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At least 973 records · Page 54Linked to original sources
PubMed1985

[Auscultation of pulmonary rales, from Laënnec to phonopneumography].

The invention in 1819 of the stethoscope by Laënnec was followed by the first classification of pulmonary adventitial sounds. A number of new nomenclatures based upon acoustic principles have subsequently been suggested. Phonopneumography consists of the recording of respiratory sounds and their breakdown into different harmonics by frequential analysis. Broadly speaking, a distinction is drawn between continuous sounds, including sibilants and rhonchi, and discontinuous sounds, covering crepitations and coarse rales.

Auscultation↗
PubMed1985

[Testicular exploration by Doppler ultrasonography in children. Importance, indications, limitations. Apropos of 90 cases].

The authors evaluate the testicular blood flow by Doppler stethoscope in 90 infants and children; they tell two indications: In emergency the most common is "acute scrotal swelling": 78 cases, 4 false negative are reported in diagnosis of torsion of the spermatic cord; the limit of the Doppler examination are the possibility of a interepididymo-testicular torsion and, above all, the inflammation of the scrotal wall. If Doppler examination are in agreement, unnecessary surgical explorations must be avoided. Outside emergency, Doppler examination may be help-full to evaluate varicocele and to control some surgical operation involving spermatic cord (12 cases).

Child↗
PubMed1985

[Non-invasive nuclear medical evaluation of left ventricular function in patients with coronary heart disease. Comparative study with the floating catheter].

In this paper there has been analysed the diagnostic value of the parameters of the diastolic function (Peak Filling Rate, PFR and Time to Peak Filling Rate, TPFR) which are not to be covered by invasive methods. To this examination we applied a recently discovered nuclear medical method: we used the Nuclear Stethoscope and with it were able to investigate not only the systolic function (Ejection Fraction) but also the diastolic function (PFR, TPFR). In addition to this we undertook a floating catheter during exercise for the critical examination of the left ventricle. The examined patients consisted of 28 patients, suffering from Coronary Heart Disease, the majority of them after myocardial infarction. In patients suffering from CHD there may be found relations between the nuclear medical parameters of the diastolic function and the pulmonary capillary wedge pressure as far as in all patients who showed a functional disturbance with the aids of invasive methods this could also be proved non-invasively.

Blood Pressure↗
PubMedDate not supplied

Oculoplethysmography and carotid phonoangiography for the noninvasive detection of extracranial carotid occlusive disease.

Clinical applications of imaging techniques and noninvasive physiological vascular evaluations provide useful assistance in the detection and management of stroke-prone patients by minimizing unnecessary carotid arteriography and surgery. Two such evaluation techniques are oculoplethysmography (OPG) and carotid phonoangiography (CPA). Developed, used, and proved highly reliable at the Tucson (Arizona) Medical Center, the techniques have been documented in 12,000 tests on approximately 8500 patients. OPG simultaneously records the bilateral ocular pulses concomitantly with external carotid pulses. Delays in timing of these pulses reflect reduction of flow in the internal and/or external carotid arteries, respectively. CPA consists of electronic stethoscopic auscultation, direct visualization, and photographic recording of carotid bruits or blood flow sounds.

Arterial Occlusive Diseases↗
PubMedDate not supplied

Scintillation probe detector in the assessment of cardiovascular disease.

A simple device that permits measurement of cardiac function in humans after intravenous injection of technetium-99m-labeled albumin or red blood cells is described. The device (nuclear stethoscope cardiac probe) is based on the application of microprocessor technology to a scintillation detector. It can be used to monitor ventricular function continuously and in exercise testing for the detection of coronary heart disease.

Coronary Disease↗
PubMedDate not supplied

[Design and production problems with stethophonoendoscopes].

The existing stethophonendoscope models with separate stethoscopic and phonendoscopic heads fail to give adequate reproduction of processes under investigation within the auscultation frequency range with intensity sufficient for reliable diagnosis. The Leningrad industrial association "Krasnogvardeets" offers a new stethophonendoscope design with a head reproducing acoustic signs at a necessary intensity level within a wide frequency range. These stethophonendoscopes can be manufactured serially because their most complicated and functionally responsible elements are strictly unified for different models.

Auscultation↗
PubMedDate not supplied

Transcutaneous Doppler ultrasound in the prediction of healing and the selection of surgical level for dysvascular lesions of the toes and forefoot.

Dysvascular lesions of the toes and forefoot are divided into 5 grades and matched with appropriate treatment programs. Patients with diabetes mellitus and arterosclerosis obliterans make up the greatest number presenting with such problems. Transcutaneous Doppler ultrasound has been added to clinical criteria as an aid in the prediction of healing. Systolic blood pressures are taken at the thigh, knee, calf, ankle, foot and toes using transcutaneous Doppler ultrasound as a sensitive stethoscope. Systolic blood pressure taken at the antecubital fossa is divided into the lower extremity pressures to obtain an ischemic index. Healing can be predicted with 90% or better accuracy where the ischemic index is above 0.35 in the arteriosclerotic foot and above 0.45 in the diabetic foot.

Amputation, Surgical↗
PubMed1982

[Carcinoid cardiopathy].

A series of 5 males and 2 females aged 23-73 yr with carcinoid cardiopathy is presented, all of them with clinical and instrumental signs of liver metastasis. The main clinical signs were dyspnoea and asthenia rendered ingravescent by effort, and, in the later stage, a frank picture of congestive cardiac decompensation. All subjected presented stethoscopic evidence of tricuspid valvulopathy, combined with pulmonary stenosis in 2 cases. The ECG picture displayed a constant reduction in cardiac potentials, together with right branch bundle block in 3 cases. In cases where an echocardiogram was taken, this confirmed tricuspid involvement. The disease progressed in all cases, and four patients died as a result of terminal liver failure.

Adult↗
PubMed1984

[Quality assurance and quality control of blood pressure measurements. Experiences with the Munich blood pressure study].

More than 12 000 blood pressure measurements were taken in the Munich Blood Pressure Study (MBS). The reliability of these blood pressure measurements is reported. After consideration of possibilities for systematic and random measurement errors we present methods used in the MBS to control and assess the quality of the blood pressure readings over a long period of time: measures for standardizing the recording conditions and procedures; training and testing of the field staff using audio tape-recording and simultaneous measurements with a double stethoscope; analysis of inter- and intraobserver-variation relative to that of reference measurements; analysis of observer preferences for certain terminal digits. With the application of these methods one can indeed successfully reduce observer variability to a tolerable amount even over a considerable period of time.

Blood Pressure Determination↗
PubMed1983

[A new, non-invasive study method for the determination of left-ventricular function in patients with coronary disease].

With the new development of the Nuclear Stethoscope-a microprocessor based cardiac scintillation probe-it is possible to determine the contractile parameters and the diastolic filling measurement of the left ventricle, after the application of Technetium 99m. Due to the high sensitivity and specificity a functional diagnosis of the left ventricle is possible to approximately 90%. The report describes our first attempts to determine the ejection fraction (EF) at rest and during exercise in 24 patients with diagnosed coronary heart disease. Of the 24 patients, 18 (75%) were already found to have abnormal, in that they did not have the expected increase in the EF. The comparison of the results from the non-invasive probe with those of the coronary angiographic findings demonstrate a good correlation Correlation coefficient r = 0.960). The determination of the EF of coronary patients at rest and especially during exercise, from the point of view of rehabilitation, is of great practical relevance, allowing the residual function of the myocardium after infarction and harmful overloading to be better defined.

Adult↗
PubMed1983

[Hemodynamic studies on varicocele using bidirectional ultrasound Doppler sonography].

At first the ultrasonic Doppler sonography is described in the evaluation of the retrograde venous blood flow in a varicocele. With the Doppler stethoscope the incidence of venous reflux amounted to 70% in young men aged from 19 to 22 years. At physical examination a palpable varicocele was detected in 55% of the cases. By the bidirectional technique you can define various haemodynamic types of varicoceles: "pressure-type" and "shunt-type". 205 patients with varicoceles were examined by bidirectional Doppler probe. The Doppler recording was correlated with the severity of varicocele. In small varicoceles the "pressure-type" is found most frequently, while in large varicoceles the "shunt-type" occurs.

Adult↗
PubMed1984

[Training effect and hemodynamic parameters in myocardial infarct patients undergoing rehabilitation].

Thirty-five patients with previous myocardial infarction underwent a programme of supervised physical rehabilitation. Twenty-two patients achieved a training effect (TE), after rehabilitation, i.e. a decrease of the double product (DP) for corresponding work loads and an increase of their physical work capacity (PWC). Thirteen patients, despite the absence of any clinical signs of decreased performance, did not obtain the above mentioned haemodynamic effects. In all of the patients the ejection fraction (EF) both at rest and during exercise was measured using a nuclear stethoscope. In patients with TE, the EF was 57 +/- 5% at rest, and 64 +/- 9% during exercise; in patients without TE the EF was 52 +/- 8% at rest and 46 +/- 10% during exercise. The correlation between TE (delta% PWC) and EF at rest and during exercise respectively, is positive and statistically significant, but there is a higher (r = 0,73) and more significant (p less than 001) correlation between delta% PWC and EF during exercise.

Adult↗
PubMed1981

[Laennec. The bicentenary of the birth of the author of "auscultation mèdiate" (author's transl)].

R. T. H. Laennec (17. 2. 1781-13. 8. 1826), the founder of the principles of auscultation, started from poor beginnings to become the leading clinician of France. In the prime of life, holder of two chairs of clinical medicine and physician to prominent persons in public life, Laennec contracted pulmonary tuberculosis, which led to his death at his home in Brittany at the early age of 45 years. Laennec is still remembered by posterity as the inventor of the stethoscope and author of a pioneering textbook on diseases of the heart and lungs, which is still worth reading today.

Auscultation↗
PubMedDate not supplied

Tourniquet hemostasis. A clinical study.

A clinical study was undertaken to evaluate the pneumatic tourniquet setting required for adequate hemostasis in extremity surgery. After induction of anesthesia, the pneumatic tourniquet pressure at which the peripheral pulse disappeared was determined using a Doppler stethoscope. For upper-extremity procedures 50 mm Hg was added to this setting to allow for collateral circulation and blood pressure changes. An average pressure of 189.9 +/- 24.1 mm Hg was used for the upper-extremity group (44 patients), and an average of 231.0 +/- 26.5 mm Hg was used for the lower-extremity group (40 patients). Maximum pressures utilized were 255 mm Hg in the upper extremity and 305 mm Hg in the lower extremity. This simple, noninvasive technique uses tourniquet pressure settings well below those recommended in standard reference texts without sacrificing the adequacy of hemostasis to obtain a "bloodless field."

Adolescent↗
PubMed1980

[Hygiene in general practice (author's transl)].

This investigation of the hygienic-microbiological situation in general practices included an analysis of hygienic behaviour by questionnaire, environmental examinations by means of "Rodac"-plates and swabs and an efficiency control of sterilising apparatus with spore strips.--It was the aim of the study to find out the present hygineic standards in general practices and to obtain indicatios of possible weak points.--In spite of lacking hygienic consciousness and the mostly insufficient use of disinfectants, the level of contamination of the microbiological environment does not exceed that known from hospitals. Pathogenic staphylococci are demonstrated most frequently and, besides Candida spec., are of special importance. Gram-negative germs, most frequently P. aeruginosa, could be demonstrated but appear comparatively less often. The contamination of hands, common towels, sphygmomanometer cuffs and floors which is well known from hospitals could be confirmed in the general practice. Stethoscopes, soap cakes and journals were, however, less contaminated. Among 103 examined hot air sterilisers 15% failed and in 24% of the cases they were incorrectly operated.--Suggestions for the improvement of practice hygiene are given.

Bacteria↗
PubMed1982

Plasma motilin levels in patients with abdominal surgery.

Plasma motilin levels were measured by radioimmunoassay both pre- and postoperatively in 37 patients who underwent abdominal surgery. In 8 colorectal cancer patients with tumor removal and in 13 stomach cancer patients with total gastrectomy by Roux-en-Y anastomosis or subtotal gastrectomy of Billroth I anastomosis, the motilin levels decreased before the onset of postoperative peristalsis, and at the time when peristaltic sounds could be detected stethoscopically, the plasma motilin levels had increased by 200% of the preoperative level. Similar motilin levels were maintained until the time of the initial postoperative flatus and/or stool. Thereafter, plasma motilin levels decreased and returned to almost the same levels as the preoperative ones. The postoperative time course of plasma motilin in 10 gallstone patients was very similar to that in the 21 gastrointestinal cancer patients above. In 5 stomach cancer patients with subtotal gastrectomy of Billroth II anastomosis, however, the peak at the time of the initial postoperative peristalsis was not as remarkable as that in the 13 stomach cancer patients.

Adult↗
PubMed1978

The deaf doctor.

Cardiopulmonary auscultation and considerable difficulty in hearing lecturers are major problems which face prospective deaf medical students. As a result, their opportunities for obtaining a medical degree have been, until recently, severely limited. However, rapid advance in electronics research have now made available to them a suitably amplified electronic stethoscope and a free-field radio transmission system.

Clinical Competence↗
PubMed1981

The varicocele and male infertility.

Varicocele is accepted as a common cause of male subfertility, even though many men with varicocele appear to have normal fertility. The pathophysiology of the varicocele effect on fertility remains unclear, but the association of varicocele with decreased testicular size, abnormal testicular histology, and abnormal semen parameters is clearly established. Because a small varicocele may impair fertility, it must be diligently sought, and the Doppler stethoscope may be helpful in establishing the diagnosis when a venous thrill is equivocal during the Valsalva maneuver in a standing patient. Abnormal semen parameters should be demonstrated in subfertile males with varicocele prior to advising varicocelectomy. Decreased sperm motility or a "stress pattern" in the semen should be documented; however a decreased sperm count may or may not be present. Various surgical approaches are available. When suprainguinal approaches have been used, failures have been shown to be attributable to secondarily incompetent cremasteric system veins. When high inguinal approaches are used, unsuccessful operations are probably secondary to a failure to identify one of the several venous tributaries that may be present at this level. The surgeon's approach should be based on available data, and his patients should be informed that failures are possible with any method of varicocelectomy until experience indicates otherwise. In most series, improvement in semen quality and pregnancy rates have been reported in a significant percentage of patients undergoing varicocelectomy for infertility. However, prior to subjection of the patient to varicocelectomy, the wife of the varicocele patient should be thoroughly studied (and treated when indicated).

Adolescent↗