Repeatability of subject/bed interface pressure measurements

The repeatability of a technique for measuring interface pressures has been assessed. Pressure was measured using a Talley SA500 Pressure Evaluator under six anatomical sites (occiput, scapula, elbow, sacrum, buttock, and heel) of six healthy subjects lying supine on a Clinifloat mattress (trademark, SSI). For each site of each subject, four repeat readings were taken per day on four separate days. Mean pressures varied significantly between subjects (p < 0.02), though differences in mean pressures between sites were greater. Pressure was not significantly related to subject mass. The overall repeatability of the technique was ± 0.77 kPa (± 5.8 mm Hg) which was much smaller than the range of pressures found under different sites (2.72 kPa or 20.4 mm Hg at the sacrum to 9.00 kPa or 67.5 mm Hg at the heel). Repeatability varied from site to site, from ± 0.47 kPa (± 3.5 mm Hg) at the buttocks to ± 1.20 kPa (± 9.0 mm Hg) at the heel. Measurements were found to vary significantly more between days than between repeats on the same day (p < 0.02).     

Cot mattresses as reservoirs of potentially harmful bacteria and the sudden infant death syndrome

Cot mattress materials were investigated as potential reservoirs of bacteria in relation to the sudden infant death syndrome (SIDS). The sleeping position of the infant significantly influenced bacterial population density of cot mattress polyurethane foams (p<0.0000001) and their covers (p<0.004). Staphylococcus aureus was isolated at significantly higher frequency (p<0.03) from the infant's head region of cot mattress materials. Significantly higher bacterial population densities (p<0.001) were associated with polyurethane foams from non-integral mattresses (exposed polyurethane foam), when compared to those from mattresses completely covered by polyvinyl chloride (integral type mattress). The frequency of isolation of S. aureus from polyurethane foams from non-integral mattresses was also significantly higher (p=0.03) than from foams from the integral type. The following factors were significantly associated with increased frequency of isolation of S. aureus: from the polyurethane foam, previous use of non-integral mattresses by another child (p=0.03 for all sample sites, p=0.01 for torso region); from the covers, sleeping in the prone position (p=0.003 head region, p=0.001 torso region). Prone sleeping was also significantly associated with increased bacterial population levels (p=0.01) and increased frequency of isolation of Escherichia coli (p=0.02) from the torso region of cot mattress covers. These findings could explain some recently identified risk factors for SIDS associated with type and previous use of cot mattresses. Clostridium perfringens was isolated at very low frequency and Streptococcus pyogenes was not isolated from any cot mattress materials tested.     

Used cot mattresses as potential reservoirs of bacterial infection: nutrient availability within polyurethane foam

Aim: To evaluate possible source of nutrients for bacterial growth within polyurethane (PU) foam of used cot mattresses as determinants of bacterial population density. Methods and Results: Used infant mattresses (n = 30) were analysed for bacteria capable of degrading colloidal PU and for aqueous soluble chemical components (aromatic amines, ammonium ions, phosphates and protein). Mattress type (waterproof cover vs exposed PU foam at the infant‐head region), mattress age and previous use by another child were evaluated as factors that could influence the measured parameters. The levels of protein extracted from PU foam were (i) significantly (P = 0·0019) higher for mattresses lacking a waterproof cover at the infant‐head region and (ii) positively correlated with both culturable bacterial population densities of the PU foams and extent of growth of Staphylococcus aureus on aqueous leachates. No statistically significant (P > 0·05) associations between other measured parameters and mattress type/use factors were identified. Conclusions: Infant use of cot mattresses with exposed PU foam leads to accumulation of proteins within the PU, which can promote bacterial growth. Significance and Impact of the Study: The study provides a mechanistic explanation for increased levels of bacteria associated with exposed PU of cot mattresses. In the context of the common bacterial toxins hypothesis for the sudden infant death syndrome (SIDS), this could explain the lowered risk of SIDS associated with use of a waterproof cover above the mattress.     

Effect of Different Levels of Pressure Relieving Air-Mattress Firmness on Cough Strength

Cough is an important host-defense mechanism. The elderly and patients who are severely ill cannot cough effectively when lying in the supine position. Furthermore, pressure relieving air-mattresses are recommended for preventing the development of pressure ulcers. In this study, we clarified whether or not the cough peak flow (CPF), an index of cough strength, is affected by different firmness levels of a pressure relieving air-mattress in healthy volunteers in the supine position. Fifty-two healthy young men participated. All the measurements were carried out on each participant in the supine position on a pressure relieving air-mattress. The participants were assessed at two firmness levels, a “hard” and “soft” mode. The CPF, forced vital capacity (FVC), maximal expiratory pressure (PEmax), and maximal inspiratory pressure (PImax) were determined for each mode. The sinking distance of the body into the mattress was measured without any activity and the difference between the sinking distances of the two firmness levels was determined. The CPF, FVC, PEmax, and PImax were determined for each mode. The sinking distance of the body into the mattress was measured and the difference between the sinking distances of the two firmness levels was determined. The CPF, FVC, PEmax and PImax values of the participants coughing on the mattress were significantly lower when the mattress was in “soft” than in “hard” mode. The differences between the sinking distances of the mattress in “soft” and “hard” modes were larger for the anterior superior iliac spine. A harder mattress may lead to increased CPF in healthy young men lying in the supine position, and increased CPF may be important for host defense.     

Synanthropic Mites of Kolkata, India: An Ecological Appraisal

Ecological observations were made on house dust mites of Kolkata as they form a major part of synanthropic mite community. Dust samples were collected with regard to the abundance of mite in relation to certain socio-ecological parameters like, habitat preference, location of house, construction pattern of house, types of mattresses used and the frequency of cleaning of mattresses. Among two different habitats examined, bed dust contained significantly higher mite population (p < 0.01) than the corresponding bedroom floor dust. The density of total mites and glycyphagids are significantly higher in rural houses in comparison to those of urban houses. In contrast, rural houses contained least number of pyroglyphids/g of dust. The density of total mites as well as pyroglyphid mites/g of dust are higher in mud house in comparison to concrete house. The density of total mites, pyroglyphids and glycyphagids are higher in cotton mattress in comparison to that of foam mattress. The frequency of cleaning has a significant effect on reducing mite densities i.e., the more the frequency of cleaning the lesser are the mite densities.     

An evaluation of mattresses and mats in two dairy units

In order to investigate the relative merits of mats and mattresses in terms of cow comfort, production and performance, 29 cows were housed on ethylethene vinyl acetate (EVA) mats and 29 on mattresses of loose rubber crumb with a polypropylene cover, at each of two similar dairy units (SAC Auchincruive and Myerscough). Both mats and mattresses were newly installed at the start of the trial. The cows were housed in the autumn after calving. Milk yield was recorded daily. Cows were weighed and scored for body condition, locomotion, dirtiness and hock and knee injury at fortnightly intervals. Feed offered was recorded daily and refusals were weighed weekly. Monthly milk records of milk yield, milk composition and somatic cell count data were available for both herds. In addition, 24 h behavioural observations of 15 core cows in each group were made at weeks 0, 2, 4, 6, 8, 16, and 32 post-housing. There was no difference between cows on mats and mattresses in milk yield, composition or quality; in feed intake; in weight loss or body condition score; in severe hock or knee injury, or in the incidence of lameness. Cows on mattresses tended to have slightly higher total dirtiness scores than those on mats (7.06 vs. 6.95, P=0.074) and had dirtier udders (mattress, 7.50 vs. mat, 6.52, P<0.05). However, over the whole housing period, cows on mattresses spent longer feeding, ruminating and lying and a greater proportion of their lying time was spent ruminating. They spent less time standing doing nothing (idling) than cows on mats and less time idling in cubicles. Cows on mattresses appeared to adapt to housing more quickly than those on mats. Overall, neither mat nor mattress gave advantages in terms of production or performance, cows were slightly cleaner on mats but behavioural indices suggest that cow comfort was greater on mattresses.     

Usage of high‐performance mattresses for transport of Indo‐Pacific bottlenose dolphin

Ground transport can be a stressful operation for dolphins if the long period of restraint causes damage to internal organs, especially to the lung, generated by their own weight. Buoyancy is deprived from dolphins under moist transport, in which dolphins are transported on mattresses. Upgrading mattresses is an effective way to modify the transportation method so as to compensate for the loss of buoyancy. In Indo‐Pacific bottlenose dolphins (Tursiops aduncus), we tried to find mattresses that performed well at distributing the dolphins' weight and preserved their pulmonary function. When using EV‐17 (thickness, 50 mm) put on EE‐20 (thickness, 50 mm), a wider support area, less extreme changes in pressure, and lower maximum pressures were observed compared with other mattress systems tested. On this mattress system, lower breathing rates, lower heart rates, and higher exhaled CO₂ concentrations were shown compared with using standard mattresses. These results suggest that the performance of the combination of EV‐17 and EE‐20 is better than that of the standard mattress in terms of the cardiopulmonary function of dolphins. Zoo Biol 27:331–340, 2008. © 2008 Wiley‐Liss, Inc.     

Aerial release of bacteria from cot mattress materials and the sudden infant death syndrome

AIM: To investigate aerial release of bacteria from used cot mattresses and to assess factors that may influence this process. METHODS AND RESULTS: Movement on used mattresses, simulating that of an infant's head, significantly enhanced aerial release of naturally acquired bacteria from the polyurethane foams (total count data, P = 0.008; Staphylococcus aureus, P = 0.004) or from polyvinyl chloride covers (total count data, P = 0.001). Aerial release of naturally acquired bacteria from used cot mattresses showed high variability and was poorly correlated (R2 < or = 0.294) with bacterial cell density within the materials. In experiments involving inoculation of S. aureus and Escherichia coli onto the polyurethane of unused cot mattresses, aerial release of the species correlated well (R2 > or = 0.950) with inoculation density when simulated infant head movement was applied. Aerial release of these bacterial species from the material decreased with increase in width or aqueous content of the material, and was lower from polyurethane foam of a used cot mattress. CONCLUSIONS: Simulated infant movement and mattress related factors influence aerial release of bacteria from cot mattress materials. With simulated infant movement on cot mattress polyurethane foam, levels of airborne bacteria above the material are proportional to bacterial population levels inoculated onto the material. SIGNIFICANCE AND IMPACT OF THE STUDY: Cot mattresses harbouring relatively high levels of naturally acquired toxigenic bacteria, such as S. aureus, could pose a relatively high risk of infection to the infant's respiratory tract through increased aerial contamination. This has impact in the context of recent findings on cot mattress related risk factors for sudden infant death syndrome.     

Encasing mattresses in black plastic will not provide thermal control of bed bugs, Cimex spp. (Hemiptera: Cimicidae)

The suggestion that bed bug (Cimex spp.; Hemiptera: Cimicidae)-infested mattresses wrapped in black plastic and exposed to sunlight will be heated sufficiently to kill the bed bugs was tested. Two types of mattresses were tested: a thin mattress of solid foam rubber and a thick multilayered inner spring mattress. Temperature probes were placed on both upper and lower sides of the mattresses, which were wrapped in black plastic and placed outside on a summer day for >9 h wherein the ambient temperature peaked at 36.5 degrees C. The maximum recorded temperature on the upper (sun-exposed) sides was 85 degrees C for both mattresses, whereas lower side temperatures for the thick mattress never exceeded 35 degreesC, and some areas of the thin mattress failed to exceed 36.50C. Therefore, with published thermal death points of 40-45 degrees C depending on exposure time, and opportunities for bed bugs to avoid lethal temperatures by retreating from hot zones, this technique seems to be not suitable for bed bug management.     

Less frequent turning intervals and yet less pressure ulcers

The aim of the doctoral dissertation summarised here, was to study the effect of different turning intervals and to optimise this method of pressure ulcer prevention. Prior to the main study, the pressure reducing effect of mattresses, cushions, sitting and lying positions was investigated. Based on the results of 3 pre-studies, 4 different turning schemes were compared in a randomised controlled trial in 838 high-risk nursing home residents. Turning every 4 hours in combination with the use of a pressure reducing viscoelastic mattress reduced the number of pressure ulcers significantly compared to the other 3 schemes: turning every 6 hours on a viscoelastic mattress, and turning every 2 or 4 hours on a non-pressure reducing mattress.     

Age-Related Circadian Rhythm of DHEAS Plasma Levels in Male Subjects

The aging influences the endocrine temporal structure, including DHEAS which can be considered as a biomarker of aging, since its levels gradually decrease in older subjects. The aim of this work was to observe the circadian rhythms of DHEAS, prolactin, cortisol and body temperature, in healthy elderly male subjects (73.7 ± 2.5 years) compared with healthy young subjects (27.2 ± 6.6 years). The results documented that in our subjects no significant age-related differences in prolactin levels existed. In elderly subjects cortisol levels were weakly enhanced in comparison with young subjects. DHEAS showed a preserved circadian rhythm, but markedly lower rhythm adjusted mean (74.38 ± 10.29 versus 273.63 ± 26.39) (p &lt; 0.001) and decreased amplitude of oscillation (p &lt; 0.001), when expressed as absolute value, in elderly subjects when compared with young subjects. In elderly subjects the DHEAS circadian rhythm modifications could represent an impairment of of the endocrine temporal structure.     

Urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) as a marker of oxidative stress in rheumatoid arthritis and aging: effect of progressive resistance training

Urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG), as a measure of oxidative stress, was measured before and after 12 weeks of progressive resistance strength training in 8 healthy elderly (65–80 yr) and eight healthy young (22–30 yr) men and women, and in eight adults (25–65 yr) with rheumatoid arthritis (RA).Training subjects exercised at 80% of their one-repetition maximum and performed eight repetitions per set, three sets per session, on a twice-weekly basis. 8-OHdG was measured at baseline and follow-up (at least 24 hr after the last exercise session) in the RA and elderly subject groups, and at baseline only in young subjects.Baseline 8-OHdG levels were greater among subjects with RA compared to both healthy young (P < 0.001) and elderly (P < 0.05) subjects. There were no changes in 8-OHdG levels in either RA or elderly subjects as a result of the strength training intervention.These results suggest that subjects with RA have higher levels of oxidative stress than young and elderly healthy individuals. Furthermore, there is no change in oxidative stress, measured by urinary 8-OHdG, in elderly healthy individuals or in subjects with RA after a 12-week strength training intervention.     

Measurement of soft tissue thickness over the sacrum of elderly hospital patients using B-mode ultrasound

The thickness of soft tissues over the sacrum of elderly hospital in-patients has been measured using B-mode ultrasound. Forty patients were scanned, of which nine had recognizable superficial pressure sores at the sacrum. No correlation was found between the depth of soft tissue and either age or Norton score. Patients with sores had less soft tissue over the sacrum (p < 0.025). Excluding one patient whose sacral sore appeared to be the final stage of the healing process, the remaining eight all had less than 8.5 mm of sacral soft tissue cover. Five patients without sacral sores also had less than 8.5 mm of sacral soft tissue cover. However, a combination of the presence of incontinence and the depth of sacral soft tissue cover identified seven of the eight patients with sacral sores with no inclusion of patients without sores.     

Iron deficiency anemia induces postural control disorders in young women

BackgroundDue to menstruation and restrictive dietary practices, women are at a particular risk of iron deficiency anemia (IDA). This hematologic manifestation could impair postural control as it induces fatigue, muscle weakness, cognitive and neurological functions alteration.AimThis study aimed to investigate IDA effects on postural control in young women in comparison to healthy counterparts.Material and methodsTwenty-four young women with IDA and twenty-four controls participated in this study. Center of pressure (CoP) excursions, in the bipedal and semi-tandem postures on the firm and foam surfaces in the eyes opened (EO) and closed (EC), were recorded, and Romberg index was calculated to evaluate postural control. Besides physical performance, attentional capacity, fatigue, and heart and respiratory rates were assessed.ResultsYoung women with IDA had significantly higher CoP velocity (CoPv) values in the bipedal posture in both vision and surface conditions (EO [firm: P < 0.001 and foam: P < 0.01]; EC: P < 0.001), as well as in the semi-tandem posture (EO [firm: P < 0.01 and foam: P < 0.001]; EC: P < 0.001) compared to controls indicating that they had worse postural control than their peers. In addition, values of the respiratory rate (P < 0.001), attentional capacity (P < 0.001), physical performance (P < 0.001), fatigue (P < 0.001), and Romberg index on the foam surface in both postures (P < 0.05) were significantly higher in young women with IDA compared to controls.ConclusionsPhysical performance, fatigue, tachypnea and attentional capacity resulting from IDA may explain postural control disorder in young women.     

House dust mite allergens in domestic homes in Cheonan, Korea

House dust mites produce inhalant allergens of importance to allergic patients. We measured the major group 1 allergens, Der p 1 and Der f 1, from the house dust mites Dermatophagoides pteronyssinus and Dermatophagoides farina, respectively in 100 randomly selected domestic homes from Cheonan, Korea. Dust samples were collected by vacuuming from the living room floor and 1 mattress in each home. Der p 1 and Der f 1 were measured by double monoclonal ELISA. Der p 1 levels were very low, with geometric mean levels for floors and mattresses being 0.11 microgram/g (range: 0.01-4.05) and 0.14 microgram/g (range: 0.01-30.0), respectively. Corresponding levels of Der f 1 were higher, 7.46 microgram/g (range: 0.01-262.9) and 10.2 microgram/g (range: 0.01-230.9) for floors and mattresses, respectively. D. farinae appears to be the dominant house dust mite in Cheonan.     

Antihypertensive efficacy of alpha-methyldopa,chlorothiazide and Supres-150 (alpha-methyldopa-chlorothiazide).

Twenty-two white men and two white women with uncomplicated essential hypertension participated in a randomized double-blind trial comparing placebo with alpha-methyldopa (750 mg/d orally) and chlorothiazide (450 mg/d orally), alone or in combination. There were no significant differences in blood pressures as measured with the patients lying down; however, with the patients standing the systolic, diastolic and mean arterial blood pressures were significantly lower (P < 0.05) after treatment with alpha-methyldopa or the combination product. The higher the blood pressure before treatment, the greater the fall with treatment. Adverse effects were infrequent.     

House-dust mite (Pyroglyphidae) populations in mattresses,and their control by electric blankets

A reduction in house-dust-mite populations of 19–84% in beds in regular use could be achieved by heating the mattresses with electric blankets, when the beds were not being slept on. The effect of the heating treatment on the temperature and relative humidity inside the mattress is discussed. Housedust mites in the heated portions of the mattress migrated deeper inside the mattress to a depth of 3.5–5.0 cm. Evidence was also found that house-dust mites in non-heated mattresses do not only live near the surface, but that they are also present deep inside the mattress.This investigation was supported by a research grant from the Nederlands Astma Fonds.     

Comparison of carpal canal pressure in paraplegic and nonparaplegic subjects: clinical implications

The purpose of this study was to evaluate the pressure within the carpal tunnel that was generated with certain tasks in paraplegic versus nonparaplegic subjects. Four groups of subjects were evaluated: 10 wrists in six paraplegic subjects with carpal tunnel syndrome, 11 wrists in six paraplegics without the syndrome, 12 wrists in nine nonparaplegics with the syndrome, and 17 wrists in 11 nonparaplegics without the syndrome. Carpal canal pressures were measured in the wrists in three positions (neutral, 45-degree flexion, 45-degree extension) and during two dynamic tasks [wheelchair propulsion and RAISE (relief of anatomic ischial skin embarrassment) maneuver]. External force resistors were placed over the carpal canal and correlated with internal tunnel pressures. At each wrist position, paraplegics with carpal tunnel syndrome consistently had higher carpal canal pressure than did the other groups at the corresponding wrist position; statistical significance was evident with regard to the neutral wrist position (p < 0.05). Within each group of subjects, wrist extension and wrist flexion produced a statistically significant increase in carpal canal pressure (p < 0.05), compared with the neutral wrist position. Dynamic tasks (wheelchair propulsion and the RAISE maneuver) significantly elevated the carpal canal pressure in paraplegics with carpal tunnel syndrome, compared with the other groups (p < 0.05). Lastly, there is a linear positive correlation between carpal canal pressure and external force resistance.     

Expression of IAP family proteins in colon cancers from patients with different age groups

Members of the inhibitor of apoptosis protein (IAP) family including survivin, are expressed in many tumors. However, age-related changes in their expression in cancer have not been clarified. Thus, we investigated the expression of mRNA-coding for IAP family proteins in colon cancer samples from young (<70 years of age) and elderly (>70 years) patients by real-time quantitative RT-PCR. Samples were collected from cases with well-differentiated adenocarcinoma or moderately differentiated adenocarcinoma and their adjacent normal epithelial tissue. Well-differentiated adenocarcinoma tended to express higher levels of survivin than normal mucosa, and expression in moderately differentiated adenocarcinoma was significantly greater than in normal mucosa in samples from both groups of patients (p<0.05, respectively). When samples were compared between the different age groups, the normal mucosa exhibited similar levels of survivin expression. However, samples from older patients showed a significantly higher level of expression than those from younger patients in well and moderately differentiated adenocarcinomas (p<0.05, respectively). In contrast, the levels of expression of cIAP1, cIAP2, and NAIP in the cancerous tissues were lower than those found in normal mucosa regardless of age. As for age-related changes, the expression of cIAP2 in normal mucosa and moderately differentiated adenocarcinoma was stronger in the elderly group than the young group (p<0.05, respectively), and NAIP expression in well-differentiated adenocarcinoma was higher in the young group than the elderly group (p<0.05). XIAP expression was similar in normal and cancerous tissues in both the young and elderly groups. These results suggest that the expression of IAP family proteins, especially survivin, is associated with the age-related biological characteristics of colon cancer.     

Determinants of skin contact pressure formation during non-invasive ventilation

There is no published data about mask features that impact skin contact pressure during mask ventilation.To investigate the physical factors of skin contact pressure formation.We measured masks with original and reduced air cushion size and recorded contact pressure. We determined cushion contact and mask areas by planimetric measurements.Contact pressures necessary to prevent air leakage during inspiration exceed inspiratory pressure by 1.01±0.41 hPa independent of cushion size.Contact area, ventilator pressure and mask area during inspiration and expiration impact contact pressure. Mask contact pressures are higher during expiration. The contact pressure increases with increase in inspiratory pressures independent of the ventilator cycle. During expiration, the contact pressure will increase in proportion to the expiratory pressure reduction of the ventilator. The mask with reduced air cushion size developed higher contact pressures.Contact pressure can be reduced by selecting masks with a small mask area in combination with a large mask cushion.