study to compare the cerebral hemodynamics between patients with obstructive sleep apnea syndrome (OSA) and periodic limb movement syndrome (PLMS) during nocturnal sleep with near-infrared spectroscopy (NIRS)

    Science.gov (United States)

    Zhang, Zhongxing; Schneider, Maja; Laures, Marco; Fritschi, Ursula; Hügli, Gordana; Lehner, Isabella; Qi, Ming; Khatami, Ramin

    2014-03-01

    Obstructive sleep apnea syndrome (OSA) and periodic limb movement in sleep syndrome (PLMS) are two common sleep disorders. Previous studies showed that OSA and PLMS share common features, such as increased cardio-vascular risk, both apnea events and limb movements occur periodically, they are usually associated with cortical arousals, and both of them can induce declines in peripheral oxygen saturation measured with pulse oximetry. However, the question whether apnea events and limb movements also show similar characteristics in cerebral hemodynamic and oxygenation has never been addressed. In this pilot study, we will first time compare the cerebral hemodynamic changes induced by apnea events and limb movements in patients with OSA (n=4) and PLMS (n=4) with NIRS. In patients with OSA, we found periodic oscillations in HbO2, HHb, and blood volume induced by apnea/hypopnea events, HbO2 and HHb showed reverse changing trends. By contrast, the periodic oscillations linked to limb movements were only found in HbO2 and blood volume in patients with PLMS. These findings of different cerebral hemodynamics patterns between apnea events and limb movements may indicate different regulations of nervous system between these two sleep disorders.

  5. Successful 1:1 proportion ventilation with a unique device for independent lung ventilation using a double-lumen tube without complications in the supine and lateral decubitus positions. A pilot study.

    Directory of Open Access Journals (Sweden)

    Michał Kowalczyk

    Full Text Available Adequate blood oxygenation and ventilation/perfusion matching should be main goal of anaesthetic and intensive care management. At present, one of the methods of improving gas exchange restricted by ventilation/perfusion mismatching is independent ventilation with two ventilators. Recently, however, a unique device has been developed, enabling ventilation of independent lungs in 1:1, 2:1, 3:1, and 5:1 proportions. The main goal of the study was to evaluate the device's utility, precision and impact on pulmonary mechanics. Secondly- to measure the gas distribution in supine and lateral decubitus position.69 patients who underwent elective thoracic surgery were eligible for the study. During general anaesthesia, after double lumen tube intubation, the aforementioned control system was placed between the anaesthetic machine and the patient. In the supine and lateral decubitus (left/right positions, measurements of conventional and independent (1:1 proportion ventilation were performed separately for each lung, including the following: tidal volume, peak pressure and dynamic compliance.Our results show that conventional ventilation using Robertshaw tube in the supine position directs 47% of the tidal volume to the left lung and 53% to the right lung. Furthermore, in the left lateral position, 44% is directed to the dependent lung and 56% to the non-dependent lung. In the right lateral position, 49% is directed to the dependent lung and 51% to the non-dependent lung. The control system positively affected non-dependent and dependent lung ventilation by delivering equal tidal volumes into both lungs with no adverse effects, regardless of patient's position.We report that gas distribution is uneven during conventional ventilation using Robertshaw tube in the supine and lateral decubitus positions. However, this recently released control system enables precise and safe independent ventilation in the supine and the left and right lateral decubitus

  6. Incidental dose to coronary arteries is higher in prone than in supine whole breast irradiation. A dosimetric comparison in adjuvant radiotherapy of early stage breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wuerschmidt, Florian; Stoltenberg, Solveigh; Kretschmer, Matthias; Petersen, Cordula

    2014-06-15

    Sparing of normal lung is best achieved in prone whole breast irradiation (WBI). However, exposure of the heart and coronary arteries might increase due to anterior movement of the heart in prone WBI. Treatment plans of 46 patients with large breasts irradiated for mammary cancer after breast-conserving surgery were retrospectively analyzed. The average treated breast volume of right-sided breasts (n = 33) was 1,804 ccm and 1,500 ccm for left-sided breasts (n = 13). The majority had invasive cancer (96 %) of which 61 % were pT1 and 39 % pT2 tumors. All patients received radiation therapy to the breast only. For three-dimensional (3D) treatment planning, all patients underwent a noncontrast-enhanced CT in the supine position with a wingboard and a second CT in the prone position using a prone breastboard. Nontarget volumes of the lung, heart, and coronary arteries were contoured. A total dose of 50.4 Gy was prescribed to the breast only. Differences were calculated for each patient and compared using the Wilcoxon signed-rank test. Treatment of left-sided breasts resulted in similar average mean heart doses in prone versus supine WBI (4.16 vs. 4.01 Gy; p = 0.70). The left anterior descending artery (LAD) had significantly higher dose exposure in left versus right WBI independent of position. Prone WBI always resulted in significantly higher exposures of the right circumflex artery (RCA) and LAD as compared to supine WBI. In left WBI, the mean LADprone was 33.5 Gy vs. LADsupine of 25.6 Gy (p = 0.0051). The V20prone of the LAD was 73.6 % vs. V20supine 50.4 % (p = 0.0006). The heart dose is not different between supine and prone WBI. However, in left WBI the incidental dose to the LAD with clinically relevant doses can be significantly higher in prone WBI. This is discussed controversially in the literature as it might depend on contouring and treatment techniques. We recommend contouring of LAD if patients are treated in prone WBI and evaluation of alternative

  7. Pre- and in-therapy predictive score models of adult OSAS patients with poor adherence pattern on nCPAP therapy

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    Wang Y

    2015-05-01

    Full Text Available Yeying Wang,1,2 Alan F Geater,3 Yanling Chai,1 Jiahong Luo,2 Xiaoqun Niu,1 Bing Hai,1 Jingting Qin,1 Yongxia Li1 1Department of Respiratory Medicine, The 2nd Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, People’s Republic of China; 2Department of Epidemiology and Biostatistics, School of Public Health, Kunming Medical University, Kunming, Yunnan Province, People’s Republic of China; 3Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand Objectives: To identify patterns of adherence to nasal continuous positive airway pressure (nCPAP use in the first 3 months of therapy among newly diagnosed adult patients with obstructive sleep apnea/hypopnea syndrome (OSAS and their predictors. To develop pretherapy and in-therapy scores to predict adherence pattern. Methods: Newly diagnosed adult OSAS patients were consecutively recruited from March to August 2013. Baseline clinical information and measures such as Epworth Sleepiness Scale (ESS, Fatigue Severity Scale (FSS, Zung’s Self-Rating Depression Scale (SDS, and The Pittsburgh Sleep Quality Index (PSQI at baseline and at the end of 3rd-week therapy were collected. Twelve weeks’ adherence data were collected from the nCPAP memory card, and K-means cluster analysis was used to explore adherence patterns. Predictive scores were developed from the coefficients of cumulative logit models of adherence patterns using variables available at baseline and after 3 weeks of therapy. Performance of the score was validated using 500 bootstrap resamples. Results: Seventy six patients completed a 12-week follow-up. Three patterns were revealed. Patients were identified as developing an adherence pattern that was poor (n=14, mean ± SD, 2.3±0.9 hours per night, moderate (n=19, 5.3±0.6 hours per night, or good (n=43, 6.8±0.3 hours per night. Cumulative logit regression models (good → moderate → poor revealed independent baseline

  8. Effect of degenerative change of lumbar spine on lateral bone mineral density measurement using dual energy x-ray absorptiometry: usefulness of measurement in the supine lateral projection

    International Nuclear Information System (INIS)

    Seo, Ja Young; Jo, Jin Man; Choi, Yun Young; Cho, Suk Shin; Cho, Su Hyeon

    1998-01-01

    To evaluate the usefulness of supine lateral bone mineral density (BMD) measurement using DXA by comparing AP and lateral spine BMD in patients with degenerative change Six hundred and seventy-two women underwnet AP and lateral BMD measurement of L-spine, using DXA. Spur changes and end-plate sclerosis were considered as degenerative change, and osteoporosis was defined according to WHO criteria. The ratio of mid-lateral BMD to AP BMD was calculated and the differences in ratio were analyzed in the degenerative group and controls, according to aging and osteoporosis, using the t test and ANOVA. The correlation coefficiency between aging and AP BMD and lateral BMD, respectively, was calculated. The mLat/AP ratio in the control and degenerative group was 0.710±0.005/0.622±0.028(p=3D0.003) in the 40-49-year-old group, 0.663±0.006/0.612±0.016 (p=3D0.002) in the 50-59-year-old group. 0.626±0.015/0.552±0.023 (p+0.007) in the 60-69-year-old group, and 0.717±0.028/0.600±0.045 (p=3D0.076) in those aged over 70. The ratio was 0.656±0.015/0.598±0.038(p=3D0.099) in osteoporosis, 0.684±0.008/0.596±0.016 (p=3D0.000) in osteopenia, and 0.688±0.005/0.583±0.019 (p=3D0.000) in normal subjects, showing that lateral BMD is more sensitive than AP BMD, espectially in the degenerative group. There was negative correlation between aging and AP BMD(r=3D-0.545), lateral BMD(r=3D0.571), and mid-lateral BMD(r=3D-0.583). In a selective group of patients with degenerative change, supine lateral BMD measurement of L-spine is useful

  9. Clinical and microbiological characteristics of cryptococcosis in Singapore: predominance of Cryptococcus neoformans compared with Cryptococcus gattii

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    Monica Chan

    2014-09-01

    Conclusion: C. neoformans var. grubii, subtype VN I, was the predominant subtype in Singapore, infecting younger, mainly immunocompromised hosts with HIV. C. gattii was uncommon, causing pulmonary manifestations in older, immunocompetent patients and were RFLP type VG II.

  10. The “DOC” screen: Feasible and valid screening for depression, Obstructive Sleep Apnea (OSA) and cognitive impairment in stroke prevention clinics

    Science.gov (United States)

    Swartz, Richard H.; Cayley, Megan L.; Lanctôt, Krista L.; Murray, Brian J.; Cohen, Ashley; Thorpe, Kevin E.; Sicard, Michelle N.; Lien, Karen; Sahlas, Demetrios J.; Herrmann, Nathan

    2017-01-01

    Background Post-stroke Depression, Obstructive sleep apnea (OSA) and Cognitive impairment (“DOC”) are associated with greater mortality, worse recovery and poorer quality of life. Best practice recommendations endorse routine screening for each condition; yet, all are under-assessed, diagnosed and treated. We seek to determine the feasibility and validity of an integrated tool (“DOC” screen) to identify stroke clinic patients at high-risk of depression, OSA, and cognitive impairment. Methods All consecutive new referrals to a regional Stroke Prevention Clinic who were English-speaking and non-aphasic were eligible to be screened. Time for screen completion was logged. DOC screen results were compared to the neuropsychological battery and polysomnogram assessments using a modified receiver operator characteristic and area under the curve analysis. Data is reported to conform to STARD guidelines. Findings 1503 people were screened over 2 years. 89% of eligible patients completed the screen in 5 minutes or less (mean 4.2 minutes), less than half the time it takes to complete the Montreal Cognitive Assessment (MoCA). 437 people consented to detailed testing. Of those, 421 completed the Structured Clinical Interview for Depression within 3 months of screening, 387 completed detailed neuropsychological testing within 3 months, and 88 had overnight polysomnograms. Screening scores combined with demographic variables (age, sex, education, body mass index), had excellent validity compared to gold standard diagnoses: DOC-Mood AUC 0.90; DOC-Apnea AUC 0.80; DOC-Cog AUC 0.81. DOC screen scores can reliably categorize patients in to low-, intermediate- or high-risk groups for further action and can do so with comparable accuracy to more time-consuming screens. Conclusions Systematic screening of depression, obstructive sleep apnea, and cognitive impairment in 5 minutes or less is feasible and valid in a high volume stroke clinic using the DOC screen. The DOC screen may

  11. Equações alométricas para estimativa de carbono em árvores de uma área urbana em Viçosa-MG

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    Daniel Brianezi

    2013-12-01

    Full Text Available Objetivou-se com este estudo gerar equações para estimar o carbono presente na arborização do campus-sede da Universidade Federal de Viçosa, contribuindo para o conhecimento sobre a capacidade das áreas verdes urbanas no sequestro e estocagem de carbono. Assim, inventariaram-se todas as árvores com DAP igual ou superior a 5 cm presentes na Universidade. Para as árvores não palmeiras, selecionaram-se 721 árvores-amostra, que foram cubadas rigorosamente em pé através da aplicação sucessiva da expressão de Smalian até o diâmetro-limite de 5 cm, tanto para o fuste quanto para os galhos. No caso das palmeiras, cubaram-se 100% dos indivíduos utilizando a expressão de Huber. A densidade básica da madeira com casca e o teor de carbono foram obtidos, nas palmeiras, com a retirada de um disco na porção do DAP, dada a dificuldade de tradagem. Já nas demais árvores, utilizou-se um trado mecânico. Com base no volume, na densidade básica e no teor de carbono, calcularam-se o carbono total e o carbono dos galhos. Ademais, avaliaram-se os modelos de Schumacher e Hall (1933 e Spurr (1952, modificado para estimar o carbono fixado nesses indivíduos. Nas árvores não palmeiras do campus-sede da Universidade Federal de Viçosa, o carbono total e o carbono dos galhos podem ser estimados, em kg, em razão do Diâmetro à Altura do Peito (DAP, em cm e da Altura Total (Ht, em m, por -0,906586+1,60421*LnDAP+0,37162*LnHt e por -2,052673+1,89903*LnDAP+0,24156*LnHt, respectivamente. Nas palmeiras, o carbono total pode ser estimado por -4,46988+199082*LnDAP+1,06420*LnHt.

  12. Attentional Profiles and White Matter Correlates in Attention-Deficit/Hyperactivity Disorder Predominantly Inattentive Type

    OpenAIRE

    Rossi, Adriana Suzart Ungaretti; de Moura, Luciana Monteiro; de Mello, Claudia Berlim; de Souza, Altay Alves Lino; Muszkat, Mauro; Bueno, Orlando Francisco Amodeo

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a widely studied neurodevelopmental disorder. It is a highly heterogeneous condition, encompassing different types of expression. The predominantly inattentive type is the most prevalent and the most stable over the lifetime, yet it is the least-studied presentation. To increase understanding of its cognitive profile, 29 children with Attention-deficit/hyperactivity disorder of predominantly inattentive type (ADHD-I) and 29 matched controls, ...

  13. Open questions in the management of nodular lymphocyte predominant hodgkin lymphoma.

    Science.gov (United States)

    Tyran, Marguerite; Gonzague, Laurence; Bouabdallah, Reda; Resbeut, Michel

    2014-01-01

    Localized Nodular Lymphocyte Predominant Hodgkin Lymphoma is a rare disease with an overall good prognosis but frequent late relapses. Due to it's rarity there is no standard therapeutic approach and pathological diagnosis may be hard. In this paper we discuss the technical aspects of the radiation therapy and histological issues. The new fields reductions proposed for classical Hodgkin lymphoma cannot be applied to early stages Nodular Lymphocyte Predominant Hodgkin lymphomas which are usually treated with radiation therapy without systemic chemotherapy.

  14. Abdominal Pain-Predominant Functional Gastrointestinal Disorders in Jordanian School Children.

    Science.gov (United States)

    Altamimi, Eyad M; Al-Safadi, Mohammad H

    2014-12-01

    Recurrent abdominal pain (RAP) is a common complaint in children. Significant portion of them are of functional origin. This study aimed to assess the prevalence of abdominal pain-predominant functional gastrointestinal disorder (FGID) and its types in Jordanian school children. This is a school-based survey at south Jordan. Information using the self-reporting form of the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III Version (QPGS-RIII) - the official Arabic translation - was collected. Classes from academic years (grades) 6 - 8 were selected. SPSS Statistical Package Version 17 (IBM, Armonk, NY, USA) was used. Categorical data were analyzed using Fisher's exact test, and continuous data were analyzed using t -test. P abdominal pain-predominant FGID. Seventy-nine (68%) of them were females. Forty-seven (10.6%) had irritable bowel syndrome (IBS). Thirty-six (8%), 17 (3.8%), 11 (2.4%) and five (1.1%) had abdominal migraine, functional abdominal pain, functional abdominal pain syndrome and functional dyspepsia, respectively. Abdominal pain-predominant FGID has become a major health issue in Jordanian children. One of four children between the ages of 11 and 15 years exhibits at least one abdominal pain-predominant FGID. The most common form of abdominal pain-predominant FGID in our children was IBS. Females are affected more often than males. Intestinal and extra-intestinal symptoms are seen regularly with abdominal pain-predominant FGIDs.

  15. Anemia ferropriva em crianças de 6 a 12 meses atendidas na rede pública de saúde do município de Viçosa, Minas Gerais Iron deficiency anemia in 6 to 12-month-old infants attended at the public health service of Viçosa, Minas Gerais, Brazil

    Directory of Open Access Journals (Sweden)

    Danielle Góes da SILVA

    2002-09-01

    Full Text Available Este estudo teve como objetivos verificar a prevalência de anemia em lactentes de 6 a 12 meses atendidos na rede pública de saúde do município de Viçosa, MG e analisar alguns possíveis fatores de risco. As informações foram obtidas através de questionário aplicado aos responsáveis pela criança e através da verificação de medidas antropométricas e da dosagem de hemoglobina por hemoglobinômetro portátil. No diagnóstico de anemia, utilizou-se o ponto de corte de 11 g/dL. A prevalência de anemia ferropriva nas 204 crianças estudadas foi 60,8%, e 55,6% dos casos de anemia eram graves. A média da hemoglobina foi 9,28±1,07 nos anêmicos e 12,07±0,89 mg/dL nos não-anêmicos. A baixa escolaridade paterna e a idade materna mostraram associação estatística com a anemia (pThis study aimed at verifying the prevalence of anemia in 6 to 12-month-old infantsattended at the public health service of the city of Viçosa, state of Minas Gerais, and analyzing some possible risk factors. Information was obtained through questionnaire applied to those responsible for the infants and through the verification of the anthropometric measures and the hemoglobin dosage by portable hemoglobinometer. In diagnosing anemia, a 11g/dL cutoff point was used. The prevalence of iron deficiency anemia in a total of 204 infants reached 60.8%, and 55.6% of the cases of anemia were serious. The hemoglobin average was 9.28±1.07 mg/dL in anemic infants, and 12.07± 0.89 mg/dL in non-anemic ones. The father's low school level and the mother's age showed statistical association with anemia (p<0.05. A high prevalence and severity of the anemia was found, emphasizing the need for prevention and control of this disease in the city of Viçosa.

  16. Diurnal Variation and Twenty-Four Hour Sleep Deprivation Do Not Alter Supine Heart Rate Variability in Healthy Male Young Adults.

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    Daniel S Quintana

    Full Text Available Heart rate variability (HRV has become an increasingly popular index of cardiac autonomic control in the biobehavioral sciences due to its relationship with mental illness and cognitive traits. However, the intraindividual stability of HRV in response to sleep and diurnal disturbances, which are commonly reported in mental illness, and its relationship with executive function are not well understood. Here, in 40 healthy adult males we calculated high frequency HRV-an index of parasympathetic nervous system (PNS activity-using pulse oximetry during brain imaging, and assessed attentional and executive function performance in a subsequent behavioral test session at three time points: morning, evening, and the following morning. Twenty participants were randomly selected for total sleep deprivation whereas the other 20 participants slept as normal. Sleep deprivation and morning-to-night variation did not influence high frequency HRV at either a group or individual level; however, sleep deprivation abolished the relationship between orienting attention performance and HRV. We conclude that a day of wake and a night of laboratory-induced sleep deprivation do not alter supine high frequency HRV in young healthy male adults.

  17. Percutaneous ultrasound-guided renal biopsy in supine antero-lateral position: a new approach for obese and non-obese patients.

    Science.gov (United States)

    Gesualdo, Loreto; Cormio, Luigi; Stallone, Giovanni; Infante, Barbara; Di Palma, Anna Maria; Delli Carri, Paolo; Cignarelli, Mauro; Lamacchia, Olga; Iannaccone, Salvatore; Di Paolo, Salvatore; Morrone, Luigi; Aucella, Filippo; Carrieri, Giuseppe

    2008-03-01

    Percutaneous ultrasound (US)-guided renal biopsy is the gold standard in the evaluation of renal diseases, but some patients, such as the obese, may not be eligible for this procedure. Aim of this study was to determine the feasibility, efficacy and safety of US-guided percutaneous renal biopsy in supine antero-lateral position (SALP) in high-risk patients (BMI > 30 and/or respiratory difficulty), as well as to compare the overall outcome of SALP with that of traditional prone position (PP) in low-risk patients (BMI SALP (Group 2), whereas 20 high-risk patients received US-guided renal biopsy in SALP (Group 3) and were our observational cohort study. Comfort compliance and breathing difficulty in each group were evaluated by the Visual Analogue Scale (VAS). Bleeding complications were evaluated through US renal scanning. Mean operating time was 7 min. Comfort compliance and breathing difficulty were significantly better for SALP in both low- and high-risk patients; there were no significant differences in pain after biopsy among the three groups. Bleeding complications were slightly higher in Group 1. Diagnostic yield was similar in all groups. SALP is reliable, minimally invasive, easy, highly successful, timesaving and almost free from severe side-effects. A better VAS score for breathing difficulty and comfort compliance characterizes this procedure, making it particularly suitable for obese patients.

  18. Malleolar fractures and their ligamentous injury equivalents have similar outcomes in supination-external rotation type IV fractures of the ankle treated by anatomical internal fixation.

    Science.gov (United States)

    Berkes, M B; Little, M T M; Lazaro, L E; Sculco, P K; Cymerman, R M; Daigl, M; Helfet, D L; Lorich, D G

    2012-11-01

    It has previously been suggested that among unstable ankle fractures, the presence of a malleolar fracture is associated with a worse outcome than a corresponding ligamentous injury. However, previous studies have included heterogeneous groups of injury. The purpose of this study was to determine whether any specific pattern of bony and/or ligamentous injury among a series of supination-external rotation type IV (SER IV) ankle fractures treated with anatomical fixation was associated with a worse outcome. We analysed a prospective cohort of 108 SER IV ankle fractures with a follow-up of one year. Pre-operative radiographs and MRIs were undertaken to characterise precisely the pattern of injury. Operative treatment included fixation of all malleolar fractures. Post-operative CT was used to assess reduction. The primary and secondary outcome measures were the Foot and Ankle Outcome Score (FAOS) and the range of movement of the ankle. There were no clinically relevant differences between the four possible SER IV fracture pattern groups with regard to the FAOS or range of movement. In this population of strictly defined SER IV ankle injuries, the presence of a malleolar fracture was not associated with a significantly worse clinical outcome than its ligamentous injury counterpart. Other factors inherent to the injury and treatment may play a more important role in predicting outcome.

  19. Social Representations of the Artisan Work: Study of Case of an Association of Craftsmen in Viçosa, Minas Gerais – Brazil

    Directory of Open Access Journals (Sweden)

    Alair Ferreira de Freitas

    2010-07-01

    Full Text Available This article aims to analyze the social representations of small-scale artisans working for associated Association of Artisans and food producers Homemade of Viçosa, Minas Gerais State-Brazil (Adapac. To this end we have tried to identify and analyse the trajectory of the craftsmen and the reasons for becoming involved with crafts and renditions of the craft for craftsmen linked to this Association. The methodological strategy adopted for the research consisted in case study. As an instrument of data collection, were used to survey participant and application of semi-structured interviews. The method of "content analysis" was used in the Organization and analysis of data. For discussion of the results were defined two categories: (i motivations for the craft and (ii representations of the craft. The results show that this type of work associates itself as the premier opportunity to occupation and income generation found by some members and another as vocation and manual skills. For women the social representations of craft relate the condition of personal satisfaction and possibility of reconciliation with the domestic activities, while for men representations indicate the enhancement of the economic dimension of the craft, distinguishing it from domestic activities.

  20. Influence of environmental variables on the shrub and tree species distribution in two Semideciduous Forest sites in Viçosa, Minas Gerais, Brazil.

    Science.gov (United States)

    Pinto, Sheila Isabel do C; Martins, Sebastião V; de Barros, Nairam F; Dias, Herly Carlos T; Kunz, Sustanis H

    2008-09-01

    The floristic variations of shrub and tree components were studied in two sites of Semideciduous Forest, initial forest and mature forest, located in the Mata do Paraíso Forest Reserve, in Viçosa, State of Minas Gerais, Southeastern Brazil, in order to analyze the floristic similarity and the correlations between environmental variables and the distribution of tree species in these forests. Individual trees with a diameter at breast height (DBH) > or = 4.8 cm were sampled in twenty 10 x 30 m plots (10 plots in each site). The plots were distributed systematically at 10 m intervals. The environmental variables analyzed were: the canopy openness and soil chemical and texture characteristics. The two forest sites showed clear differences in the levels of canopy openness and soil fertility, factors that reflect the floristic and successional differences of the shrub and tree component, revealed by the low similarity between these forests by cluster analysis. The canonical correspondence analysis (CCA) of environmental variables and species abundance indicated that the species in these forests studied are distributed under strong influence of canopy openness, moisture and soil fertility.

  1. O papel das franquias na reestruturação das cidades: a ascensão do setor em Viçosa – MG

    Directory of Open Access Journals (Sweden)

    Rodrigo Moraes Fritz

    2017-12-01

    Full Text Available No estágio atual do sistema capitalista no mundo, as estratégias dos agentes econômicos para sobreviverem no mercado se fazem cada vez mais notórias. Tida como uma modernização na forma de vender e comprar, o Franchising vem se destacando em todo mundo e sendo fator importante na economia dos países. As franquias são muito presentes em realidades urbanas complexas, como as metrópoles, porém, nos últimos anos, nota-se sua difusão para centros urbanos intermediários, particularmente em cidades consideradas como médias, que possuem certo grau de influência regional. A cidade de Viçosa, localizada na Zona da Mata mineira, faz parte desse conjunto de cidades que, pela centralidade que exercem, atraem capitais, pessoas e mercadorias. O crescente número de franquias na cidade em questão despertou o interesse em caracterizá-las e entendê-las do ponto de vista da sua espacialidade, bem como do potencial que apresentam para promover mudanças na estrutura urbana, já que elas são indutoras de investimentos, reestruturações e, principalmente, de centralidade.

  2. Sistemas de classificações geotécnicas de solos: estudo de caso aplicado à rodovia não pavimentada vcs 346, Viçosa, MG Geotechnical soil classification systems: case study applied to the vcs 346 unpaved road, Viçosa, MG

    Directory of Open Access Journals (Sweden)

    Taciano Oliveira da Silva

    2010-04-01

    Full Text Available Este artigo aborda uma contribuição às classificações geotécnicas tradicionais de solos Unified Soil Classification System (USC, Transportation Research Board System (TRB e a Metodologia Miniatura, Compactado, Tropical (MCT para um caso aplicado à rodovia municipal não pavimentada VCS 346, no Município de Viçosa, MG, considerando-se várias amostras deformadas de solos coletadas no subleito da referida via. Os principais objetivos deste estudo residem na contribuição de um banco de dados geotécnicos sobre classificações de solos tropicais, bem como na verificação de possíveis agrupamentos entre os sistemas geotécnicos tradicionais de classificação e a metodologia MCT. O programa de laboratório envolveu a realização dos seguintes ensaios: (i granulometria conjunta; (ii limites de Atterberg (LL e LP; (iii massa específica dos grãos do solo; (iv compactação Mini-MCV; e (v perda de massa do corpo-de-prova por imersão em água. Os resultados possibilitaram verificar que, após a classificação das amostras, vários agrupamentos entre os sistemas de classificações geotécnicas tradicionais coincidiram com aqueles já apresentados na metodologia MCT e, considerando a pedogênese da região de Viçosa, MG, para o grupo NG', houve a contribuição dos grupos SC, SM e CL do Sistema USC e do grupo A-4 do Sistema TRB.This paper addresses a contribution to the traditional geotechnical soil classifications systems USC (Unified Soil Classification and TRB (Transportation Research Board, and the MCT methodology (Miniature, Compacted, Tropical applied to a case study involving the laboratory geotechnical characterization of disturbed samples from the subgrade of the VCS 346 municipal unpaved road, located in Viçosa - MG. The main goals of this study are to contribute to the formation of a database directed to the geotechnical classification of tropical soils as well as to verify possible groupings among the traditional

  3. Prevalência do complexo teníase-cisticercose na zona rural do município de Viçosa, Minas Gerais Prevalence of Taeniasis-cysticercosis complex in the rural area of Viçosa-MG, Brazil

    Directory of Open Access Journals (Sweden)

    Adriana Felix Iasbik

    2010-07-01

    Full Text Available A teníase é uma doença que se manifesta no ser humano em decorrência da presença da forma adulta da Taenia sp., enquanto a cisticercose decorre da infecção pelo estágio larvar da Taenia sp. ou Taenia solium, no caso dos suínos e humanos. Foi realizado um estudo transversal visando a determinar a prevalência de cisticercose em suínos e de teníase em 176 propriedades localizadas na zona rural de Viçosa, Minas Gerais (MG. Foram coletadas amostras de sangue de 226 suínos e fezes de 266 humanos, além da realização de um inquérito epidemiológico. Não foi identificada teníase humana, e a prevalência da cisticercose suína foi de 0,4%. As informações obtidas mostraram que a maioria das pessoas possuía o hábito de consumir carne suína não inspecionada; entretanto, todas as pessoas se alimentavam da carne bem aquecida. Em apenas 1,1% das propriedades, o esgoto era depositado diretamente no solo e em 99,4% destas a água era canalizada, enquanto 88,1% dos suínos eram criados presos. Concluiu-se que, na zona rural do município de Viçosa-MG, a prevalência do complexo teníase-cisticercose foi baixa, mostrando ainda um nível de contaminação inferior ao de outros municípios onde o complexo foi estudado.Taeniasis occurs due to the presence of the adult form of Taenia sp. in human beings, and cysticercosis is caused by the presence of the larval stage of T. solium in pigs and humans. A transversal study was conducted aiming to determine the prevalence of porcine cysticercosis and Taeniasis in 176 farms located in rural areas of Viçosa-MG. Blood samples of 226 pigs, and feces samples of 266 humans were collected. An epidemiological survey has also been done. We found a prevalence of 0.4% of porcine cysticercosis and Taeniasis has not been found. The epidemiological data has shown that although most people consumed non-inspected pork, it used to be prepared well-done. Data showed that 88.1% of the pigs are reared in confinement

  4. Relationship between soft stratum thickness and predominant frequency of ground based on microtremor observation data

    Science.gov (United States)

    Chia, Kenny; Lau, Tze Liang

    2017-07-01

    Despite categorized as low seismicity group, until being affected by distant earthquake ground motion from Sumatra and the recent 2015 Sabah Earthquake, Malaysia has come to realize that seismic hazard in the country is real and has the potential to threaten the public safety and welfare. The major concern in this paper is to study the effect of local site condition, where it could amplify the magnitude of ground vibration at sites. The aim for this study is to correlate the thickness of soft stratum with the predominant frequency of soil. Single point microtremor measurements were carried out at 24 selected points where the site investigation reports are available. Predominant period and frequency at each site are determined by Nakamura's method. The predominant period varies from 0.22 s to 0.98 s. Generally, the predominant period increases when getting closer to the shoreline which has thicker sediments. As far as the thickness of the soft stratum could influence the amplification of seismic wave, the advancement of micotremor observation to predict the thickness of soft stratum (h) from predominant frequency (fr) is of the concern. Thus an empirical relationship h =54.917 fr-1.314 is developed based on the microtremor observation data. The empirical relationship will be benefited in the prediction of thickness of soft stratum based on microtremor observation for seismic design with minimal cost compared to conventional boring method.

  5. Prospective study of postoperative whole breast radiotherapy for Japanese large-breasted women: a clinical and dosimetric comparisons between supine and prone positions and a dose measurement using a breast phantom

    International Nuclear Information System (INIS)

    Takahashi, Kana; Morota, Madoka; Kagami, Yoshikazu; Okamoto, Hiroyuki; Sekii, Shuhei; Inaba, Koji; Murakami, Naoya; Igaki, Hiroshi; Ito, Yoshinori; Uno, Takashi; Itami, Jun

    2016-01-01

    This prospective study aimed to compare dose volume histograms (DVH) of the breasts and organs at risk (OARs) of whole breast radiotherapy in the supine and prone positions, and frequency and severity of acute and late toxicities were analyzed. Early-stage breast cancer patients with large breasts (Japanese bra size C or larger, or the widest measurements of the bust ≥ 95 cm) undergoing partial mastectomy participated in this study. CT-based treatment plans were made in each position, and various dosimetric parameters for the breast and OARs were calculated to compare the supine and prone radiotherapy plans. The actual treatment was delivered in the position regarded as better. From 2009 to 2010, 22 patients were prospectively accrued. Median follow-up period was 58 months. The homogeneity index and lung doses were significantly lower in the prone position (P = 0.008, P < 0.0001 and P < 0.0001, respectively). Cardiac dose showed no significant differences between two positions. By comparing two plans, the prone position was chosen in 77 % of the patients. In the prone position, ≥ grade 2 acute dermatitis were seen in 47 % of patients treated, whereas 20 % of the patients treated in the supine position had grade 2 and no cases of grade 3, although without a statistical significance of the rates of ≥ grade 2 acute dermatitis between the two positions (P = 0.28). The actual dose measurement using a breast phantom revealed significantly higher surface dose of the breast treated in the prone position than that in the supine position. Breast irradiation in the prone position improves PTV homogeneity and lowers doses to the OARs in the Japanese large-breast patients. However meticulous positioning of the breast in the prone board avoiding the bolus effect is necessary to prevent acute dermatitis

  6. Long-Range Correlation in alpha-Wave Predominant EEG in Human

    Science.gov (United States)

    Sharif, Asif; Chyan Lin, Der; Kwan, Hon; Borette, D. S.

    2004-03-01

    The background noise in the alpha-predominant EEG taken from eyes-open and eyes-closed neurophysiological states is studied. Scale-free characteristic is found in both cases using the wavelet approach developed by Simonsen and Nes [1]. The numerical results further show the scaling exponent during eyes-closed is consistently lower than eyes-open. We conjecture the origin of this difference is related to the temporal reconfiguration of the neural network in the brain. To further investigate the scaling structure of the EEG background noise, we extended the second order statistics to higher order moments using the EEG increment process. We found that the background fluctuation in the alpha-predominant EEG is predominantly monofractal. Preliminary results are given to support this finding and its implication in brain functioning is discussed. [1] A.H. Simonsen and O.M. Nes, Physical Review E, 58, 2779¡V2748 (1998).

  7. Enhanced thyroid iodine metabolism in patients with triiodothyronine-predominant Graves' disease

    International Nuclear Information System (INIS)

    Takamatsu, J.; Hosoya, T.; Naito, N.

    1988-01-01

    Some patients with hyperthyroid Graves' disease have increased serum T3 and normal or even low serum T4 levels during treatment with antithyroid drugs. These patients with elevated serum T3 to T4 ratios rarely have a remission of their hyperthyroidism. The aim of this study was to investigate thyroid iodine metabolism in such patients, whom we termed T3-predominant Graves' disease. Mean thyroid radioactive iodine uptake was 51.0 +/- 18.1% ( +/- SD) at 3 h, and it decreased to 38.9 +/- 20.1% at 24 h in 31 patients with T3-predominant Graves' disease during treatment. It was 20.0 +/- 11.4% at 3 h and increased to 31.9 +/- 16.0% at 24 h in 17 other patients with hyperthyroid Graves' disease who had normal serum T3 and T4 levels and a normal serum T3 to T4 ratio during treatment (control Graves' disease). The activity of serum TSH receptor antibodies was significantly higher in the patients with T3-predominant Graves' disease than in control Graves' disease patients. From in vitro studies of thyroid tissue obtained at surgery, both thyroglobulin content and iodine content in thyroglobulin were significantly lower in patients with T3-predominant Graves' disease than in the control Graves' disease patients. Thyroid peroxidase (TPO) activity determined by a guaiacol assay was 0.411 +/- 0.212 g.u./mg protein in the T3-predominant Graves' disease patients, significantly higher than that in the control Graves' disease patients. Serum TPO autoantibody levels determined by immunoprecipitation also were greater in T3-predominant Graves' disease patients than in control Graves' disease patients. Binding of this antibody to TPO slightly inhibited the enzyme activity of TPO, but this effect of the antibody was similar in the two groups of patients

  8. Predominant CD4 T-lymphocyte tropism of human herpesvirus 6-related virus.

    OpenAIRE

    Takahashi, K; Sonoda, S; Higashi, K; Kondo, T; Takahashi, H; Takahashi, M; Yamanishi, K

    1989-01-01

    Human herpesvirus 6 (HHV-6)-related virus was isolated from CD4+ CD8- and CD3+ CD4+ mature T lymphocytes but could not be isolated from CD4- CD8+, CD4- CD8-, and CD3- T cells in the peripheral blood of exanthem subitum patients. HHV-6-related virus predominantly infected CD4+ CD8+, CD4+ CD8-, and CD3+ CD4+ cells with mature phenotypes and rarely infected CD4- CD8+ cells from cord blood mononuclear cells, which suggested predominant CD4 mature T-lymphocyte tropism of HHV-6-related virus.

  9. Diagnostic accuracy of the gravity stress test and clinical signs in cases of isolated supination-external rotation-type lateral malleolar fractures.

    Science.gov (United States)

    Nortunen, S; Flinkkilä, T; Lantto, I; Kortekangas, T; Niinimäki, J; Ohtonen, P; Pakarinen, H

    2015-08-01

    We prospectively assessed the diagnostic accuracy of the gravity stress test and clinical findings to evaluate the stability of the ankle mortise in patients with supination-external rotation-type fractures of the lateral malleolus without widening of the medial clear space. The cohort included 79 patients with a mean age of 44 years (16 to 82). Two surgeons assessed medial tenderness, swelling and ecchymosis and performed the external rotation (ER) stress test (a reference standard). A diagnostic radiographer performed the gravity stress test. For the gravity stress test, the positive likelihood ratio (LR) was 5.80 with a 95% confidence interval (CI) of 2.75 to 12.27, and the negative LR was 0.15 (95% CI 0.07 to 0.35), suggesting a moderate change from the pre-test probability. Medial tenderness, both alone and in combination with swelling and/or ecchymosis, indicated a small change (positive LR, 2.74 to 3.25; negative LR, 0.38 to 0.47), whereas swelling and ecchymosis indicated only minimal changes (positive LR, 1.41 to 1.65; negative LR, 0.38 to 0.47). In conclusion, when gravity stress test results are in agreement with clinical findings, the result is likely to predict stability of the ankle mortise with an accuracy equivalent to ER stress test results. When clinical examination suggests a medial-side injury, however, the gravity stress test may give a false negative result. ©2015 The British Editorial Society of Bone & Joint Surgery.

  10. Insights into the clinical management of the syndrome of supine hypertension--orthostatic hypotension (SH-OH): the Irish Longitudinal Study on Ageing (TILDA).

    Science.gov (United States)

    Romero-Ortuno, Roman; O'Connell, Matthew D L; Finucane, Ciaran; Soraghan, Christopher; Fan, Chie Wei; Kenny, Rose Anne

    2013-07-15

    Our previously proposed morphological classification of orthostatic hypotension (MOH) is an approach to the definition of three typical orthostatic hemodynamic patterns using non-invasive beat-to-beat monitoring. In particular, the MOH pattern of large drop/non-recovery (MOH-3) resembles the syndrome of supine hypertension-orthostatic hypotension (SH-OH), which is a treatment challenge for clinicians. The aim of this study was to characterise MOH-3 in the first wave of The Irish Longitudinal Study of Ageing (TILDA), with particular attention to concurrent symptoms of orthostatic intolerance (OI), prescribed medications and association with history of faints and blackouts. The study included all TILDA wave 1 participants who had a Finometer® active stand. Automatic data signal checks were carried out to ensure that active stand data were of sufficient quality. Characterisation variables included demographics, cardiovascular and neurological medications (WHO-ATC), and self-reported information on comorbidities and disability. Multivariable statistics consisted of logistic regression models. Of the 4,467 cases, 1,456 (33%) were assigned to MOH-1 (small drop, overshoot), 2,230 (50%) to MOH-2 (medium drop, slower but full recovery), and 781 (18%) to MOH-3 (large drop, non-recovery). In the logistic regression model to predict MOH-3, statistically significant factors included being on antidepressants (OR = 1.99, 95% CI: 1.50 - 2.64, P hypertensive patients with cardiovascular medications that were not associated with adverse outcomes in our study. Therefore, the evidence of benefit does not necessarily have to conflict with the evidence of potential harm.

  11. Computed tomography scan in supine and prone positions: an alternative method to detect intramural gas in emphysematous cystitis and to evaluate efficacy after adjuvant continuous intravesical irrigation treatment.

    Science.gov (United States)

    Cortés-González, Jeff R; Ortiz-Lara, Gerardo E; Salinas, Matías; Hernández-Galván, Fernando; Gómez-Guerra, Lauro S

    2013-04-01

    To evaluate the efficacy of continuous intravesical irrigation with saline plus amikacin as adjuvant therapy and to evaluate the computed tomography (CT) scan in supine and prone positions (CystoCT scan) as an alternative diagnostic and evaluation method of intramural gas in emphysematous cystitis (EC) before and after treatment. Consecutive patients with a diagnosis of EC who were hospitalized between March 2006 and January 2011 were investigated. The diagnosis was made by CystoCT scan. Treatment consisted of intravenous antibiotics, control of concomitant diseases, and placement of a 3-way urinary catheter for continuous irrigation of 500 mg of amikacin diluted in 1 l of saline given on days 0, 3, and 7. Treatment was considered successful when there was an absence of gas in the bladder wall, the urine culture was negative, there was clinical improvement, and there was an absence of toxicity. Eleven patients were hospitalized with a diagnosis of EC during the study period. Four were excluded from the study, 2 due to the lack of confirmation of the diagnosis with the CystoCT scan. Treatment was successful in all patients; for 6 (86%) this was achieved in 3 days and for 1 (14%) in 7 days. No toxicity was reported. Continuous intravesical irrigation with saline plus amikacin as adjuvant treatment of EC is an inexpensive, effective, and safe tool that might help conventional treatment and provide a rapid recovery. The CystoCT scan is an alternative method to diagnose and evaluate intramural gas in EC patients. These findings should be challenged in a randomized, multi-centre, placebo-controlled clinical trial.

  12. Risky consumption habits and safety of fluid milk available in retail sales outlets in Viçosa, Minas Gerais State, Brazil.

    Science.gov (United States)

    Pieri, Fabio Alessandro; Colombo, Monique; Merhi, Carolina Milner; Juliati, Vinícius Augusto; Ferreira, Marcello Sebe; Nero, Marcelo Antônio; Nero, Luis Augusto

    2014-06-01

    This study aimed to assess raw milk consumption habits in the urban population of Viçosa, Minas Gerais, Brazil, and the microbiological safety and quality of the fluid milk available in retail sales outlets in the same region. A simplified questionnaire regarding raw milk consumption was applied to the persons responsible for food acquisition in 411 residences. The regular consumption of raw milk was observed by 18.5% of the interviewers, and lack of knowledge of possible risks related to this food product. Microbiological safety and quality were assessed for raw (n=69), pasteurized (n=80), and ultra-high-temperature (UHT)-treated milk (n=80) by analyzing the counts of mesophilic aerobes, coliforms, and Escherichia coli, and detection of Listeria monocytogenes and Salmonella spp.; raw milk samples were also subjected to enumeration of coagulase-positive Staphylococcus. Concerning raw milk, 59.4% of the samples were considered as produced in inadequate hygienic conditions, 5.8% of the samples presented counts of coagulase-positive Staphylococcus lower than 100 colony-forming units (CFU)/mL, and no samples presented with positive results for L. monocytogenes or Salmonella spp. All pasteurized and UHT milk samples presented with low counts of mesophilic aerobes and coliforms, while L. monocytogenes and Salmonella spp. were absent. The data demonstrated that raw milk was consumed by the population studied. Despite the absence of potential hazards, raw milk was of poor hygienic quality, in contrast with the processed fluid milk available in retail sales outlets that was safe and of good hygienic quality, highlighting the suitability of pasteurized and UHT milk for human consumption.

  13. Diversidade e equitabilidade de Plantas Alimentícias Não Convencionais na zona rural de Viçosa, Minas Gerais, Brasil

    Directory of Open Access Journals (Sweden)

    T.F. BARREIRA

    2015-01-01

    Full Text Available RESUMO O presente estudo analisou a diversidade e equitabilidade de plantas alimentícias não convencionais (PANCs na zona rural de Viçosa, Minas Gerais, Brasil. A pesquisa foi conduzida utilizando a amostragem Bola de Neve com entrevistas semiestruturadas aplicadas à 20 moradores de nove comunidades rurais. Avaliou-se a frequência relativa de citação das espécies (Fr; a diversidade e equitabilidade das mesmas, utilizando os índices de Shannon-Wiener (H’ e de Pielou (J’, respectivamente. As espécies foram listadas pela família, nome científico, nomes populares, ambiente de propagação, hábito de crescimento, formas de consumo, estado de domesticação, ciclo de produção e registro por meio de consultas em herbários do bioma Mata Atlântica. Foram encontradas 59 espécies de PANCs, distribuídas em 30 famílias botânicas e 48 gêneros. As famílias asteraceae e myrtaceae se destacaram pela riqueza florística, contribuindo com 11 e 7 espécies, respectivamente. Espécies da família asteraceae obtiveram as maiores frequências relativas (32,2. Obteve-se índice de diversidade Shannon-Wiener de 1,65 (Base 10, e de equitabilidade de Pielou de 0,93. Os resultados encontrados estão similares à de outros estudos desenvolvidos no bioma Mata Atlântica, observou-se ampla diversidade de PANCs na área de estudo, e o conhecimento sobre estas encontra-se distribuído uniformemente entre os moradores.

  14. Patrones de riqueza altitudinal de Papilionidae, Pieridae y Nymphalidae (Lepidoptera: Rhopalocera en áreas montañosas de México

    Directory of Open Access Journals (Sweden)

    David

    2013-09-01

    Full Text Available Las mariposas diurnas integran uno de los grupos más utilizados para el reconocimiento y monitoreo de la diversidad de una biota. Se realizó un estudio comparativo de las faunas de mariposas de las familias Papilionidae, Pieridae y Nymphalidae de cinco áreas montañosas de México, situadas en las vertientes Atlántico y Pacífico: las sierras de Atoyac de Álvarez, Manantlán, Juárez, y las áreas de Teocelo-Xalapa y la región Loxicha, con un total de 34 localidades representativas de los cinco transectos altitudinales, que comprenden de los 300 a los 3 100m de altitud. Se observó una tendencia general a la disminución de la riqueza con la altitud. Se analizó la similitud entre el total de localidades mediante el índice de Sørensen, diferenciándose en primer lugar las dos estaciones de elevaciones superiores (sobre los 2 500msnm, caracterizadas por pobres lepidóptero-faunas. En el grupo principal (32 sitios las principales agrupaciones se dan de acuerdo, en primer lugar, a la pertenencia a la vertiente pacífica o atlántica, evento más histórico que ecológico y, después, las estaciones de una misma sierra o según tres diferentes pisos altitudinales, que se caracterizan de acuerdo con los táxones predominantes.

  15. INFLUÊNCIA DOS FATORES EDÁFICOS NA VARIAÇÃO FLORÍSTICA DE FLORESTA ESTACIONAL SEMIDECIDUAL, EM VIÇOSA, MG

    Directory of Open Access Journals (Sweden)

    Antonio Jorge Tourinho Braga

    2015-08-01

    Full Text Available RESUMOO objetivo deste estudo foi verificar a possível correlação dos fatores edáficos na distribuição dos indivíduos de espécies arbóreas e a similaridade florística entre as populações, em dois trechos distintos de um fragmento de Floresta Estacional Semidecidual, em Viçosa, MG (20°46' S e 42°52' W. No trabalho, foram amostrados os indivíduos arbóreos superiores ou iguais a 15 cm (CAP, presentes em 20 parcelas de 25×10 m, estando metade dessas alocadas (10 em cada trecho de floresta. Na área das parcelas, foram coletadas amostras de solo (0-10 cm e submetidas às análises química e física. Os resultados dos atributos físicos e químicos do solo indicaram variações conforme as mudanças na topografia do terreno. A análise de correspondência canônica (CCA indicou correlação significativa entre a distribuição das espécies arbóreas avaliadas no perfil topográfico e a fertilidade do solo, enquanto a comparação entre as espécies pertencentes às florestas inicial e avançada apontou baixa similaridade florística. Verificou-se ainda que espécies como Casearia arborea, Ocotea laxa, Myrcia fallax, Siparuna guianensis, Apuleia leiocarpa, Matayba elaeagnoides e Sparattosperma leucanthum estão associadas a solos argilosos mais ácidos, de encostas e com maior teor de alumínio, permitindo o uso delas em programas de recuperação ambiental.

  16. Estado actual de contaminación con coliformes fecales de los cuerpos de agua de la Península de Osa

    Directory of Open Access Journals (Sweden)

    Jesús Mora

    2010-12-01

    Full Text Available La contaminación de los cuerpos de aguaen Costa Rica y en todo el mundo es unode los principales problemas ambientales,debido a la importancia estratégicade este recurso. El recurso hídrico esun elemento esencial no solo para lapreservación de la vida, sino también parala conservación de la flora y fauna de laregión.Su conservación y su calidad estánestrechamente vinculadas, prácticamente,a todas las actividades económicas ysociales en forma ineludible, así como a lasalud de su población.La Península de Osa se ha caracterizadopor ser una zona con una exuberantebiodiversidad, tanto en su flora comoen su fauna, raramente encontrada enuna zona pequeña.En 1975, se creó elParque Nacional de Corcovado,el más importante parque de Costa Rica y queprotege a un tercio de la península. Esteexótico territorio que es la Península deOsa no está exento de amenazas, debido ala fragmentación y destrucción del hábitat,la deforestación por la explotación de lamadera y el mal planeamiento en el uso dela tierra, la extracción ilegal de recursos,entre ellos el oro, y el crecimiento de lapoblación en sus alrededores.El Reglamento para la evaluación y laclasificación de la calidad de cuerpos deagua superficiales establece como límiteen el contenido de coliformes fecalesen el agua para actividades recreativasde contacto primario, un valor de 1000(NMP/100mL. Este mismo valor máximose aplica para el riego de hortalizas yotros alimentos que se consumen crudos;mientras que para el uso en abrevaderosy actividades pecuarias el valor máximopermisible de coliformes fecales es de2000, por mencionar algunos casos.Se realizó un estudio sobre la contaminaciónmicrobiológica, utilizando como indicador                                                          el contenido de coliformes fecales                                                   

  17. Composición de especies leñosas en comunidades invadidas en montañas del centro de Argentina: su relación con factores ambientales locales

    Directory of Open Access Journals (Sweden)

    Sebastián R. Zeballos

    2014-12-01

    Full Text Available En todo el mundo, las invasiones de especies leñosas exóticas están amenazando las funciones ecosistémicas. La dispersión y el subsecuente reemplazo de bosques de especies nativas por comunidades dominadas por exóticas es evidente, particularmente, en proximidad a centros urbanos donde la presión de propágulos de especies exóticas es alta. Sin embargo, existe una falta de información sobre los factores ambientales que subyacen este reemplazo. En este estudio nos propusimos responder las siguientes preguntas: (1 ¿se observa una segregación espacial a escala local entre especies leñosas exóticas y/o nativas dominantes?, y (2 si existe esa segregación, ¿está asociada a variables ambientales? En el 2010 se establecieron 31 parcelas distribuidas en 16 laderas en los bosques Chaqueños de las Sierras de Córdoba, en Argentina central. En cada uno de los sitios de muestreo se relevó la composición y abundancia de todas las especies leñosas con un diámetro a la altura de la base superior a 5cm. Para caracterizar el ambiente en cada una de las parcelas medimos la posición topográfica (pendiente y orientación y algunas propiedades asociadas con la física (densidad aparente y compactación, estructura (profundidad y textura y con la química (pH y el contenido de nutrientes y agua del suelo. A través, de un análisis jerárquico de agrupamiento, se identificaron cinco comunidades de leñosas coexistiendo: (1 Bosques dominados por Ligustrum lucidum, (2 Bosques mixtos dominados por Lithraea molleoides y Celtis australis, (3 Matorrales de Condalia buxifolia, (4 Matorrales de Cotoneaster glaucophyllus, y (5 Pajonales con emergentes de Pyracantha angustifolia. Estas comunidades se asociaron diferencialmente a las variables topográficas y edáficas locales. La segregación ambiental observada sugiere que las especies invasoras tienen una capacidad potencial para colonizar casi todos los ambientes en el área de estudio (variando la

  18. Latina "Testimonios": A Reflexive, Critical Analysis of a "Latina Space" at a Predominantly White Campus

    Science.gov (United States)

    Flores, Judith; Garcia, Silvia

    2009-01-01

    Judith Flores and Silvia Garcia (University of Utah) draw from the work of their mentor, Rina Benmayor and "Telling to live: Latina feminist testimonios" to establish an organization for Latinas who are staff, faculty, students, alumni, and community members at a predominantly White institution (PWI). Critical race feminism (CRF),…

  19. Coloring the Academic Landscape: Faculty of Color Breaking the Silence in Predominantly White Colleges and Universities

    Science.gov (United States)

    Stanley, Christine A.

    2006-01-01

    This article, based on a larger, autoethnographic qualitative research project, focuses on the first-hand experiences of 27 faculty of color teaching in predominantly White colleges and universities. The 27 faculty represented a variety of institutions, disciplines, academic titles, and ranks. They identified themselves as African American,…

  20. Black Female Voices: Self-Presentation Strategies in Doctoral Programs at Predominately White Institutions

    Science.gov (United States)

    Shavers, Marjorie C.; Moore, James L., III

    2014-01-01

    Drawing on a larger study, this qualitative investigation uses Black feminist thought as the interpretive lens to investigate perceptions and experiences of African American female doctoral students at predominately White institutions (PWIs). Semistructured interviews were used to gain an understanding of their experiences and how these…

  1. Black Male College Achievers and Resistant Responses to Racist Stereotypes at Predominantly White Colleges and Universities

    Science.gov (United States)

    Harper, Shaun R.

    2015-01-01

    In this article, Shaun R. Harper investigates how Black undergraduate men respond to and resist the internalization of racist stereotypes at predominantly White colleges and universities. Prior studies consistently show that racial stereotypes are commonplace on many campuses, that their effects are usually psychologically and academically…

  2. Social Functioning in Predominantly Inattentive and Combined Subtypes of Children with ADHD

    Science.gov (United States)

    Solanto, Mary V.; Pope-Boyd, Sabrina A.; Tryon, Warren W.; Stepak, Brenda

    2009-01-01

    Objective: The objective of this study was to compare the social functioning of children with the Combined (CB) and Predominantly Inattentive (PI) subtypes of Attention Deficit/Hyperactivity Disorder (ADHD), controlling for comorbidity and medication-status, which may have confounded the results of previous research. Method: Parents and teachers…

  3. Perceptions of Stereotype Vulnerability, Belonging and Campus Climate by African Americans Attending a Predominately White Institution

    Science.gov (United States)

    Thompson, Loren Wright

    2017-01-01

    The purpose of this study was to examine of stereotype vulnerability, sense of belonging and campus climate for African American college students at a Predominately White Institution (PWI) in the Southeast. This research used a sociocultural model to explore African American student perceptions at a PWI in the southeast of the United States. This…

  4. Is the Feeling Mutual? Examining Parent-Teacher Relationships in Low-Income, Predominantly Latino Schools

    Science.gov (United States)

    Miller, Hannah; Robinson, Michelle; Valentine, Jessa Lewis; Fish, Rachel

    2016-01-01

    Strong parent-teacher relationships are critical to students' academic success. Mismatches in parents' and teachers' perceptions of each other may negatively affect children's outcomes. Using survey data collected from parents and teachers in 52 low-income, predominantly Latino schools, we explore subgroup variation in parents' and teachers'…

  5. Black African Immigrant College Students' Perceptions of Belonging at a Predominately White Institution

    Science.gov (United States)

    Stebleton, Michael J.; Aleixo, Marina B.

    2016-01-01

    A growing number of college-age Blacks in the United States are Black African immigrants. Using a constructivist grounded theory approach, the researchers interviewed 12 undergraduate Black African immigrant college students attending a predominately White institution (PWI) about their experiences and perceptions of belonging. Findings suggest…

  6. Black Undergraduate Women and Their Sense of Belonging in STEM at Predominantly White Institutions

    Science.gov (United States)

    Dortch, Deniece; Patel, Chirag

    2017-01-01

    Because little work exists on the sense of belonging focusing on just Black undergraduate women in science, technology, engineering, and math (STEM), especially at highly selective predominantly white institutions (PWIs), this study takes a phenomenological approach to understand the lived experiences of Black undergraduate women in STEM by…

  7. Identification of predominant aroma components of raw, dry roasted and oil roasted almonds.

    Science.gov (United States)

    Erten, Edibe S; Cadwallader, Keith R

    2017-02-15

    Volatile components of raw, dry roasted and oil roasted almonds were isolated by solvent extraction/solvent-assisted flavor evaporation and predominant aroma compounds identified by gas chromatography-olfactometry (GCO) and aroma extract dilutions analysis (AEDA). Selected odorants were quantitated by GC-mass spectrometry and odor-activity values (OAVs) determined. Results of AEDA indicated that 1-octen-3-one and acetic acid were important aroma compounds in raw almonds. Those predominant in dry roasted almonds were methional, 2- and 3-methylbutanal, 2-acetyl-1-pyrroline and 2,3-pentanedione; whereas, in oil roasted almonds 4-hydroxy-2,5-dimethyl-3(2H)-furanone, 2,3-pentanedione, methional and 2-acetyl-1-pyrroline were the predominant aroma compounds. Overall, oil roasted almonds contained a greater number and higher abundance of aroma compounds than either raw or dry roasted almonds. The results of this study demonstrate the importance of lipid-derived volatile compounds in raw almond aroma. Meanwhile, in dry and oil roasted almonds, the predominant aroma compounds were derived via the Maillard reaction, lipid degradation/oxidation and sugar degradation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Pre- and perinatal risk factors for pyloric stenosis and their influence on the male predominance

    DEFF Research Database (Denmark)

    Krogh, Camilla; Gørtz, Sanne; Wohlfahrt, Jan

    2012-01-01

    whether these factors modified the male predominance. Information on pre- and perinatal factors and pyloric stenosis was obtained from national registers. Poisson regression models were used to estimate rate ratios. Among 1,925,313 children, 3,174 had surgery for pyloric stenosis. The authors found...

  9. Being White in Black Spaces: Teaching and Learning at a Predominately Black Institution

    Science.gov (United States)

    Harrington, Timothy E.; Thomas, Michael

    2018-01-01

    This paper serves as a beginning conversation of how two White males perspectives' were shaped and how those perspectives evolved while attending and teaching at a Predominately Black Institution (PBI). Their initial understandings of Whiteness are introduced. This is an ethnographic study that utilized personal narratives from a college professor…

  10. A Predominately Female Accounting Profession: Lessons from the Past and Other Professions

    Science.gov (United States)

    Whitten, Donna

    2016-01-01

    Currently, the accounting profession is in the process of transitioning from a male dominated profession to a predominantly female one. Other professions that have undergone this switch experienced declines in the status of the profession and the salaries. So, although women have not yet gained equal access to all levels of the accounting…

  11. African American Faculty Expressing Concerns: Breaking the Silence at Predominantly White Research Oriented Universities

    Science.gov (United States)

    Ross, Henry H.; Edwards, Willie J.

    2016-01-01

    A Delphi method was used with a panel of 24 African American faculty employed at 43 predominantly white doctoral extensive universities to arrive at a group consensus on a list of concerns that African American faculty in general experienced or held. Using the Delphi method a panel of African American faculty initially worked from a list of eight…

  12. Breast milk and energy intake in exclusively, predominantly, and partially breast-fed infants

    NARCIS (Netherlands)

    Haisma, H; Coward, WA; Albernaz, E; Visser, GH; Wells, JCK; Wright, A; Victoria, CG; Victora, C.G.

    2003-01-01

    Objective: To investigate the extent to which breast milk is replaced by intake of other liquids or foods, and to estimate energy intake of infants defined as exclusively (EBF), predominantly (PBF) and partially breast-fed (PartBF). Design: Cross-sectional. Setting: Community-based study in urban

  13. Perceptions of Financial Aid: Black Students at a Predominantly White Institution

    Science.gov (United States)

    Tichavakunda, Antar A.

    2017-01-01

    This study provides qualitative context for statistics concerning Black college students and financial aid. Using the financial nexus model as a framework, this research draws upon interviews with 29 Black juniors and seniors at a selective, -private, and predominantly White university. The data suggest that students -generally exhibited high…

  14. Fighting through Resistance: Challenges Faced by African American Women Principals in Predominately White School Settings

    Science.gov (United States)

    Jackson, Alicia D.

    2013-01-01

    African American women represented a growing proportion within the field of education in attaining leadership roles as school principals. As the numbers continued to rise slowly, African American women principals found themselves leading in diverse or even predominately White school settings. Leading in such settings encouraged African American…

  15. Prevalence of comorbidities according to predominant phenotype and severity of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Camiciottoli G

    2016-09-01

    Full Text Available Gianna Camiciottoli,1,2 Francesca Bigazzi,1 Chiara Magni,1 Viola Bonti,1 Stefano Diciotti,3 Maurizio Bartolucci,4 Mario Mascalchi,5 Massimo Pistolesi1 1Section of Respiratory Medicine, Department of Clinical and Experimental Medicine, 2Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, 3Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi,” University of Bologna, Cesena, 4Department of Diagnostic Imaging, Careggi University Hospital, 5Radiodiagnostic Section, Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy Background: In addition to lung involvement, several other diseases and syndromes coexist in patients with chronic obstructive pulmonary disease (COPD. Our purpose was to investigate the prevalence of idiopathic arterial hypertension (IAH, ischemic heart disease, heart failure, peripheral vascular disease (PVD, diabetes, osteoporosis, and anxious depressive syndrome in a clinical setting of COPD outpatients whose phenotypes (predominant airway disease and predominant emphysema and severity (mild and severe diseases were determined by clinical and functional parameters. Methods: A total of 412 outpatients with COPD were assigned either a predominant airway disease or a predominant emphysema phenotype of mild or severe degree according to predictive models based on pulmonary functions (forced expiratory volume in 1 second/vital capacity; total lung capacity %; functional residual capacity %; and diffusing capacity of lung for carbon monoxide % and sputum characteristics. Comorbidities were assessed by objective medical records. Results: Eighty-four percent of patients suffered from at least one comorbidity and 75% from at least one cardiovascular comorbidity, with IAH and PVD being the most prevalent ones (62% and 28%, respectively. IAH prevailed significantly in predominant airway disease, osteoporosis prevailed

  16. Predominant Bacteria Detected from the Middle Ear Fluid of Children Experiencing Otitis Media: A Systematic Review.

    Science.gov (United States)

    Ngo, Chinh C; Massa, Helen M; Thornton, Ruth B; Cripps, Allan W

    2016-01-01

    Otitis media (OM) is amongst the most common childhood diseases and is associated with multiple microbial pathogens within the middle ear. Global and temporal monitoring of predominant bacterial pathogens is important to inform new treatment strategies, vaccine development and to monitor the impact of vaccine implementation to improve progress toward global OM prevention. A systematic review of published reports of microbiology of acute otitis media (AOM) and otitis media with effusion (OME) from January, 1970 to August 2014, was performed using PubMed databases. This review confirmed that Streptococcus pneumoniae and Haemophilus influenzae, remain the predominant bacterial pathogens, with S. pneumoniae the predominant bacterium in the majority reports from AOM patients. In contrast, H. influenzae was the predominant bacterium for patients experiencing chronic OME, recurrent AOM and AOM with treatment failure. This result was consistent, even where improved detection sensitivity from the use of polymerase chain reaction (PCR) rather than bacterial culture was conducted. On average, PCR analyses increased the frequency of detection of S. pneumoniae and H. influenzae 3.2 fold compared to culture, whilst Moraxella catarrhalis was 4.5 times more frequently identified by PCR. Molecular methods can also improve monitoring of regional changes in the serotypes and identification frequency of S. pneumoniae and H. influenzae over time or after vaccine implementation, such as after introduction of the 7-valent pneumococcal conjugate vaccine. Globally, S. pneumoniae and H. influenzae remain the predominant otopathogens associated with OM as identified through bacterial culture; however, molecular methods continue to improve the frequency and accuracy of detection of individual serotypes. Ongoing monitoring with appropriate detection methods for OM pathogens can support development of improved vaccines to provide protection from the complex combination of otopathogens within

  17. Predominant Bacteria Detected from the Middle Ear Fluid of Children Experiencing Otitis Media: A Systematic Review

    Science.gov (United States)

    Ngo, Chinh C.; Massa, Helen M.; Thornton, Ruth B.; Cripps, Allan W.

    2016-01-01

    Background Otitis media (OM) is amongst the most common childhood diseases and is associated with multiple microbial pathogens within the middle ear. Global and temporal monitoring of predominant bacterial pathogens is important to inform new treatment strategies, vaccine development and to monitor the impact of vaccine implementation to improve progress toward global OM prevention. Methods A systematic review of published reports of microbiology of acute otitis media (AOM) and otitis media with effusion (OME) from January, 1970 to August 2014, was performed using PubMed databases. Results This review confirmed that Streptococcus pneumoniae and Haemophilus influenzae, remain the predominant bacterial pathogens, with S. pneumoniae the predominant bacterium in the majority reports from AOM patients. In contrast, H. influenzae was the predominant bacterium for patients experiencing chronic OME, recurrent AOM and AOM with treatment failure. This result was consistent, even where improved detection sensitivity from the use of polymerase chain reaction (PCR) rather than bacterial culture was conducted. On average, PCR analyses increased the frequency of detection of S. pneumoniae and H. influenzae 3.2 fold compared to culture, whilst Moraxella catarrhalis was 4.5 times more frequently identified by PCR. Molecular methods can also improve monitoring of regional changes in the serotypes and identification frequency of S. pneumoniae and H. influenzae over time or after vaccine implementation, such as after introduction of the 7-valent pneumococcal conjugate vaccine. Conclusions Globally, S. pneumoniae and H. influenzae remain the predominant otopathogens associated with OM as identified through bacterial culture; however, molecular methods continue to improve the frequency and accuracy of detection of individual serotypes. Ongoing monitoring with appropriate detection methods for OM pathogens can support development of improved vaccines to provide protection from the

  18. Enhanced thyroid iodine metabolism in patients with triiodothyronine-predominant Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Takamatsu, J.; Hosoya, T.; Naito, N.; Yoshimura, H.; Kohno, Y.; Tarutani, O.; Kuma, K.; Sakane, S.; Takeda, K.; Mozai, T.

    1988-01-01

    Some patients with hyperthyroid Graves' disease have increased serum T3 and normal or even low serum T4 levels during treatment with antithyroid drugs. These patients with elevated serum T3 to T4 ratios rarely have a remission of their hyperthyroidism. The aim of this study was to investigate thyroid iodine metabolism in such patients, whom we termed T3-predominant Graves' disease. Mean thyroid radioactive iodine uptake was 51.0 +/- 18.1% ( +/- SD) at 3 h, and it decreased to 38.9 +/- 20.1% at 24 h in 31 patients with T3-predominant Graves' disease during treatment. It was 20.0 +/- 11.4% at 3 h and increased to 31.9 +/- 16.0% at 24 h in 17 other patients with hyperthyroid Graves' disease who had normal serum T3 and T4 levels and a normal serum T3 to T4 ratio during treatment (control Graves' disease). The activity of serum TSH receptor antibodies was significantly higher in the patients with T3-predominant Graves' disease than in control Graves' disease patients. From in vitro studies of thyroid tissue obtained at surgery, both thyroglobulin content and iodine content in thyroglobulin were significantly lower in patients with T3-predominant Graves' disease than in the control Graves' disease patients. Thyroid peroxidase (TPO) activity determined by a guaiacol assay was 0.411 +/- 0.212 g.u./mg protein in the T3-predominant Graves' disease patients, significantly higher than that in the control Graves' disease patients. Serum TPO autoantibody levels determined by immunoprecipitation also were greater in T3-predominant Graves' disease patients than in control Graves' disease patients. Binding of this antibody to TPO slightly inhibited the enzyme activity of TPO, but this effect of the antibody was similar in the two groups of patients.

  19. Condições de serventia de estradas não-pavimentadas: estudo de caso aplicado às vias do município de Viçosa, Estado de Minas Gerais, Brasil = Serviceability of unpaved roads: a case study applied to net road from Viçosa, Minas Gerais

    Directory of Open Access Journals (Sweden)

    Taciano Oliveira da Silva

    2011-04-01

    Full Text Available Este artigo apresenta a adaptação do método de classificação de estradas nãopavimentadas proposto por Eaton às condições encontradas em rodovias vicinais do município de Viçosa, Estado de Minas Gerais, considerando a sua potencialidade como ferramenta de suporte à gerência destas vias. Este estudo foi desenvolvido a partir deavaliações objetiva, realizada com o emprego de uma escala de notas, e subjetiva, em obediência à metodologia de Eaton, que foram conduzidas por uma equipe treinada previamente que executou inspeções de campo, atribuindo notas a 20 unidades amostrais, possuindo cada uma delas 50 m de comprimento e representativas de 10 trechos analisados de vias não-pavimentadas. A análise dos dados desta pesquisa possibilitou concluir que: (i não houve correlação entre os resultados das avaliações subjetiva e objetiva, e a aplicação dametodologia de Eaton à gerência de manutenção de vias não-pavimentadas pode não refletir as suas prioridades reais; (ii a avaliação subjetiva do trecho e a avaliação subjetiva do conjunto de suas unidades amostrais são correlatas, indicando ser coerente o emprego deste procedimento.This paper addresses the adaptation of the method of classification of unpaved roads developed by Eaton to the field conditions of local roads from the city of Viçosa, Minas Gerais State, Brazil, considering its potential as a support tool for the management of these roads. This study was developed encompassing objective evaluation, carried out with the application of a note scale, and subjective evaluation, according to the methodology of Eaton, which were performed by a team that accomplished the field inspections, attributing notes to the 20 sample units, each one 50 meters long andrepresenting 10 analyzed unpaved road segments. Conclusions are as follows: (i it was not observed any correlation between data from the objective and the subjective field evaluations, leading to the conclusion

  20. Tendências recentes nos elementos do clima e suas implicações na evapotranspiração da cultura do milho em Viçosa - MG Recent trends in the weather elements and its implications in the maize crop evapotranspiration in Viçosa-MG, Brazil

    Directory of Open Access Journals (Sweden)

    Leonidas P. de Alencar

    2011-01-01

    Full Text Available A mudança nas condições climáticas tem gerado grandes preocupações em nível mundial, sendo que uma das grandes questões, neste contexto, é o aquecimento global. As alterações ocorridas nas condições climáticas podem afetar a demanda de água das plantas, porque a evapotranspiração é afetada por mudanças nos elementos climáticos. O objetivo deste trabalho foi analisar os efeitos das possíveis mudanças dos elementos do clima na evapotranspiração de referência e na evapotranspiração da cultura do milho para a região de Viçosa - MG. Mediante análise de tendência pelo teste de Mann-Kendall e da estatística do teste t da regressão linear, verificou-se o comportamento dos seguintes elementos climáticos: temperaturas máxima e mínima, insolação, velocidade do vento e umidade relativa. Observou-se uma redução na evapotranspiração de referência e da cultura do milho ao longo dos últimos 41 anos, principalmente em razão da redução da insolação e da velocidade do vento. A evapotranspiração de referência apresentou redução da ordem de 4,2 mm por ano.The change in weather conditions has caused great concern in the world and the major issue, in this context, is the global warming. The changes in climate may affect the water demand of plants, because the evapotranspiration is affected by changes in climatic elements. The objective of this study was to examine the possible effects of climatological changes in evapotranspiration and reference evapotranspiration of corn in Viçosa - MG, Brazil. Trend analysis by the Mann-Kendall statistic and student t test of the linear regression were used to study the behavior of the following weather elements: maximum and minimum temperatures, sunshine duration, wind speed and relative humidity. It was observed a reduction in the reference evapotranspiration and maize crop evapotranspiration over the recent past 41 years, mainly because of reduced solar radiation and wind

  1. Carotenos e provitamina A em bertalha e ervas aromáticas comercializadas em Viçosa, Estado de Minas Gerais, durante as quatro estações do ano = Carotenes and provitamin A in basella and aromatic herbs marketed in Viçosa, Minas Gerais State, during the four seasons of the year

    Directory of Open Access Journals (Sweden)

    Marina Andrade Batista

    2006-01-01

    Full Text Available Este estudo teve como objetivos investigar o teor de a-caroteno, b-caroteno e calcular o valor de vitamina A em hortaliças comercializadas no mercado formal e informal de Viçosa, Estado de Minas Gerais, bem como avaliar a influência das quatro estações doano e do local de comercialização sobre o conteúdo desses nutrientes. As hortaliças (bertalha, cebolinha, coentro, manjericão e salsa foram analisadas utilizando-se a cromatografia líquida de alta eficiência (CLAE. Devido ao conteúdo inexpressivo de a-caroteno em todas as amostras, foi possível quantificar apenas o b-caroteno. Não se verificou diferença estatisticamente significativa (a = 0,05 no conteúdo de b-caroteno das hortaliças entre os diferentes estabelecimentos, nem entre as estações do ano. As hortaliçasmostraram-se excelentes fontes de provitamina A, e se consumidas regularmente, contribuem de forma importante na adequação diária de vitamina A para adultos e crianças. Além disso, esses alimentos são acessíveis à população por apresentarem baixo custo e serem facilmente encontrados.This study aimed to investigate the level of a-carotene, b-carotene and to calculate the value of vitamin A in vegetables sold at local markets and informal markets of Viçosa, Minas Gerais State, as wellas to evaluate the seasonal and commercial effects on the content of these pigments. The vegetables (basella, green onion, cilantro, sweet basil and parsley were analyzed through high-performance liquid chromatography (HPLC, being b-carotene the only pigment present in all the analyzed samples. No significant statistical differences (a = 0.05 were found in the contents of b-carotene of the vegetables either among the different stores, or among the different seasons. The vegetables analyzed are great provitamin A sources and, ifeaten on a regular basis, they can fit the daily requirements of vitamin A for adults and children. Besides, these foods are very accessible due to their

  2. Flutuação populacional de espécies de cigarrinhas transmissoras da clorose variegada dos citros (CVC em Viçosa-MG Population dynamics of sharpshooters species transmitter of citrus variegated chlorosis (CVC in Viçosa-MG

    Directory of Open Access Journals (Sweden)

    Dierlei dos Santos

    2005-08-01

    Full Text Available Os objetivos deste trabalho foram avaliar a presença e a dinâmica populacional, ao longo do ano, de cigarrinhas transmissoras da CVC, no município de Viçosa - MG. As coletas foram realizadas no período de agosto de 2003 a julho de 2004, com auxílio de armadilhas adesivas amarelas e com rede entomológica (puçá. Das onze espécies comprovadamente capazes de transmitir a CVC, foram encontradas nove. O número total de cigarrinhas capturadas foi de 2.966, sendo 2.805 nas armadilhas e 161 no puçá. As três espécies da família Cicadellidae mais expressivas em número de insetos foram Bucephalogonia xanthophis (36,6% capturados na rede entomológica e 34,7% na armadilha, Dilobopterus costalimai (9,9% capturados na rede entomológica e 11,3% na armadilha e Acrogonia citrina (6,8% capturados na rede entomológica e 7,4% na armadilha. No mês de novembro, foram coletadas 378 cigarrinhas, correspondendo ao mês de maior incidência, sendo que 292 dessas foram coletadas na primeira quinzena, concorrendo para um pico populacional. Não houve diferença significativa entre o número médio de cigarrinhas coletadas no interior e na periferia da área.The objectives of this work were to evaluate the presence and the population dynamics of Citrus CVC transmitter sharpshooters along the year in the municipality of Viçosa- MG. The sharpshooter populations were monitored in the period of August 2003 to July 2004 using yellow adhesive traps and entomologic nets. During this period 2966 sharpshooters were captured and identified. Among eleven species known as CVC transmitters, nine were found in the region. The three most expressive species in number found were Bucephalogonia xanthophis (36,6% captured in entomological net and 34,7% in the trap, Dilobopterus costalimai (9,9% captured in entomological net and 11,3% in the trap and Acrogonia citrina (6,8% captured in entomological net and 7,4% in the trap. The largest incidence of sharpshooters occurred

  3. Avaliação do perfil de trabalhadores e das condições de trabalho em marcenarias no município de Viçosa-MG Evalution of workers' profile and work conditions joineries in Viçosa, Minas Gerais, Brazil

    Directory of Open Access Journals (Sweden)

    Kátia Regina Silva

    2002-11-01

    Full Text Available Esta pesquisa foi desenvolvida nos ambientes de trabalho de marcenarias localizadas no município de Viçosa, Minas Gerais, para realizar o levantamento do perfil dos trabalhadores e das condições de trabalho relacionadas às atividades exercidas em marcenarias, visando a melhoria da saúde, do bem-estar, da segurança, do conforto e da produtividade dos trabalhadores. O levantamento do perfil dos trabalhadores e das condições de trabalho foi realizado por intermédio da aplicação de questionários aos trabalhadores das marcenarias avaliadas e das observações e anotações realizadas durante a coleta dos dados. Pelos resultados obtidos, foram constatados diversos problemas relacionados aos marceneiros, como, por exemplo, cansaço, dores nas pernas e na coluna, alergia devido à utilização de produtos químicos e ao pó da madeira, falta de treinamento para exercer a profissão e praticamente nenhuma noção sobre segurança e higiene no trabalho. A incidência de acidentes relatados foi baixa; as mãos foram as partes mais afetadas por cortes leves, não tendo sido relatado nenhum tipo de acidente grave. Pôde-se constatar também que há necessidade de conscientizar os proprietários das marcenarias sobre a importância e os benefícios da segurança e higiene no trabalho para os seus funcionários.This work was carried out in joineries located in Viçosa, Minas Gerais, Brazil, to survey the profile of workers and work conditions related to the activities performed, aiming to promote health, welfare, safety, comfort and productivity of the workers. This survey was carried out by means of the application of questionnaires to the workers and from observations made during data collection. According to the obtained results, various problems related to the joiners were observed, such as fatigue, pain in legs and spine, allergies due to the use of chemicals and sawdust, lack of training for the work and almost none knowledge about work

  4. Response of right ventricular size, function, and pressure to supine exercise: a comparison of patients with chronic obstructive lung disease and normal subjects

    Energy Technology Data Exchange (ETDEWEB)

    Slutsky, R; Hooper, W; Ackerman, W; Moser, K

    1982-12-01

    The response of right ventricular ejection fraction (RVEF) and right ventricular end-diastolic volume (RVEDV) to exercise was studied in 11 patients with severe (FEV/sub 25/sub(%)sub(-)/sub 75/sub(%)=0.32+-0.13, mean+-SD) chronic obstructive pulmonary disease (COPD). Using gated radionuclide cardiac blood pool imaging techniques, the response of the patients with COPD was compared with that of 15 control subjects. Arterial blood gases, pulmonary arterial pressures, wedge pressure, and right ventricular pressures also were monitored in patients with COPD. The resting RVEF was lower and the resting RVEDV was higher in patients with COPD than in normals (both, P<0.01). Two of the 11 COPD patients had a RVEF during rest that was below lower limits, while 10 of 11 patients had RV dilation. Right ventricular end-diastolic pressure, measured during rest in patients with COPD, was normal (6.1+-2.1 mm Hg) and cardiac index was within normal limits (3.55+-0.82 l/min/m/sup 2/). With exercise this cardiac index rose to 5.52+-1.7/min/m/sup 2/(P<0.01) due to the increase in heart rate (83+-18 to 125+-25 beats/min; P<0.01) while stroke volume did not significantly change. During exercise, normal subjects showed an increase in RVEF while RVEDV did not change; in patients with COPD, the RVEF fell and the RVEDV increased. In the patients with COPD, mild resting arterial hypoxemia and hypercapnia were both exaggerated during exercise; and mild resting pulmonary arterial hypertension (PAm=24.3+-7.65 mm Hg) also worsened with exercise (PAm=41+-19 mm Hg, P<0.01). Correlation between change in RVEF and PAm was -0.58, and between change in RVEDV and PAm was 0.63. We conclude that patients with severe COPD often have right ventricular dilation at rest and commonly respond to supine exercise with a fall in FV ejection fraction and further dilation of the right ventricle.

  5. Magnetic Resonance Imaging Assessment of Spinal Cord and Cauda Equina Motion in Supine Patients With Spinal Metastases Planned for Spine Stereotactic Body Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Tseng, Chia-Lin [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Sussman, Marshall S. [Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Ontario (Canada); Atenafu, Eshetu G. [Department of Biostatistics, University Health Network, University of Toronto, Toronto, Ontario (Canada); Letourneau, Daniel [Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Ma, Lijun [Department of Radiation Oncology, University of California San Francisco, San Francisco, California (United States); Soliman, Hany; Thibault, Isabelle [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Cho, B. C. John; Simeonov, Anna [Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Yu, Eugene [Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Ontario (Canada); Fehlings, Michael G. [Department of Neurosurgery and Spine Program, Toronto Western Hospital, University of Toronto, Toronto, Ontario (Canada); Sahgal, Arjun, E-mail: arjun.sahgal@sunnybrook.ca [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario (Canada)

    2015-04-01

    Purpose: To assess motion of the spinal cord and cauda equina, which are critical neural tissues (CNT), which is important when evaluating the planning organ-at-risk margin required for stereotactic body radiation therapy. Methods and Materials: We analyzed CNT motion in 65 patients with spinal metastases (11 cervical, 39 thoracic, and 24 lumbar spinal segments) in the supine position using dynamic axial and sagittal magnetic resonance imaging (dMRI, 3T Verio, Siemens) over a 137-second interval. Motion was segregated according to physiologic cardiorespiratory oscillatory motion (characterized by the average root mean square deviation) and random bulk shifts associated with gross patient motion (characterized by the range). Displacement was evaluated in the anteroposterior (AP), lateral (LR), and superior-inferior (SI) directions by use of a correlation coefficient template matching algorithm, with quantification of random motion measure error over 3 separate trials. Statistical significance was defined according to P<.05. Results: In the AP, LR, and SI directions, significant oscillatory motion was observed in 39.2%, 35.1%, and 10.8% of spinal segments, respectively, and significant bulk motions in all cases. The median oscillatory CNT motions in the AP, LR, and SI directions were 0.16 mm, 0.17 mm, and 0.44 mm, respectively, and the maximal statistically significant oscillatory motions were 0.39 mm, 0.41 mm, and 0.77 mm, respectively. The median bulk displacements in the AP, LR, and SI directions were 0.51 mm, 0.59 mm, and 0.66 mm, and the maximal statistically significant displacements were 2.21 mm, 2.87 mm, and 3.90 mm, respectively. In the AP, LR, and SI directions, bulk displacements were greater than 1.5 mm in 5.4%, 9.0%, and 14.9% of spinal segments, respectively. No significant differences in axial motion were observed according to cord level or cauda equina. Conclusions: Oscillatory CNT motion was observed to be relatively minor. Our results

  6. Very low frequency oscillations in the power spectra of heart rate variability during dry supine immersion and exposure to non-hypoxic hypobaria.

    Science.gov (United States)

    Tripathi, K K

    2011-06-01

    The origin of very low frequency (VLF) oscillations in the power spectra of heart rate variability (HRV) is controversial with possible mechanisms involving thermoregulation and/or renin-angiotensin-aldosterone system. Recently, a major contribution from vagal influences has been suggested. The present study investigated the behaviour of VLF (0.004-0.040 Hz) components of HRV power spectra in a group of healthy male volunteers during their exposure to (1) dry, supine, immersion in thermo-neutral water for 6 h (n = 7) and (2) non-hypoxic hypobaria (breathing 40-60% oxygen at 15,000' simulated in a decompression chamber) for 5 h (n = 15). The two manoeuvres are established to increase vagal outflow. During both the manoeuvres, all the frequency domain indices of HRV exhibited a significant increase. Increase in HRV was much more than that in the R-R interval. At 6 h of immersion, the R-R interval increased by ∼ 15% but the total power increased ∼ fourfold. Similarly, at 5 h of exposure to hypobaria, total power increased ∼ twofold with a very modest increase in an R-R of ∼ 9%. Increase in spectral power was appreciable even after normalization with mean R-R(2). Increase in VLF during immersion was more than reported during enalaprilat blockade of angiotensin convertase enzyme. Plasma renin activity did not vary during hypobaria. There was a significant increase in pNN50, an established marker of cardiac vagal activity. Centre frequencies of the spectra and slope (β) of the relation between log(PSD) and log(frequency) did not change. Results were supportive of the notion that the parasympathetic system is pre-potent to influence slower (than respiratory) frequency components in HRV spectrum. Additionally, such an effect was without a change in the time constant of effector responses or pacemaker frequencies of VLF and LF periodicities and HRV was not a simple linear surrogate for cardiac vagal effects. An invariance of spectral exponent (β) ruled out

  7. Hereditary motor and sensory neuropathy with proximal predominance (HMSN-P).

    Science.gov (United States)

    Campellone, Joseph V

    2013-06-01

    Hereditary motor and sensory neuropathy with proximal predominance (HMSN-P) is a rare disorder inherited in an autosomal dominant fashion. Patients present with slowly progressive proximal-predominant weakness, painful muscle cramps, fasciculations, large-fiber sensory loss, and areflexia. Electrodiagnostic (EDX) studies typically reveal abnormalities consistent with a sensorimotor neuronopathy. A patient with HMSN-P underwent EDX studies, revealing ongoing and chronic neurogenic denervation, motor unit instability, and neuromyotonic discharges, further defining the spectrum of EDX findings in HMSN-P. The clinical, pathological, and genetic features are also reviewed. The appearance of HMSN-P in the United States and elsewhere calls for clinicians in nonendemic regions to be familiar with this rare disorder, which has typically been geographically confined.

  8. Health and Well-being of Women Migrating from Predominantly Muslim Countries to the United States.

    Science.gov (United States)

    Kamimura, Akiko; Pye, Mu; Sin, Kai; Nourian, Maziar M; Assasnik, Nushean; Stoddard, Mary; Frost, Caren J

    2018-01-01

    The purpose of this study was to examine the health and well-being of women migrating from predominantly Muslim countries to the U.S. Women from predominantly Muslim countries completed a paper survey on the following topics from June to December in 2016 (N=102): depression; physical functioning; self-reported general health; experiences with health care; and demographic characteristics. There were several women's health-related issues: low rates for mammography and Pap smear screening, and preference for female physicians and/or physicians from the same culture. Only one-third of the participants had received a physical exam in the past year, and having done so was related to higher levels of depression and worse physical functioning. The participants who were not in a refugee camp reported higher levels of depression than those who were.

  9. Low-Dose Involved-Field Radiotherapy as Alternative Treatment of Nodular Lymphocyte Predominance Hodgkin's Lymphoma

    International Nuclear Information System (INIS)

    Haas, Rick L.M.; Girinsky, Theo; Aleman, Berthe; Henry-Amar, Michel; Boer, Jan-Paul de; Jong, Daphne de

    2009-01-01

    Purpose: Nodular lymphocyte predominance Hodgkin's lymphoma is a very rare disease, characterized by an indolent clinical course, with sometimes very late relapses occurring in a minority of all patients. Considerable discussion is ongoing on the treatment of primary and relapsed disease. Patients and Methods: A group of 9 patients were irradiated to a dose of 4 Gy on involved areas only. Results: After a median follow-up of 37 months (range, 6-66), the overall response rate was 89%. Six patients had complete remission (67%), two had partial remission (22%), and one had stable disease (11%). Of 8 patients, 5 developed local relapse 9-57 months after radiotherapy. No toxicity was noted. Conclusion: In nodular lymphocyte predominance Hodgkin's lymphoma, low-dose radiotherapy provided excellent response rates and lasting remissions without significant toxicity.

  10. The Lived Experience of Black Nurse Faculty in Predominantly White Schools of Nursing.

    Science.gov (United States)

    Whitfield-Harris, Lisa; Lockhart, Joan Such; Zoucha, Richard; Alexander, Rumay

    2017-03-01

    This study explored the experiences of Black nurse faculty employed in predominantly White schools of nursing. High attrition rates of this group were noted in previous literature. Understanding their experiences is important to increase nurse diversity. Hermeneutic phenomenology was used to explore the experiences of 15 Black nurse faculty using interviews. Four themes were extracted as the following: cultural norms of the workplace, coping with improper assets, life as a "Lone Ranger," and surviving the workplace environment. The study provided insight to understand the meaning that Black faculty members give to their experiences working in predominantly White schools of nursing. Findings exemplify the need to improve culturally competent work environments and mentoring programs. Results suggest that better communication and proper respect from students, colleagues, and administrators are necessary. The limited research on this topic illustrates that Black nurse faculty remain under investigated; research is necessary to determine effective change strategies.

  11. The Workplace Environment for African-American Faculty Employed in Predominately White Institutions.

    Science.gov (United States)

    Whitfield-Harris, Lisa; Lockhart, Joan Such

    2016-01-01

    Diversity in academia requires attention, especially with the expected increase in minority populations in the United States (American Association of Colleges of Nursing, (AACN) 2014). Despite theoretical papers that suggest that several challenges are encountered by minority faculty employed in predominately White institutions, a dearth of research on this topic has been published. The purpose of this literature review was to analyze the published research that addressed the workplace environment of African-American faculty employed in predominately White institutions. In utilizing the keywords in various combinations, 236 articles were retrieved through multiple databases. After applying inclusion and exclusion criteria, 15 studies were reviewed with only three related to nursing. Two themes were extracted from the review: 1) the cultural climate of the workplace environment and, 2) underrepresentation of African-American faculty. It is apparent from this review that additional research is needed to understand the experiences of this group of faculty to target effective recruitment and retention strategies.

  12. Abdominal Pain-Predominant Functional Gastrointestinal Disorders in Jordanian School Children

    OpenAIRE

    Altamimi, Eyad M.; Al-Safadi, Mohammad H.

    2014-01-01

    Background Recurrent abdominal pain (RAP) is a common complaint in children. Significant portion of them are of functional origin. This study aimed to assess the prevalence of abdominal pain-predominant functional gastrointestinal disorder (FGID) and its types in Jordanian school children. Methods This is a school-based survey at south Jordan. Information using the self-reporting form of the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III Version (QPGS-RIII) - the official Arabi...

  13. Pulmonary microRNA profiling: implications in upper lobe predominant lung disease

    OpenAIRE

    Armstrong, David A.; Nymon, Amanda B.; Ringelberg, Carol S.; Lesseur, Corina; Hazlett, Haley F.; Howard, Louisa; Marsit, Carmen J.; Ashare, Alix

    2017-01-01

    Background Numerous pulmonary diseases manifest with upper lobe predominance including cystic fibrosis, smoking-related chronic obstructive pulmonary disease, and tuberculosis. Zonal hypoxia, characteristic of these pulmonary maladies, and oxygen stress in general is known to exert profound effects on various important aspects of cell biology. Lung macrophages are major participants in the pulmonary innate immune response and regional differences in macrophage responsiveness to hypoxia may co...

  14. Predominantly Electronic or Personal Service Delivery? A Case in the Wealth Management Context

    OpenAIRE

    Sunikka, Anne

    2009-01-01

    Financial services have been a recurrent subject of a multichannel inquiry but investigation into the wealth management area is scarce. This paper intends to fill the gap and presents the results of a questionnaire directed at customers of a financial conglomerate. The objective of this research is to examine which variables influence consumers’ channel preferences in the wealth management context,and to find out possible differences between the customers who prefer predominantly electronic s...

  15. SO DO SENSOR TM NA ESTIMATIVA DA TEMPERATURA DA SUPERFÍCIE E MUDANÇA NO USO DO SOLO EM VIÇOSA, MG, BRASIL

    Directory of Open Access Journals (Sweden)

    Rafael Coll Delgado

    2015-09-01

    Full Text Available O objetivo deste trabalho foi avaliar a dinâmica nouso e cobertura da terra em área de abrangência de Viçosa, Minas Gerais. Para tanto, utilizou-se o algoritmo SEBAL (Surface Energy Balance Algorithm for Land e o método de classificação não supervisionada por meio do algoritmo ISODATA. Foi utilizada uma série históricade temperatura do ar (ºC, da Estação Meteorológica Convencional (EMC do Instituto Nacional de Meteorologia (INMET e imagens do sensor TM Landsat 5 do Instituto Nacional de Pesquisas Espaciais (INPE, noperíodo que compreendeu 16 anos (1994-2010. Os resultados mostraram que nos anosde 1999, 2000, 2003, 2006, 2009 e 2010 mais de 20 mil hectares foram antropizadas, porém, a partir de 1999 inicia-se um acentuado crescimento das áreas classificadas como mata. Os valores demonstraram avanço das áreas antropizadas (58,92% em 1994 para 71,90% em 2010 e uma redução das áreas de pastagens (27,04% em 1994 para 5,90% em 2010. A temperatura da superfície estimada pelo algoritmo SEBAL para os anos de 1994 e 2010, apresentaram valores máximos de 38ºC em áreas antropizadas e valores mínimos de 18ºC em áreas de vegetação. Com base no cálculo do viés médio (VM, o presente estudo mostrou que os dados estimados da temperatura da superfície apresentaram boa correlação de 0,67 com os dados do INMET, já que as temperaturas foram subestimadas e superestimadas com valores mínimos e máximos de -3,83ºC e 2,65ºC em 1994 e 2003. Os resultados obtidos, ainda que em caráter preliminar, indicam a eficiência do Sensoriamento Remoto (SR por meio da análise das bandas refletivas e termal do satélite Landsat 5 como ferramenta de análise na identificação da dinâmica do uso do solo, mostrando-se eficaz quanto à espacialização dessas anomalias no espaço e no tempo.

  16. USO DO SENSOR TM NA ESTIMATIVA DA TEMPERATURA DA SUPERFÍCIE E MUDANÇA NO USO DO SOLO EM VIÇOSA, MG, BRASIL

    Directory of Open Access Journals (Sweden)

    Rafael Coll Delgado

    2013-11-01

    Full Text Available O objetivo deste trabalho foi avaliar a dinâmica nouso e cobertura da terra em área de abrangência de Viçosa, Minas Gerais. Para tanto, utilizou-se o algoritmo SEBAL (Surface Energy Balance Algorithm for Land e o método de classificação não supervisionada por meio do algoritmo ISODATA. Foi utilizada uma série históricade temperatura do ar (ºC, da Estação Meteorológica Convencional (EMC do Instituto Nacional de Meteorologia (INMET e imagens do sensor TM Landsat 5 do Instituto Nacional de Pesquisas Espaciais (INPE, noperíodo que compreendeu 16 anos (1994-2010. Os resultados mostraram que nos anosde 1999, 2000, 2003, 2006, 2009 e 2010 mais de 20 mil hectares foram antropizadas, porém, a partir de 1999 inicia-se um acentuado crescimento das áreas classificadas como mata. Os valores demonstraram avanço das áreas antropizadas (58,92% em 1994 para 71,90% em 2010 e uma redução das áreas de pastagens (27,04% em 1994 para 5,90% em 2010. A temperatura da superfície estimada pelo algoritmo SEBAL para os anos de 1994 e 2010, apresentaram valores máximos de 38ºC em áreas antropizadas e valores mínimos de 18ºC em áreas de vegetação. Com base no cálculo do viés médio (VM, o presente estudo mostrou que os dados estimados da temperatura da superfície apresentaram boa correlação de 0,67 com os dados do INMET, já que as temperaturas foram subestimadas e superestimadas com valores mínimos e máximos de -3,83ºC e 2,65ºC em 1994 e 2003. Os resultados obtidos, ainda que em caráter preliminar, indicam a eficiência do Sensoriamento Remoto (SR por meio da análise das bandas refletivas e termal do satélite Landsat 5 como ferramenta de análise na identificação da dinâmica do uso do solo, mostrando-se eficaz quanto à espacialização dessas anomalias no espaço e no tempo.

  17. Tuberculosis transmission of predominant genotypes of Mycobacterium tuberculosis in northern suburbs of Buenos Aires city region.

    Science.gov (United States)

    Morcillo, N; Zumarraga, M; Imperiale, B; Di Giulio, B; Chirico, C; Kuriger, A; Alito, A; Kremer, K; Cataldi, A

    2007-01-01

    In 2003, the incidence of tuberculosis in Argentina showed an increase compared to 2002. The severe national crisis at the end of the 90s has probably strongly contributed to this situation. The goal of this work was to estimate the extent of the spread of the most predominant Mycobacterium tuberculosis strains and to assess the spread of predominant M. tuberculosis clusters as determined by spoligotyping and IS6110 RFLP. The study involved 590 pulmonary, smear-positive TB cases receiving medical attention at health centers and hospitals in Northern Buenos Aires (NBA) suburbs, from October 2001 to December 2002. From a total of 208 clinical isolates belonging to 6 major clusters, 63 (30.2%) isolates had identical spoligotyping and IS6110 RFLP pattern. Only 22.2% were shown to have epidemiological connections with another member of their respective cluster. In these major clusters, 30.2% of the 208 TB cases studied by both molecular techniques and contact tracing could be convincingly attributable to a recently acquired infection. This knowledge may be useful to assess the clonal distribution of predominant M. tuberculosis clusters in Argentina, which may make an impact on TB control strategies.

  18. Is microscopic colitis a missed diagnosis in diarrhea-predominant Irritable Bowel Syndrome?

    Directory of Open Access Journals (Sweden)

    Hamid Tavakoli

    2008-08-01

    Full Text Available

    • BACKGROUND: There are controversies about the importance of biopsies of normal colon mucosa in the investigation of patients with diarrhea predominant irritable bowel syndrome (IBS. On the other hand, microscopic colitis may bemissed based on normal colonoscopy and laboratory examination in this group of patients
    • METHODS: The study took place in Alzahra and Noor hospitals and Poursina Hakim Research Institute, from 2002 to 2004. Eligible patients were those suffering from diarrhea for at least 4 weeks. A total of 138 patients were included in the study after meeting Rome criteria (II with normal CBC, ESR, stool examination and no endoscopic abnormality.
    • RESULTS: The histologic findings in 138 patients with diarrhea predominant IBS with mean age of 34.7 years (female 55.1% and male 44.9% were as follows: 10 patients (7.2% had collagenous colitis and 3 patients (2.2% were compatible with lymphocytic colitis. No significant diagnostic histologic findings were seen in the rest of patients. Collagenouscolitis was detected in 13% of right colon biopsies and in 10% of sigmoid and transverse colon biopsies. Nocturnal diarrhea was found in 30% of collagenous colitis patients.
    • CONCLUSIONS: Total colonoscopy and multiple biopsies in diarrhea predominant IBS patients are necessary for earlydiagnosis of microscopic colitis.
    • KEY WORDS: Irritable bowel syndrome, microscopic colitis, colonoscopy, biopsy, diarrhea.

  19. Culture-Dependent and -Independent Methods to Investigate the Predominant Microorganisms Associated with Wet Processed Coffee.

    Science.gov (United States)

    Feng, Xiaomin; Dong, Honghong; Yang, Pan; Yang, Ruijuan; Lu, Jun; Lv, Jie; Sheng, Jun

    2016-08-01

    The fermentation process of Yunnan arabica coffee is a typical wet fermentation. Its excellent quality is closely related to microbes in the process of fermentation. The purpose of this study was to isolate and identify the microorganisms in the wet method of coffee processing in Yunnan Province, China. Microbial community structure and dominant bacterial species were evaluated by traditional cultivated separation method and PCR-DGGE technology, and were further analyzed in combination with the changes of organic acid content, activity of pectinase, and physical parameters (pH and temperature). A large number of microorganisms which can produce pectinase were found. Among them, Enterobacter cowanii, Pantoea agglomerans, Enterobacteriaceae bacterium, and Rahnella aquatilis were the predominant gram-negative bacteria, Bacillus cereus was the predominant gram-positive bacterium, Pichia kluyveri, Hanseniaspora uvarum, and Pichia fermentans were the predominant yeasts, and all those are pectinase-producing microorganisms. As for the contents of organic acids, oxalic was the highest, followed by acetic and lactic acids. Butyrate and propionate, which were unfavorable during the fermentation period, were barely discovered.

  20. Counselling by primary care physicians may help patients with heartburn-predominant uninvestigated dyspepsia

    Science.gov (United States)

    Paré, Pierre; Math, Joanna Lee M; Hawes, Ian A

    2010-01-01

    OBJECTIVE: To determine whether strategies to counsel and empower patients with heartburn-predominant dyspepsia could improve health-related quality of life. METHODS: Using a cluster randomized, parallel group, multicentre design, nine centres were assigned to provide either basic or comprehensive counselling to patients (age range 18 to 50 years) presenting with heartburn-predominant upper gastrointestinal symptoms, who would be considered for drug therapy without further investigation. Patients were treated for four weeks with esomeprazole 40 mg once daily, followed by six months of treatment that was at the physician’s discretion. The primary end point was the baseline change in Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire score. RESULTS: A total of 135 patients from nine centres were included in the intention-to-treat analysis. There was a statistically significant baseline improvement in all domains of the QOLRAD questionnaire in both study arms at four and seven months (Pheartburn-predominant uninvestigated dyspepsia. Further investigation is needed to confirm the potential benefits of providing patients with comprehensive counselling regarding disease management. PMID:20352148

  1. Estructura, riqueza y composición de plantas leñosas en el golfo de Tribugá, Chocó, Colombia

    Directory of Open Access Journals (Sweden)

    Galicano Gloria

    2001-07-01

    Full Text Available Se estudió la estructura, riqueza y composición florística del componente leñoso de los bosques del Golfo de Tribugá, Costa Pacífica del Chocó, Colombia, con base en el muestreo de los individuos con DAP?: 5 cm en dos transectos de 0.4 ha cada uno y en la información previamente publicada para una ha en la misma zona. Los bosques son estructuralmente homogéneos y están caracterizados por la abundancia de palmas arborescentes, la escasez de lianas y la alta frecuencia de raíces zancos. Comparados con otros bosques de la región del Chocó biogeográfico con precipitación similar, los bosques del Golfo de Tribugá son más pobres en especies de plantas leñosas (en promedio 29 especies > 10 cm DAP en 0.1 ha, tienen menos individuos (en promedio 48 individuos z 10 cm DAP en 0.1 ha, árboles más gruesos (en promedio 9.8% de los individuos> 40 cm DAP en 0.1 ha y un área basal mayor (en promedio 3.16 m? por 0.1 ha incluyendo individuos > 10 cm DAP. Estas diferencias parecen ser consistentes con la existencia de una correlación negativa entre la fertilidad del suelo y, la densidad y la riqueza de árboles. A pesar de que la abundancia de especies y familias fue igual en todos los sitios, la similitud en composición florística fue muy baja. Sólo hubo 10 especies > 10 cm DAP comunes a los tres sitios. La importancia ecológica de las Moráceas parece estar entre las más altas registradas en el Neotrópico (VIF=48.2-53.9 para los individuos> 10 cm DAP. La estructura y los valores de riqueza de plantas leñosas de los bosques del Golfo de Tribugá se acercan más a los bosques de La Selva, Costa Rica, que a otros bosques igualmente lluviosos del Chocó biogeográfico.Structure, richness and floristic composition of the woody elements ofthe forests of the Golfo de Tribugá, Pacific Coast of Chocó, Colombia, were studied in two 0.4 ha plots sampled for all individuals ?: 5 cm dbh and using also previously published information for one l

  2. Effects of CPAP-therapy on brain electrical activity in obstructive sleep apneic patients: a combined EEG study using LORETA and Omega complexity : reversible alterations of brain activity in OSAS.

    Science.gov (United States)

    Toth, Marton; Faludi, Bela; Kondakor, Istvan

    2012-10-01

    Effects of initiation of continuous positive airway pressure (CPAP) therapy on EEG background activity were investigated in patients with obstructive sleep apnea syndrome (OSAS, N = 25) to test possible reversibility of alterations of brain electrical activity caused by chronic hypoxia. Normal control group (N = 14) was also examined. Two EEG examinations were done in each groups: at night and in the next morning. Global and regional (left vs. right, anterior vs. posterior) measures of spatial complexity (Omega complexity) were used to characterize the degree of spatial synchrony of EEG. Low resolution electromagnetic tomography (LORETA) was used to localize generators of EEG activity in separate frequency bands. Before CPAP-treatment, a significantly lower Omega complexity was found globally and over the right hemisphere. Due to CPAP-treatment, these significant differences vanished. Significantly decreased Omega complexity was found in the anterior region after treatment. LORETA showed a decreased activity in all of the beta bands after therapy in the right hippocampus, premotor and temporo-parietal cortex, and bilaterally in the precuneus, paracentral and posterior cingulate cortex. No significant changes were seen in control group. Comparing controls and patients before sleep, an increased alpha2 band activity was seen bilaterally in the precuneus, paracentral and posterior cingulate cortex, while in the morning an increased beta3 band activity in the left precentral and bilateral premotor cortex and a decreased delta band activity in the right temporo-parietal cortex and insula were observed. These findings indicate that effect of sleep on EEG background activity is different in OSAS patients and normal controls. In OSAS patients, significant changes lead to a more normal EEG after a night under CPAP-treatment. Compensatory alterations of brain electrical activity in regions associated with influencing sympathetic outflow, visuospatial abilities, long

  3. Reflexiones sobre la protección del consumidor de servicios turísticos frente a la publicidad engañosa de sociedades mercantiles turísticas

    OpenAIRE

    Barrero Rodríguez, Enrique; Viguera Revuelta, Rodrigo; Jiménez Caballero, José Luis (Coordinador)

    2016-01-01

    En la presente Comunicación, sus autores pretenden exponer la situación en la que los potenciales clientes de las empresas turísticas pueden sufrir engaños como consecuencia de la publicidad engañosa. En tales supuestos, el mercado se suele caracterizar por el uso de una determinada publicidad que pretende incidir en la voluntad del consumidor, de manera que la actividad publicitaria se muestra como realmente relevante y decisiva para la formación de la voluntad de los ref...

  4. Resumen de tesis. El régimen jurídico de la publicidad engañosa por omisión: especial referencia a los derechos mexicano y español

    OpenAIRE

    Gómez Anel, María Isabel

    2015-01-01

    [ES] La investigación doctoral analiza el régimen legal de la publicidad engañosa por omisión llevando a cabo un análisis comparativo de los ordenamientos jurídicos español y mexicano. En primer término se aborda la publicidad en el marco de la tutela de los consumidores, los derechos fundamentales extensivos a la publicidad comercial y los principios básicos que las comunicaciones comerciales deben cubrir en torno a la protección jurídica de los consumidores. Es analizada la publicidad il...

  5. Análisis del éxito de incubación de la tortuga lora (Lepidochelys olivacea) en función del manejo de los nidos. Península de Osa, Costa Rica

    OpenAIRE

    Malmierca Pérez, Atenea

    2018-01-01

    En este trabajo de final de grado se expone un análisis del éxito de incubación (éxito de eclosión y éxito de emergencia) de la tortuga lora (Lepidochelys olivacea) en las playas Carate y La Leona (Península de Osa, Costa Rica), según los diferentes métodos de manejo de nidos realizados (nidos in situ, nidos reubicados en playa y nidos reubicados en el vivero). El objetivo principal de este trabajo es ver si tanto el manejo de los nidos, como la temperatura de la arena y el recubrimiento h...

  6. La protección al consumidor por publicidad engañosa en el Ecuador y sus limitaciones legales de acuerdo a la legislación vigente

    OpenAIRE

    Guerra Naranjo, Marco Vinicio

    2006-01-01

    El ámbito comercial, inmensamente competitivo de proveedores de bienes y servicios y la masificación de sus ventas ha llevado a que se utilice con mayor frecuencia estrategias que implican el uso de publicidad agresiva y falsa, que tiende a perjudicar a los consumidores, quienes adquieren bienes y servicios, distintos a los que fueron publicitados o promocionados por cualquier medio, vulnerando con ello sus derechos con la ilícita publicidad engañosa. Por el contrario, el em...

  7. Projeto Sabão Ecológico: uma estratégia educacional para a reciclagem do óleo de cozinha no município de Viçosa

    OpenAIRE

    Yaankha Bharbara Allecxandria Bernardo da Silva Barbosa Cardoso; Sabrina Marcelino Amoglia; Julie Louise McClelland; Amanda Ferreira Teixeira; Laura Fernandes Melo

    2017-01-01

    O descarte inadequado de resíduos de óleo de cozinha usado pode causar danos ambientais no local onde é descartado, bem como no entorno, fato que desrespeita um dos direitos do ser humano: o acesso ao ambiente ecologicamente equilibrado. Neste contexto, o Projeto Sabão Ecológico foi criado pela ONG Engenheiros Sem Fronteiras – Núcleo Viçosa, devido à necessidade de conscientizar a população sobre os danos inerentes ao descarte incorreto desse óleo. Por meio de oficinas teórico-práticas, que e...

  8. High cancer-related mortality in an urban, predominantly African-American, HIV-infected population.

    Science.gov (United States)

    Riedel, David J; Mwangi, Evelyn Ivy W; Fantry, Lori E; Alexander, Carla; Hossain, Mian B; Pauza, C David; Redfield, Robert R; Gilliam, Bruce L

    2013-04-24

    To determine mortality associated with a new cancer diagnosis in an urban, predominantly African-American, HIV-infected population. Retrospective cohort study. All HIV-infected patients diagnosed with cancer between 1 January 2000 and 30 June 2010 were reviewed. Mortality was examined using Kaplan-Meier estimates and Cox proportional hazards models. There were 470 cases of cancer among 447 patients. Patients were predominantly African-American (85%) and male (79%). Non-AIDS-defining cancers (NADCs, 69%) were more common than AIDS-defining cancers (ADCs, 31%). Cumulative cancer incidence increased significantly over the study period. The majority (55.9%) was taking antiretroviral therapy (ART) at cancer diagnosis or started afterward (26.9%); 17.2% never received ART. Stage 3 or 4 cancer was diagnosed in 67%. There were 226 deaths during 1096 person years of follow-up, yielding an overall mortality rate of 206 per 1000 person years. The cumulative mortality rate at 30 days, 1 year, and 2 years was 6.5, 32.2, and 41.4%, respectively. Mortality was similar between patients on ART whether they started before or after the cancer diagnosis but was higher in patients who never received ART. In patients with a known cause of death, 68% were related to progression of the underlying cancer. In a large cohort of urban, predominantly African-American patients with HIV and cancer, many patients presented with late-stage cancer. There was substantial 30-day and 2-year mortality, although ART had a significant mortality benefit. Deaths were most often caused by progression of cancer and not from another HIV-related or AIDS-related event.

  9. Cortical restricted diffusion as the predominant MRI finding in sporadic Creutzfeldt-Jakob disease

    Energy Technology Data Exchange (ETDEWEB)

    Talbott, Sabrina D.; Sattenberg, Ronald J.; Heidenreich, Jens O. (Dept. of Radiology, Univ. of Louisville, Louisville (United States)), e-mail: sdtalb02@gwise.louisville.edu; Plato, Brian M (Dept. of Neurology, Univ. of Louisville, Louisville (United States)); Parker, John (Dept. of Pathology and Laboratory Medicine, Univ. of Louisville, Louisville (United States))

    2011-04-15

    Creutzfeldt-Jakob disease is a rare and fatal neurodegenerative disorder with MR findings predominantly limited to the grey matter of the cortex and the basal ganglia. Sporadic Creutzfeldt-Jakob disease can produce a spectrum of MR imaging findings of the brain, most notably on DWI and FLAIR sequences. Involvement of the basal ganglia and neocortex is the most common finding, but isolated involvement of the cortex can also be seen. We describe the clinical history and MRI findings of three patients with sporadic Creutzfeldt-Jakob disease confirmed by brain biopsy or autopsy and review the literature of imaging manifestations of this disease

  10. Fault current limiter-predominantly resistive behavior of a BSCCO shielded-core reactor

    International Nuclear Information System (INIS)

    Ennis, M. G.; Tobin, T. J.; Cha, Y. S.; Hull, J. R.

    2000-01-01

    Tests were conducted to determine the electrical and magnetic characteristics of a superconductor shielded core reactor (SSCR). The results show that a closed-core SSCR is predominantly a resistive device and an open-core SSCR is a hybrid resistive/inductive device. The open-core SSCR appears to dissipate less than the closed-core SSCR. However, the impedance of the open-core SSCR is less than that of the closed-core SSCR. Magnetic and thermal diffusion are believed to be the mechanism that facilitates the penetration of the superconductor tube under fault conditions

  11. Cortical restricted diffusion as the predominant MRI finding in sporadic Creutzfeldt-Jakob disease

    International Nuclear Information System (INIS)

    Talbott, Sabrina D.; Sattenberg, Ronald J.; Heidenreich, Jens O.; Plato, Brian M; Parker, John

    2011-01-01

    Creutzfeldt-Jakob disease is a rare and fatal neurodegenerative disorder with MR findings predominantly limited to the grey matter of the cortex and the basal ganglia. Sporadic Creutzfeldt-Jakob disease can produce a spectrum of MR imaging findings of the brain, most notably on DWI and FLAIR sequences. Involvement of the basal ganglia and neocortex is the most common finding, but isolated involvement of the cortex can also be seen. We describe the clinical history and MRI findings of three patients with sporadic Creutzfeldt-Jakob disease confirmed by brain biopsy or autopsy and review the literature of imaging manifestations of this disease

  12. Comparative cross-sectional study of masticatory performance and mastication predominance for patients with missing posterior teeth.

    Science.gov (United States)

    Iwashita, Hayato; Tsukiyama, Yoshihiro; Kori, Hidehiro; Kuwatsuru, Rika; Yamasaki, Yo; Koyano, Kiyoshi

    2014-10-01

    Missing posterior teeth can decrease masticatory function and cause horizontal mastication deviation, i.e., mastication predominance. Mastication predominance may lead to abnormal tooth attrition and temporomandibular disorders. This study evaluated masticatory performance and mastication predominance in patients with missing posterior teeth to investigate effects of missing posterior teeth on masticatory performance and mastication predominance. Thirty volunteers with normal dentition (control group), 30 patients with unilateral missing posterior teeth (unilateral group), and 23 patients with bilateral missing posterior teeth (bilateral group) participated. Gummy jellies were used to evaluate participants' masticatory performance, and electromyography was used to assess the degree of mastication predominance. Chewing gums, gummy jellies, and peanuts were used as foods of various hardnesses for evaluating mastication predominance. Compared with the control group, masticatory performance did not differ in the unilateral group but was significantly decreased in the bilateral group. With chewing gum and gummy jellies, the degree of mastication predominance was significantly increased in both unilateral and bilateral groups than the control group. With peanuts, the degree of mastication predominance was significantly increased in the unilateral group than the control group. Although masticatory performance was not decreased in the unilateral group, the degree of mastication predominance was increased. Decreased masticatory performance was observed in the bilateral group, and for foods with normal hardness and soft foods, the degree of mastication predominance was increased. These results suggested that mastication predominance should be considered in the recovery of masticatory performance in patients with missing posterior teeth. Copyright © 2014 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  13. Blue Rubber Bleb Nevus Syndrome Showing Vascular Skin Lesions Predominantly on the Face

    Directory of Open Access Journals (Sweden)

    Ayumi Korekawa

    2015-07-01

    Full Text Available An 81-year-old Japanese man presented with dark blue papules and nodules on his face. There were multiple soft papules and nodules, dark blue in color, compressive, and ranging in size from 2 to 10 mm. A few similar lesions were seen on the patient's right dorsal second toe and right buccal mucosa. There were no skin lesions on his trunk and upper limbs. The patient's past history did not include gastrointestinal bleeding or anemia. Histopathological examination showed dilated vascular spaces lined by the normal epithelium extending beneath the dermis and into the subcutaneous fat. Endoscopy of the gastrointestinal tract to check for colon involvement was not performed. X-ray images of the limbs revealed no abnormalities in the bones or joints. Laboratory investigations did not show anemia. Although we failed to confirm a diagnosis by endoscopy, the skin lesions, histopathological findings, lack of abnormal X-ray findings, and the presence of oral lesions as a part of gastrointestinal tract guided the diagnosis of blue rubber bleb nevus syndrome (BRBNS. Skin lesions of BRBNS occur predominantly on the trunk and upper limbs. However, the present case showed multiple skin lesions predominantly on the face. Therefore, it is important for clinicians to know about a possible atypical distribution of skin lesions in BRBNS.

  14. Acculturation and Intention to Breastfeed among a Population of Predominantly Puerto Rican Women.

    Science.gov (United States)

    Barcelona de Mendoza, Veronica; Harville, Emily; Theall, Katherine; Buekens, Pierre; Chasan-Taber, Lisa

    2016-03-01

    Latinas have high overall breastfeeding initiation rates, yet Puerto Ricans have among the lowest exclusive breastfeeding rates. This study sought to determine if acculturation was associated with intent to breastfeed in a predominantly Puerto Rican population. A cohort of Latina women were enrolled in Proyecto Buena Salud, and provided information on infant feeding intent (n = 1,323). Acculturation was assessed via the Psychological Acculturation Scale (PAS), language preference, and generation in the United States. Increasing acculturation as measured by English language preference (aOR 0.61 [95% CI 0.42-0.88]) and second or third generation in the United States (aOR 0.70 [95% CI 0.52-0.95)] was inversely associated with odds of intending to exclusively breastfeed. Similarly, women with higher levels of acculturation as measured by the PAS (aOR 0.67 [95% CI 0.45-0.99]), English language preference (aOR 0.48 [95% CI 0.33-0.70]) and second or third generation in the United States (aOR 0.42 [95% CI 0.31-0.58]) were less likely to report intent to combination feed as compared with women with lower acculturation. Acculturation was inversely associated with intent to exclusively breastfeed and intent to combination feed in this predominantly Puerto Rican sample. © 2015 Wiley Periodicals, Inc.

  15. Eluxadoline in the treatment of diarrhea-predominant irritable bowel syndrome: The SEPD perspective

    Directory of Open Access Journals (Sweden)

    Isabel Vera

    Full Text Available Functional gut disorders, including diarrhea-predominant irritable bowel syndrome, are highly prevalent conditions worldwide that significantly impact health economy and patient quality of life, yet lacking fully satisfactory therapeutic options. These circumstances fostered research on various molecules with more specific therapeutic targets, including opioid receptors. Eluxadoline (Allergan's Vibercy® in the USA, Truberzi® in Europe is a locally-acting mixed µ- and κ-opioid receptor agonist, and δ-opioid receptor antagonist, that was licensed in 2015 by the Food and Drug Administration (FDA and in 2016 by the European Medicines Agency (EMA for use in diarrhea-predominant irritable bowel syndrome. Eluxadoline provides, with advantage over the current standard of care, control of both stool consistency and abdominal pain, good tolerability in most cases, and improved quality of life, hence it deserves consideration when approaching a patient with this disorder. As with any recently approved therapy, adequate pharmacovigilance is to be expected, as well as studies to inform on different scenarios such as on-demand therapy, loss of response assessment, use as rescue therapy for other molecules, and cost-effectiveness, to further characterize and more accurately position eluxadoline within the therapeutic spectrum.

  16. Maple sap predominant microbial contaminants are correlated with the physicochemical and sensorial properties of maple syrup.

    Science.gov (United States)

    Filteau, Marie; Lagacé, Luc; Lapointe, Gisèle; Roy, Denis

    2012-03-01

    Maple sap processing and microbial contamination are significant aspects that affect maple syrup quality. In this study, two sample sets from 2005 and 2008 were used to assess the maple syrup quality variation and its relationship to microbial populations, with respect to processing, production site and harvesting period. The abundance of maple sap predominant bacteria (Pseudomonas fluorescens group and two subgroups, Rahnella spp., Janthinobacterium spp., Leuconostoc mesenteroides) and yeast (Mrakia spp., Mrakiella spp.,Guehomyces pullulans) was assessed by quantitative PCR. Maple syrup properties were analyzed by physicochemical and sensorial methods. Results indicate that P. fluorescens, Mrakia spp., Mrakiella spp. G. pullulans and Rahnella spp. are stable contaminants of maple sap, as they were found for every production site throughout the flow period. Multiple factor analysis reports a link between the relative abundance of P. fluorescens group and Mrakia spp. in maple sap with maple and vanilla odor as well as flavor of maple syrup. This evidence supports the contribution of these microorganisms or a consortium of predominant microbial contaminants to the characteristic properties of maple syrup. Copyright © 2011 Elsevier B.V. All rights reserved.

  17. Factors That Influence Park Use and Physical Activity in Predominantly Hispanic and Low-Income Neighborhoods.

    Science.gov (United States)

    Dolash, Karry; He, Meizi; Yin, Zenong; Sosa, Erica T

    2015-04-01

    Park features' association with physical activity among predominantly Hispanic communities is not extensively researched. The purpose of this study was to assess factors associated with park use and physical activity among park users in predominantly Hispanic neighborhoods. Data were collected across 6 parks and included park environmental assessments to evaluate park features, physical activity observations to estimate physical activity energy expenditure as kcal/kg/ minute per person, and park user interviews to assess motivators for park use. Quantitative data analysis included independent t tests and ANOVA. Thematic analysis of park user interviews was conducted collectively and by parks. Parks that were renovated had higher physical activity energy expenditure scores (mean = .086 ± .027) than nonrenovated parks (mean = .077 ± .028; t = -3.804; P motivation to be physically active, using the play spaces in the park, parks as the main place for physical activity, and social support for using parks. Renovations to park amenities, such as increasing basketball courts and trail availability, could potentially increase physical activity among low-socioeconomic-status populations.

  18. The predominance of Lactobacillus sanfranciscensis in French organic sourdoughs and its impact on related bread characteristics.

    Science.gov (United States)

    Lhomme, Emilie; Orain, Servane; Courcoux, Philippe; Onno, Bernard; Dousset, Xavier

    2015-11-20

    Fourteen bakeries located in different regions of France were selected. These bakers use natural sourdough and organic ingredients. Consequently, different organic sourdoughs used for the manufacture of French bread were studied by the enumeration of lactic acid bacteria (LAB) and 16S rRNA sequencing of the isolates. In addition, after DNA extraction the bacterial diversity was assessed by pyrosequencing of the 16S rDNA V1-V3 region. Although LAB counts showed significant variations (7.6-9.5log10CFU/g) depending on the sourdough studied, their identification through a polyphasic approach revealed a l