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At least 1,279 records · Page 71Linked to original sources
PubMed1996

Use of diagnostic ultrasonography in horses with signs of acute abdominal pain.

OBJECTIVE: To evaluate the use of abdominal ultrasonography as a diagnostic tool in horses with signs of colic. DESIGN: Prospective study. ANIMALS: 226 horses with signs of acute abdominal pain were compared to 20 clinical normal horses. PROCEDURE: The following were performed in horses with signs of colic: physical examination, CBC, abdominal fluid analysis, placement of a nasogastric tube to obtain gastric reflux, abdominal palpation per rectum, and ultrasonography of the abdomen. Results of ultrasonography were compared with the surgical, necropsy, or medical findings. RESULTS: Ultrasonography of horses with primary small-intestine lesions revealed images of small intestine with a wall thickness of 0.2 to 1.8 cm and a diameter of 3.6 to 13.5 cm without evidence of motility. Horses with peritonitis did have evidence of small-intestine motility on ultrasonography with a wall thickness of 0.5 to 1.3 cm and a diameter of 2 to 5.1 cm. Horses with primary large-colon lesions or small-colon impactions had small-intestine diameters on ultrasonographic evaluation of 3 to 7.1 cm. In these horses, small-intestine motility was detected. If abnormal small intestine that lacked motility was detected by ultrasonographic evaluation, the sensitivity, specificity, and positive and negative predictive values for small-intestine stragulation obstructions were 100%. Detection of distended or edematous small intestine by abdominal palpation per rectum provided a sensitivity of 50%, specificity of 98%, positive predictive value of 89%, and negative predictive value of 89% for small-intestine strangulation obstructions. CLINICAL IMPLICATIONS: The use of abdominal ultrasonography. In horses with signs of colic is accurate for detecting small-intestine strangulation obstructions.

Abdominal Pain↗
PubMed1995

The relationship between muscle tenderness and craniomandibular disorders: a study of 35-year-olds from the general population.

Of a random sample of 345 subjects aged 35 years and drawn from the general population of Västerbotten County, Sweden, 276 (80%) participated in an epidemiologic survey on muscle tenderness of the jaw, neck, shoulder, arm, hand, and calf, and on the prevalence of signs and symptoms of craniomandibular disorders. The control group consisted of 144 subjects (52%) who had no tenderness. The remaining subjects were separated into groups: (1) 59 subjects (21%) with tenderness only in jaw muscles; (2) 26 subjects (9%) with tenderness only in neck/shoulder muscles; (3) 39 subjects (14%) with tenderness in muscles of the jaw and neck/shoulder; and (4) eight subjects (3%) with tenderness in all palpated muscles of the neck, shoulder, arm, hand, and calf. Women were found to have palpation tenderness significantly more often than men (P < .05). The main finding of this study was the presence of a significantly higher proportion of signs and symptoms of craniomandibular disorders in the group who had both jaw muscle tenderness and neck/shoulder muscle tenderness and in the group who had generalized tenderness than in the control group. The results indicate that in epidemiologic and clinical research of craniomandibular disorders, a distinction between local, regional, and general tenderness should be made since the etiology may differ.

Adult↗
PubMed1997

[Iodine supply at various periods in life and ultrasonographic thyroid volume in school children in a region of Switzerland].

In Switzerland the previous severe iodine deficiency has been corrected by iodization of salt. Changing food habits make it mandatory to periodically monitor iodine intake. In 1994 we therefore measured thyroid volume by sonography in 217 schoolchildren, and iodine, creatinine and sodium in casual urine samples of 214 schoolchildren, 40 pregnant women and 30 breast-fed newborns. Iodine was also measured in 30 breast milk samples. In schoolchildren, goiters of WHO grades Ia/Ib/II were found by palpation in 10.6/2.3/ 0.9%. By contrast, only two of the children had a sonographic thyroid volume exceeding the 97 percentile of the WHO, which underlines the difficulty of estimating the size of small goiters by palpation. Mean thyroid volume at 6/7/9/ 10/11 years of age was 2.1/2.2/3.3/3.3/3.1 ml, which is well within the normal range suggested by the WHO. Mean urinary iodine in schoolchildren (118 +/- 49 micrograms per gram creatinine) and in pregnant women (193 +/- 113 micrograms per gram creatinine) is within required limits, albeit with a decrease since 1988. In breast milk (7.8 +/- 5.9 micrograms/dl) and in urine of newborns (6.6 +/- 3.3 micrograms/dl) iodine values are below the Swedish reference values but well above values found in iodine deficient areas. We conclude that the iodine supply in schoolchildren and pregnant women is just sufficient and in newborns slightly below recently recommended limits. Compared to 1988 the iodine supply to schoolchildren is diminishing. The discrepancy between the rather low iodine content in breast milk despite a normal iodine supply during pregnancy remains to be explained.

Breast Feeding↗
PubMed1997

[Pre- and intraoperative localization of neuroendocrine tumors].

Previous studies of the intraoperative use of a hand-held gamma probe to localize metastases and primary tumors of colorectal cancer have shown improved assessment of tumor spread and changes in surgical management based on added information gained by radioimmunoguided surgery. Following the injection of 180 MBq [111In-DTPA-D-Phe1]-pentetreotide and/or 500 MBq 99mTc-dimercaptosuccinic acid (both for dual-radionuclide scintigraphy) preoperative somatostatin receptor imaging [11 patients with GEP tumors] and dual-radionuclide scintigraphy. (8 patients with relapsing medullary thyroid carcinomas) was performed. One patient with a metastasizing pheochromocytoma underwent 123]-MIBg scintigraphy. Results were combined with the information obtained from conventional imaging modalities. Intraoperative radiodetection was performed 24 hours after administration of [111In-DTPA-D-Phe1]-pentetreotide or 4 hours following the injection of 99mTc(V)DMSA using a hand-held gamma probe (Tec Probe 2000. Stratec, FRG). Intraoperative gamma counting localized 39 somatostatin receptor positive lesions of GEP tumors whereas preoperative receptor imaging visualized 81%, surgical palpation 41% and radiological imaging modalities localized only 31%. In 8 patients with recurrent medullary thyroid carcinoma the surgeon was successful in localizing and removing 18 tumor lesions by the help of the gamma probe. Dual-radionuclide scintigraphy revealed 77% (Octreoscan 5/18; 99mTc-V-DMSA 9/18), surgical palpation 55% and conventional imaging methods (CT, sonography) only 38% of all lesions detected intraoperatively by the hand-held gamma probe. In summary, this preliminary data show that intraoperative hand-held gamma probe detection of microscopic and occult endocrine tumors is feasible and more sensitive than external scintigraphy and conventional imaging.

Adrenal Gland Neoplasms↗
PubMed1997

[Critical comparison of rectal and ultrasonographic results of ovarian conditions in the interestrus of cattle].

41 heifers of 260-440 kg body weight used in an experiment were polyovulated with PGF2 alpha and PMSG (1000 IU). Animals were slaughtered during luteal phase of ovarian cycle (day 12-15). Shortly before slaughter ovarian structures were defined by rectal palpation und ultrasonographical examination. Post mortem ovaries were collected to compare their structures with previously performed in vivo diagnosis. More follicular structures were detected sonographically (109%) than could be found by morphologic examination (100%). Concerning corpora lutea a right diagnosis was made by palpation in 94% of cases, whereas the rate was only 85% for ultrasonographical examination. Main reasons for false diagnoses of ultrasonographical examination are as follows: multiple ovarian structures, corpora lutea with holes inside, atypical shape of ovaries, atypical ultrasonographical pictures and irregular shape of follicles.

Animals↗
PubMed1998

Laparoscopic anterior spinal arthrodesis with rhBMP-2 in a titanium interbody threaded cage.

Anterior lumbar interbody arthrodesis is commonly performed for conditions involving infection, deformity, and instability. The purpose of this investigation was to determine the effective dose of recombinant human bone morphogenetic protein-2 (rhBMP-2) as a bone graft substitute inside a titanium threaded interbody fusion cage using a nonhuman primate model of laparoscopic anterior lumbar interbody arthrodesis. Eight adult rhesus monkeys underwent laparoscopic exposure of the lumbosacral spine followed by insertion of a hollow titanium threaded cylindrical cage (Sofamor-Danek, Memphis, TN, U.S.A.). Before insertion, the chamber of the cage was filled with a collagen sponge delivery vehicle soaked with either 0 mg/ml (sham, buffer only), 0.75 mg/ml (low dose), or 1.5 mg/ml (high dose) of rhBMP-2 (Genetics Institute, Cambridge, MA, U.S.A.). Fusions were evaluated in a blinded fashion with plain radiographs and computed tomography (CT) scans 12 and 24 weeks after surgery, and by manual palpation and histology after euthanasia 24 weeks after surgery. All five monkeys treated with a cage filled with rhBMP-2 obtained a solid fusion as assessed by manual palpation. The two monkeys that received no growth factor did not achieve solid fusions. Plain radiographs were of limited value, with fusions best assessed on sagittally reconstructed CT scans. Scans from the two animals treated without growth factor showed ingrowth of bone only into the outer edges of the cage, but not through the center. Scans from the rhBMP-2-treated animals demonstrated arthrodesis with continuous bone growth through the cage. Histologic analysis demonstrated normal mature trabecular bone surrounding and growing through the cages, which correlated with the CT scan findings. We conclude that rhBMP-2 delivered in a threaded titanium interbody cage can serve as a bone graft substitute in a nonhuman primate model. Sagittal reconstructed CT may be a better method to assess for fusion with this device.

Animals↗
PubMedDate not supplied

Magnetic resonance imaging in the diagnosis of local recurrences in breast cancer.

Breast conserving therapy (BCT) has turned out to be the standard procedure for the treatment of breast cancer. While the risk of local recurrences was reported as 1-2% or more per year after treatment, follow-up including clinical examination, mammography and even sonography is of priority. This study was performed to assess the efficacy of contrast-enhanced dynamic magnetic resonance tomography (NMR) for the diagnosis of local recurrences after breast conserving therapy, compared to palpation, mammography and ultrasound. In 33 patients local recurrences within the breast were diagnosed after breast conserving surgery. The sensitivity for the diagnosis of local recurrences after BCT was as follows: palpation (51%), mammography (67%), ultrasound (85%) and NMR (91%). All multicentric local recurrences were diagnosed by NMR. Mammography was not able to diagnose 11 local recurrences in radiodense breasts. Here ultrasound was able to diagnose 8 of 11 recurrences, while NMR was able to diagnose 10 of 11 recurrences. Therefore, ultrasound should be included into routine follow-up protocols after BCT to achieve an acceptable sensitivity for the detection of local recurrences. Under defined conditions and indications MRI is the best method to complement mammography and sonography with the highest sensitivity for the diagnosis of local recurrences in the radiodense breast.

Adult↗
PubMed1998

[Epidemiology of iodine deficiency in the middle Ob regions].

AIM: Epidemiological rvaluation of goiter endemia and iodine deficiency in population of the Middle Ob region. MATERIALS AND METHODS: Thyroid palpation and ultrasonic investigations, iodine measurements in the urine were made in 6256 children and adolescents aged 8-17 years. RESULTS: Euthyroid condition was clinically stated in all the examinees. Palpation discovered thyroid enlargement in 36.78% of the examinees. Age prevalence was: 27.3, 33.28, 42.8, 46.18% in children and adolescents aged 8-10, 11-12, 13-14 and 15-17 years, respectively. Ultrasound detected goiter in 30.6% of the examinees. The occurrence was 34.78, 31.68, 28.2, 19.8% in the above age groups, respectively. No significant differences by thyroid size existed in girls versus boys. Urinary iodine was low in all the age groups. CONCLUSION: The Middle Ob regions belong to zone of goiter endemia with mild to moderate iodine deficiency. This dictates the necessity of introduction of special programs of iodine deficiency control and prevention.

Adolescent↗
PubMed2001

Cyclobenzaprine and back pain: a meta-analysis.

BACKGROUND: Back pain is a common problem for which cyclobenzaprine hydrochloride is frequently prescribed. OBJECTIVE: To perform a systematic review of cyclobenzaprine's effectiveness in the treatment of back pain. METHODS: We searched MEDLINE, PsycLIT, CINAHL, EMBASE, AIDSLINE, HEALTHSTAR, CANCERLIT, the Cochrane Library, Micromedex, Federal Research in Progress, and the references of reviewed articles, and contacted Merck, Sharpe and Dohme for English-language, randomized, placebo-controlled trials of cyclobenzaprine in adults with back pain. Outcomes included global improvement and 5 specific domains of back pain (local pain, muscle spasm, range of motion, tenderness to palpation, and activities of daily living). Study quality was assessed using the methods of Jadad. Summary outcomes were obtained using a random-effects model. RESULTS: Patients treated with cyclobenzaprine were nearly 5 times (odds ratio, 4.7; 95% confidence interval, 2.7-8.1) as likely to report symptom improvement by day 14 as were those treated with placebo. Slightly fewer than 3 individuals (2.7; 95% confidence interval, 2.0-4.2) needed treatment for 1 to improve. The magnitude of this improvement was modest, with an effect size of 0.38 to 0.58 in all 5 outcomes (local pain, muscle spasm, tenderness to palpation, range of motion, and activities of daily living). Treatment efficacy for these 5 outcomes was greatest early, in the first few days of treatment, declining after the first week. Patients receiving cyclobenzaprine also experienced more adverse effects, the most common being drowsiness. CONCLUSIONS: Cyclobenzaprine is more effective than placebo in the management of back pain; the effect is modest and comes at the price of greater adverse effects. The effect is greatest in the first 4 days of treatment, suggesting that shorter courses may be better. Studies comparing the relative value of acetaminophen, nonsteroidal anti-inflammatory drugs, and cyclobenzaprine individually and in combination in the treatment of back pain are needed.

Amitriptyline↗
PubMed1978

Doppler ultrasound flow detector used in temporal artery biopsy.

A doppler ultrasound flow detector can be helpful in performing a temporal artery biopsy. The anatomical location of the arteries can be traced on each side of the patient's head during the preoperative stage, and the flow pattern can be compared with the findings on simple palpation. Selection of a vessel for biopsy may thus be influenced. The detector can also be used under sterile conditions to locate the artery when the injection of local anesthesia has made palpation more difficult, thereby facilitating dissection of an adequate specimen.

Biopsy↗
PubMed1990

Computed tomography of metastatic cervical lymph nodes. A clinical, computed tomographic, pathologic correlative study.

A retrospective comparative study of 63 neck dissections was undertaken to evaluate further the accuracy of high-resolution computed tomography (CT) in the detection of nodal metastases, as previous studies have indicated a trend toward the superiority of CT scanning over palpation. The respective values of neck examination, CT scanning, and histopathologic examination were assessed in 51 patients with head and neck cancer who underwent a total of 63 neck dissections. The overall agreement between clinical examination findings and histopathologic findings was 92% vs 81% for CT scanning. A retrospective analysis of the CT findings failed to reveal greater accuracy. We found nodes measuring 10 mm or more with central low density always to be malignant. Because CT scanning seems to offer little advantage over palpation in the nonirradiated neck, it should not be regarded as an essential tool in the staging of nodal disease. After radiation therapy, as neck dissection is only performed because of clinical or radiologic suspicion, CT scanning is of utmost importance.

False Negative Reactions↗
PubMed1985

The phantom earache. Temporomandibular joint dysfunction in children.

Temporomandibular joint dysfunction is a benign, relatively uncommon childhood disorder and should be considered in children who have intermittent unilateral otalgia of three to four days' duration and whose audiographic, tympanometric, and clinical otologic examinations reveal normal findings. Most of the patients in our study had undergone orthodontic therapy during the year preceding the onset of temporomandibular joint dysfunction, and the vast majority of them had received orthodontic treatment within two weeks of each episode of otalgia. The diagnosis can be confirmed clinically by reproducing the pain associated with masticatory muscle spasm by palpation of the preauricular areas, intraotic manipulation, and palpation of the pterygoid muscles. Treatment consists of administering acetaminophen, applying hot compresses to the preauricular area, and opening and closing the mouth 30 to 40 times after each compress as an effort to interrupt the muscle spasm.

Adolescent↗
PubMed1978

Ultrasonic evaluation of ventral hernias disguised as intra-abcominal neoplasms.

Most cases of ventral hernias are easily diagnosed by palpation, but palpation is a subjective examination that may be difficult or even misleading, especially in obese patients. In cases of diagnostic uncertainty, ultrasonic examinations offer an objective means of distinguishing between a mass in the abdominal wall and one actually deep to the peritoneum. In addition, if such a mass is detected, these studies provide information that can characterize its physical nature.

Abdominal Muscles↗
PubMed2002

Behavioral training with and without biofeedback in the treatment of urge incontinence in older women: a randomized controlled trial.

CONTEXT: Previous research on urge urinary incontinence has demonstrated that multicomponent behavioral training with biofeedback is safe and effective, yet it has not been established whether biofeedback is an essential component that heightens therapeutic efficacy. OBJECTIVE: To examine the role of biofeedback in a multicomponent behavioral training program for urge incontinence in community-dwelling older women. DESIGN: Prospective, randomized controlled trial conducted from April 1, 1995, to March 30, 2001. SETTING: University-based outpatient continence clinic in the United States. PATIENTS: A volunteer sample of 222 ambulatory, nondemented, community-dwelling women aged 55 to 92 years with urge incontinence or mixed incontinence with urge as the predominant pattern. Patients were stratified by race, type of incontinence (urge only vs mixed), and severity (frequency of accidents). INTERVENTIONS: Patients were randomly assigned to receive 8 weeks (4 visits) of biofeedback-assisted behavioral training (n = 73), 8 weeks (4 visits) of behavioral training without biofeedback (verbal feedback based on vaginal palpation; n = 74), or 8 weeks of self-administered behavioral treatment using a self-help booklet (control condition; n = 75). MAIN OUTCOME MEASURES: Reduction in the number of incontinence episodes as documented in bladder diaries, patients' perceptions and satisfaction, and changes in quality of life. RESULTS: Intention-to-treat analysis showed that behavioral training with biofeedback yielded a mean 63.1% reduction (SD, 42.7%) in incontinence, verbal feedback a mean 69.4% reduction (SD, 32.7%), and the self-help booklet a mean 58.6% reduction (SD, 38.8%). The 3 groups were not significantly different from each other (P =.23). The groups differed significantly regarding patient satisfaction: 75.0% of the biofeedback group, 85.5% of the verbal feedback group, and 55.7% of the self-help booklet group reported being completely satisfied with treatment (P =.001). Significant improvements were seen across all 3 groups on 3 quality-of-life instruments, with no significant between-group differences. CONCLUSIONS: Biofeedback to teach pelvic floor muscle control, verbal feedback based on vaginal palpation, and a self-help booklet in a first-line behavioral training program all achieved comparable improvements in urge incontinence in community-dwelling older women. Patients' perceptions of treatment were significantly better for the 2 behavioral training interventions.

Aged↗
PubMed2000

Ultrasound examination of regional lymph nodes significantly improves early detection of locoregional metastases during the follow-up of patients with cutaneous melanoma: results of a prospective study of 1288 patients.

BACKGROUND: In regional lymph node metastasis of cutaneous melanoma, the number and volume of involved lymph nodes are the most important prognostic factors. Several studies have revealed that palpation of the lymphatic drainage area(s) and regional lymph nodes has a high rate of false-negative results during follow-up. The aim of the current study was to assess the sensitivity and specificity of ultrasound versus clinical diagnosis in the detection of subcutaneous and regional metastases. METHODS: During a period of 42 months, a total of 6328 lymphatic drainage areas were examined clinically and by ultrasound (7.5-10 MHz) in 1288 melanoma patients at 4435 follow-up consultations. When an ultrasound finding was suggestive of metastasis, surgery and histopathologic evaluation were performed. The results of clinical examination, ultrasound examination, and histopathologic findings were compared. RESULTS: In 504 ultrasound examinations performed on 235 patients, metastatic disease was diagnosed in 263 examinations following surgery (179 patients). Due to advanced disease or rejection, an additional 56 patients did not undergo surgery. In 239 of the 263 positive findings (90.9%), metastases from melanoma were histopathologically confirmed. In 8 cases (3%) a second malignancy and in 16 cases (6. 1%) benign lymphadenopathy was histopathologically diagnosed. Palpation of subcutaneous lymph nodes and lymph nodes gave false-negative results in 68 of the 238 cases of histopathologically proven metastases (28.6%). Clinical examination was least sensitive in the supraclavicular, axillary, and infraclavicular regions. The sensitivity and specificity for ultrasound examination were 89.2% and 99.7%, respectively, and 71.4% and 99.7% for clinical examination, respectively. CONCLUSIONS: For early diagnosis of in-transit and regional lymph node metastases in cutaneous melanoma, ultrasound scanning is distinctly superior to clinical examination. Controlled follow-up studies are proposed to examine the possible beneficial effects on survival time resulting from the ultrasound examinations of the lymphatic drainage area(s) and regional lymph nodes.

Adult↗
PubMed2000

Symphysis-fundal height measurement in pregnancy.

BACKGROUND: In many settings, symphysis-fundal height measurement has replaced clinical assessment of fetal size by abdominal palpation because the latter has been reported to perform poorly. OBJECTIVES: The objective of this review was to assess the effects of routine use of symphysis-fundal height measurements (tape measurement of the distance from the pubic symphysis to the uterine fundus) during antenatal care on pregnancy outcome. SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth Group trials register was searched. SELECTION CRITERIA: Acceptably controlled trials comparing symphysis-fundal height measurement with assessment by abdominal palpation alone. DATA COLLECTION AND ANALYSIS: One reviewer assessed trial quality and extracted data. MAIN RESULTS: One trial involving 1639 women was included. No differences were detected in any of the outcomes measured. REVIEWER'S CONCLUSIONS: There is not enough evidence to evaluate the use of symphysis-fundal height measurements during antenatal care.

Anthropometry↗
PubMed2002

Induced responses in clover to an herbaceous mite.

Halotydeus destructor feeding on subterranean clover cotyledons can cause severe damage. The mites live on the soil surface and move up onto plants to feed. Foraging behaviour consists of palpating, probing, and feeding with frequent transitions between them. Sustained feeding is made up of a series of short (1-2 min) feeds separated by periods of palpating. The mites tend to feed in aggregations, and are attracted to cotyledons damaged by other mites feeding or by mechanical damage. Mites can distinguish between resistant and susceptible cotyledons within 30 min and resistance is antixenotic due to deterrence. Study of the mechanisms shows this to be induced plant resistance. Several green leaf volatiles are involved in the plant/mite interaction. After feeding commences, 2-E-hexenal is released that at low concentrations is attractive to mites, perhaps causing the feeding aggregations. The wound-induced C(8) compound, 1-octen-3-one, plays a significant role in the deterrence of cotyledons of resistant subterranean clover varieties to H. destructor. Damaged cotyledons of resistant varieties produce more 1-octen-3-one that those of susceptible varieties. Screening for resistance has identified varieties from Italy showing resistance. H. destructor does not occur in Europe. Production of damage-induced volatiles by the resistant plants may have resulted from invasion by herbivores or pathogens, but not from coevolution with these mites. The responses of H. destructor are probably an adaptation to these general plant defensive compounds.

Aldehydes↗
PubMed1990

Intraoperative ultrasonography and the detection of liver metastases in patients with colorectal cancer.

A total of 213 patients with carcinoma of the colon and rectum were examined to detect liver metastases. The study compared preoperative ultrasonography and inspection and palpation of the liver during surgery with intraoperative ultrasonography. Preoperative ultrasonography, inspection and palpation identified 238 metastases in 42 patients. Intraoperative ultrasonography detected 116 previously unrecognized metastatic tumours during 40 surgical procedures (P less than 0.01). High resolution intraoperative ultrasonography is safe and more accurate than preoperative imaging and surgical exploratory methods. The examination is simple to perform and success appears to be related to careful attention to detail.

Colorectal Neoplasms↗