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At least 1,135 records · Page 63Linked to original sources
PubMed2005

Endometritis treatment with a PGF2alpha analog does not improve reproductive performance in a large dairy herd in Argentina.

In Argentina, most dairy cows with endometritis are treated with prostaglandin (PGF(2alpha) or its analogs) and insemination is withheld until there are no signs of endometritis. The objective of the present study was to evaluate if this method of managing endometritis enhances reproductive performance. Three experiments were conducted over 4 years in a large farm in the west of Buenos Aires province. In Experiment 1, half of the cows diagnosed with endometritis (>1.5-fold difference in diameter of uterine horns, as determined by rectal palpation) received standard endometritis management (treatment with tiaprost, a PGF(2alpha) analog, rectal palpation every 20 days, and withholding of AI until endometritis apparently resolved) and the other half was untreated, with AI at the first estrus after the voluntary waiting period. Untreated cows were inseminated and conceived 20 days earlier than treated cows, and the pregnancy rate by Day 90 postpartum was higher in the untreated group. In Experiment 2, cows with endometritis were divided into four groups according to the severity of symptoms; within each group, cows were allocated to treatment or control, as in Experiment 1. Although first service conception rate decreased as endometritis severity increased, reproductive performance in treated versus control cows was similar to that of Experiment 1 (with no interaction due to degree of endometritis). Re-evaluation of the treated cow (to confirm uterine "normality") may have been responsible for the delay in conception in both experiments. The objective of Experiment 3 was to determine the effects of tiaprost treatment on clinically normal postpartum cows (no evidence of endometritis). Tiaprost treatment reduced the interval from calving to conception in multiparous cows, but it delayed conception and reduced the conception rate in primiparous cows. In conclusion, treatment with tiaprost impaired reproductive performance in primiparous cows (in the absence of endometritis). Furthermore, the standard treatment for endometritis (treatment with a prostaglandin analog and withholding insemination until clinical signs abated) impaired reproductive performance and increased costs.

Animals↗
PubMed2005

Effect of repeated administration of PGF2alpha in the early post partum period on the prevalence of clinical endometritis and probability of pregnancy at first insemination in lactating dairy cows.

Two experiments were performed to determine the effects of repeated administration of PGF2alpha in the immediate post partum period on the prevalence of clinical endometritis at 22 and 58 days post partum, and the probability of pregnancy at first insemination, in post partum dairy cows. In Experiment 1, 228 cows on day 7 post partum were used. Cows in Group 1 (n = 114) were treated twice with PGF2alpha (25 mg, im) 8 h apart on days 7 and 14 post partum, and only once on days 22 and 35 post partum. Cows in Group 2 (n = 114) served as untreated controls. Vaginoscopy and transrectal palpation of the genital tract were done on days 22 and 58 post partum. Cows in both groups were inseminated at estrus after a voluntary waiting period of 100 days. Pregnancy was determined by transrectal palpation between 45 and 50 days after insemination. Repeated administration of PGF2alpha in the immediate post partum period did not reduce the prevalence of clinical endometritis on days 22 or 58 post partum (65 versus 62% on day 22 and 28.3 versus 35.2% on day 58 in Groups 1 and 2, respectively). There was no significant difference in the probability of pregnancy at first insemination between cows in both groups. In Experiment 2, 418 cows on day 7 post partum were used. Cows in Group 1 (n = 209) were treated twice with PGF2alpha (25 mg, im) 8h apart on days 7 and 14 post partum, and only once on days 22 and 35 post partum. Cows in Group 2 (n = 209) served as untreated controls. Cows in both groups were subjected to the Presynch and Ovsynch protocols on days 49 and 75 post partum, respectively. Pregnancy was determined by transrectal ultrasonography between days 29 and 32 after timed insemination. There was no significant difference in the probability of pregnancy at first insemination between cows in both groups. In conclusion, repeated administration of PGF2alpha to cows in this herd had no effect on the prevalence of clinical endometritis at 22 and 58 days post partum, and that there was no effect on the probability of pregnancy after insemination at estrus among cows with a voluntary waiting period of > 100 days, or at timed AI at 85 days in milk when Presynch was employed.

Animals↗
PubMed1995

The ultrasonic value of local muscle hypertrophy in patients with temporomandibular joint disorders.

Muscle pain and tenderness on palpation are two common symptoms in patients with temporomandibular joint disorders. Examination of the masticatory muscles is largely restricted to the use of electromyography. The technique of ultrasonography in the diagnosis of muscle hypertrophy in patients with temporomandibular joint disorders was investigated. The results of the study indicate that ultrasonography may be beneficial to locate affected muscles that do not exhibit symptoms of tenderness on palpation and thereby give hints for treatment planning.

Adult↗
PubMedDate not supplied

Why yet another diagnostic sign of sacroiliac movement restriction?

BACKGROUND: Poor results of interexaminer and intraexaminer reliability of movement palpation tests for sacroiliac movement restriction are found in the literature. OBJECTIVE: To analyze current diagnostic techniques for movement palpation. The most evident sources of error and technical pitfalls are detailed. METHOD: A random sample of 64 consecutive patients at a university hospital, inpatients and outpatients, were examined with the new technique, which was compared with a set of other techniques as detailed before and after treatment. RESULTS: Full agreement was found in all but two cases in which head rotation was restricted and in two cases of severe scoliosis. The interexaminer reliability of the new test between two independent (blinded) examiners in 33 patients (66 joints) was in agreement in 82% and in disagreement in 18% (0.68 kappa). CONCLUSION: For its simplicity and lack of possible errors, this is a valuable sign. Its mechanism, however, is poorly understood.

Adolescent↗
PubMed2002

Acoustic radiation force impulse imaging: in vivo demonstration of clinical feasibility.

The clinical viability of a method of acoustic remote palpation, capable of imaging local variations in the mechanical properties of soft tissue using acoustic radiation force impulse (ARFI) imaging, is investigated in vivo. In this method, focused ultrasound (US) is used to apply localized radiation force to small volumes of tissue (2 mm(3)) for short durations (less than 1 ms) and the resulting tissue displacements are mapped using ultrasonic correlation-based methods. The tissue displacements are inversely proportional to the stiffness of the tissue and, thus, a stiffer region of tissue exhibits smaller displacements than a more compliant region. Due to the short duration of the force application, this method provides information about the mechanical impulse response of the tissue, which reflects variations in tissue viscoelastic characteristics. In this paper, experimental results are presented demonstrating that displacements on the order of 10 microm can be generated and detected in soft tissues in vivo using a single transducer on a modified diagnostic US scanner. Differences in the magnitude of displacement and the transient response of tissue are correlated with tissue structures in matched B-mode images. The results comprise the first in vivo ARFI images, and support the clinical feasibility of a radiation force-based remote palpation imaging system.

Abdomen↗
PubMed1998

Menstrual cycle modulation of tender points.

Changes in pain sensitivity throughout the menstrual cycle were assessed in 36 normally menstruating women and 30 users of oral contraceptives. Pain sensitivity was measured with palpation of rheumatological tender points and with pressure dolorimetry. The number of tender points identified by palpation was greater in the follicular (postmenstrual) phase of the cycle as compared to the luteal (intermenstrual) phase in normally cycling women but not in users of oral contraceptives. These findings are related to previously described physiological and psychological features of the menstrual cycle, with particular emphasis on the role of hormonal events in modulating pain perception, particularly in musculoskeletal disorders such as fibromyalgia.

Adult↗
PubMedDate not supplied

Force-feedback grasper helps restore sense of touch in minimally invasive surgery.

The age of minimally invasive surgery has brought forth astounding changes in the health care field. Less pain and quicker patient recovery have been demonstrated with several types of operations that were once performed by an open technique. With these changes have come reports of complications. The decreased sense of touch is just one of several limitations inherent to current techniques of minimally invasive surgery that limit detection of subtle or unapparent lesions on palpation, such as common duct stones and liver lesions. The purpose of this study is to demonstrate the ability of a force-feedback-equipped grasper to restore some of the sense of touch that is lost in minimally invasive surgery. To demonstrate this ability, we created six silicone phantoms of identical dimensions but graded compliance, and asked 10 subjects to place them in increasing/decreasing order of compliance. They used three tools (their dominant gloved hand, a standard laparoscopic Babcock grasper, and our force-feedback device fitted with the identical Babcock grasper) to rate the compliance of the samples in a blinded fashion. These conditions thus approximated the conditions of open surgery, minimally invasive surgery, and minimally invasive surgery fitted with a force-sensing device, in terms of palpating tissues. Five surgeons skilled in minimally invasive surgery and five nonsurgeons participated in the study. The results indicate that the force-feedback device is significantly (P <0.05) better than a standard Babcock grasper at rating tissue compliance, but was not as successful as a gloved hand (mean of squared errors = 1.06, 3. 15, and 0.25, respectively). There was no significant difference between surgeons and nonsurgeons in rating compliance. We conclude that this force-feedback instrument is able to partially restore the sense of touch in minimally invasive surgery. This restored ability may thus potentially result in more efficient operations with improved diagnostic capabilities and fewer complications during minimally invasive surgery.

Biocompatible Materials↗
PubMed2001

Eccentric overload training for patients with chronic Achilles tendon pain--a randomised controlled study with reliability testing of the evaluation methods.

The purpose was to examine the reliability of measurement techniques and evaluate the effect of a treatment protocol including eccentric overload for patients with chronic pain from the Achilles tendon. Thirty-two patients with proximal achillodynia (44 involved Achilles tendons) participated in tests for reliability measures. No significant differences and strong (r=0.56-0.72) or very strong (r=0.90-0.93) correlations were found between pre-tests, except for the documentation of pain at rest (P<0.008, r=0.45). To evaluate the effect of a 12-week treatment protocol for patients with chronic proximal achillodynia (pain longer than three months) 40 patients (57 involved Achilles tendons) with a mean age of 45 years (range 19-77) were randomised into an experiment group (n=22) and a control group (n=18). Evaluations were performed after six weeks of treatment and after three and six months. The evaluations (including the pre-tests), performed by a physical therapist unaware of the group the patients belonged to, consisted of a questionnaire, a range of motion test, a jumping test, a toe-raise test, a pain on palpation test and pain evaluation during jumping, toe-raises and at rest. A follow-up was also performed after one year. There were no significant differences between groups at any of the evaluations, except that the experiment group jumped significantly lower than the control group at the six-week evaluation. There was, however, an overall better result for the experiment group with significant improvements in plantar flexion, and reduction in pain on palpation, number of patients having pain during walking, having periods when asymptomatic and having swollen Achilles tendon. The controls did not show such changes. Furthermore, at the one-year follow-up there were significantly more patients in the experiment group, compared with the control group, that were satisfied with their present physical activity level, considered themselves fully recovered, and had no pain during or after physical activity. The measurement techniques and the treatment protocol with eccentric overload used in the present study can be recommended for patients with chronic pain from the Achilles tendon.

Achilles Tendon↗
PubMed2003

Radioimmunodiagnosis of lymph node metastases in head and neck cancer.

INTRODUCTION: Reliable staging of the neck remains a diagnostic challenge in head and neck squamous cell carcinoma (HNSCC) patients. Monoclonal antibodies (MAbs) directed against tumour-associated antigens can be used for selective tumour targeting. When labelled with a gamma-emitting radionuclide like 99mTechnetium, such MAbs can be used for tumour detection by radioimmunoscintigraphy (RIS). OBJECTIVE: The aim of this study was to assess the potential of RIS for the detection of lymph node metastases in HNSCC patients. PATIENTS AND METHODS: In 49 patients with HNSCC, who were scheduled to undergo surgery including neck dissection, RIS using 99mTc-labelled squamous cell specific MAb E48 or U36 administered intravenously was compared with clinical palpation, computed tomography (CT), magnetic resonance imaging (MRI) and histopathological outcome. RESULTS: RIS detected lymph node metastases in 35 of 51 positive sides (sensitivity 69%). Interpretation of RIS was correct in 47 of 65 sides (accuracy 72%). Accuracy of palpation, CT and MRI were comparable. Immunohistochemical staining of lymph node metastases missed by RIS showed that the injected MAb had targeted these small tumour deposits but these were not visualized. CONCLUSIONS: RIS at its current stage of development is not superior to CT or MRI for the detection of lymph node metastases. As small tumour deposits were probably not visualized because of the limited sensitivity and/or spatial resolution of the gamma camera, positron emission tomography (PET) using MAbs labelled with positron emitters may improve the detection. As MAb-PET studies in an animal model showed promising results we will soon start a clinical MAb-PET study.

Antibodies, Neoplasm↗
PubMed2000

Generalized joint laxity and its relation with oral habits and temporomandibular disorders in adolescent girls.

A group of 248 girls, aged 15-16 years, were randomly selected and examined both clinically and by questionnaire with regard to the signs and symptoms of temporomandibular disorders (TMD), generalized joint laxity (GJL), range of mandibular opening, temporomandibular joint (TMJ) hypermobility and presence of oral parafunctions. The prevalence of GJL was 43% and that of TMJ hypermobility (TMJH) was 27.3%. A significant, albeit weak, correlation was found between the two. In the presence of joint click, both active and passive opening were significantly larger. When either muscle or joint sensitivity to palpation was present, the difference between the active and passive range of mouth opening increased significantly. The presence of reported clicks was negatively associated with GJL. This association was not valid in the presence of parafunction. Some of the signs and symptoms of TMD affected the range of mouth opening. In the presence of joint clicks, the mean active and passive mandibular opening were significantly larger. In the presence of joint and muscle sensitivity to palpation, the difference between passive and active mouth opening was larger. This was possibly because of the effect of pain on the full active range of opening, which was invalid in the registration of the passive mandibular opening. GJL, when present, did not seem to jeopardize the health of the stomatognathic system as expressed in the signs and symptoms of TMD. There was a negative association between GJL and the presence of reported joint clicks and catch. When a parafunction was present in addition to GJL, this association was invalid but not reversed, as has been previously reported.

Adolescent↗
PubMed2002

Surface alterations in the bovine pelvic peritoneum following rectal examination of reproductive organs: a scanning electron microscopy study.

The aim of the present study was to evaluate possible injury provoked by an intensive reproductive programme based on rectal palpation in the cow. Alterations to the mesothelial surface of the peritoneum and to the oviductal mucosa were explored by scanning electron microscopy (SEM). Nine multiparous Friesian cows were selected from each of two commercial dairy herds. Cows in herd 1 were maintained on a weekly reproductive health programme, while those in herd 2 were not subjected to gynaecological exploration. Surface features of the mesothelial cells of the reproductive tract and adjacent ligaments, and the oviductal mucosa were explored by SEM observation of tissue specimens from each animal. Six cows in the intensive reproductive programme showed microscopic alterations of the peritoneal surface. Strands were observed in the oviducts and adjacent ligaments in five of these cows. These strands, composed of filaments covered with mesothelial cells, were probably adhesions. Cells with abundant vacuoles on their surface were detected in the mesothelium corresponding to three animals, two of which also showed microscopic strands. No peritoneal surface alterations were observed in the cows from herd 2. No oviductal mucosal modifications were detected in either group. These findings suggest that intensive reproductive programmes based on rectal palpation may increase the risk of peritoneal surface alterations in the cow, but effects on reproductive physiology are unlikely.

Animals↗
PubMed1987

Pericranial tenderness in tension headache. A blind, controlled study.

Forty patients with tension headache and 40 healthy comparable control persons were palpated by the same "blinded" observer. Tenderness in 10 pericranial muscles on each side was rated on a four-point scale. A Total Tenderness Score was calculated for each individual by adding the scores from all palpated areas. Headache patients had significantly higher scores than controls and also significantly higher tenderness in each point separately. Median normal values and confidence limits for tenderness are given. Among 23 patients with daily headache a correlation was found between headache intensity and Total Tenderness Score. It is likely that the pathologic tenderness in patients with tension headache is the source of nociception, but pain mechanisms are more complex, as evidenced by discrepancy between tenderness and pain in some patients. Pathologic tenderness should be a contributing criterion to the diagnosis of tension headache (muscle contraction headache).

Adult↗
PubMed1996

Muscular disorders in tension-type headache.

In order to evaluate the diagnostic criteria for muscular disorders in tension-type headache, pericranial muscle tenderness and pressure pain thresholds were studied in a random sample population of 735 adults aged 25-64. In addition, quantitative EMGs were recorded in 547 of these subjects. The correlation between the three diagnostic tests was assessed and the discriminality and cut-off points were analysed using Receiver Operating Characteristics analysis. Local tenderness from the temporal muscles was closely related to the total tenderness scores from 14 pairs of muscles. In chronic tension-type headache, tenderness was positively related to EMG and inversely related to pain thresholds. In the episodic from the total tenderness score was inversely related to pain thresholds, whereas no significant relation to EMG was noted. The Receiver Operating Characteristics curves indicated that tenderness recorded by manual palpation was the most specific and sensitive test, whereas EMG and pain thresholds were of limited diagnostic value. Eighty-seven percent of subjects with the chronic, and 66% of subjects with the episodic form were found to have a "muscular disorder" defined as increased tenderness recorded by either manual palpation or pressure algometry and/or increased EMG levels. However, muscle tenderness increased significantly during pain, so the headache state should be considered in future studies. Suggestions for revision of the present diagnostic criteria for muscular disorders are given.

Adult↗
PubMed2001

[Diagnosis of urethral diverticula and periurethral masses].

AIM: To give recommendations for the standard diagnostic assessment of urethral diverticula and periurethral masses based on an evaluation of our results and a survey of the recent literature. METHODS: Group I (1981-1993) included 47 women in whom urethral diverticula (n = 34), periurethral cysts (n = 11), and periurethral leiomyomas (n = 2) were diagnosed and the results compared with the intraoperative findings. Diagnostic work-up comprised history taking, vaginal palpation, introitus ultrasound, double-balloon urethrography (DBU), voiding cystourethroscopy (VCU), excretion urography (EU), and urethrocystoscopy. Group II (1994-1996) included 12 women with urethral diverticula who were examined by DBU, 2D and 3D introitus ultrasound. The diagnostic accuracy of the different methods was assessed. RESULTS: Group I: The diagnostic accuracy in identifying urethral diverticula was 85.3% for palpation, 61.5% for introitus ultrasound, 93.8% for DBU, 37.5% for EU, and 30.0% for urethrocystoscopy. Of all imaging modalities used, only introitus ultrasound depicted periurethral cysts and leiomyomas. Group II: The DBU, 2D and 3D introitus ultrasound had a diagnostic accuracy of 100% in identifying urethral diverticula. CONCLUSIONS: Introitus ultrasound should be used as the basic diagnostic tool in clinically suspected urethral diverticula or periurethral masses and additional DBU should be restricted to cases with inconclusive findings.

Adult↗
PubMed2006

[Intraoperative ultrasound in surgery of the parotid and the head-and-neck region].

Sonography of the head-and-neck region is well established in the preoperative diagnostic process of tumorous lesions. Its intraoperative use to localise small tumours, however, has been rarely investigated to date. We applied intraoperative ultrasound to 19 patients who underwent parotid surgery and evaluated the following criteria: intraoperative tumour presentation, scan quality, comparison between sonographic visualisation and tumour detection by palpation, histological tumour borders as well as postoperative complications. All lesions were reproduceable by intraoperative ultrasound and could be demonstrated in sufficient quality. None of the 19 parotid tumours could be identified by palpation pre- and intraoperatively. All tumour capsules remained intact, the tumours were completely removed and no postoperative complications were observed. Problems of ultrasound application may arise due to significantly altered anatomic landmarks while surgical preparation proceeds. Intraoperative ultrasound is fast, dynamic and feasible under sterile conditions. Especially in parotid surgery with small, non-palpable tumours, intraoperative ultrasound supports minimal-invasive surgery.

Head and Neck Neoplasms↗
PubMed1991

[Regional lymph node metastases in malignant tumors of the head and neck: value of diagnostic procedures].

Sonography and computed tomography are used in staging of lymph nodes of patients with head and neck cancer. The accuracy of sonography (90%) and computed tomography (85%) is comparable or better than the palpatory accuracy (85%). The better delineation of reactive swollen cervical nodes leads to a higher sensitivity of sonography (90%) and computed tomography (84%) versus palpation (74%), but a lower specifity (palpation 94%, sonography 90%, computed tomography 86%). A literature survey shows that sonography, computed tomography and magnetic resonance imaging of cervical lymph nodes are comparable good methods.

Carcinoma, Squamous Cell↗
PubMed1992

[Computed tomography: the TNM staging of laryngeal carcinoma].

In 64 patients with malignant lesions of the larynx, CT and microlaryngoscopy (ML) were evaluated in terms of T-staging. Histological information was present in all cases following operation. CT showed an accuracy of 90% in T-staging. ML showed an accuracy of only 71% of correct T-staging. CT is superior to ML particularly in distinguishing between stages T3 and T4 and T1 and T2. CT tends to overestimate tumour stage whereas ML tends to underestimate it. CT was also compared with palpation and sonography as regards N-staging. In this respect sonography has the highest accuracy (94%) followed by palpation (76%) and CT (74%).

Carcinoma↗
PubMed1985

[Sonography of the thyroid gland with high-resolution real-time equipment].

The results of sonography of thyroid glands in 131 patients were compared with the findings on palpation and from scintigrams. High resolution sonography is the most accurate method of examination for demonstrating changes in the thyroid. In 40% cases sonography demonstrated lesions additional to the single abnormality found clinically. In 10% cases a suspected thyroid abnormality on palpation proved to be due to extra thyroid disease. Evaluation of the number, size and localisation of space-occupying lesions by means of sonography is superior to all other kinds of investigation. It is, however, not possible to determine whether a lesion is benign. An attempt has been made to define the usefulness of thyroid sonography and its place during routine diagnosis.

Female↗