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BMC Pediatrics Sep 2021We looked at existing recommendations and supporting evidence for successful strategies to prevent the sudden infant death syndrome (SIDS).We conducted a literature... (Review)
Review
We looked at existing recommendations and supporting evidence for successful strategies to prevent the sudden infant death syndrome (SIDS).We conducted a literature search up to the 14th of December 2020 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendation when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported.Current evidence supports statistical associations between risk factors and SIDS, but there is globally limited evidence by controlled studies assessing the effect of the social promotion strategies to prevent SIDS through knowledge, attitude and practices, due to obvious ethical reasons. A dramatic decline in SIDS incidence has been observed in many countries after the introduction of "Back to Sleep" campaigns for prevention of SIDS. All infants should be placed to sleep in a safe environment including supine position, a firm surface, no soft objects and loose bedding, no head covering, no overheating, and room-sharing without bed-sharing. Breastfeeding on demand and the use of pacifier during sleep time protect against SIDS and should be recommended. Parents should be advised against the use of tobacco, alcohol and illicit drugs during gestation and after birth.
Topics: Beds; Humans; Infant; Pacifiers; Prone Position; Risk Factors; Sleep; Sudden Infant Death; Supine Position; Systematic Reviews as Topic
PubMed: 34496779
DOI: 10.1186/s12887-021-02536-z -
Italian Journal of Pediatrics Feb 2021Positional plagiocephaly (PP) is a cranial deformation frequent amongst children and consisting in a flattened and asymmetrical head shape. PP is associated with... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Positional plagiocephaly (PP) is a cranial deformation frequent amongst children and consisting in a flattened and asymmetrical head shape. PP is associated with excessive time in supine and with congenital muscular torticollis (CMT). Few studies have evaluated the efficiency of a manual therapy approach in PP. The purpose of this parallel randomized controlled trial is to compare the effectiveness of adding a manual therapy approach to a caregiver education program focusing on active rotation range of motion (AROM) and neuromotor development in a PP pediatric sample.
METHODS
Thirty-four children with PP and less than 28 week-old were randomly distributed into two groups. AROM and neuromotor development with Alberta Infant Motor Scale (AIMS) were measured. The evaluation was performed by an examiner, blinded to the randomization of the subjects. A pediatric integrative manual therapy (PIMT) group received 10-sessions involving manual therapy and a caregiver education program. Manual therapy was addressed to the upper cervical spine to mobilize the occiput, atlas and axis. The caregiver educational program consisted in exercises to reduce the positional preference and to stimulate motor development. The control group received the caregiver education program exclusively. To compare intervention effectiveness across the groups, improvement indexes of AROM and AIMS were calculated using the difference of the final measurement values minus the baseline measurement values. If the distribution was normal, the improvement indexes were compared using the Student t-test for independent samples; if not, the Mann-Whitney U test was used. The effect size of the interventions was calculated using Cohen's d.
RESULTS
All randomized subjects were analysed. After the intervention, the PIMT group showed a significantly higher increase in rotation (29.68 ± 18.41°) than the control group (6.13 ± 17.69°) (p = 0.001). Both groups improved the neuromotor development but no statistically significant differences were found. No harm was reported during the study.
CONCLUSION
The PIMT intervention program was more effective in increasing AROM than using only a caregiver education program. The study has been retrospectively registered at clinicaltrials.gov, with identification number NCT03659032 . Registration date: September 1, 2018.
Topics: Female; Follow-Up Studies; Head Movements; Humans; Infant; Infant, Newborn; Male; Musculoskeletal Manipulations; Neck; Plagiocephaly, Nonsynostotic; Prospective Studies; Supine Position
PubMed: 33632268
DOI: 10.1186/s13052-021-00995-9 -
Intensive Care Medicine Aug 2022
Review
Topics: Humans; Patient Positioning; Prone Position; Respiration, Artificial; Respiratory Distress Syndrome; Supine Position
PubMed: 35652920
DOI: 10.1007/s00134-022-06731-z -
Sports Health Jul 2016Prone, supine, and side position exercises are employed to enhance core stability.
BACKGROUND
Prone, supine, and side position exercises are employed to enhance core stability.
HYPOTHESIS
Overall core muscle activity would be greater in prone position exercises compared with supine and side position exercises.
STUDY DESIGN
Controlled laboratory study.
METHODS
Eighteen men and women between 23 and 45 years of age served as subjects. Surface electrodes were positioned over the upper and lower rectus abdominis, external and internal obliques, rectus femoris, latissimus dorsi, and lumbar paraspinals. Electromyography data were collected during 5 repetitions of 10 exercises, then normalized by maximum voluntary isometric contractions (MVIC). Differences in muscle activity were assessed using 1-way repeated-measures analysis of variance, while t tests with a Bonferroni correction were employed to assess pairwise comparisons.
RESULTS
Upper and lower rectus abdominis activity was generally significantly greater in the crunch, bent-knee sit-up, and prone position exercises compared with side position exercises. External oblique activity was significantly greater in the prone on ball with right hip extension, side crunch on ball, and side bridge (plank) on toes compared with the prone and side bridge (plank) on knees, the crunch, or the bent-knee sit-up positions. Internal oblique activity was significantly greater in the prone bridge (plank) on ball and prone on ball with left and right hip extension compared with the side crunch on ball and prone and side bridge (plank) on knees positions. Lumbar paraspinal activity was significantly greater in the 3 side position exercises compared with all remaining exercises. Latissimus dorsi activity was significantly greater in the prone on ball with left and right hip extension and prone bridge (plank) on ball and on toes compared with the crunch, bent-knee sit-up, and prone and side bridge (plank) on knees positions. Rectus femoris activity was significantly greater in the prone on ball with left hip extension, bent-knee sit-up, or prone bridge (plank) on toes compared with the remaining exercises.
CONCLUSION
Prone position exercises are good alternatives to supine position exercises for recruiting core musculature. Side position exercises are better for oblique and lumbar paraspinal recruitment.
CLINICAL RELEVANCE
Because high core muscle activity is associated with high spinal compressive loading, muscle activation patterns should be considered when prescribing trunk exercises to those in which high spinal compressive loading may be deleterious.
Topics: Abdominal Muscles; Adult; Back Muscles; Electromyography; Exercise; Female; Humans; Male; Middle Aged; Posture; Prone Position; Sports Equipment; Supine Position; Young Adult
PubMed: 27302152
DOI: 10.1177/1941738116653931 -
Journal of Neurology Aug 2017Neurogenic orthostatic hypotension (nOH) is common in patients with neurodegenerative disorders such as Parkinson's disease, multiple system atrophy, pure autonomic... (Review)
Review
Neurogenic orthostatic hypotension (nOH) is common in patients with neurodegenerative disorders such as Parkinson's disease, multiple system atrophy, pure autonomic failure, dementia with Lewy bodies, and peripheral neuropathies including amyloid or diabetic neuropathy. Due to the frequency of nOH in the aging population, clinicians need to be well informed about its diagnosis and management. To date, studies of nOH have used different outcome measures and various methods of diagnosis, thereby preventing the generation of evidence-based guidelines to direct clinicians towards 'best practices' when treating patients with nOH and associated supine hypertension. To address these issues, the American Autonomic Society and the National Parkinson Foundation initiated a project to develop a statement of recommendations beginning with a consensus panel meeting in Boston on November 7, 2015, with continued communications and contributions to the recommendations through October of 2016. This paper summarizes the panel members' discussions held during the initial meeting along with continued deliberations among the panel members and provides essential recommendations based upon best available evidence as well as expert opinion for the (1) screening, (2) diagnosis, (3) treatment of nOH, and (4) diagnosis and treatment of associated supine hypertension.
Topics: Humans; Hypertension; Hypotension, Orthostatic; Supine Position
PubMed: 28050656
DOI: 10.1007/s00415-016-8375-x -
Journal of Clinical Anesthesia Nov 2021To review the effects of prone position and supine position on oxygenation parameters in patients with Coronavirus Disease 2019 (COVID-19). (Meta-Analysis)
Meta-Analysis
STUDY OBJECTIVE
To review the effects of prone position and supine position on oxygenation parameters in patients with Coronavirus Disease 2019 (COVID-19).
DESIGN
Systematic review and meta-analysis of non-randomized trials.
PATIENTS
Databases of EMBASE, MEDLINE and CENTRAL were systematically searched from its inception until March 2021.
INTERVENTIONS
COVID-19 patients being positioned in the prone position either whilst awake or mechanically ventilated.
MEASUREMENTS
Primary outcomes were oxygenation parameters (PaO₂/FiO₂ ratio, PaCO₂, SpO₂). Secondary outcomes included the rate of intubation and mortality rate.
RESULTS
Thirty-five studies (n = 1712 patients) were included in this review. In comparison to the supine group, prone position significantly improved the PaO₂/FiO₂ ratio (study = 13, patients = 1002, Mean difference, MD 52.15, 95% CI 37.08 to 67.22; p < 0.00001) and SpO₂ (study = 11, patients = 998, MD 4.17, 95% CI 2.53 to 5.81; p ≤0.00001). Patients received prone position were associated with lower incidence of mortality (study = 5, patients = 688, Odd ratio, OR 0.44, 95% CI 0.24 to 0.80; p = 0.007). No significant difference was noted in the incidence of intubation rate (study = 5, patients = 626, OR 1.20, 95% CI 0.77 to 1.86; p = 0.42) between the supine and prone groups.
CONCLUSION
Our meta-analysis demonstrated that prone position improved PaO₂/FiO₂ ratio with better SpO₂ than supine position in COVID-19 patients. Given the limited number of studies with small sample size and substantial heterogeneity of measured outcomes, further studies are warranted to standardize the regime of prone position to improve the certainty of evidence. PROSPERO Registration: CRD42021234050.
Topics: COVID-19; Humans; Prone Position; Respiration, Artificial; SARS-CoV-2; Supine Position
PubMed: 34182261
DOI: 10.1016/j.jclinane.2021.110406 -
Lancet (London, England) Oct 2015The Valsalva manoeuvre is an internationally recommended treatment for supraventricular tachycardia, but cardioversion is rare in practice (5-20%), necessitating the use... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The Valsalva manoeuvre is an internationally recommended treatment for supraventricular tachycardia, but cardioversion is rare in practice (5-20%), necessitating the use of other treatments including adenosine, which patients often find unpleasant. We assessed whether a postural modification to the Valsalva manoeuvre could improve its effectiveness.
METHODS
We did a randomised controlled, parallel-group trial at emergency departments in England. We randomly allocated adults presenting with supraventricular tachycardia (excluding atrial fibrillation and flutter) in a 1:1 ratio to undergo a modified Valsalva manoeuvre (done semi-recumbent with supine repositioning and passive leg raise immediately after the Valsalva strain), or a standard semi-recumbent Valsalva manoeuvre. A 40 mm Hg pressure, 15 s standardised strain was used in both groups. Randomisation, stratified by centre, was done centrally and independently, with allocation with serially numbered, opaque, sealed, tamper-evident envelopes. Patients and treating clinicians were not masked to allocation. The primary outcome was return to sinus rhythm at 1 min after intervention, determined by the treating clinician and electrocardiogram and confirmed by an investigator masked to treatment allocation. This study is registered with Current Controlled Trials (ISRCTN67937027).
FINDINGS
We enrolled 433 participants between Jan 11, 2013, and Dec 29, 2014. Excluding second attendance by five participants, 214 participants in each group were included in the intention-to-treat analysis. 37 (17%) of 214 participants assigned to standard Valsalva manoeuvre achieved sinus rhythm compared with 93 (43%) of 214 in the modified Valsalva manoeuvre group (adjusted odds ratio 3·7 (95% CI 2·3-5·8; p<0·0001). We recorded no serious adverse events.
INTERPRETATION
In patients with supraventricular tachycardia, a modified Valsalva manoeuvre with leg elevation and supine positioning at the end of the strain should be considered as a routine first treatment, and can be taught to patients.
FUNDING
National Institute for Health Research.
Topics: Emergency Service, Hospital; Female; Humans; Male; Middle Aged; Posture; Supine Position; Tachycardia, Supraventricular; Treatment Outcome; Valsalva Maneuver
PubMed: 26314489
DOI: 10.1016/S0140-6736(15)61485-4 -
American Family Physician Jan 2022
Topics: Blood Pressure; Chest Pain; Diet; Dizziness; Drinking Water; Exercise; Heart Rate; Hot Temperature; Humans; Hypotension, Orthostatic; Supine Position
PubMed: 35029960
DOI: No ID Found -
The American Journal of Managed Care Oct 2015Although orthostatic hypotension in elderly patients is common, neurogenic orthostatic hypotension (NOH) is a condition with substantial morbidity and a variable... (Review)
Review
Although orthostatic hypotension in elderly patients is common, neurogenic orthostatic hypotension (NOH) is a condition with substantial morbidity and a variable prognosis. Patients with severe NOH have difficulty standing for any period of time and must scrupulously avoid orthostatic stressors that exacerbate their condition. In about half of patients, supine hypertension complicates management. The diagnosis is based on measurements of supine and standing blood pressures or head-up tilt testing and is confirmed by autonomic testing. Two self-report questionnaires, the Orthostatic Hypotension Questionnaire and the Orthostatic Grading Scale, can help evaluate a patient's level of impairment, document progression, and assess the response to pharmacotherapy in clinical practice. There are many gaps in our knowledge of this rare disorder; this review summarizes what is currently known about the pathophysiology, epidemiology, prognosis, signs and symptoms, and the diagnosis of NOH.
Topics: Comorbidity; Humans; Hypertension; Hypotension, Orthostatic; Neurodegenerative Diseases; Prognosis; Quality of Life; Supine Position; Surveys and Questionnaires
PubMed: 26790109
DOI: No ID Found -
Urology Journal Oct 2016To compare results of studies on supine and prone percutaneous nephrolithotomy (PCNL) techniques to find the best position for treating kidney stones. (Comparative Study)
Comparative Study Meta-Analysis Review
PURPOSE
To compare results of studies on supine and prone percutaneous nephrolithotomy (PCNL) techniques to find the best position for treating kidney stones.
MATERIALS AND METHODS
A systematic literature review was done in April 2016 using PubMed, Scopus, and Web of Science databases to identify the relevant studies. Article selection was based on the preferred reporting elements of systematic reviews and meta-analysis criteria. A subgroup analysis was done comparing standard prone and supine PCNLs separately.
RESULTS
Twenty studies were selected for the analysis including 7733 PCNL cases: 2110 cases were (27.3%) in supine and 5623 cases were (72.7%) in prone position. Supine and prone PCNL had a similar stone-free rate (OR: 0.95; 95% CI: 070-1.27; P = 0.73), operation time (difference in means = -0.01, 95% CI: -0.07 to 0.03; P = .53), hospital stay (differencein means = 0.01, 95% CI: -0.07 to 0.03; P = .52), complication rate (OR: 0.88; 95% CI: 0.76-1.02; P = .09) and urinary leakage (OR: 1.14; 95% CI: 0.50-2.59; P = .75). However, patients received less blood transfusion (OR: 0.72; 95% CI: 0.55-0.94; P = .01) and had less fever rates (OR: 0.65; 95% CI: 0.52-0.80; P < 0.001) in supine PCNL.
CONCLUSION
Supine PCNL has similar stone-free rate, operation time, and hospital stay relative to prone PCNL. However, the supine position has the advantage of less fever and need for blood transfusion. Although both prone and supine PCNLs are suggested for treatment, supine PCNL may have advantages especially in patients with comorbidity. .
Topics: Blood Transfusion; Humans; Kidney Calculi; Nephrostomy, Percutaneous; Operative Time; Patient Positioning; Prone Position; Supine Position
PubMed: 27734421
DOI: No ID Found