Abstract P192: Is Auscultation Adequate To Estimate Blood Pressure Responses Related To Body Position Changes?

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Bruce Alpert ◽  
Anna Vybornova ◽  
Arlene Wurzner-Ghajar ◽  
Erietta Polychronopoulou ◽  
Sibylle Fallet ◽  
...  
Keyword(s):  
Body Position ◽  
Middle Finger ◽  
Upper Arm ◽  
Posture Change ◽  
Device Validation ◽  
The Mean ◽  
Blood Pressure Responses ◽  
Few Data ◽  
Double Blinded ◽  
Korotkoff Sounds

Double-blinded auscultation is the current reference to validate new devices in the sitting position. There are few data to tell whether it should be used for device validation in other body positions, as the Korotkoff sounds can be affected by changes in vascular tone. In this study, we recorded the BP response to orthostatic posture change (standing to supine) in 75 subjects, aged between 21 and 65 years old. Systolic (SBP) and diastolic (DBP) were measured on the left upper arm by auscultation by two independent blinded observers before and 150s after posture change. In case the observers did not agree, i.e. readings differed more than 4 mmHg, the measurement was repeated. Beat-to-beat BP values were measured on the ipsilateral middle finger with Nexfin (BMEYE, The Netherlands). Because Nexfin measurements were not available during upper-arm cuff inflation, the mean of the values in a 30s window prior to auscultation onset was used for the analysis. The distribution of the BP responses to posture change was characterized in terms of median, 10 th and 90 th percentiles (see Table). The response was considered consistent if these percentiles were on the same side of zero. Neither auscultation nor Nexfin detected any consistent posture-related changes in SBP when going from standing to supine. Nexfin detected a consistent decrease in DBP. Auscultation detected no consistent posture-related change. Compared to volume-clamp, auscultation was not able to detect any consistent changes in DBP during orthostatic challenge. Our study suggests that the use of Korotkoff sounds to estimate BP in body positions other than sitting may not be appropriate.

Therapeutic Effects of Hab Shabyar on Open-Angle Glaucoma: A Double-Blinded, Randomized, Placebo-Controlled Trial

2019 ◽  
Vol 8 ◽  
pp. 1218
Author(s):  
Ebrahim Khalil BaniHabib ◽  
Ali Mostafai ◽  
Seyyed Mohammad Bagher Fazljou ◽  
Ghadir Mohammdi
Keyword(s):  
Placebo Group ◽  
Intraocular Pressure ◽  
Open Angle Glaucoma ◽  
Controlled Trial ◽  
Intervention Group ◽  
Therapeutic Effects ◽  
Open Angle ◽  
The Mean ◽  
The Right ◽  
Double Blinded

Background: Open-angle glaucoma (OAG) is one of the leading causes of blindness worldwide. This study evaluates the therapeutic effects of hab shabyar in patients with open-angle glaucoma. Materials and Methods: In this clinical randomized controlled trial, 50 patients with OAG were randomized into two groups. The intervention group was received a drop of timolol plus 500 mg of hab shabyar every 12 hours. The placebo group was received a drop of timolol every 12 hours plus 500 mg of wheat germ as a placebo. The intraocular pressure in patients with OAG was measured in each group and compared at before the intervention (t1), one month (t2), and two months (t3) after the intervention. Results: The mean decrease in intraocular pressure for the right eye at three times in the intervention group was statistically significant, but the mean decrease in the placebo group was not significant. Similar results were obtained for the left eye at t1 when compared to t3. The patients in the intervention group expressed more satisfaction than the patients in the placebo group (P≤0.001). Conclusion: Our study demonstrated that consumption of timolol plus hab shabyar instead of consuming of timolol alone was probably more effective for reducing intraocular pressure in patients with OAG.[GMJ.2019;In press:e1218]

The Effect of Sensor Placement and Number on Physical Activity Recognition and Energy Expenditure Estimation (Preprint)

2020 ◽  
Author(s):  
Anis Davoudi ◽  
Mamoun T. Mardini ◽  
Dave Nelson ◽  
Fahd Albinali ◽  
Sanjay Ranka ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Energy Expenditure ◽  
Activity Recognition ◽  
Recognition Accuracy ◽  
Body Position ◽  
Computer Work ◽  
Accelerometer Data ◽  
Upper Arm ◽  
Lifestyle Activities

BACKGROUND Research shows the feasibility of human activity recognition using Wearable accelerometer devices. Different studies have used varying number and placement for data collection using the sensors. OBJECTIVE To compare accuracy performance between multiple and variable placement of accelerometer devices in categorizing the type of physical activity and corresponding energy expenditure in older adults. METHODS Participants (n=93, 72.2±7.1 yrs) completed a total of 32 activities of daily life in a laboratory setting. Activities were classified as sedentary vs. non-sedentary, locomotion vs. non-locomotion, and lifestyle vs. non-lifestyle activities (e.g. leisure walk vs. computer work). A portable metabolic unit was worn during each activity to measure metabolic equivalents (METs). Accelerometers were placed on five different body positions: wrist, hip, ankle, upper arm, and thigh. Accelerometer data from each body position and combinations of positions were used in developing Random Forest models to assess activity category recognition accuracy and MET estimation. RESULTS Model performance for both MET estimation and activity category recognition strengthened with additional accelerometer devices. However, a single accelerometer on the ankle, upper arm, hip, thigh, or wrist had only a 0.03 to 0.09 MET increase in prediction error as compared to wearing all five devices. Balanced accuracy showed similar trends with slight decreases in balanced accuracy for detection of locomotion (0-0.01 METs), sedentary (0.13-0.05 METs) and lifestyle activities (0.08-0.04 METs) compared to all five placements. The accuracy of recognizing activity categories increased with additional placements (0.15-0.29). Notably, the hip was the best single body position for MET estimation and activity category recognition. CONCLUSIONS Additional accelerometer devices only slightly enhance activity recognition accuracy and MET estimation in older adults. However, given the extra burden of wearing additional devices, single accelerometers with appropriate placement appear to be sufficient for estimating energy expenditure and activity category recognition in older adults.

Effectiveness and safety of repeated percutaneous intervention in an office-based endovascular center in maintaining hemodialysis access

Vascular ◽  
2021 ◽  
pp. 170853812110043
Author(s):  
Jay Patel ◽  
Stephanie Chang ◽  
Shaan Manawar ◽  
John Munn ◽  
Mark C Rummel ◽  
...  
Keyword(s):  
Percutaneous Intervention ◽  
Dialysis Access ◽  
Arteriovenous Graft ◽  
Hemodialysis Access ◽  
Upper Arm ◽  
Access Site ◽  
Arteriovenous Fistulas ◽  
Arteriovenous Grafts ◽  
The Mean

Objectives Percutaneous dialysis access interventions are routinely used to maintain the patency of dialysis access despite the lack of data regarding their long-term effectiveness. This retrospective study was undertaken to study the effectiveness and safety of percutaneous dialysis access interventions in arm fistulas and bridge grafts in an office-based endovascular center. Methods Patients who had a percutaneous dialysis access intervention in their upper extremity access site, performed at a single office-based endovascular center over a nine-year period (2007–2016) were included in this study. The patients’ demographic factors, patency, and complications were analyzed. Patients were entered in the study after first percutaneous dialysis access intervention. Results A total of 298 limbs in 259 patients had 913 procedures carried out over a nine-year period. There were 190 access arteriovenous fistulas and 108 arteriovenous grafts. The two most common arteriovenous fistulas were the brachiocephalic fistula ( n = 74, 39%) and radio cephalic fistula ( n = 69, 36%). Arteriovenous grafts were most commonly placed in the upper arm ( n = 66, 61%) followed by the forearm ( n = 42, 39%). The mean overall patency for all limbs was 50.86 months. Arteriovenous fistulas had a significantly longer patency than arteriovenous grafts (51.65 vs. 42.09 months; P = 0.01). In addition, patients with two or more percutaneous dialysis access intervention in their arteriovenous fistula had significantly greater patency than those with only one percutaneous dialysis access intervention (58.5 vs. 7.6 months; hazard ratio 0.41; P = 0.0008). This was not true for the arteriovenous graft group. Women represented 49% of the patient group. Their accesses had shorter patency than men (39.8 vs. 60 months; P = 0.0007). Conclusions This data support the use of repeated percutaneous dialysis access intervention to maintain long-term patency of dialysis access sites in an office-based endovascular center. Overall, fistulas have longer patency than grafts and women have poorer outcomes as compared to men

scholarly journals Postoperative topical analgesia of hemorrhoidectomy with policresulen and cinchocaine: a prospective and controlled study

2014 ◽  
Vol 41 (2) ◽  
pp. 92-98 ◽  
Author(s):  
Ilario Froehner Junior ◽  
Paulo Gustavo Kotze ◽  
Juliana Gonçalves Rocha ◽  
Eron Fábio Miranda ◽  
Maria Cristina Sartor ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Bowel Movement ◽  
Controlled Study ◽  
Control Group ◽  
Oral Medications ◽  
Average Pain Intensity ◽  
Average Pain ◽  
The Mean ◽  
Double Blinded ◽  
Topical Analgesia

OBJECTIVE: To evaluate the effects of topical policresulen and cinchocaine in the postoperative pain behavior of open hemorrhoidectomy.METHODS: We conducted a prospective, double-blinded, controlled study. The control group received the usual guidelines with oral medications. The topical treatment group received, in addition, the application of the ointment and was comprised of two subgroups (policresulen + cinchocaine, and placebo). Pain intensity was recorded with the visual analogue scale.RESULTS: 43 patients were operated on: control group - n = 13, one excluded; placebo - n = 15; and policresulen + cinchocaine - n = 15. The mean age was 45.98 years and 37.2% were men. The average pain intensity was 4.09 (immediate postoperative), 3.22 (hospital discharge), 5.73 (day 1) , 5.77 (day 2), 5.74 (day 3), 5.65 (day 7), 5.11 (day 10), 2.75 (day 15) and 7.70 (first bowel movement), with no difference between groups in all periods.CONCLUSION: This study showed no reduction in pain after hemorrhoidectomy with the use of topical policresulen and cinchocaine.

scholarly journals The Effect of Urtica Dioica Extract on Blood Lipids Profile in Patients with Type 2 Diabetes: A Randomized Double-blinded Clinical Trial

2021 ◽  
Author(s):  
Roya Khajeh Mehrizi ◽  
Hassan Mozaffari-Khosravi ◽  
Parisa Aboee
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Clinical Trial ◽  
Total Cholesterol ◽  
Density Lipoprotein ◽  
Urtica Dioica ◽  
Significant Difference ◽  
The Mean ◽  
Double Blinded

Background: Diabetes is an endocrine disorder that is strongly associated with cardiovascular disease. The use of alternative therapy has recently increased and medicinal plants are one of the alternative therapies for diabetic patients. This study aimed to evaluate the protective effect of Urtica dioica (Nettle) on lipid profile in patients with type 2 diabetes (T2D). Method: This parallel randomized double-blinded clinical trial was conducted on 60 men and women with T2D for an 8-week period. The participants were randomly assigned to received 100mg/kg/day extract of Urtica Dioica (UG) and the placebo group (PG). Blood triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDLc) and high density lipoprotein cholesterol (HDLc) were measured at baseline and end of the study. The data were analyzed using SPSS 16.0 and P < 0.05 was considered significant. Results: The mean difference of total cholesterol showed no significant difference in the UG compared to the PG which were -10.56±40.5 and -19.5± 35.9 (P = 0.14), respectively. The study also showed no significant difference between TG and LDLc in the UG compared to the PG (-39.8±171.5 vs. -23.37±72.3 (P = 0.68) and -3.16±33.4 vs. -11.2±35.6 (P = 0.15), respectively). The mean difference of HDLc in the UG and PG were -2.68±8.11 and 2.62±10.6 (P = 0.05), respectively, indicating a significant increase in the UG compared to the PG. Conclusion: The results demonstrated that consumption of 100mg/kg/day extract of UD for 8 weeks by increasing HDL concentration can decrease the risk of cardiovascular disease in patients with T2D.

Vasodilatation Measurement Using Finger Vascular Images by Near-Infrared Light and Comparison with RH-PAT

2022 ◽  
Vol 54 ◽  
pp. 41-50
Author(s):  
Satoshi Shimawaki ◽  
Izumi Urakami
Keyword(s):  
Near Infrared ◽  
Cuff Pressure ◽  
Reactive Hyperemia ◽  
Middle Finger ◽  
Infrared Light ◽  
Upper Arm ◽  
Peripheral Arterial Tonometry ◽  
Average Brightness ◽  
Nir Light ◽  
Digital Pulse

Examination of vascular endothelial function can help infer atherosclerosis progression. This study investigated whether vascular visualization by near-infrared (NIR) light can detect vasodilatation after cuff pressure release of the upper arm and what the correlation is between the brightness decrease ratio (R1) corresponding to vasodilation and the reactive hyperemia index (RHI). We obtained finger vascular images of 53 male subjects by photographing NIR light (wavelength 850 nm) transmitted through the middle phalanx of the middle finger with a charge-coupled device camera. The upper arm was compressed for 10 min using a cuff (200 mmHg), and vascular images before and after cuff compression release were obtained. We analyzed the finger vascular images by NIR light and digital pulse volume using endothelial peripheral arterial tonometry (Endo-PAT). We also calculated the average brightness of each vascular image. Using only the data of the ischemic finger, R1 was defined using the average brightness just before cuff release and the minimum average brightness after cuff release. The brightness of vascular images of the ischemic finger decreased after cuff release probably because of vasodilation. We found significant correlation between R1 and the RHI (r = 0.52; P < 0.001). R1 in the lowest RHI quartile was significantly smaller compared to the highest and second-highest RHI quartiles (P < 0.05). Vascular visualization by NIR light can detect vasodilation after cuff release. This is significantly correlated with the RHI on Endo-PAT.

Fluid and electrolyte shifts in women during +Gz acceleration after 15 days' bed rest

1977 ◽  
Vol 42 (1) ◽  
pp. 67-73 ◽  
Author(s):  
J. E. Greenleaf ◽  
H. O. Stinnett ◽  
G. L. Davis ◽  
J. Kollias ◽  
E. M. Bernauer
Keyword(s):  
Mean Corpuscular Volume ◽  
Body Position ◽  
Venous Blood ◽  
Bed Rest ◽  
Corpuscular Volume ◽  
The Third ◽  
Before And After ◽  
The Mean ◽  
Electrolyte Loss ◽  
Reduced Activity

Twelve women (23–34 yr), comprising a bed-rest (BR) group of eight subjects and an ambulatory (AMB) group of four subjects, were centrifuged after 14 days of ambulatory control (C),after 15 days of a 17-day BR period, and on the third day of recovery (R). Venous blood was taken before and after the third +3.0 G acceleration run (1.8 G/min). Relative to (C), the +Gz tolerance after BR was reduced -49.0% (P less than 0.05) in the BR group and -38.7% (NS) in the AMB group; during (R) the BR group regained up to 89.4% and the AMB group up to 87.1% of their (C) tolerances. In each of the three test periods, the shifts in plasma Na, Cl, PO4, and osmotic contents, which accompanied +Gz, followed the outward shift of plasma volume (PV). The correlation of the shift of PV during acceleration with the +Gz tolerance was 0.72 (P less than 0.01). During acceleration, the PV and electrolyte loss for both groups after BR was about half the loss of (C) and (R). Compared with (C) and (R) values, potassium shifts were variable but the mean corpuscular volume and mean corpuscular Hb contents and concentrations were unchanged during all +Gz runs; The results indicate that: 1) the higher the (C) + Gz tolerance, the greater the tolerance decline due to BR; 2) relative confinement and reduced activity contribute as much to the reduction in tolerance as does the horizontal body position during BR; 3) bed-rest deconditioning has no effect on the erythrocyte volume during +3.0 Gz; and 4) about one-half the loss in tolerance after BR can be attributed to PV and electrolyte shifts.

Effect of body position on ventricular CSF methotrexate concentration following intralumbar administration.

1995 ◽  
Vol 13 (1) ◽  
pp. 177-179 ◽  
Author(s):  
S M Blaney ◽  
D G Poplack ◽  
K Godwin ◽  
C L McCully ◽  
R Murphy ◽  
...  
Keyword(s):  
Prone Position ◽  
Drug Exposure ◽  
Body Position ◽  
Drug Distribution ◽  
Sitting Position ◽  
Nonhuman Primate Model ◽  
Primate Model ◽  
Therapeutic Modalities ◽  
Methotrexate Concentration ◽  
The Mean

PURPOSE Intralumbar methotrexate is one of the primary therapeutic modalities for the prevention and treatment of meningeal leukemia. However, methotrexate distribution to the ventricles is limited and highly variable following intralumbar dosing, and cytotoxic concentrations of methotrexate are not always achieved or sustained in the ventricular CSF. We used a nonhuman primate model to determine the effect of body position on the caudal distribution of an intralumbar dose of methotrexate. METHODS Methotrexate (1.0 mg) was administered by intralumbar injection to four animals, which were then immediately placed either in an upright sitting position or in a prone position for 1 hour, then upright. Each animal served as its own control and was studied in each position on at least one occasion. RESULTS The mean peak ventricular methotrexate concentration was 0.12 mumol/L (range, 0.091 to 0.20) in animals that were immediately placed upright, compared with 2.81 mumol/L (range, 0.21 to 8.9) in animals that remained prone for 1 hour. The mean area under the concentration-versus-time curves (AUC) was 0.51 mumol/L.h (range, 0.26 to 1.1) in the upright animals and 12.0 mumol/L.h (range, 0.9 to 35.4) in the prone animals. CONCLUSION Maintaining a prone position for 1 hour after an intralumbar dose increased the peak methotrexate concentration and drug exposure in ventricular CSF. CSF drug distribution following intralumbar therapy can be influenced by body position after the injection.

Impact of body posture change on peripherally inserted central catheter tip position in Chinese cancer patients

2020 ◽  
Vol 21 (5) ◽  
pp. 732-737
Author(s):  
Chunli Liu ◽  
Dingbiao Jiang ◽  
Tao Jin ◽  
Chuanyin Chen ◽  
Ruchun Shi ◽  
...  
Keyword(s):  
Upright Position ◽  
Body Posture ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Posture Change ◽  
Body Change ◽  
Catheter Tip ◽  
The Mean ◽  
Tip Position ◽  
Chinese Cancer Patients

Purpose: To evaluate the influence of body posture change on the peripherally inserted central catheter tip position in Chinese cancer patients. Methods: A prospective observational trial was conducted in a tertiary cancer hospital from August to September 2018. After the insertion of peripherally inserted central catheter, chest X-ray films were taken to check the catheter tip in the upright and supine positions, respectively. The distance from the carina to the catheter tip was separately measured on both chest films by nurses. The primary study outcome was the distance and direction of the catheter tip movement. The secondary study outcome was to analyze the influence factors on the catheter tip movement. The third study outcome was to observe the related adverse events caused by the catheter tip movement. Results: A total of 79 patients were included, the results showed that 61 moved cephalad, 14 moved caudally, and 4 did not move with body change from the supine to the upright position. When moved cephalad, the mean distance was 19.34 ± 11.95 mm; when moved caudally, the mean distance was –15.83 ± 8.97 mm. The difference between the two positions was statistically significant ( p < 0.001). There was also a statistically significant difference between catheter tip movement direction and body mass index ( p = 0.009) and height ( p = 0.015). Two patients developed arrhythmias; no cardiac tamponade was found due to body posture change. Conclusion: The results of this work implied that the tips of the catheter tend to shift toward the cephalad with body change from the supine to the upright position. A study involving a larger sample size is needed to find more information in the future.

Third Place — Resident Clinical Science Award 1993: Effect of Pentoxyfylline on Myocutaneous Flap Viability in Pigs

1993 ◽  
Vol 109 (4) ◽  
pp. 668-675 ◽  
Author(s):  
Michael Armstrong ◽  
Dario R. Kunar ◽  
Charles W. Cummings
Keyword(s):  
Laser Doppler Velocimetry ◽  
Myocutaneous Flap ◽  
Skin Flap ◽  
Third Place ◽  
Myocutaneous Flaps ◽  
Partial Necrosis ◽  
Flap Viability ◽  
Before And After ◽  
The Mean ◽  
Double Blinded

Partial necrosis of a skin flap can complicate reconstructive surgery. We performed a double-blinded crossover study to determine if pentoxifylline improves perfusion and survival of a myocutaneous flap. Ten 20-kg pigs were fed pentoxifylline (400 mg three times a day) or placebo for 1 week before and after raising a 5 × 30 cm panniculus carnosus flap on one flank. After 1 week of washout, each pig began the opposite drug treatment and the surgery was repeated on the opposite flank. Immediately after surgery, perfusion dermofluorometry and laser Doppler velocimetry demonstrated a significant increase in the perfusion of pentoxifylline-treated flaps compared to control flaps. On postoperative day 7, the mean area of clinical necrosis was 39.7 ± 4.7 cm2 on the placebo sides and 30.1 ± 4.6 cm2 on the pentoxifylline sides ( f = 2.21, p < 0.05). We conclude that pentoxifylline improves perfusion and survival of myocutaneous flaps in pigs. Clinical trials appear to be indicated on the basis of the findings of this experiment

Sign in / Sign up

Export Citation Format

Share Document