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At least 865 records · Page 48Linked to original sources
PubMed1994

Assessment of implant mobility at second-stage surgery with the Periotest: DICRG Interim Report No. 3. Dental Implant Clinical Research Group.

Many of the presently used methods of evaluating osseointegration at implant uncovering are highly subjective. The Periotest is claimed to offer a more objective means to assess osseointegration by means of microcomputer-controlled percussion. Investigators involved in a long-term clinical study of dental implants being conducted by the Dental Implant Clinical Research Group used the Periotest to evaluate the mobility associated with all study implants at second-stage surgery and correlate the Periotest values with various bone densities. The Periotest values for 1,838 root form implants ranged from -8 to +25. Implants that appeared to be osseointegrated at uncovering recorded a mean Periotest value of -3.37 +/- 3.25, while nonosseointegrated implants had a mean Periotest value of +13.87 +/- 14.27. Mean Periotest values were -3.82 +/- 3.04 for quality 1 bone, -3.70 +/- 3.06 for quality 2 bone, -3.31 +/- 3.18 for quality 3 bone, and -1.29 +/- 3.57 for quality 4 bone. The Periotest has the potential of being a valuable instrument for assessing the status of osseointegration at second-stage surgery.

Alveolar Process↗
PubMed1994

The influence of implant type, material, coating, diameter, and length on periotest values at second-stage surgery: DICRG interim report no. 4. Dental Implant Clinical Research Group.

Many of the presently used methods of evaluating osseointegration at second-stage surgery are highly subjective. The Periotest is claimed to offer a more objective means to assess osseointegration by means of microcomputer-controlled percussion. In 1991 the Dental Implant Clinical Research Group initiated a long-term clinical study in cooperation with the Department of Veterans Affairs to investigate the influence of implant design, application, and site of placement on clinical performance and crestal bone height. As part of this investigation, the Periotest values for 1,565 root form implants were determined at second-stage surgery and correlated with type, material, coating, diameter, and length. Hydroxyapatite-coated implants and increased implant diameter and length produced Periotest values that indicated a greater extent of stability as compared with noncoated implants with shorter diameters and lengths. Hydroxyapatite-coated cylinder-type implants yielded the most favorable Periotest readings. Not only does the Periotest have the potential of being a valuable instrument for assessing implant mobility at second-stage surgery, but it also appears to have the capability of determining slight differences in the implant-bone complex.

Dental Alloys↗
PubMed1971

Cardiovascular responses to tilting in tetraplegic man.

1. A study has been made of the effect of head-up tilt on blood pressure, heart rate, forearm blood flow and occluded vein pressure in the hand and foot in non-bedridden patients with chronic, closed, complete, localized traumatic transection of the cervical spinal cord.2. In typical responses the blood pressure fell and the heart rate rose progressively for about 2 min, tending to plateau thereafter. The average falls in mean blood pressure for tilts of +30, +45 and +60 degrees were from 68 to 44, 74 to 36 and 70 to 44 mm Hg respectively, and the corresponding heart rate increases were from 67 to 85, 62 to 97 and 62 to 103 beats/min respectively. One patient lost consciousness when his blood pressure was 29/19 mm Hg and one other patient experienced symptoms suggesting cerebral ischaemia.3. Following the return to horizontal, the blood pressure and heart rate usually returned to their previous values within 1 min and the blood pressure tended to overshoot slightly in the following few minutes. No immediate blood pressure overshoot occurred after the tilt except in association with a spasm of skeletal muscles.4. There was consistently a decrease in forearm blood flow, sometimes to unrecordably low levels and a venoconstriction with postural change and it is argued that these changes are the result of spinal cardiovascular reflexes to peripheral vessels. Following the return to the horizontal position, there was occasionally a large immediate increase in forearm blood flow.5. Following the intravenous administration of 3 mg atropine on two occasions, head-up tilting produced further small heart rate increases.6. Spasms of skeletal muscle occur frequently in these patients and greatly modify the effects of postural stimuli. Bladder percussion also modifies the normal response.

Adult↗
PubMed1996

Temporal artery tap: usefulness and limitations in carotid sonography.

PURPOSE: To examine the effectiveness of percussion of the superficial temporal artery for identification of the external carotid artery (ECA). MATERIALS AND METHODS: The temporal artery tap maneuver was performed on 324 carotid arteries (163 patients). Evidence for transmission of the effect of the temporal tap was sought in the pulsed Doppler ultrasound waveforms of the ECA, common carotid artery (CCA), and internal carotid artery (ICA). The location and severity of stenotic lesions were recorded. The relative amplitudes of the oscillations created by the tap were compared. RESULTS: The temporal tap effect could be seen in 262 ECAs (81%), 174 CCAs (54%), and 106 ICAs (33%). The tap effect can be seen in the ICA at all grades of ICA disease. When the oscillations were seen in only one of the two major branches, that branch was always the ECA. When the temporal tap effect was found in the ICA, the amplitudes of the oscillations were the same as or greater than those of the ECA in 26% of cases. CONCLUSION: Waveform oscillations from the temporal tap maneuver often can be found beyond the ECA in the CCA and ICA. Thus, the temporal tap alone may not reliably distinguish the ECA from the ICA or CCA.

Adolescent↗
PubMed1992

Myoedema. A clinical and electrophysiological evaluation.

Stationary muscle mounding after muscle percussion without electrical muscle activity is called myoedema. Out of 105 patients with different neurological diseases, 88% had this phenomenon. Muscle conduction velocity and stimulated single fiber EMG disclosed no abnormalities. Myoedema is a normal physiological phenomenon, and its presence does not indicate a neuromuscular disorder.

Brain Ischemia↗
PubMed1975

Advances in the treatment of pulmonary alveolar proteinosis.

Our currecnt technique for lung lavage is described. This technique can be safely and effectively applied to patients with pulmonary alvelar proteinosis who require therapy. Normal saline alone is as effective a solution as one containing heparin and acetylcysteine. Chest percussion during lung lavage considerably enhances the yeild of each lavage and thus shortens the time required for the procedure. Lung lavage results in remarkable clearing of the chest roentgenogram and reversal of the physiologic defects and symptoms of the patient by the following day. In our experience this improvement lasts for at least one year.

Acetylcysteine↗
PubMed1981

Sapheno-femoral valve insufficiency in varicose veins of the lower limb.

SFV competence was investigated in 100 patients (189 legs) suffering from varicose veins. The incidence was found to depend on the method used. The simpler clinical methods such as the cough test, percussion test, Trendelenburg test, revealed SFV insufficiency to be between 15.4-21.6%. Using the Doppler ultrasound the incidence increased to 47.6%; by using the MABP, SFV insufficiency was found to be increased 20%. The SFV competence was indicated as playing an important role in the pathogenesis of varicose veins. The phlebologist's decision to carry out high ligation and stripping of the saphena magna in patients with varicose veins should be considered only for those cases where the extent of incompetence has been established beyond doubt.

Adolescent↗
PubMed1981

Physical assessment series: the thorax and the lungs.

The anatomy of the thorax and lungs and the physiology or respiration are complex. The physical assessment techniques which, on the surface, appear relatively easy to master, require hours of practice of observation, palpation, percussion, and auscultation before the examiner becomes familiar with the more subtle changes of disease process and the wide variations of normal that may be confused with illness. These are skills that may be quickly lost if not regularly applied. But perhaps with the use of such techniques, the pharmacist can play an even greater role in the monitoring of drug therapy.

Adult↗
PubMed1999

Physiotherapy for airway clearance in adults.

Techniques for augmenting, when necessary, the normal mucociliary and cough clearance mechanisms of the lungs are not new, but, in more recent years, techniques have been developed which are effective, comfortable and can be used independent of an assistant in the majority of adolescents and adults. Postural drainage with chest clapping and chest shaking has, in most parts of the world, been replaced by the more effective techniques of the active cycle of breathing, autogenic drainage, R-C Cornet, Flutter, positive expiratory pressure mask, high-frequency chest wall oscillation and intrapulmonary percussive ventilation. Glossopharyngeal breathing is being considered again and is often a useful technique for increasing the effectiveness of cough in patients with tetraplegia or neuromuscular disorders. The evidence in support of these techniques is variable, and the literature is confusing and conflicting. There may or may not be significant differences among the techniques in the short or long term. Many of the regimens now include the forced expiratory manoeuvre of a "huff" and this has probably increased the effectiveness of airway clearance. If objective differences are small, individual preferences and cultural influences may be significant in increasing adherence to treatment and in the selection of an appropriate regimen or regimens for an individual patient.

Adult↗
PubMedDate not supplied

The process of conducting a physical assessment: a nursing perspective.

Physical assessment is a new responsibility for many nurses in the UK who are expanding their parameters of advanced clinical practice. A physical assessment framework can be used by both community and acute care nurses as a guide to the process of conducting a physical assessment. The framework presented here consists of the following sequence of steps: identifying the purpose of the assessment; taking a health history; choosing a comprehensive or focused approach; and examining the patient using the sequence of inspection, palpation, percussion and auscultation. The next step, interpretation of the clinical findings, which results in either the recognition of abnormality or identification of a differential diagnosis, then becomes the basis for clinical decision making. This paper describes a comprehensive, head-to-toe assessment as one example of the application of this physical assessment framework in clinical practice.

Auscultation↗
PubMed1998

A new provocative test for carpal tunnel syndrome. Assessment of wrist flexion and nerve compression.

To establish the value of median nerve compression with wrist flexion as a provocative test for carpal tunnel syndrome (CTS), we performed a prospective study of 64 patients (95 hands) with CTS confirmed by electrodiagnostic studies and 50 normal subjects (96 hands). We recorded results for the common provocative tests (Tinel's percussion test, Phalen's wrist flexion test and the carpal compression test) and the new test which combines wrist flexion with median nerve compression. Using a receiver operator characteristic curve (ROC) technique, we found that the optimal cut-off time for the wrist-flexion and median-nerve compression test was 20 s, giving a sensitivity of 82% and a specificity of 99%. These results were significantly better than for Phalen's wrist flexion test (61% and 83%, respectively) and for the sensitivity of Tinel's test (74%). The positive predictive values of the wrist flexion and median-nerve compression test, which is more important clinically, were 99%, 95% and 81% at population prevalences of 50%, 20% and 5%, respectively. These were significantly better than those of the three other provocative tests at each prevalence. Electrodiagnostic studies have significant false-positive and false-negative rates in CTS, and therefore provocative tests remain important in its diagnosis. We have shown that wrist flexion combined with the median-nerve compression test at 20 s, is significantly better than the other methods, and may thus be clinically useful.

Adult↗
PubMed1985

Does chest physical therapy work?

Postural drainage has usually been shown to be an effective component of chest physical therapy; there is currently no data showing a beneficial effect of percussion or vibration; directed coughing may be as efficacious as postural drainage (Table 3); the forced expiration technique may increase sputum clearance with or without postural drainage (Table 4).

Acute Disease↗
PubMed2000

[Teaching physical pulmonary examination through the problem-based method].

Action-research was accomplished at the Federal University of Goiás College of Nursing in 1998 aiming at implementing and analyzing the teaching resources of physical pulmonary examination through the problem-based method. The Arch Method Phases were developed with sophomores in the undergraduate Nursing Course. During the Conclusion Hypothesis phase, the need of various activities in order to fix the theme was observed. In the theoretical and psycho-motor evaluation, we verified that the students had more difficulty in performing percussion and palpitation. It was concluded that the application of the problem-based pedagogy in physical examination was feasible.

Education, Nursing↗
PubMed2000

[Percussional auscultation of frontal sinuses].

Percussional auscultation of the frontal sinuses is used for diagnosis of frontal sinusitides. Phonendoscope placed by the sinus walls auscultates sounds forming as a result of comparative percussion of the anterior sinus walls. Three main percussional tones are singled out. This method was employed for diagnosis in 48 patients with frontal sinusitis. The technique is easy to perform, safe and precise (90%). The trend in frontal sinusitides development can be followed up.

Adult↗
PubMed1975

Left displacement of the abomasum in a clinically normal cow.

A cow with left displacement of the abomasum (lda) was found to be clinically normal for 1 1/2 years. During this period, the cow calved twice and ate and produced milk normally. Auscultation and percussion at approximately weekly intervals revealed the continuing abomasal displacement, which was confirmed at necropsy.

Abomasum↗
PubMed1996

[The anatomical-clinical observations of R.T.H. Laennec's Service at the Hôpital Necker (1816-1819)].

It is through Laennec's students observations, revised by himself, that we are able to follow his medical knowledge strides. Starting from the first mediate auscultation (1817) it shows the raising prevalence of physical marks against functional ones. It starts by the impairing of human voice sounds and tackles abnormal breathing murmurs; all these are combined with every other investigating process as percussion. Nevertheless, some failings appear about cardiology which is occasionally defective. Very complete autopsies give now famous descriptions of pulmonary emphysema and atrophic cirrhosis. Such a documentation shows how high a value Laennec and his followers were setting on anatomo-clinical method though they admitted its limit.

Auscultation↗
PubMed2002

[Acute abdomen in primary care].

The author--using his 30 years practical medical experience, from the point of view of a family doctor giving the first diagnose, analyses the problem of acute abdomen. Gives an overview of anamnesis (heteroanamnesis) and the data and their significance investigated during the physical examination of patient (inspection, palpation, percussion, auscultation), and that of the usefulness for the right diagnose. The author orients the reader's attention to the fact, that the beginning of the third millennium in the world of instrumental and laboratory diagnostics, in case of certain illnesses--so in the case of acute abdomen--physical examinations have not lost a bit from their significance.

Abdomen, Acute↗
PubMed1976

[Respiratory therapy in childhood asthma. Part 1 (author's transl)].

The therapeutic approach in childhood asthma can be substantially supported by various forms of respiratory therapy. Objective improvements and increased well-being have been demonstrated by different authors. The physiology of correct and defective breathing are outlined briefly. The major aim of respiratory therapy is the return to normal breathing patterns including normalized clearing functions of the lung. If successful even moderately severe attacks of bronchial asthma may be averted. Personality changes in the form of increased self-confidence and loss of fear of dyspnoea are important. Part 1 outlines physicial treatment forms such as postural drainage and percussions of the chest.

Asthma↗