Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PALPATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 775 records · Page 43Linked to original sources
PubMed1998

Craniosacral rhythm: reliability and relationships with cardiac and respiratory rates.

Craniosacral rhythm (CSR) has long been the subject of debate, both over its existence and its use as a therapeutic tool in evaluation and treatment. Origins of this rhythm are unknown, and palpatory findings lack scientific support. The purpose of this study was to determine the intra- and inter-examiner reliabilities of the palpation of the rate of the CSR and the relationship between the rate of the CSR and the heart or respiratory rates of subjects and examiners. The rates of the CSR of 40 healthy adults were palpated twice by each of two examiners. The heart and respiratory rates of the examiners and the subjects were recorded while the rates of the subjects' CSR were palpated by the examiners. Intraclass correlation coefficients were calculated to determine the intra- and inter-examiner reliabilities of the palpation. Two multiple regression analyses, one for each examiner, were conducted to analyze the relationships between the rate of the CSR and the heart and respiratory rates of the subjects and the examiners. The intraexaminer reliability coefficients were 0.78 for examiner A and 0.83 for examiner B, and the interexaminer reliability coefficient was 0.22. The result of the multiple regression analysis for examiner A was R = 0.46 and adjusted R2 = 0.12 (p = 0.078) and for examiner B was R = 0.63 and adjusted R2 = 0.32 (p = 0.001). The highest bivariate correlation was found between the CSR and the subject's heart rate (r = 0.30) for examiner A and between the CSR and the examiner's heart rate (r = 0.42) for examiner B. The results indicated that a single examiner may be able to palpate the rate of the CSR consistently, if that is what we truly measured. It is possible that the perception of CSR is illusory. The rate of the CSR palpated by two examiners is not consistent. The results of the regression analysis of one examiner offered no validation to those of the other. It appears that a subject's CSR is not related to the heart or respiratory rates of the subject or the examiner.

Adult↗
PubMed1999

Defining the role of haptic feedback in minimally invasive surgery.

INTRODUCTION: The applications of Minimally Invasive Surgery (MIS) and Laparoscopy are rapidly expanding. Despite this expansion, the technology related to our understanding of the importance of haptic feedback related to laparoscopic surgery remains in its infancy. While many surgeons feel that the use of minimally invasive techniques eliminates force feedback and tactile sensation, the importance of haptics in MIS has not been fully evaluated. Moreover, there is considerable interest in the development of haptic simulators for MIS even though the importance of force feedback remains poorly understood. This study was designed to determine the ability of novice surgeons to interpret haptic feedback with respect to texture, shape and consistency of an object. METHOD: Subjects were presented objects in a random order and participants were blinded as to their identity. Inspection by direct palpation, palpation with conventional instruments, and palpation with laparoscopic instruments was performed on all objects. Statistical analysis of the data was performed using a Fischer exact probability test. RESULTS: Direct palpation provided the greatest degree of haptic feedback and was associated with the highest accuracy for texture discrimination, shape discrimination, and consistency discrimination. A significant decrease in the ability to identify shapes was noted with both CI and LI. A significant decrease in the ability to differentiate consistency was noted for LI only. When comparing palpation with conventional instruments to palpation with laparoscopic instruments, there was no significant difference in shape or texture discrimination. There was, however, a significant decrease in consistency discrimination. CONCLUSION: This data indicates that laparoscopic instruments do in fact provide the surgeon with haptic feedback. While the instruments change the information available to the surgeon, interpretation of the texture, shape and consistency of objects can be performed. Our ongoing work is directed at further defining force interactions. Through the use of force feedback impulse devices in VR simulators, one should be able to create a more realistic theatre in which the novice surgeon can learn operative skills that will readily translate into the operating room.

Feedback↗
PubMed2005

Role of multimedial diagnosis of breast cancer in women below 36 year of age.

PURPOSE: To evaluate the sensitivity for breast cancer of different diagnostic tests performed in a consecutive series of women aged under 36 years. MATERIALS AND METHODS: The study analyses 155 women with breast cancer incident in the Tuscany Cancer Registry from 1985 to 2000. The sensitivity of each method was evaluated in relation to the most recent test performed during the year before diagnosis and to different variables, such as tumour size and calendar period. RESULTS: Sensitivity was 70.3 % for physical examination, 76.0% for mammography, 69.1% for ultrasonography and 80.6% for cytology (86.2% if inadequate samples are excluded). Sensitivity was associated to pT category for physical examination (pT1=60.6%; pT2-4=86.4%; chi squared=10.2, p= 0.001) and for ultrasonography (pT1=61.9%; pT2-4=92.0%; chi squared=5.7, p=0.01) and to breast radiological density for mammography (50-100% density=75.5%; 0-50% density=91.3%; chi squared=1.85, p<0.17). Among 112 cases examined with palpation, mammography and cytology, these methods had a sensitivity of 78.5%, 75.8% and 91.9%, respectively, and an overall sensitivity of 98.2%. Among 65 cases examined with palpation, ultrasonography and cytology, these methods had a sensitivity of 67.6%, 70.7% and 92.3%, respectively, and an overall sensitivity of 95.3%. Among 123 cases examined with palpation, imaging (mammography and/or ultrasonography) and cytology, these methods had a sensitivity of 76.4%, 78.0% and 90.2%, respectively, and an overall sensitivity of 96.7%. Cancer was suspected by one method only in 2.4% of cases with palpation, 1.6% with imaging and 7.3% with cytology. Comparison between mammography and ultrasonography was possible in 58 cases undergoing both tests: sensitivity was 79.3% for ultrasonography and 74.1% for mammography, respectively chi squared=0.1, p=0.66). If sensitivity had been determined according to the test performed immediately before diagnosis it would have been higher, that is 74.4% for palpation, 76.8% for mammography, 73.5% for ultrasonography and 90.9% for cytology (97.7% if inadequate samples were excluded), and overall sensitivity would be 96.1%. CONCLUSIONS: Differential diagnosis of breast cancer in women aged under 36 years is difficult, sensitivity being lower as compared to older women, with the only exception of cytology. The association of multiple tests (diagnostic imaging and cytology) is crucial to achieve an acceptable false negative rate. In particular, the extensive use of cytology in the presence of an even minimal doubt at palpation and/or imaging is strongly recommendable. Sensitivity must be calculated on the basis of an independent pathology registry, and false negatives must be defined within a given period after the test. Analysis limited to tests performed immediately before diagnosis leads to a biased overestimation of sensitivity.

Adult↗
PubMed2005

Cyclic effects on experimental pain response in women with temporomandibular disorders.

AIMS: Since cyclic effects on experimental pain response in women with temporomandibular disorders (TMD) have not been adequately studied, the aim of this study was to assess variations in experimental pain response at 4 phases of the menstrual cycle. METHODS: Eighteen normally cycling women with TMD, 25 women with TMD and taking oral contraceptives (OC), 25 normally cycling pain-free controls, and 26 pain-free controls taking OC underwent 3 experimental pain procedures at 4 phases during each of 3 menstrual cycles. These procedures included algometer palpations at fixed amounts of pressure and pressure pain thresholds at several body sites, and an ischemic arm pain task. Repeated measures analysis of variance was used to compare cycle phase, TMD group, and OC status differences in experimental pain response. RESULTS: Significant phase-related differences were seen for palpation intensity measures (P values < .05). Normally cycling women with TMD showed higher palpation pain intensity at menses and midluteal phases, while women with TMD taking OC showed stable palpation pain intensity ratings at menses, ovulatory, and midluteal phases, with increased intensity at the late luteal phase. TMD subjects had greater palpation pain and ischemic pain intensity and lower pressure pain thresholds compared to controls. CONCLUSION: Phase-related differences in experimental pain response were not strong and were more often found for experimental stimuli with greater clinical relevance (ie, palpation pain) compared with an ischemic pain task.

Adolescent↗
PubMed2002

Quantitative measurement of post-irradiation neck fibrosis based on the young modulus: description of a new method and clinical results.

BACKGROUND: Postirradiation fibrosis is one of the most common late effects of radiation therapy for patients with head and neck carcinoma. An objective and quantitative method for its measurement is much desired, but the criteria currently used to score fibrosis are mostly semiquantitative and partially subjective. METHODS: The Young Modulus (YM) is a physical parameter that characterizes the deformability of material to stress. The authors measured the YM in soft tissues of the neck, at defined reference points, using an ultrasound probe and computer algorithm that quantified the indentation (deformation) on tissue due to a measured, applied force. One hundred five patients who had received previous radiation therapy to the entire neck were assessed, and the results were compared with the hand palpation scores and with a functional parameter represented by the range of neck rotation, and all results were correlated with symptoms. RESULTS: The YM was obtained successfully in all patients examined. It had a significant positive correlation with the palpation score and a significant negative correlation with the range of neck rotation. The YM was significantly higher on the side of the neck that received a boost dose of radiation, although the corresponding palpation scores were similar. The results of all three measurement methods were correlated with symptoms. CONCLUSIONS: Postirradiation neck fibrosis can be measured in absolute units based on the YM. The results showed a significant correlation with hand palpation scores, with restriction of neck rotation, and with symptoms. Compared with the palpation method, the YM is more quantitative, objective, focused on small subregions, and better discriminates regions subject to differential radiation dose levels. Its inclusion in the Analytic category of the Late Effects of Normal Tissues-SOMA system should be considered to facilitate comparative studies.

Dose-Response Relationship, Radiation↗
PubMed1990

A comparison of measurements of blood pressure, heart-rate and oxygenation during inter-hospital transport of the critically ill.

Critically ill patients transferred between hospitals are often inadequately monitored in transit, with outcome adversely affected. In 22 such patients, we compared direct and palpated measurements of systolic pressure, oscilloscopic and aneroid manometric measurements of mean pressure, ECG and palpated measurements of heart-rate and clinical and oximetric assessments of oxygenation. On average palpated readings of systolic pressure under-read direct readings by 29% and palpated readings of heart-rate under-read ECG readings by 2%. The mean difference between oscilloscopic and manometric readings of mean pressure was zero. Oxygen saturation readings did not reach a level which allowed valid comparison. If direct measurement of heart-rate and blood pressure by battery-powered monitors is not feasible, palpation of heart-rate and manometric measurement of mean arterial pressure are acceptable alternatives during secondary transport of the critically ill.

Adolescent↗
PubMed1995

A clinical, mammographic, sonographic and histologic evaluation of breast cancer.

OBJECTIVE: To evaluate histologic tumor size in comparison with preoperative determination of tumor diameter by palpation, mammography and sonography. METHODS: In a retrospective analysis we compared the histologic, clinical, mammographic and sonographic findings obtained from 160 patients with breast carcinoma. RESULTS: The histologically determined tumors showed an average diameter of 25.7 mm. By comparison, the average tumor diameter determined by mammography, sonography and palpation was 23.8, 26.1 and 30.6 mm, respectively. Mammography was capable of detecting 94.5% of breast carcinomas, breast sonography 91% and palpation 87%. The combinations of mammography and sonography or mammography and palpation detected 99% of carcinomas, and sonography and palpation 95% of carcinomas. CONCLUSION: As supplementary methods to preoperative clinical examination, mammography and breast sonography are mutually complementary, high-resolution imaging techniques of utmost importance in the preoperative diagnosis and surgical treatment of breast cancer patients.

Adult↗
PubMed2003

The association between wear facets, bruxism, and severity of facial pain in patients with temporomandibular disorders.

STATEMENT OF PROBLEM: It is unclear whether patients with temporomandibular disorders (TMD) who report high levels of bruxism have more severe signs and symptoms of TMD and more advanced tooth wear than patients with TMD who report lower levels of bruxism. PURPOSE: The purpose of this study was to determine whether there was a significant association between tooth wear, the parafunctional oral habit of bruxism, temporomandibular joint (TMJ) pain, and muscle pain severity in a TMD population. MATERIAL AND METHODS: A total of 84 subjects previously diagnosed with TMD, according to the Research Diagnostic Criteria for TMD (RDC/TMD) and who met 10 specific inclusion/exclusion criteria underwent a thorough multiaxial examination and classification recommended by the National Institute of Dental and Craniofacial Research (NIDCR). Measurement of tooth wear facets by use of a 4-point scale were graded in 10 zones on mandibular casts. One calibrated examiner performed all scoring. Bruxism was assessed in a standardized pretreatment questionnaire and in the dental history and interview (RDC/TMD) to indicate how frequently (0 = never to 3 = very often) subjects performed a list of oral habits, which included bruxism. The Kappa reliability coefficient (range from: -1.0 to 1.0) was used to correct for chance agreement, and was computed for each of the 10 study sites designated for rating. Subjects were also compared for muscle and joint pain. Muscle pain was a summed measure derived from the dental examination findings (range 0 to 20), calculated from the presence or absence of pain induced by palpation of 20 predetermined muscle sites. Similarly, joint pain was a summed measure of the presence or absence of pain in the TMJs induced by palpation of the joints on the outer surface and in the external auditory canal in 5 different positions of the mandible. A Pearson product-moment correlation was used to compute the summed severity of tooth wear and the subjects' age. Analysis of covariance was used to determine whether the number of wear facets was significantly higher in patients with TMD who reported a history of bruxism, compared with patients with TMD who reported no or minimal bruxism, after controlling for the effect of age. Multivariate analysis of variance was used to determine whether the number of painful muscles of mastication and joint sites on standardized examination were significantly higher in patients with TMD with a history of bruxism (alpha=.05). RESULTS: In the population tested, tooth wear was modestly correlated with age (r =.40, P<.001). Of the 84 subjects studied, 11.9% reported no bruxing activity, 32.1% reported some or occasional bruxing activity, and 47.6% had frequent bruxism activity; the remaining 8.4% were eliminated from analysis because they provided inconsistent responses. Bruxism activity was not correlated with muscle pain on palpation and was inversely associated with TMJ pain on palpation. Tooth wear was not significantly correlated with bruxism, TMJ pain, or muscle pain. CONCLUSIONS: In this TMD population, tooth wear factors did not differentiate patients with bruxism from those without. The amount of bruxism activity was not associated with more severe muscle pain and was associated with less pain in the TMJ on palpation.

Adult↗
PubMed1997

The impact of ultrasound scanning in the staging and follow-up of patients with clinical stage I cutaneous melanoma.

In 85 patients with intermediate to high risk cutaneous melanoma, concomitant palpation and ultrasound scanning (US) of the axillary and inguinal sites were performed in order to detect any locoregional lymph node metastases at pre-operative staging and postoperative monitoring. At 12 months follow-up, US identified 12 out of 13 (92%) histologically proven metastases, while palpation indicated metastatic disease in only 3 (23%) patients. Metastases were intranodal in 6 out of 12 cases detected with US, and extranodal in all the 3 cases identified by palpation, thus confirming that US is more effective than palpation in the early detection of lymph node metastases from melanoma. US was also more effective in discriminating all non-neoplastic lymph nodes: its overall specificity was 100% versus 85% for palpation. Thus, when carried out by well-trained radiologists, US is a very useful diagnostic tool for the surgical oncologist dealing with melanoma patients.

Adult↗
PubMedDate not supplied

Out-of-hospital use of a pulse oximeter to determine systolic blood pressures.

STUDY OBJECTIVE: Blood pressure (BP) in the out-of-hospital setting is one of the most important diagnostic tools used by emergency medical services (EMS) providers. Conventional methods of palpation and auscultation can be time consuming, and the measurements often are inaccurate because of the adverse working conditions encountered. Pulse oximetry waveform systolic blood pressure (POWSBP) measurement has been used successfully in emergency departments to monitor BP. The objective of this study was to compare the accuracy of field POWSBP measurements obtained by noninvasive electronic BP measurement (NIBPM), auscultation, and palpation in the out-of-hospital environment. DESIGN: Blood pressure measurements used for this study were obtained by POWSBP, NIBPM (PROPAQ model 102; Protocol Systems, Beaverton, Oregon USA), auscultation, and palpation on patients in moving ambulances. Measurement of POWSBP was accomplished by observing the return of the waveform on the pulse oximeter at the time of cuff deflation. The order in which the readings were obtained as well as the arm chosen for measurement were randomized. SETTING AND PARTICIPANTS: Paramedics and emergency medical technicians in an urban, inner-city emergency medical services (EMS) system. MEASUREMENTS AND MAIN RESULTS: Blood pressure measurements were sampled from 69 patients. Regression analysis identified significant correlation between POWSBP and the four methods utilized, with r = 0.92 for NIPBM, r = 0.95 for auscultation, and r = 0.97 for palpation, all significant at p < 0.0001. CONCLUSIONS: The use of POWSBP measurement is a fast, easy, and accurate technique with which to measure systolic BP in the field. It may have special importance for noisy environments and moving vehicles in which conventional methods of auscultation or palpation may be difficult.

Adolescent↗
PubMed2003

A comparison of five techniques for detecting cardiac activity in infants.

BACKGROUND: The new guidelines for cardiopulmonary resuscitation recommend that laypersons should begin chest compressions without checking for a pulse because the pulse check has serious limitations in accuracy. We determined the efficacy of the most suitable method to search for cardiac activity in infants. METHODS: Twenty-eight nurses tried to detect infants' cardiac activity and determined their heart rates with five different techniques: palpation of brachial pulse, carotid pulse, femoral pulse, apical impulse and auscultation of apical impulse with the naked ear (direct auscultation technique). RESULTS: The mean time interval required to find the pulse within 30 s in the auscultation, the apical, the brachial, the carotid and the femoral were 2.4 +/- 1.2, 3.5 +/- 2.7, 4.0 +/- 2.7, 9.9 +/- 7.0 and 9.1 +/- 5.9 s, respectively. The required time was significantly shorter in the auscultation method than in the palpation of carotid and femoral pulses. The percentage and 95% confidence intervals (95% CI) of pulses identified within 10 s (= the number of the correct identified within 10 s/the number of all cases) in auscultation, apical, brachial, carotid and femoral palpations were 100.0% (95% CI 51.8, 100), 75.0% (95% CI 28.9, 89.3), 73.1% (95% CI 52.2, 88.4), 50.0% (95% CI 30.6, 69.4) and 42.9% (95% CI 24.5, 62.8), respectively. These values were greater in the auscultation method than in all the palpation methods. CONCLUSIONS: The direct auscultation technique was more rapid and accurate than any other techniques to determine cardiac activity without instruments. It is suggested that direct a auscultation technique is also superior to the palpation of brachial artery in cardiopulmonary resuscitation in infants.

Brachial Artery↗
PubMed2000

Central sensitization in tension-type headache--possible pathophysiological mechanisms.

The aim of the present thesis was to investigate the pathophysiology of chronic tension-type headache with special reference to central mechanisms. Increased tenderness to palpation of pericranial myofascial tissues is the most apparent abnormality in patients with tension-type headache. A new piece of equipment, a so-called palpometer, that makes it possible to control the pressure intensity exerted during palpation, was developed. Thereafter, it was demonstrated that the measurement of tenderness could be compared between two observers if the palpation pressure was controlled, and that the Total Tenderness Scoring system was well suited for the scoring of tenderness during manual palpation. Subsequently, it was found that pressure pain detection and tolerance thresholds were significantly decreased in the finger and tended to be decreased in the temporal region in chronic tension-type headache patients compared with controls. In addition, the electrical pain threshold in the cephalic region was significantly decreased in patients. It was concluded that the central pain sensitivity was increased in the patients probably due to sensitization of supraspinal neurones. The stimulus-response function for palpation pressure vs. pain was found to be qualitatively altered in chronic tension-type headache patients compared with controls. The abnormality was related to the degree of tenderness and not to the diagnosis of tension-type headache. In support of this, the stimulus-response function was found to be qualitatively altered also in patients with fibromyalgia. It was concluded that the qualitatively altered nociception was probably due to central sensitization at the level of the spinal dorsal horn/trigeminal nucleus. Thereafter, the prophylactic effect of amitriptyline, a non-selective serotonin (5-HT) reuptake inhibitor, and of citalopram, a highly selective 5-HT reuptake inhibitor, was examined in patients with chronic tension-type headache. Amitriptyline reduced headache significantly more than placebo, while citalopram had only a slight and insignificant effect. It was concluded that the blockade of 5-HT reuptake could only partly explain the efficacy of amitriptyline in tension-type headache, and that also other actions of amitriptyline, e.g. reduction of central sensitization, were involved. Finally, the plasma 5-HT level, the platelet 5-HT level and the number of platelet 5-HT transporters were found to be normal in chronic tension-type headache. On the basis of the present and previous studies, a pathophysiological model for tension-type headache is presented. According to the model, the main problem in chronic tension-type headache is central sensitization at the level of the spinal dorsal horn/trigeminal nucleus due to prolonged nociceptive inputs from pericranial myofascial tissues. The increased nociceptive input to supraspinal structures may in turn result in supraspinal sensitization. The central neuroplastic changes may affect the regulation of peripheral mechanisms and thereby lead to, for example, increased pericranial muscle activity or release of neurotransmitters in the myofascial tissues. By such mechanisms the central sensitization may be maintained even after the initial eliciting factors have been normalized, resulting in the conversion of episodic into chronic tension-type headache. Future basic and clinical research should aim at identifying the source of peripheral nociception in order to prevent the development of central sensitization and at ways of reducing established sensitization. This may lead to a much needed improvement in the treatment of chronic tension-type headache and other chronic myofascial pain conditions.

Central Nervous System↗
PubMed1999

Are anatomic landmarks reliable in determination of fusion level in posterolateral lumbar fusion?

STUDY DESIGN: Determination of the fusion level by direct observation and palpation of anatomic landmarks is compared with the finding obtained from a lateral intraoperative radiograph. OBJECTIVES: To assess the reliability of the use of intraoperative anatomic landmarks in determination of the fusion level. SUMMARY OF BACKGROUND DATA: Accurate determination of the level to be fused in noninstrumented posterolateral fusion is crucial. No studies are available in which the value of direct observation and palpation of the anatomic landmarks in determination of the fusion level has been assessed. METHODS: Eighty patients who underwent posterolateral fusion without instrumentation in the lumbosacral spine were included in this study. During surgery, first, the cephalad transverse process at the desired level to be fused was determined by direct observation and palpation of the anatomic landmarks; second, a metal mark was placed beneath the cephalad transverse process at the level determined by anatomic landmarks. This was followed by a lateral radiograph. The consistency and discrepancy between the use of the anatomic landmarks and lateral radiography in determining the desired fusion level were recorded. RESULTS: The fusion level determined by direct observation and palpation of the anatomic landmarks was accurate in 76 (95%) cases. In the remaining four cases, intraoperative x-rays determined that the selection of the cephalad transverse process for fusion was one level too high in three cases and one level too low in the other case. All errors in determination of the level to be fused occurred in patients who had extensive laminectomy at L4-S1. CONCLUSIONS: Determination of fusion level by direct observation and palpation of the anatomic landmarks is not reliable in patients who have had or require decompressive procedures. A lateral radiograph should be routinely obtained for accurate identification of the level to be fused.

Adult↗
PubMed1986

Effect of various veterinary procedures on plasma concentrations of cortisol, luteinising hormone and prostaglandin F2 alpha metabolite in the cow.

Five commonly practised veterinary procedures were studied: Palpation per rectum of the reproductive tract, intramuscular injection, single venepuncture, repeated venepuncture and jugular vein catheterisation. Plasma cortisol concentrations increased from baseline values of approximately 2 ng/ml to maximum mean values between 6.5 +/- 2.5 ng/ml and 13.8 +/- 5.6 ng/ml approximately 13 to 27 minutes after each manipulation. Baseline values occurred approximately 80 minutes later. In the control bleeding periods unacclimatised cows initially had high values of plasma cortisol (5 to 10 ng/ml) which returned to baseline after two hours, ie, before beginning any procedure. There were no statistically significant changes in luteinising hormone concentrations. The concentration of 13,14 dihydro, 15-keto prostaglandin F2 alpha (PGFM) increased from 61.0 +/- 4.6 pg/ml to 209.8 +/- 152.1 pg/ml in three out of five cows palpated on days 16 and 19 of the oestrous cycle. Increases did not occur in five other cows palpated during the follicular phase, nor in five cows palpated on day 12. However, after palpation on day 8, one animal did have concentrations of PGFM similar to those occurring during spontaneous release on days 18 to 20 of the oestrous cycle.

Animals↗
PubMed2002

Computed tomography and ultrasonographic evaluation of metastatic cervical lymph nodes with surgicoclinicopathologic correlation.

The detection of cervical lymph nodal metastasis and carotid artery invasion by metastatic lymph nodes is an important issue in the management of head and neck malignancies. This study compared the evaluation of metastasis by palpation, ultrasonography (USG) and computed tomography (CT) in patients with known head and neck malignancies. Twenty-five consecutive patients with head and neck malignancy were prospectively evaluated for the presence of cervical lymphadenopathy and carotid artery invasion. All patients underwent clinical examination (palpation), USG and CT examination. A modified CT criteria was employed which yielded acceptable results for the detection of metastatic nodes. Radical neck dissection was performed for 26 neck sides, and the results of pre-operative evaluation were confirmed by the surgical and histopathological findings. Palpation, ultrasound and CT have comparable sensitivity in the determination of metastasis involving cervical lymph nodes. Thus palpation should be employed as the primary method of assessment of secondaries in the neck. However, palpation is less sensitive than CT and USG in the detection of carotid artery involvement, hence the clinical suspicion of arterial invasion should be confirmed by either CT or USG which have similar accuracy in the detection of carotid artery invasion.

Adult↗
PubMed2004

Relationship between temporomandibular joint (TMJ)-related pain and morphological changes of the TMJ condyle in patients with temporomandibular disorders.

OBJECTIVES: The purpose of this study was to analyse the relationship between temporomandibular joint (TMJ)-related pain and morphological change of the TMJ condyle in patients with temporomandibular disorders. METHODS: Data were obtained from 178 joints in 89 patients. The joints were clinically assessed for pain on mandibular function and on lateral palpation of the TMJ. They were also assessed for radiographic evidence of bone change at the articular surface (OAAS) and resorption of the lateral part of the condyle (RLC). RESULTS: A higher prevalence of joint pain on function was observed in joints with OAAS than in those without OAAS (Chi-square test of independence, P < 0.05). Significant relationships were found between palpation pain and OAAS and between palpation pain and RLC (Chi-square test of independence, P < 0.05). In addition, patients with RLC showed a significantly lower pain threshold for external mechanical stimuli than those without RLC (Welch's t-test, P < 0.05). CONCLUSIONS: These results suggest a possible relationship between pain on function and OAAS as well as a relationship between palpation pain and RLC. Pain on lateral palpation may be related to the pathological conditions that induce RLC.

Adolescent↗
PubMed1987

Effects of body weight groupings on productivity, feather loss, and nervousness of caged hens.

Two experiments compared performance traits, feather loss, and nervousness of hens kept in contrasting homogeneous and heterogeneous body weight groupings. In addition, 15-day periods of daily uterine palpating vs nonpalpating for an egg in the uterus were compared for effects on egg production. Eighteen-wk-old pullets were weighed and characterized as light, medium, or heavy and housed in laying cages at 19 wk for a 50-wk production period. In Experiment 1, two hens were placed in each cage and there were three treatment groups: both light (L), mixed or 1 heavy and 1 light (X), and both heavy (H). In Experiment 2, three pullets were used per cage; a medium-weight group (M) was included and mixed cages included 1 heavy, 1 medium, and 1 light weight bird. In an ancillary experiment, 50-wk-old hens were also palpated or not palpated for an egg in the uterus over a single 15-day period. Results indicated that differences that were present in initial body weight groups persisted over the 50-wk period in Experiments 1 and 2 with no effect of weight grouping on body weight gain, egg production, and livability. Differences that were associated with weight groups were: age at sexual maturity, egg weight, egg mass, and nervousness score. No differences in mean feather scores were present among weight groups. Comparisons between individual hens of the same relative weight but kept in homogeneous or heterogeneous weight groups failed to indicate competitive advantages or disadvantages in egg production, feathering, and nervousness scores. No significant associations were found between nervousness scores of individual hens and other traits except for total body weight gain in Experiment 1, in which individuals that gained more were less nervous in the X groups (r = -.55). Palpating hens daily for two 15-day periods significantly increased hen-day egg production in Experiment 2 and nonsignificantly in Experiment 1, with no influence of palpation on hen-day egg production, egg weight, or egg mass in the ancillary experiment.

Animal Husbandry↗
PubMedDate not supplied

Serum thyroglobulin levels after fine-needle aspiration of thyroid nodules.

OBJECTIVE: To investigate whether a minor insult to the thyroid gland attributable to fine-needle aspiration (FNA) or external thyroid palpation can cause a release of serum thyroglobulin (Tg) into the circulation. METHODS: We determined serum Tg levels before and at 60 minutes and 15 days after FNA in 25 patients with thyroid nodules. Results were compared with those obtained in 25 patients with thyroid nodules, in whom serum Tg concentrations were determined before and 60 minutes after palpation of the thyroid, and in 15 healthy subjects without thyroid disease, who had no thyroid palpation and no FNA, from whom 2 blood specimens were obtained 60 minutes apart. All participants had normal results of thyroid function tests and no detectable antithyroglobulin or thyroid peroxidase antibodies. RESULTS: After FNA, 22 of 25 patients had significant elevation of serum Tg concentrations. The Tg levels returned to baseline values 15 days after FNA. In 4 of the 25 patients with thyroid nodules who had palpation of the thyroid, a significant increase in serum Tg levels was elicited. None of the 15 healthy subjects with normal thyroid glands (and with no FNA or thyroid palpation) had significant Tg elevations. CONCLUSION: FNA causes a significant increase in serum Tg concentrations, which may persist for 15 days. Therefore, Tg assay should not be scheduled prematurely after FNA.

Adult↗