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At least 1,189 records · Page 66Linked to original sources
PubMed1977

Pain arising in the posterior arch of the atlas.

Headache of cervical origin is by no means an adequate diagnosis. The exact mechanism has to be established for the case in question. A type of cervical headache which arises from the posteriorr arch of the atlas is described. The basic finding is tenderness of this structure on palpation; the technique of palpation is described. In a majority of cases movement restriction (blockage) between the occiput and the atlase is found. The headache as described by the patient is not characteristic, migrainous attacks being present in about one-third of the cases. A frequent feature is pain on retroflexion of the head. Treatment consists of manipulation of the blockage, and infiltration or needling of the posterior arch of the atlas if there is no blockage or if pain continues after the restoration of mobility. In the more complicated cases remedial exercise is indicated. Experience with 64 cases is described.

Atlanto-Occipital Joint↗
PubMed1979

Pregnancy diagnosis in the common marmoset (Callithrix jacchus jacchus).

Abdominal palpation of the uterus was carried out on 25 pregnant and 29 non-pregnant marmosets (Callithrix jacchus jacchus). 195 complete 24-hour urine specimens, collected between the first week of gestation and term (21 weeks), were tested with the Sub-Human Primate Tube (SHPT) test. No significant differences between the two methods in their ability to diagnose pregnancy were obtained between the first and 13th week of gestation. The SHPT test was seldom positive after the 13th week of pregnancy, whereas, with one exception, palpation always indicated pregnancy.

Animals↗
PubMedDate not supplied

Evaluation of branchiogenic cysts by ultrasound.

Ultrasound and palpation findings of 17 patients with branchiogenic cysts were studied. Results were compared with operative and histopathologic findings in 13 patients, and to fistulography, cytologic examination and/or CT in 4 patients. Ultrasound findings (appearance, location and extension) were characteristic in 15 of 17 cases. Palpation proved to be incorrect or inconclusive in more than half of the patients. It is concluded that ultrasound examination of the neck may contribute to the correct presurgery diagnosis of branchiogenic cysts.

Biopsy, Needle↗
PubMed1975

Muscular tension and psychopathology. A comparison of four psychopathological groups by general physiotherapeutic examination of muscular tension.

From 1968 to 1970, 136 test patients divided in four groups have been examined by general physiotherapeutic muscle tension examination. Group 1 were psychotic patients, group 2 were neurotic patients, and both groups were inpatients in a psychiatric hospital. Group 3 were ambulant patients at a physical institute and group 4 were healthy control persons. Each group was examined by five different, independent clinical muscle tension investigations: (1) examination of posture when standing and lying supine; (2) examination of respiration standing and lying supine; (3) examination of resistance to passive movements; (4) examination of muscle elasticity on palpation, and (5) examination of the patients reaction to the palpation. Altogether 47 variables were investigated, and of these 34 gave results which were statistically significant. This study confirms that there is a systematic connection between muscle tension and psychic conditions and the physiotherapeutic muscle tension investigation can contribute to diagnosing the degree of psychopathology and could be an aid in the selection of treatment. It is of interst to find out whether there is a connection between tension of the skeletal muscles on the one side and psychopathology on the other. A possible connection between the two might open the door for a comprehensive understanding of somatical and psychological illnesses, and offer the possibility for a more concise and direct treatment.

Adolescent↗
PubMed1992

Effect of digital rectal examination on serum concentration of prostate-specific antigen.

Prostate-specific antigen (PSA) is used for screening and follow-up of patients with prostate cancer. The effect of certain diagnostic procedures on PSA serum levels is not well defined. Therefore, the effect of digital rectal examination (DRE) on PSA serum levels was investigated. No significant difference was observed in PSA values before and after DRE when blood samples were taken 1-3 min after palpation of the prostate. Kinetic studies demonstrated a significant increase in PSA values up to the factor 3.2 in 14 of 19 patients 2-6 h after DRE. In 9 of 14 cases, PSA was within the initial range 24 h after DRE. That means that a urologist is allowed to take blood samples for the determination of PSA at least within 3 min after palpating a suspicious prostate without getting false-positive results.

Aged↗
PubMed1989

Computed tomography in patients with laryngeal carcinoma: a clinical perspective.

Among the various diagnostic modalities that have been recommended for preoperative assessment of the patient with laryngeal carcinoma is computed tomography. While good overall correlation between CT findings and operative findings has been noted, a significant number of false positives and false negatives have been found, particularly with regard to cartilage invasion and lymphadenopathy. We compared the findings of direct laryngoscopy, palpation of the neck, and CT with pathologic specimens in 29 patients who underwent surgery for carcinoma of the larynx. We found that CT scanning underestimated the extent of neoplastic involvement in over half the cases. With respect to cartilage invasion we determined a significant number of false-negative findings. Computed tomographic scanning was equivalent to palpation in predicting cervical metastasis. Our findings indicate that the role of CT scanning may be more limited than previously acknowledged, particularly in patients for whom nonconservation surgery is planned.

Carcinoma↗
PubMed2001

Pressure-pain thresholds and MRI effusions in TMJ arthralgia.

It has been suggested that MRI-depicted effusions identify patients with TMJ arthralgia. The Research Diagnostic Criteria (RDC) propose a pressure-pain threshold (PPT) of 1 pound for the identification of TMJ arthralgia. The hypotheses in this study were that: (1) there is no association between MRI-depicted effusions and TMJ arthralgia, and (2) a PPT of 1 pound does not discriminate between subjects with and those without arthralgia. Thirty females with TMJ disc displacement with reduction were divided into two groups based on the presence or absence of the self-report of TMJ pain. Bilateral TMJ PPTs and MRIs were obtained. Increasing palpation pressure from 1 to 3 pounds increased the sensitivity for identifying arthralgia from 22% to 100%, with a corresponding decrease in the specificity from 100% to 81%. The sensitivity and specificity of effusions for identifying arthralgia were 85% and 28%, respectively. These results suggest that the use of palpation pressures greater than 1 pound is a valid test for TMJ arthralgia. However, TMJ effusions lack adequate specificity for identifying TMJ arthralgia and were not associated with pain.

Adult↗
PubMed2003

Epidemiological investigations of an outbreak of intestinal atresia in two Israeli dairy herds.

An epidemiological investigation of an outbreak of intestinal atresia in Israeli Holstein-Friesian newborn calves showed a linkage with rectal palpation for early pregnancy diagnosis, performed less than 42 days after insemination. The odds of an exposed calf, i.e., one born to a dam that was diagnosed by early palpation as having intestinal atresia were 119.7 times higher than one born in normal control herds (95% CI; 7.4-1946.3). A total of 682 calves-at-risk was recorded from mid-1998 to mid-2000 and a total of 47 calves (6.9%) were born with intestinal atresia during this period. Two forms of intestinal atresia were recognized at post-mortem: atresia coli and atresia ilei.

Animals↗
PubMedDate not supplied

Doppler ultrasound--basics revisited.

Palpation of pedal pulses alone is known to be an unreliable indicator for the presence of arterial disease. Using portable Doppler ultrasound to measure the resting ankle brachial pressure index is superior to palpation of peripheral pulses as an assessment of the adequacy pf the arterial supply in the lower limb. Revisiting basics, this article aims to aid the clinician to understand and perform hand-held Doppler ultrasound effectively while involving the client or patient in the process. The author describes the basics of Doppler ultrasound, how to select correct equipment for the process, and interpretation of results to further enhance clinicians' knowledge.

Animals↗
PubMed1995

Ankle pulses are not sufficient to detect impaired arterial circulation in patients with leg ulcers.

Much debate has taken place on the use of Doppler ultrasound in the community setting. A sequential study of patients attending a community ulcer clinic was undertaken to identify community nurses' ability to detect arterial disease by palpation of pedal pulses and to compare these figures with the recording of a resting pressure index. A total of 462 patients (553 limbs) were studied; 167 (31%) had no detectable pulses at the ankle. Of the 93 limbs with a reduced resting pressure index (< 0.9), 37% had detectable pulses. Of the 440 with a normal resting index (> or = 0.9), 25% had no detectable ankle pulses. A number of risk factors were identified. Palpation of pedal pulses alone by community nurses is a poor prediction of arterial disease and should be accompanied by the recording of a resting pressure index.

Aged↗
PubMed2000

Analysis of physician ability in the measurement of pulsus paradoxus by sphygmomanometry.

CONTEXT: Measurement of pulsus paradoxus (PP) is one of several measures previously advocated in the National Heart, Lung, and Blood Institute asthma management guidelines: a pulsus of > 12 mm Hg warranted hospital admission. It is one of only a few measures that is not effort dependent and therefore important in the evaluation of patients with asthma. OBJECTIVE: Determination of physician accuracy in measuring PP. DESIGN: A model of induced PP in a trained healthy subject without respiratory disease was constructed with a fixed inspiratory resistance with measurement of inspiratory air pressure and beat-to-beat BP noninvasively. SETTING: Laboratory. PARTICIPANTS: Attending physicians from emergency medicine and critical care disciplines who served as consecutive examiners of the trained reference subject generating known PP. INTERVENTIONS: A total of 19 attending physicians were assessed for ability in measuring PP by sphygmomanometry and by palpation. The reference subject generated 4 degrees of PP sequentially, with each examiner blinded to the value of negative inspiratory pressure and PP. Examiners first assessed PP qualitatively by palpation, followed by its measurement within 2 min. MAIN OUTCOME MEASURE: Proximity of physician-measured PP (PPm) to true PP (PPt). RESULTS: At inspiratory pressures of - 10, - 15, - 20, and - 25 mm Hg, PPt was 13.7, 16.2, 19.1, and 20.7 mm Hg, respectively (F = 14.8, p < 0. 0001; analysis of variance [ANOVA]). At the same pressures, PPm was 13.1, 17.5, 17.7, and 18.0 mm Hg (p > 0.10; ANOVA). Linear regression of PPm against PPt for each examiner revealed a slope (SE) of 0.53 (0.23), and not a 1:1 relationship. CONCLUSIONS: Past and present guidelines do not account for the challenges in measuring PP, especially in tachypneic patients. Sphygmomanometric determination of PP should be augmented by new aids developed through technological innovation.

Adult↗
PubMed2006

The treatment of painful temporomandibular joint clicking with oral splints: a randomized clinical trial.

BACKGROUND: The authors compared the efficacy of bilateral balanced and canine guidance (occlusal) splints in the treatment of temporomandibular joint (TMJ) pain in subjects who experienced joint clicking with a nonoccluding splint in a double-blind, controlled randomized clinical trial. METHODS: The authors randomly assigned 57 people with signs of disk displacement and TMJ pain into three groups according to the type of splint: bilateral balanced, canine guidance and nonoccluding. The authors followed the groups for six months using analysis of a visual analog scale (VAS), palpation of the TMJ and masticatory muscles, mandibular movements and joint sounds. They used repeated analysis of variance and a chi(2) test to test the hypothesis. RESULTS: The type of guidance used did not influence the pain reduction, yet both occlusal splints were superior to the nonoccluding splint, on the basis of the VAS. Despite similar outcomes in relation to opening, left lateral and protrusive movements, TMJ and muscle pain on palpation, subjects who used the occlusal splints had improved clinical outcomes. The frequency of joint noises decreased over time, with no significant differences among groups. Subjects in the groups using the occlusal splints reported more comfort. CONCLUSION: The type of lateral guidance did not influence the subjects' improvement. All of the subjects had a general improvement on the VAS, though subjects in the occlusal splint groups had better results that did subjects in the nonoccluding splint group.

Adult↗
PubMed2002

Primary thyroid disorders in endogenous Cushing's syndrome.

OBJECTIVE: To study the prevalence of primary thyroid disorders in patients who underwent endogenous hypercortisolism. DESIGN: Retrospective evaluation of 59 patients with Cushing's syndrome (CS) who had, at least, a record of thyroid palpation by expert endocrinologists and basal measurements of TSH by second generation assays. When available, tri-iodothyronine and thyroxine serum levels, TRH-TSH tests and anti-thyroid antibodies were also analyzed. There were two age- and gender-matched control groups. The 'goiter control group' comprised 118 healthy subjects who underwent thyroid palpation. The 'antibody control group' was composed of 40 individuals who attended the blood bank of our hospital. Antibodies against thyroperoxidase and measurements of TSH were analyzed in their blood samples. METHODS: Available files of 83 CS patients admitted to our endocrine unit from 1985 to 1998 were examined. Fifty-nine patients (52 women and 7 men) with a mean age of 36.2 years (range 14-61 years) met the above requirements. Diagnosis of hypercortisolism had been established by a standard 1-mg overnight dexamethasone suppression test and urinary free cortisol (UFC). Etiological diagnosis involved dynamic testing, measurements of ACTH levels and imaging techniques. After treatment, all but one of the patients were cured or controlled of their hypercortisolism. This was established by the finding of subnormal serum cortisol concentrations and/or subnormal 24-h UFC levels. Primary thyroid disorders were defined by the presence of one or more of the following diagnostic criteria: (i) goiter, (ii) positive anti-thyroid antibodies and/or (iii) primary thyroid function abnormalities. RESULTS: Eighteen (30.5%) patients had goiter (diffuse in 78% and nodular in 22%), 14 (23.7%) had primary subclinical hypothyroidism and 5 (8.4%) had hyperthyroidism. In 41 patients evaluated for antithyroid antibodies, it was found that 23 (56.1%) had positive titers. In a group of patients in which thyroid autoantibodies were measured both before and after resolution of hypercortisolism, prevalences of positive titers were 26.7% and 86.7% respectively (P=0.001). The overall frequency of primary thyroid abnormalities in our patients with Cushing's syndrome was 55.9%. CONCLUSIONS: Patients with endogenous Cushing's syndrome exhibit a remarkably high prevalence of primary thyroid disease. Resolution of hypercortisolism seems to trigger the development of autoimmune thyroid disorders in presumably predisposed subjects.

Adolescent↗
PubMed2001

Hepatosplenic schistosomiasis in field-based studies: a combined clinical and sonographic definition.

A combined clinical and sonographic classification of hepatosplenic schistosomiasis mansoni to be used in field-based studies is proposed herein. Seven hundred forty one individuals out of 892 (83%), living in an area endemic for schistosomiasis in Brazil, have been submitted to clinical and ultrasound examinations. Based on two stool examinations the overall prevalence for schistosomiasis in this area was 73%. Abdominal palpation was performed with patients in dorsal decubit, during deep breath, by two experienced physicians and a portable ultrasound was used for the evaluation of liver fibrosis, portal collaterals and spleen size. Four groups of individuals were identified using data obtained by abdominal palpation and ultrasound examination: (1) palpable spleen and intense periportal thickening in 9 individuals (1.2%); (2) spleen not palpable and intense periportal thickening in 15 (2%); (3) palpable spleen with light to moderate periportal thickening in 32 (4.3%), and (4) palpable spleen with a normal liver on ultrasound in 30 (4%). The definition of hepatosplenic schistosomiasis in field-based studies as the finding of Schistosoma mansoni eggs in the stools in an individual with splenomegaly is not acceptable anymore. Abdominal ultrasound should be combined with clinical examination to accurately identify hepatosplenics in endemic areas for schistosomiasis.

Adolescent↗
PubMed2003

Noninvasive classification of liver disease in asymptomatic and oligosymptomatic male alcoholics.

The predominant type of liver alteration in asymptomatic or oligosymptomatic chronic male alcoholics (N = 169) admitted to a psychiatric hospital for detoxification was classified by two independent methods: liver palpation and multiple quadratic discriminant analysis (QDA), the latter applied to two parameters reported by the patient (duration of alcoholism and daily amount ingested) and to the data obtained from eight biochemical blood determinations (total bilirubin, alkaline phosphatase, glycemia, potassium, aspartate aminotransferase, albumin, globulin, and sodium). All 11 soft and sensitive, and 13 firm and sensitive livers formed fully concordant groups as determined by QDA. Among the 22 soft and not sensitive livers, 95% were concordant by QDA grouping. Concordance rates were low (55%) in the 73 firm and not sensitive livers, and intermediate (76%) in the 50 not palpable livers. Prediction of the liver palpation characteristics by QDA was 95% correct for the firm and not sensitive livers and moderate for the other groups. On a preliminary basis, the variables considered to be most informative by QDA were the two anamnestic data and bilirubin levels, followed by alkaline phosphatase, glycemia and potassium, and then by aspartate aminotransferase and albumin. We conclude that, when biopsies would be too costly or potentially injurious to the patients to varying extents, clinical data could be considered valid to guide patient care, at least in the three groups (soft, not sensitive; soft, sensitive; firm, sensitive livers) in which the two noninvasive procedures were highly concordant in the present study.

Adult↗
PubMed2004

Prevalence of abdominal aortic aneurysms--a screening program in São Paulo, Brazil.

CONTEXT: Abdominal aortic aneurysm is an asymptomatic but potentially fatal condition. Elective surgery can prevent death from rupture, and is indicated for aneurysms larger than 45 mm. Because aneurysms tend to grow with time, detection of small ones (> 29 mm) may lead to a closer follow-up of patients at risk. OBJECTIVE: To determine the prevalence of abdominal aortic aneurysms in São Paulo, Brazil. DESIGN: Prospective, descriptive. SETTING: University Hospital. PARTICIPANTS: Persons aged 50 years or more were offered, through the press, the opportunity to be screened for abdominal aortic aneurysm. The total number screened was 2,756. PROCEDURE: All were submitted to abdominal palpation and ultrasound examination. PARAMETER STUDIED: A maximum diameter of 30 mm or more was considered to be an aneurysm. RESULTS: Sixty-four aneurysms were detected, nine of which measuring more than 49 mm. Palpation detected 60 aneurysms, but only 20 of these were confirmed by the ultrasound. Conversely, 41 of the ultrasound-detected aneurysms were not palpable. The percentages of abdominal aortic aneurysms found in the subgroups via ultrasound examination (with 95% confidence interval) were as follows: total group, 2.3 (1.8-3); men, 4.6 (3.5-5.9); women, 0.6 (0.3-1.1); men aged 60 or more, 6 (4.3-8); women aged 60 or more, 0.9 (0.4-1.8). CONCLUSION: In Sao Paulo, Brazil, 1.8 to 3 % of persons aged 50 years or more are expected to have abdominal aortic aneurysms. In the subgroup of men aged 60 or more, the expected prevalence is between 4.3 and 8%.

Age Distribution↗
PubMed1990

[Quantification of tenderness of masticatory muscle].

As more dentists diagnose and treat the patient with temporomandibular disorders, muscle palpation has been recognized as a valuable diagnostic method. But this method was depended on sensibility and experience of the operator. The purpose of this study was to establish the quantification of muscle palpation by new pressure pain threshold apparatus. Pressure pain threshold (PPT) was determined by the subject when a ramp force applied to the skin changed from "pressure" to "pain". The subjects for the experiments were 90 normal males, 100 normal females and one patient with temporomandibular disorders. Total of 12 sites, anterior temporal M., posterior temporal M., superficial portion of masseter M. and deep portion of masseter M., were measured. The results obtained were as follows: 1. The females showed lower PPT than the males. 2. No difference of PPT between right and left sides was recognized in normal subject, but the significant difference in the patient. 3. PPT of the normal subjects were significantly higher in the posterior temporal M. than the other sites and lower in the superficial portion of masseter M. than the other sites.

Facial Pain↗
PubMed1987

Standardized endosonographic evaluation of prostate cancer: receiver-operator-characteristic analysis.

A standardized endosonographic numeric method has been developed for the detection of prostate cancer. Eighty-six men were examined with a 5-MHz, 96-element linear-array probe. Mean gray-scale amplitudes were produced by a semiautomatic method for periprostatic fat and regions of interest within the external portion of the prostate gland that were visually suspicious for prostate cancer. Mean gray-scale amplitude ratios of visually abnormal areas of prostate to periprostatic fat (Ap/Af) were calculated. Pathologic confirmation of disease was obtained in all patients. Three different numeric Ap/Af ratios were compared with digital palpation and subjective visual interpretation of sonograms. The numeric method resulted in a consistently higher specificity, accuracy, and positive predictive value when compared with palpation and subjective interpretation. The initial results suggest that this technique may also detect atypical hyperplasia.

Adenocarcinoma↗