Foam Pillows Research Articles

Cervical Spine Motion Generated With Manual Versus Jackson Table Turning Methods in a Cadaveric C1–C2 Global Instability Model

STUDY DESIGN.: Cadaveric biomechanical study. OBJECTIVE.: To quantify spinal motion created by transfer methods from supine to prone position in a cadaveric C1-C2 global instability model. SUMMARY OF BACKGROUND DATA.: Patients who have sustained a spinal cord injury remain at high risk for further secondary injury until their spine is adequately stabilized. To date, no study has evaluated the effect of patient transfer methods from supine to prone position in the operating room, on atlantoaxial cervical spine motion. METHODS.: A global instability was surgically created at the C1-C2 level in 4 fresh cadavers. Two transfer protocols were tested on each cadaver. The log-roll technique entailed performing a standard 180 degrees log-roll rotation of the supine patient from a stretcher to the prone position onto the operating room Jackson table (OSI, Union City, CA). The "Jackson technique" involved sliding the supine patient to the Jackson table, securing them to the table, and then rotating them into a prone position. An electromagnetic tracking device registered motion between the C1 and C2 vertebral segments. Three different head holding devices (Mayfield, Prone view, and blue foam pillow) were also compared for their ability to restrict C1-C2 motion. Six motion parameters were tracked. Repeated measures statistical analysis was performed to evaluate angular and translational motion. RESULTS.: For 6 of 6 measures of angulation and translation, manual log-roll prone positioning generated significantly more C1-C2 motion than the Jackson table turning technique. Out of 6 motion parameters, 5 were statistically significant (P < 0.001-0.005). There was minimal difference in C1-C2 motion generated when comparing all 3 head holding devices. CONCLUSION.: The data demonstrate that manual log-roll technique generated significantly more C1-C2 motion compared to the Jackson table technique. Choice of headrest has a minimal effect on the amount of motion generated during patient transfer, except that the Mayfield device demonstrates a slight trend toward increased C1-C2 motion.

Are Pressure Redistribution Surfaces or Heel Protection Devices Effective for Preventing Heel Pressure Ulcers?

Heel pressure ulcers are recognized as second in prevalence only to pressure ulcer (PU) on the heel among hospitalized patients, and recent studies suggest their incidence may be higher than even sacral ulcers. We systematically reviewed the literature to identify and evaluate whether pressure redistribution surfaces or heel protection devices are effective for the prevention of heel ulcers. We searched CINAHL and MEDLINE databases, using the keywords "pressure ulcer" and "heel," which we also searched the Cochrane Library, using the key terms "pressure ulcer," "heel," and "support surface." We hand searched the ancestry of pertinent research reports and review articles in order to identify additional studies. Inclusion criteria were (1) any study that compared one or more pressure redistribution surfaces or heel protection devices designed specifically to prevent heel PU and (2) any study comparing 2 or more pressure redistribution surfaces designed to prevent PU that specifically reported differences in the incidence of heel PU. Exclusion criteria were (1) studies that did not measure heel PU incidence as an outcome, (2) studies without an English language abstract, and (3) studies that reported overall PU incidence but did not analyze heel PU incidence separately. Clinical evidence concerning the efficacy of pressure redistribution surfaces or heel protection devices is sparse. Existing evidence suggests that pressure redistribution surfaces vary in their ability to prevent heel pressure ulcers, but there is insufficient evidence to determine which surfaces are optimal for this purpose. A single study suggests that a wedge-shaped viscoelastic foam cushion is superior to standard foam pillows for preventing heel PU, but further research is needed before a definitive conclusion concerning this issue can be reached. There is insufficient evidence to determine whether heel protection devices are more effective than a standard hospital foam pillow for the prevention of heel PU. Research is urgently needed to determine the effectiveness of available heel protection devices for the prevention of heel PU. Studies should address efficacy among the available products and compare efficacy to standard foam pillows. Given the paucity of clinical evidence, clinical decisions about the selection of an optimal device for preventing heel PU rely on a combination of existing evidence and clinical experience. While pressure redistribution devices may reduce tissue interface pressures at the heels, expert opinion and clinical experience concur that elevation of the heel is indicated to both reduce pressure and prevent shear and friction caused by frequent movement of the heel due to restlessness, reflex movements of the legs, or voluntary movement. A variety of heel protection devices are available that are designed to both relieve tissue interface pressure and protect the heel from shear and friction. Considerations for selecting an optimal heel protection device include its ability to elevate the heel off the underlying support surface while preventing foot-drop and rotation of the leg, the boot's ability to wick away temperature, its ability to be cleaned, whether it allows patient ambulation, its ability to remain in place despite patient movement, and its ability to remain in place without causing pressure to other surfaces of the foot.

Pillow use: The behaviour of cervical pain, sleep quality and pillow comfort in side sleepers

A random allocation single blind block design pillow field study was undertaken to investigate the behaviour of cervico-thoracic spine pain in relation to pillow use. Participants ( N = 106) who reported preference for side sleep position with one pillow were recruited via a telephone survey and newspaper advertisement. They recorded sleep quality and pillow comfort ratings, frequency of retiring and waking cervical pain and duration of waking cervical pain while sleeping for a week on their usual pillow, polyester, foam, feather and rubber pillows of regular shape and a foam contour pillow. Analysis was undertaken comparing sleep quality, pillow comfort, waking and temporal cervical pain reports, between the usual pillow and the trial pillows, between pillows of differing content and foam pillows of differing shape. This study provides evidence to support recommendation of rubber pillows in the management of waking cervical pain, and to improve sleep quality and pillow comfort. The rubber pillow performed better than subjects' own pillow in most instances. Subjects' own pillow performed similarly to foam and polyester pillows, and there is no evidence that the use of a foam contour pillow has advantages over the regular shaped pillows. Feather pillows should not be recommended.

Cervical Spine Motion in Manual Versus Jackson Table Turning Methods in a Cadaveric Global Instability Model

A study of spine biomechanics in a cadaver model. To quantify motion in multiple axes created by transfer methods from stretcher to operating table in the prone position in a cervical global instability model. Patients with an unstable cervical spine remain at high risk for further secondary injury until their spine is adequately surgically stabilized. Previous studies have revealed that collars have significant, but limited benefit in preventing cervical motion when manually transferring patients. The literature proposes multiple methods of patient transfer, although no one method has been universally adopted. To date, no study has effectively evaluated the relationship between spine motion and various patient transfer methods to an operating room table for prone positioning. A global instability was surgically created at C5-6 in 4 fresh cadavers with no history of spine pathology. All cadavers were tested both with and without a rigid cervical collar in the intact and unstable state. Three headrest permutations were evaluated Mayfield (SM USA Inc), Prone View (Dupaco, Oceanside, CA), and Foam Pillow (OSI, Union City, CA). A trained group of medical staff performed each of 2 transfer methods: the "manual" and the "Jackson table" transfer. The manual technique entailed performing a standard rotation of the supine patient on a stretcher to the prone position on the operating room table with in-line manual cervical stabilization. The "Jackson" technique involved sliding the supine patient to the Jackson table (OSI, Union City, CA) with manual in-line cervical stabilization, securing them to the table, then initiating the table's lock and turn mechanism and rotating them into a prone position. An electromagnetic tracking device captured angular motion between the C5 and C6 vertebral segments. Repeated measures statistical analysis was performed to evaluate the following conditions: collar use (2 levels), headrest (3 levels), and turning technique (2 levels). For all measures, there was significantly more cervical spine motion during manual prone positioning compared with using the Jackson table. The use of a collar provided a slight reduction in motion in all the planes of movement; however, this was only significantly different from the no collar condition in axial rotation. Differences in gross motion between the headrest type were observed in lateral bending (Foam Pillow<Prone View, P=0.045), medial lateral translation (Foam Pillow<Mayfield, P=0.032), and anterior posterior translation (Prone View<Mayfield, P=0.030). The data suggest that the manual transfer technique produces 2 to 3 times more cervical spine angular motion than the Jackson table method of transfer. The use of a collar provides significant benefit in limiting spine motion that is only observed in axial rotation. Choice of headrest does have a significant effect on the amount of motion allowed during turning, with the Foam Pillow and Prone View generally providing more effective stabilization compared with the Mayfield.

Symptoms of asthma and atopic disorders in preschool children: prevalence and risk factors

Published epidemiological data suggested that asthma and allergies may be increasing in preschool children. Identification of the risk factors is important for planning possible early intervention to prevent asthma. This study was designed to measure the prevalence of, and risk factors for, asthma and atopic disorders in preschool children from Hong Kong. Children aged 2-6 years living in Hong Kong were recruited through the local nurseries and kindergartens for this study to ascertain the presence of symptoms of asthma and various possible risk factors. The parental questionnaire was developed based on the International Study of Asthma and Allergies in Childhood questionnaire. A total of 3089 children (1506 boys) from 14 nurseries and kindergartens participated in this study. The prevalence of wheeze ever and current wheeze were 16.7% and 9.3%. Two hundred and thirty-four subjects were born in mainland China and migrated to Hong Kong subsequently. When compared with children born and raised in Hong Kong, children born in mainland China had significantly lower prevalence of current wheeze (3.4% vs. 9.6%, P<0.01). Two environmental factors in the first year of life were associated with wheezing attacks within the last 12 months. They were the use of foam pillow (Odds ratio: 1.45; 95% Confidence interval: 1.04-2.00) and the use of gas as cooking fuel (1.68; 1.03-2.75). Frequent use of paracetamol was also associated with wheezing attack in the past 12 months. This study confirms the high prevalence of symptoms of atopic disorders in preschool children from Hong Kong. Early environmental exposure factors are important determinants of subsequent development of asthma symptoms in the preschool years. Further studies are needed to evaluate the possible pathogenetic role of the identified risk factors.

만성 목 통증 환자의 인간공학 베개 효과

The object of this study is to examine the relative efficacy of three types of pillows(ordinary pillow, memory foam pillow, and ergonomic pillow) for chronic neck pain. The subjects were 98 patients who were randomly divided into three groups corresponding to each of the three types of pillows. All subjects were assessed with the same measurements before and after sleep, and their level of satisfaction in the pillows was assessed on the last day of the study. There were no significant changes in the level of pain with the use of ordinary pillows and memory foam pillows, but the group using ergonomic pillows showed a significant decreases in the level of pain(p?0.05). The sleeping time and quality and the time to fall in sleeping showed significant differences among the three groups and the ergonomic pillow group showed a significant increase compared to the ordinary pillow group and memory foam group(p?0.05). The satisfaction of pillows showed significant difference among the three groups and the ergonomic pillow group showed a significant increase in the level of satisfaction compared to the ordinary pillow group and memory foam group(p?0.05). In conclusion, the ergonomic pillows may improve alleviation of pain, sleeping quality and the satisfaction of pillow compared to the ordinary pillow and the memory foam pillow for chronic neck pain.

Preoperative skin traction or pillow nursing in hip fractures: A prospective, randomized study in 123 patients

Purpose: To study the influence on pain and handling of different preoperative immobilization procedures for hip fractures.Method: 123 consecutive patients with displaced cervical and trochanteric hip fractures were randomized to skin traction, placement in a special foam pillow (Lasse pillow), and comfortable placement with an ordinary pillow under the hip from admission to operation. The effect on pain alleviation was evaluated with a Visual Analogue Scale and by the number of doses of analgesics administered. The processing time through the emergency department, X-ray department and to the ward as well as time to operation was registered.Results: No clinically significant difference in the VAS pain evaluation was found. There was no difference in the total consumption of analgesics in the emergency department or on the ward and no effect of immobilization type on the processing time or time to operation. Fracture type did not affect the outcome. Approximately one third of the patients found placement on a regular pillow or the application of skin traction uncomfortable as opposed to only one of 19 of the patients lying in the special Lasse pillow. There was no other difference in processing time with regard to different forms of pillow nursing and skin traction.Conclusion: The most convenient immobilization should be chosen as there is no significant difference concerning pain and handling time. Increased attention to analgesic medication and rapid handling to be operated are of importance to promote the rehabilitation process.

Factors associated with difference in prevalence of asthma in children from three cities in China: multicentre epidemiological survey

Objective To determine the factors associated with difference in prevalence of asthma in children in different regions of China.Design Multicentre epidemiological survey.Setting Three cities in China.Participants 10 902 schoolchildren aged...

Transformation of Chlorofluorocarbons Through Catalytic Hydrodehalogenation

Chlorofluorocarbons (CFCs), which were discovered as early as in 1930 by Thomas Midgley, find a variety of industrial applications. They have four basic uses: (i) Refrigerants, (ii) Foam blowing agents, (iii) Cleaning agents and (iv) Propellants. As refrigerants, CFCs are used in freezers, refrigerators and in air conditioning units in automobiles and buildings. As blowing agents CFCs are used in making both rigid foam which appears in items such as foam ice chests and fast-food hamburger boxes, and flexible foam used in furniture cushions and foam pillows. As cleaning agents they wash hundreds of products in electronic and other industries ranging from computer chips to artificial hip joints. In addition to their application as propellants, these are also used in aerosol sprays. CFCs are also used in fire extinguishing units and urethane shoe soles.

A clutch of new syndromes

In the ENT subsection of his paper (March 2002 JRSM1) Dr Le Fanu quotes a patient's description of sore ear, affecting a ‘line of rigid muscle alongside the soft outer ear’. Whilst there exist fine muscles on the posterior, or cranial, surface the skin adheres closely to the anterior, or lateral, surface of the auricle, which has very little subcutaneous tissue2. Seemingly the patient refers to a fold in the elastic cartilage known as the antihelix. The symptoms in this case closely resemble those of chondrodermatitis nodularis helicis. Histologically such lesions show focal degenerative change with surrounding perichondritis and overlying hyperkeratosis and acanthosis3. The usual treatment is simple excision, but a patient who declined surgery later told me how he had invented his own method to avoid discomfort at night—cutting a hollow into his foam pillow to reduce pressure on the ear.

Components of variance when assessing there producibility of body composition measurements using bio-impedance and the Hologic QDR-2000 DXA scanner

This study evaluated the reproducibility of measuring lean tissue mass (LTM), fat mass(FM DXA), bone mineral content (BMC) and density (BMD) with a Hologic QDR-2000 DXA scanner, and both fat free mass (FFM bio) and fat mass (FM bio) with an impedance meter. Furthermore, the study aimed to assess whether sheets and pillows significantly altered the DXA results. Fifty-one healthy volunteers aged 20–61 years were examined before and after repositioning ( n = 20), removal of the sheets ( n = 10), addition of two foam pillows ( n = 11) or a regular pillow ( n = 10). One to 7 days later a re-examination was performed ( n = 35). Eight surgical patients were also scanned twice 1–7 days apart. The day to day coefficients of variation were about 1% for most measurements, though more than 2%for FM DXA, and FM bio. For total tissue mass, LTM, and BMC there was a significant biological day to day variance whereas for the other measurements the day to day variation could be accounted for by just measurement variance. Pillows systematically changed the estimates of bone mineral and soft tissue, but sheets did not.

A precision repeat localization head frame for fractionated stereotactic radiotherapy

An immobilization device was constructed for Fractionated Stereotactic Radiotherapy (FSRT) based on registration of the teeth and facial bones in a single thermoplastic mask system, along with a custom hardened foam pillow for posterior head immobilization relative to the mask. The unit interfaces mechanically with all of our current radiosurgery equipment and can be used with any standard stereotactic planning system. After initial trials to design a reproducible radiographic localization test, we performed a series of daily AP and Lateral port films on 3 patients over five isocenters. Seventy-nine films were reviewed and the maximum deviation in anatomical projection in both sagittal and coronal planes was less than 2 mm, with over 60% of films showing no distinguishable deviations from initial port films. Ninety-three percent of the test films showed a repositioning accuracy of less than 1 mm for all tested structures. We have developed an accurate, non-invasive means of repeat head immobilization that, when properly constructed, can facilitate precise fractionated stereotactic radiation therapy with patient comfort, ease of construction and long term stability.

Home environment and severe asthma in adolescence: a population based case-control study

To investigate the effects of the home environment on the risk of severe asthma during adolescence. A questionnaire based case-control study drawn from a cross sectional survey of allergic diseases among secondary school pupils in Sheffield in 1991. 763 children whose parents had reported that over the previous 12 months they had suffered either 12 or more wheezing attacks or a speech limiting attack of wheeze. A further 763 children were frequency matched for age and school class to act as controls. Analysis was restricted to 486 affected children and 475 others born between 1975 and 1980 who had lived at their present address for more than three years. Independent associations with severe wheeze were seen for non-feather bedding, especially foam pillows (odds ratio 2.78; 95% confidence interval 1.89 to 4.17), and the ownership of furry pets now (1.51; 1.04 to 2.20) and at birth (1.70; 1.20 to 2.40). These estimates were derived from subjects whose parents denied making changes in the bedroom or avoiding having a pet because of allergy. Parental smoking, use of gas for cooking, age of mattress, and mould growth in the child's bedroom were not significantly associated with wheezing. Either our study questionnaire failed to detect the avoidance or removal of feather bedding by allergic families or there is some undetermined hazard related to foam pillows. Synthetic bedding and furry pets were both widespread in this population and may represent remediable causes of childhood asthma.