Does premature birth affect Brazilian parents' practices related to infant positioning? / A prematuridade afeta as práticas maternas brasileiras relacionadas ao posicionamento de lactentes?

Abstract Objective: To verify whether the time spent in prone, supine, or seated positions differed between term and preterm infants; and to determine whether a single verbal guidance session for parents changed the time spent in different positions, and, consequently, the motor development scores, after one month in preterm infants. Methods: Sixty-one infants from a full-term and preterm group from Brazil were included. Motor development was assessed by the Alberta Infant Motor Scale (AIMS) and the parents registered the time spent in each position on a 24-hour schedule. A month after verbal guidance, a second assessment was performed only on the preterm infants. Results: The positioning times awake determined for the full-term and preterm parents were similar. Preterm infants spent more time in the prone sleeping position (2.1 vs. 0.8 h; p=0.037) than full-term infants. The AIMS percentile scores did not differ significantly between the groups. For preterm infants, the time spent in all positions did not change during the second assessment (n=18). Conclusions: The fact that some parents position their infants in the prone posture during sleeping periods reinforce the importance of parental education approaches for sudden infant death syndrome (SIDS) prevention during the first months of life. The verbal guidance provided to parents of preterm infants did not influence the AIMS percentile and time spent in various positions but increased preterm parents' confidence in placing their infants in a prone position to play.

RESUMO Objetivo: Verificar se o tempo nas posições prono, supino ou sentado difere entre lactentes a termo e pré-termo; bem como determinar se uma única sessão de orientação verbal aos pais alterou o tempo despendido nas diferentes posições e, consequentemente, o escore de desenvolvimento motor, após um mês em lactentes pré-termo. Métodos: Foram incluídos 61 lactentes brasileiros nos grupos a termo e pré-termo. O desenvolvimento motor foi avaliado pela Alberta Infant Motor Scale (AIMS), e os pais registraram o tempo despendido em cada posição em uma linha do tempo de 24 horas. Um mês após a orientação verbal, uma segunda avaliação foi realizada apenas nos lactentes pré-termo. Resultados: O tempo de posicionamento acordado determinado pelos pais de lactentes a termo e pré-termo foi semelhante. Os lactentes pré-termo passaram mais tempo dormindo na posição prona (2,2 vs. 0,8 h; p=0,037) do que os lactentes a termo. Os escores de percentil AIMS não diferiram significativamente entre os grupos. Para lactentes pré-termo, o tempo despendido em todas as posições não se modificou durante a segunda avaliação (n=18). Conclusões: O fato de alguns pais posicionarem os lactentes em decúbito ventral durante os períodos de sono reforça a importância das abordagens educativas parentais para a prevenção da síndrome da morte súbita do lactente (SMSL) durante os primeiros meses de vida. A orientação verbal fornecida aos pais de prematuros não influenciou o percentil da AIMS e o tempo de permanência em várias posições, mas aumentou a confiança dos pais de lactentes prematuros em utilizar a posição prona para brincar.

Characteristics of the Distance and Space Required for Knife Slashing Using a Motion Capture System / 法医学杂志

OBJECTIVES@#To investigate the relationship between the perpetrator's sex, victim's position and slashing location as well as anthropometric parameters on distance and space required for slashing, to provide the theoretical basis for the judgment of whether the crime scene was consistent with the criminal activity space.@*METHODS@#The kinematics data of 12 male and 12 female subjects slashing the neck of standing and supine mannequins as well as the chest of the standing mannequins with a kitchen knife were obtained by using a 3D motion capture system. The relationship between the perpetrator's sex-victim's position, the perpetrator's sex-slashing location, and anthropometric parameters and the distance and space required for the slashing were analyzed by two-factor repeated measures ANOVA and Pearson correlation analysis respectively.@*RESULTS@#Compared with slashing the neck of supine mannequins, the distance (L) and normalized L (l) of slashing the neck of standing mannequins were greater, while vertical distance (LVR) and normalized LVR (lVR) of the knife side were smaller. Compared with slashing the neck of standing mannequins, the L and l slashing the chest of standing mannequins were greater, while LVR and lVR were smaller. Horizontal distance (LHR) and normalized LHR (lHR) of the knife side in males were greater than that in females. Height and arm length were positively correlated with L, LHR, and LVR when striking the standing mannequins.@*CONCLUSIONS@#When slashing the neck of supine or standing victims, the slashing distance is shorter and the slashing height is greater. Furthermore, the distance and space required for slashing are correlate with anthropometric parameters.

Síndrome de apneas e hipopneas obstructivas del sueño posicional / Positional Obstructive Sleep Apnea/Hypopnea Syndrome

La posición del cuerpo influye en la frecuencia y duración de apneas e hipopneas en los individuos con apneas obstructivas del sueño. La posición en decúbito supino es en la que más frecuentemente se registran eventos obstructivos y por lo tanto mayores valores en los indicadores de severidad. Aunque existen diferentes definiciones y clasificaciones, el síndrome de apneas del sueño posicional representa el 60% de todos los pacientes evaluados en una unidad de sueño, y su diferenciación tiene por objetivo determinar cuáles serán los candidatos que se beneficiarían de terapia posicional. Hasta el momento no hay una definición aceptada universalmente y la evidencia del beneficio clínico del rol de clasificar a los pacientes con apneas posicionales es aún controvertida en numerosos aspectos. La terapia posicional se basa en disminuir el tiempo en supino y la severidad de los eventos obstructivos, herramienta de la que se beneficiaría una importante proporción de los pacientes. La CPAP es el tratamiento más eficaz y se recomienda en formas severas y moderadas con manifestaciones clínicas y antecedentes cardiovasculares. En este grupo la terapia posicional podría recomendarse como tratamiento coadyuvante.

Body position during sleep time influences the frequency and duration of apneas and hypopneas in individuals who suffer from obstructive sleep apnea. Individuals in supine position show higher frequency of obstructive events and therefore, higher values in severity indexes. Though there are different definitions and classifications, the positional sleep apnea syndrome represents 60% of all patients evaluated in a sleep unit, and differentiating it aims to determine which candidates will benefit from positional therapy. There is no universally accepted definition and the evidence of the clinical benefit of classifying patients with positional sleep apnea is still controversial in many aspects. Positional therapy has the purpose of decreasing supine time and the severity of obstructive events. A significant proportion of patients would benefit from this treatment. The continuous positive airway pressure (CPAP) is the most effective treatment and is recommended for severe and moderate forms with clinical manifestations and cardiovascular history. In this group, positional therapy could be recommended as adjuvant treatment.

Effects of pneumoperitoneum and trendelenburg position on intraocular pressure (IOP) in isofluorane anesthetised cats / Efeitos do pneumoperitônio e da posição de trendelenburg sobre a pressão intraocular em gatos anestesiados com isoflurano

The aim of this study was to determine whether a pneumoperitoneum of 10 mmHg combined or not with the Trendelenburg position could lead to significant changes in intraocular pressure (IOP), ocular pressure perfusion (OPP), and cardiorespiratory variables; as well as determine whether a correlation exists between IOP and mean arterial blood pressure (MAP), and/or partial pressure of carbon dioxide in arterial blood (PaCO2) in cats. Animals were allocated in two groups (n=7/group): GC (without inclination) and GTREN (Trendelenburg position). The variables were recorded before (baseline) and during 30 minutes (T5-T30) after insufflation. In GTREN, a reduction in heart rate was observed at T5 and in respiratory rate at T5 and T15. There was an increase in IOP at T5-T30 in comparison to baseline. There was a reduction in potential of hydrogen in arterial blood in both groups at all times in comparison to baseline. Partial pressure of carbon dioxide in arterial blood was increased at T15-T30 in GC and at T5-T30 in GTREN. In conclusion, the pneumoperitoneum of 10mmHg CO2 did not significantly affect IOP or OPP in cats anaesthetised with isofluorane and kept under spontaneous ventilation. However, induced pneumoperitoneum combined with Trendelenburg position resulted in an increase in IOP in cats subjected to the same anaesthetic conditions, but did not affect OPP.

O objetivo deste estudo foi determinar se o pneumoperitônio de 10 mmHg associado, ou não, à posição de Trendelenburg poderia levar a alterações significativas na Pressão Intraocular (PIO), Pressão de Perfusão Ocular (PPO) e variáveis cardiorrespiratórias, bem como determinar se havia correlação entre a PIO e a Pressão Arterial Média (PAM) e/ou Pressão Parcial de Dióxido de Carbono no Sangue Arterial (PaCO2) em gatos. Os animais foram alocados em dois grupos (n = 7/grupo): GC (sem inclinação) e GTREN (posição de Trendelenburg). As variáveis foram registradas antes (linha de base) e durante 30 minutos (T5-T30) após a insuflação. No GTREN, foi observada redução na frequência cardíaca em T5 e, na frequência respiratória, em T5 e T15. Houve aumento da PIO no T5-T30 comparativamente ao valor basal. Houve redução no Potencial de Hidrogênio no sangue arterial em ambos os grupos em todos os momentos comparativamente à linha de base. A Pressão Parcial de Dióxido de Carbono no sangue arterial aumentou em T15-T30 no GC e em T5-T30 no GTREN. Concluiu-se que o pneumoperitônio de 10mmHg CO2 não afetou significativamente a PIO ou a PPO em gatos anestesiados com isofluorano e mantidos sob ventilação espontânea. No entanto, o pneumoperitônio induzido combinado à posição de Trendelenburg resultou em aumento da PIO em gatos submetidos às mesmas condições anestésicas, mas não afetou a PPO.

Influence of body position on the measurement of electrocardiographic waves in healthy dogs / Influência do posicionamento corporal na mensuração das ondas eletrocardiográficas em cães sadios

The agreement between the electrocardiographic waves measured from tracings recorded in right lateral recumbency and several other unusual body positions was assessed. Electrocardiograms were recorded in 160 healthy dogs in right lateral, left lateral, dorsal and sternal recumbencies, as well as in standing position. Considering the right lateral recordings as the gold standard, the lowest biases for the majority of ECG parameters were calculated from left lateral recordings, whereas the highest biases were documented from dorsal and standing positions. For the mean electrical axis, the dorsal recumbency produced the lowest bias, while the greatest one was identified in sternal position. An analysis of variance indicated differences when the means of P wave duration and amplitude, duration of QRS and QT, and mean electrical axis obtained in unusual positions were compared with right lateral. In conclusion, left lateral recumbency produced the most similar measurements as compared to right lateral, but the wide limits of agreement preclude the use and interpretation of these positions interchangeably.(AU)

A concordância entre a mensuração das ondas eletrocardiográficas a partir de traçados registrados em cães mantidos em decúbito lateral direito e em vários outros posicionamentos corporais foi avaliada nesta pesquisa. Para tanto, traçados eletrocardiográficos de 160 cães saudáveis foram registrados com os pacientes posicionados nos decúbitos lateral direito, lateral esquerdo, dorsal e esternal, assim como em posição quadrupedal. Tomando como padrão ouro os registros obtidos em decúbito lateral direito, as menores diferenças médias para a maioria dos parâmetros eletrocardiográficos foram obtidas a partir dos traçados registrados com o cão mantido em decúbito lateral esquerdo, enquanto as maiores diferenças médias foram documentadas nos registros obtidos nos decúbitos dorsal e quadrupedal. Para o eixo elétrico médio, o decúbito dorsal produziu a menor diferença média, enquanto a maior foi identificada no registro em posição esternal. A análise de variância mostrou diferenças entre as médias da duração e amplitude da onda P, duração do QRS e do intervalo QT e o eixo elétrico médico quando as posições não usuais foram comparadas com o decúbito lateral direito. Esta pesquisa mostrou que o decúbito lateral esquerdo produziu as medidas mais semelhantes quando comparado àquelas obtidas em decúbito lateral direito. No entanto, os limites de concordância amplos impedem que essas posições sejam utilizadas e interpretadas de maneira intercambiável.(AU)

Development of ocular care device for ocular burn patients with various body positions / 医疗卫生装备

Object To develop an ocular care device for ocular burn patients with various body positions, to promote the rehabilitation of patients' eyes and improve the quality of nursing.Methods The device was designed based on the principles of moisture chamber glasses and sunglasses shading, which was composed of one lens houses system, one colored shade lens system and one fixing belt system. The colored shade lens system and the fixing belt system could be respectively and freely fixed on the lens houses system as required by patient conditions, positions and demands.Results The device provided a relatively closed and sterile environment with proper humidity and pressure, which contributed to enhancing eye rehabilitation, patient comfort and satisfaction as well as nursing efficiency and quality.Conclusion The device gains advantages in simple structure, low cost, easy operation and high safety, and thus is worthy promoting practically.

Application of radiotherapy-assistance fixation device in salivary gland scintigraphy / 医疗卫生装备

Objective To apply a simple fixator to salivary gland scintigraphy to evaluate its effect on body position movement. Methods Totally 30 female patients complaining xerostomia were randomly and equally divided into a conventional scan group and a simple fixator group,who were injected with Technetium Tc-99m Pertechnetate intravenously. In the conventional scan group the patients had their necks fixed with the bracket and cushion,while in the other group the fixation was executed with the single fixator. SPECT imager was used for dynamic salivary gland scintigraphy, and two nuclear medicine physicians evaluated the maximum shift of the parotid gland along left-right(X)and head-foot(Y)axes in series of dynamic images. SPSS 16.0 software was used for data analysis. Results In the conventional scan group the maximum shift was(6.6±4.6)mm at X axis and(5.2±3.4)mm at Y axis;in the single fixator group the maximum shift was(3.2± 1.6)mm at X axis and(3.0±1.3)mm at Y axis.There were significant differences between the maximum shifts in the two groups (P=0.012,X axis;P=0.027,Y axis).Conclusion The single fixator assists in salivary gland scintigraphy,and alleviates the body position movement during dynamic acquisition and provides data support for functional parameter calculation and result determination.

Experimental study on effect of body position on lung ventilation determined by electrical impedance tomography / 医疗卫生装备

Objective To monitor and compare the effects of body position on the regional lung volume and FEV1/FVC with electrical impedance tomography(EIT).Methods Twelve healthy young subjects[(26.6±2.5)yr]were detected by EIT during FVC maneuver in 3 body positions (sitting,supine and prone).Functional EIT images of FVC and FEV1/FVC were obtained;the proportion of regional ventilation volume and the mean of regional FEV1/FVC were calculated.Results The ventral and dorsal proportion of ventilation volume was 37.65% : 62.35% in sitting position and 37.59% : 62.41% in supine position, respectively.While in the prone position,the value was 48.56%:51.44%,which was close to 1:1.The mean of regional FEV1/FVC in the dependent lung region was 0.84 in supine position and 0.81 in prone position,while in sitting position,the corresponding value was 0.90 and 0.94, respectively. Conclusion The results shows that the ventilation transfers to the gravity dependent region obviously, while the flow rate decreases. The result provides direct evidences for mechanical ventilation patients using prone position to improve oxygenation,as well as a research foundation for EIT monitoring regional lung ventilation in the clinical setting.

The effectiveness of special body position on the patients after the surgery for retinal detachment:systematic review and meta-analysis / 中国实用护理杂志

Objective To assess the effectiveness of special body position comparing with regular nursing on the patients after the surgery for retinal detachment. Methods We searched seven electronic databases including Medline, EMBASE, Cochrane Library, Web of Science, CBM, CNKI and Wanfang. Two independent reviewers identified the eligible studies, extracted the data and evaluated the risk of bias of the included studies. We chose the random or fixed effect model to synthesize the data based on the result of the test of heterogeneity. Results We totally included ten studies with 946 patients. The methodological and reporting quality of the included studies was relatively low. Compared to the regular nursing, the special body position could reduce the re-incidence of retinal detachment again (RR=0.31, 95％CI: 0.16-0.60, P=0.0005), the total rate of postoperative complications (RR = 0.35,95％CI:0.28-0.44,P<0.01) and the specific complications such as corneal edema, palpebral edema, intraocular hypertension and pain of the operative eyes, the uncomfortable and unsatisfactory feeling caused by forcing body position (RR=0.51,95％CI:0.40-0.66,P<0.01;RR=0.15,95％CI:0.05-0.49,P=0.002, respectively), and promote the rehabilitation of vision (RR = 1.18,95％CI:1.01-1.37,P=0.0005). Conclusions The special body position comparing with regular nursing could apparently reduce the re-incidence of retinal detachment and postoperative complications and improve the rehabilitation of vision, comfortable and satisfactory of nursing.

The role of low-back soft tissue after vertebroplasty and kyphoplasty for spinal osteoporotic fractures / 中华创伤骨科杂志

Objective To investigate the effect of soft tissue on the posterior lumbar spine after percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) for spinal osteoporotic fractures. Methods From January 2015 to December 2016, 52 patients with thoracolumbar osteoporotic fracture in our hospital underwent PKP or PVP. According to their fat suppression sequence (FSE) on Magnetic Resonance Imaging (MRI), they were divided into FSE positive and FSE negative groups. The FSE negative group had 38 patients, 9 males and 29 females with a mean age of 75.1 ± 6.0 years; the FSE positive group had 14 pa-tients, 4 males and 10 females with a mean age of 73.9 ± 5.8 years. The 2 groups were compared in terms of visual analogue scale (VAS) for lying on bed and standing at the 1, 3 and 7 days after surgery and painless ambulation at the 3 time points as well. Results There were no significant differences between the 2 groups in age, gender or responsible vertebrae distributions. When the patients were lying on bed, their VAS scores at the 1, 3 and 7 days after surgery were 4.1 ± 1.7, 3.0 ± 0.9 and 1.0 ± 0.8 for the FSE negative group, and 4.8 ± 1.0, 3.0 ± 0.7 and 1.3 ± 0.9 for the FSE positive group; when the patients were standing, their VAS scores at the 1, 3 and 7 days after surgery were 4.2 ± 1.1, 3.2 ± 0.7 and 1.9 ± 0.7 for the FSE negative group, and 5.4 ± 1.1, 4.0 ± 1.0 and 2.3 ± 0.5 for the FSE positive group. The VAS scores for standing at the 1 and 3 days after surgery for the FSE negative group were significantly lower than those for the FSE positive group (P <0.05). There were no significant differences between the 2 groups in the VAS scores for lying on bed at the 1, 3 or 7 days after surgery and for standing at the 7 days after surgery (P > 0.05). At the 1, 3 and 7 days after surgery, there were respectively 22, 37 and 38 patients in the FSE negative group who accomplished painless ambulation and there were respectively 3, 9 and 14 patients in the FSE positive group who accomplished painless ambulation. A significantly larger proportion of the patients in the FSE negative group accomplished painless ambulation than in the FSE positive group (P <0.05). At 7 days after surgery, all the patients in the 2 group accomplished painless ambulation. Conclusions The soft tissue of the lower back may play an important role after PKP and PVP, for fine soft tissue can reduce time for lying on bed and foster surgical efficiency. The VAS scores for standing may be more significant than those for lying on bed in prediction of ambulant time.

A study on the set-up accuracy by using body plate with vacuum cushion and thermoplastic mask technique in comparison with the conventional arm support technique in thoracic tumor radiotherapy / 中国癌症杂志

Background and purpose: Radiation therapy has entered the era of precise radiotherapy. Set-up error becomes important factor affecting the effects of radiotherapy. The aim of this study was to analyze the set-up accuracy of the in-house developed technique of body plate with vacuum cushion and thermoplastic mask (Group A) and the conventional technique of arm support (Group B) in thoracic tumor radiotherapy. Methods: A total of 19 patients with thoracic tumor were enrolled in this study and randomly separated into Group A and Group B. The patients of Group A underwent the secondary set-up: align the marker on vacuum cushion and patient's body to the room laser, cover the patient's body with thermoplastic mask and align the marker on the mask to the room laser. The patients of Group B were directly setup by aligning the marker on the patient's body to the room laser. The kilo-voltage cone beam computed tomography (KV-CBCT) was performed on each patient to collect the pre- and post-treatment CBCT images. The CBCT images were registered to the planning CT to analyze the translational error of Group A and Group B. Results: The pre-treatment set-up errors of Group A vs Group B were (1.06±0.58) vs (1.82±0.82) mm in left and right (LR) direction, (1.31±0.40) vs (2.18±1.20) mm in superior and inferior (SI) direction, and (1.28±0.66) vs (2.94±1.81) mm in anterior and posterior (AP) direction. The post-treatment set-up errors of Group A vs Group B were (0.86±0.54) vs (1.29±0.58) mm in LR direction, (1.07±0.58) vs (1.08±0.45) mm in SI direction, and (0.98±0.53) vs (1.56±0.63) mm in AP direction.Conclusion: The in-house developed immobilization technique of body plate with vacuum cushion and thermoplastic mask was more accurate and reproducible than the conventional immobilization technique of arm support in thoracic tumor radiotherapy.

Development and effect evaluation of magnetic angulometer for elevated headboard and footboard / 医疗卫生装备

Objective To develop a magnetic angulometer for the elevated headboard and footboard of manual hospital bed and then evaluate its performances.Methods The angulometer was made of a rectangular PVC,wooden or metal board.The board had a semicircular angle display area at one end,with the straight line at the top while the curve at the bottom of the board.At the other end there was a magnet fixed with a double coated film,which paralleled the top margin of the angulometer.The angle display area was divided into two symmetrical parts,with the angle range from 0 to 90° and the scale being 15°.A string hanging a weight at the center of the angulometer was used to indicate the angle.A control group was formed with the rusults that 14 nurses got with the troditional angulometers in June.2015,and an observation group came into being with the resalts that the 14 nurses obtained with the developed angulometers in July 2015.The two groups with different angulometers were compared on the efficiency for elevating the headboard to some angle appointed.Results The observation group gained significantly higher position compliance with elevation than the control group (x2=75.15,P＜0.01),and also statistically higher angulometer efficiency when elevating the headboard to the appointed angle (t=-8.80,-5.68) (P＜0.01).Conclusion The angulometer has simple structure and easy operation,and enhances the compliance to body position nursing and the nurse's efficiency.

Effect of body positions on peak expiratory flow rates in adult asthmatics

Background: The National Institute of Health asthma guidelines recommend assessing PEF during hospitalization including improvement to a PEF of >70% of the predicted value before discharge. The Global Initiative for asthma recommends monitoring of PEF in hospitalized patients. Current guidelines for correct PEF maneuver include standing, but it has been observed that many respiratory therapists and patients use supine position. Aim: To determine which one of the 3 different positions i.e. standing, lying back at 450 angle on pillows and sitting up slumped forward 100 with legs extended generates higher peak expiratory pressure and can be used as optimal position for generating peak expiratory flow in asthmatics. Materials and methods: A cross sectional study was performed in 20 asthmatic subjects aged 18-50 years in whom correct instructions for PEF technique were given according to guidelines of National Institute of Health. The steps were repeated 3 times in each position and the best of 3 attempts in each of the 3 positions were used for analysis. Level of significance kept at 5%. Results: Mean and SD of lying back at 450 was 254.5±29.28, sitting up with slumped forward 100 was 281±28.26 and that of standing was 302.5±27.88. Statistically significant result was found using nonparametric test i.e. Friedman test where χ2 =40 and p=0.0001. Conclusion: There is significant difference between PEFR values in standing, sitting with slump forward 100 and lying back 450 position. Standing position is the best option for adult asthmatics to measure their PEF values as it generated maximum PEF.

Influence of combined spinal epidural anesthesia with head -up of 10°on maternal hemodynamics during ;cesarean section / 中国基层医药

Objective To explore the anesthesia effect and influence of combined spinal epidural anesthesia (CSEA)with head -up of 10°on maternal hemodynamics during cesarean section.Methods 120 pregnant women undergoing cesarean section were selected,and were randomly divided into group A,B and C,40 cases in each group. Three groups were all given CSEA,yet pregnant women in group A were taken supine position,group B was taken head-up of 10°,and group C was taken head -up of 20°.Hemodynamic parameters of three groups of the following time points were compared,including before anesthesia(T0 ),5min after anesthesia(T1 ),skin incision(T2 ),fetal disen-gagement immediately(T3 ),and operation at the end(T4 ),also anesthesia effect was recorded,and usage of ephedrine and local anesthetic was noted,and adverse reactions were compared.Results Compared with T0 ,group A's hemody-namics in T1 decreased,including systolic blood pressure (SBP),diastolic blood pressure (DBP),and increased in T2 and T3 ,yet there were no statistical differences on hemodynamics in three groups in T4 .Compared with group B and C,there were statistical differences on hemodynamics in T1 ,T2 and T3 in group A(t =3.63 -7.25,P 0.05). Anesthesia block scores in group A,B and C were (2.0 ±0.3)points,(2.5 ±0.2)points,(2.6 ±0.2)points,and scores of B and C were higher than that in group A(t =3.92,4.01,all P <0.05).Cases and total usage of ephedrine in group A were higher than those of group B and C(χ2 =31.43,50.61,t =16.27,20.17,all P <0.01).Cases of adjusting surgical position,and addition of local anesthetic in group C were significantly higher than those of group B (χ2 =23.85,28.47,all P <0.01).Conclusion It has better anesthetic effect of taking CSEA by head -up of 10°, and maternal hemodynamics are more stable,can better meet operation's requirements,also with easier operation,so it is superior to supine position and head -up of 20°.

Effect of lateral body position on transesophageal echocardiography images and the association with patient characteristics: A prospective observational study.

Background: Changes in heart position are occasionally observed on the transesophageal echocardiography (TEE) image screen after changing the body position from supine to lateral, although the magnitude of change in cardiac position varies individually. We hypothesized that this variation is associated with certain patient characteristics and evaluated how lateral positioning affects visualization of the heart on TEE and whether the magnitude of change in the heart position correlates with patient characteristics. Methods: Fifty‑three lung resection patients were enrolled. Two angle and two length parameters (ΔθTV, ΔθAP, ΔLTV, and ΔLAP) were defined to describe location change of the lateral tricuspid annulus and right ventricular apex on the TEE image between supine and lateral position. The correlation coefficients were calculated between these four parameters and patient characteristics, including age, body mass index (BMI), epicardial fat thickness, and pulmonary function variables. Results: The ΔθTV correlated positively and inversely with BMI in both right and left lateral patients (right: r = 0.6365, P = 0.0034; left: r = −0.6616, P < 0.0001, respectively). In left lateral patients, the ΔθTV correlated inversely with epicardial fat thickness (r = −0.4879, P = 0.0182), and the ΔLAP correlated positively with the forced vital capacity percent predicted (r = 0.5736, P = 0.0082). Conclusions: Lateral body positioning affects cardiac visualization on TEE, and the BMI, epicardial fat thickness, and pulmonary function moderate this effect.

Reliability Comparison of Rebound Tonometer at the Upright and Supine Position

PURPOSE: Rebound tonometer has been used to measure the intraocular pressure (IOP) in the supine as well as normal upright positions. We investigated the reliability of IOP measurements using the rebound tonometer in the upright and supine positions. METHODS: IOP was measured in 30 patients (60 eyes) with open-angle glaucoma who had no history of ocular surgery and no anterior segment pathology, in both the upright and supine positions using rebound tonometer (IcarePRO; Icare Finland Oy, Finland). The average IOP value after 6 measurements was recorded. We measured IOP repeatedly until 3 reliable values within normal limits of the measurement's variation were obtained. We calculated the intraclass correlation coefficient (ICC), coefficient of variation, and number of repeated measurements necessary to obtain 3 reliable IOP values in each position as measured by one examiner. RESULTS: ICC values for IOP measurements were 0.852 (95% confidence interval [CI], 0.784-0.903; p < 0.001) in the upright position and 0.684 (95% CI, 0.563-0.784; p < 0.027) in the supine position. Coefficient of variation was 8.7 +/- 0.1% in the upright position and 24.0 +/- 0.1% in the supine position. An average of 3.3 times of repeated measurements in the upright position and 6.2 times in the supine position were necessary to obtain 3 reliable IOP values within the normal range of standard deviation. CONCLUSIONS: When measuring IOP using the IcarePRO rebound tonometer, the measurement reliability was different between the upright and supine positions. Reproducibility of IOP measurements was lower in the upright than the supine position.

Body Posture in Relation with Musculoskeletal Symptoms amongst Computer Operators.

Aims: The aim of this paper is to present the prevalence of musculoskeletal symptoms among computer operators and its association with the body posture at the workplace as well as break time usage during the working hours. Study Design: The paper represents a cross sectional study which includes computer operators. Place and Duration of Study: Municipality, administrative department in combine, elementary and high schools and IT in software developing company. The duration of the study was 12 months. Methodology: The survey included 800 computer operators. For detection of musculoskeletal symptoms among computer workers Nordic standardized questionnaire was administrated and Maastricht Upper Extremity Questionnaire (MUEQ) registered the body posture during the working time and the quality of the break. Results: 28% of participants have claimed musculoskeletal symptoms. As of the total number with registered symptoms, 57% were females and the average age was 41.91±11.72 years. Positive correlation coefficient was obtained between the neck pain and taking the setting same position during working hours, sitting with arms raised for more than 2 hours, performing repetitive tasks, holding the head in a bent position and placement of the body in asymmetric position. During the testing of cross-correlation regarding the musculoskeletal symptoms and the usage of break at work, there is a positive coefficient received between the neck and shoulder pain within the inability to use break of 10 min after 2 hours of work at the computer, not planning the break with the symptoms in the shoulder and wrist, and the insufficient break usage with the shoulder symptoms. Conclusion: The prevalence of musculoskeletal symptoms in computer operators in Republic of Macedonia show that it is not high leveled. According to the research of muscle-skeletal system disorder at computer workers it is shown that the most frequent are the symptoms in the neck area and shoulders.

Application of body position intervention combined with lying position logo in the patients after retinal vitreous operation / 中国实用护理杂志

Objective To explore the influence of body position intervention combined with lying position logo on the compliance of patients after vitrectomy needing to keep lying position. Methods A total of 100 patients, who were hospitalized in ophthalmology ward from January to June 2013,received vitrectomy combined with gas or silicone oil filled were involved. All the patients were divided into intervention group (60 cases) and control group (40 cases) according to the order of admission. Patients in control group received routine nursing after retinal vitreous operation, guiding the proper way to keep lying position, putting a sponge pillow, shaping凹, under patients′heads. And some pertinence measures were applied in intervention group on this basis. Results The percentage of the patients who could keep the special position complying with doctor's orders at 72 h and 1 week after the operation were 95.0%(57/60),91.7%(55/60) in intervention group, which were greater than those in control group 80.0%(32/40),75.0%(30/40), and there were significant differences,χ2=4.090,4.003,P<0.05.The mastery of the body position, and the satisfaction of the nursing care were 96.7%(58/60), 98.3%(59/60) in intervention group, which were better than those in control group 77.5%(31/40), 85.0%(34/40),and there were significant differences, χ2=7.154, 4.666,P <0.05. Conclusions Developing a reasonable nursing plan depending on the body position intervention and relevant nursing measures can help the patients comply with doctor's orders effectively, improve comfort,and extend the time to keep the special position,so as to improve postoperative recovery and ensure the success of the operation.

Application of Comfortable Nursing for Body Position in Endoscopic Thyroidectomy / 中国微创外科杂志

[Summary] A total of 108 cases of endoscopic thyroidectomy via thoracic approach were conducted in our department between January 2012 and January 2015.The comfortable nursing was applied during the operation.The patients’ body position was adjusted properly according to requirements of the operation at different periods of pre-operation, intra-operation and post operation.No complications due to nursing mistakes or improper position occurred in the 108 patients. Follow-up checkups on the second postoperative day found 2 patients with vomiting.According to the Wong-Banker Faces Pain Scale to evaluate the head and back pain, there were 46 cases of 0 point, 51 cases of 1 point, 11 cases of 2 points.We got the conclusion that the application of comfortable nursing for proper position of patient not only reflects the nursing principle of Patients First, but also improves the entire quality of nursing services.

Application of waist pillow in defecation of bedridden patients in emergency department / 中国实用护理杂志

Objective To explore the efficacy of self-designed waist pillow combined with plastic toilet in bedridden patients in emergency department.Methods From August 2013 to February 2014,90 bedridden patients in emergency department were divided into the observation group 1,the observation group 2 and the control group by random digits table with 30 cases in each group.Patients in the observation group 1 lied in the suprine position,and elevating head of bed 15 to 30 degrees,with pillow under the waist,and plastic toilet under the buttocks.Patients in the observation group 2 used the same method as that of the observation group 1,except that they did not use waist pillow.The control group lied in the suprine position,only used plastic toilet.The defecation and other related items were compared between the three groups.Results The observation group 1 was better than those of the observation group 2 and the control group in preventing pressure ulcers,urine leakage and backflow,comfort degree,worrying degree,defecation difficulty degree.Conclusions Application of waist pillow and plastic toilet in bedridden patients in emergency department could reduce the skin damage,and let patients defecate smoothly,which was in accordance with the connotation of comfort nursing.