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At least 145 records · Page 8Linked to original sources
PubMed1987

[Value of breast palpation in gynecologic practice].

A representative inquiry was carried out among 100 Austrian gynecologists and obstetricians. Aim of the study was to determine the percentage of gynecologists, who carry out routinely the palpation of the breast in their office: 73% of all gynecologists are performing breast-palpation routinely in every patient, 27% only in case of complaints. The highest percentage of routine-breast-palpation performing gynecologists was found among doctors, who are in private-practice only (97%). Particularly low percentages, however, were found e. g. among doctors, who have contracts with all social insurances (58%), who have a high frequency of social-insured patients (55%) or have many patients per day (61%). Since the routine-breast-palpation is of particular importance for the reduction of breast cancer mortality, this examination should be also performed routinely by all general practitioners, internists and surgeons. Therefore, from the point of view of preventive medicine and public health the routine examination of the female breast should be refunded by social insurance in Austria.

Austria↗
PubMed1981

A comparison of intrarectal Doppler and rectal abdominal palpation for pregnancy testing in goats.

Two methods of pregnancy diagnosis--rectal abdominal palpation and the intrarectal Doppler technique--were compared for accuracy in the female goat (does). Three veterinarians were given a short period of instruction as to the use of these methods, after which 38 does were evaluated by both methods by each veterinarian. The percentage of correct determination for pregnant does ranged from 94% to 100% for examiners using the intrarectal Doppler technique and from 94% to 97% for the rectal abdominal palpation. The percentage of correct determinations for nonpregnant does ranged from 25% to 75% for intrarectal Doppler technique and was 75% for rectal abdominal palpation; however, the number of nonpregnant does was small and did not allow a valid conclusion. The results indicated that both methods are reasonably accurate for pregnancy diagnosis in does at 55 days or more after breeding and can be learned with only brief training. However, rectal abdominal palpation appears to be more hazardous with respect to rectal injury and abortion and, therefore, would not be the preferred method.

Animals↗
PubMed1995

[Finding appropriate tube position by the cuff palpation method in children].

The present study was designed to examine whether palpation of the endotracheal tube cuff indicates appropriate positioning in the children. In 59 children, we used a cuffed endotracheal tube (3.5-5 mm ID) to measure the distance from the carina to the distal tip of the endotracheal tube, when we can palpate the endotracheal tube cuff between the cricoid cartilage and the suprasternal notch. Following slow induction of anesthesia and muscle relaxation, each patient was intubated with a cuffed endotracheal tube of size suitable for age. The cuff was inflated with 0.5-1 ml of air, and palpated between the cricoid cartilage and the suprasternal notch. The distance between the carina and the tube tip measured by a fiberscope was more than 1.0 cm, which is thought to be safe to prevent bronchial intubation. The cuff was deflated after measurement. There were no complications attributable to use of cuffed endotracheal tubes. We concluded that the cuff palpation method was a rapid, reliable and simple technique to ensure the proper tube position in children.

Child↗
PubMedDate not supplied

Interexaminer reliability of palpation for cervical spine tenderness.

OBJECTIVE: To assess the interexaminer reliability of manual palpation for cervical spine tenderness in neck pain patients. DESIGN: Interexaminer reliability was studied using a within-subjects (repeated measures) design. Seven joints on the symptomatic side of the neck were palpated for maximal tenderness. SETTING: Private chiropractic practice of the Los Angeles College of Chiropractic. PATIENTS: Thirty patients with unilateral mechanical neck pain, symptomatic at the time of examination, were recruited from a chiropractic practice. RESULTS: Good interexaminer reliability (kappa = .68, p < .001, percent agreement 76.6%). CONCLUSION: In this population, palpation for cervical spine tenderness is a highly reliable examination tool. The findings of this study are consistent with those of palpation of the lumbar spine. Further investigation is needed to assess the usefulness of spinal tenderness as an outcome measure, the behavior of tenderness over time, and the prevalence of tenderness in symptomatic and asymptomatic populations.

Adult↗
PubMedDate not supplied

Palpation--problems and implications.

Palpation is one of the main tools in manipulative therapy as well as diagnosis. Analysis of palpation shows that it combines two types of sensation: that of touch and of motion, i.e., proprioception. In addition, it causes interaction with the patient resulting in a feedback-situation, which further complicates reproduction, e.g., objectification and measurement. The objection to palpation being "subjective" is further enhanced by the discovery of palpatory illusion. Thus, there is an urgent need for research in palpation, which could provide basic scientific credibility to manipulative techniques.

Chiropractic↗
PubMed1998

[The value of palpation as basis for decision on lymph node excision].

The purpose of the study was to evaluate palpation of the regional lymph nodes in control examinations of patients with malignant disease. A retrospective review of the medical records of 188 cases in which the patients had had an extirpation of the regional lymph nodes was performed. We have compared the preoperative findings through palpation with the histological diagnosis. The patients were grouped according to the region in which the lymph node removal had been done. The specificity of palpation when the histological diagnosis was malignant was (with 95% confidence limits), in the axilla 0.65 (0.54-0.75), in the inguinal region 0.86 (0.75-0.94) on the neck 0.83 (0.52-0.98) and in the suprahyoid region 0.58 (0.28-0.85). In conclusion, palpation of regional lymph nodes is not a sufficient control examination in the estimation of the course of malignant disease. Supplementary examination methods are recommended.

Axilla↗
PubMed1998

Digital palpation of intraocular pressure.

BACKGROUND AND OBJECTIVE: Previous studies investigating the accuracy of digital palpation through the eyelids to estimate intraocular pressure (IOP) have shown disappointing results. In this study, the accuracy of digital assessment of IOP by palpation of the bare cornea is investigated. MATERIALS AND METHODS: The IOP of a cadaveric eye model was varied from 5 to 40 mm Hg in increments of 5 mm Hg. Two examiners, one experienced and one inexperienced, digitally palpated the corneas and estimated IOP. The results were compared before and after a 1-hour training session. RESULTS: Prior to the training session, the experienced examiner guessed correctly 46% of the time and was correct within 5 mm Hg 100% of the time. The inexperienced examiner guessed correctly 21% of the time and was within 5 mm Hg 62% of the time. After the training session, the experienced examiner's score did not significantly (38% correct, 88% within 5 mm Hg, P = .05. CONCLUSIONS: Digital assessment of IOP by palpation of bare cornea is accurate when performed by experienced individuals. A minimal amount of training using the eye model may improve one's accuracy.

Cadaver↗
PubMed1995

Embryonic loss from 30 to 60 days post breeding and the effect of palpation per rectum on pregnancy.

This study was conducted over a 12-mo period to determine the rate of bovine embryo death between 30 and 60 d of gestation. In addition, palpation per rectum as a means of pregnancy detection was evaluated as a possible cause of embryo death. Estrus was synchronized in Holstein heifers (n = 1358), weighing > or = 385 kg, with a single intramuscular injection of 25 mg prostaglandin F(2alpha). Estrus was primarily detected by the absence of paint marks on the tailhead. The heifers were artificially inseminated with semen from 5 Holstein sires. Blood was collected between 30 and 45 d after breeding, and sera were evaluated for the presence of bovine pregnancy-specific protein B (bPSPB) by RIA to determine pregnancy. Palpation for fetal membrane slip was conducted by an experienced technician in approximately one-half of the inseminated heifers. To determine embryonic survival, a second blood sample was collected at approximately 60 d from 862 heifers that were determined to be pregnant at the first blood sampling. Embryonic loss averaged 5.3% during the interval between the initial detection of pregnancy at 30 to 45 d and the subsequent detection of pregnancy at 60 d of gestation. Embryo loss in heifers that were palpated was 6.5% compared with that of 4.3% in the control heifers (X(2): P = 0.145). These findings establish that there was substantial loss of embryos between 30 and 60 d post breeding but that embryo loss was not affected by palpation per rectum.

Journal Article↗
PubMed1995

The relationship of the interval from breeding to uterine palpation for pregnancy diagnosis with calving outcomes in holstein cows.

This study used data collected prospectively at 32 dairy herds to examine the effect of interval from breeding to uterine palpation for pregnancy diagnosis on calving interval and likelihood of calving. Multivariable statistical models were used to control for other factors that were significantly associated with the outcomes of interest. Cows diagnosed pregnant from 30 to 36 d post breeding had 2-wk longer calving intervals than cows palpated at later intervals. The interval from breeding until a cow was diagnosed open had a significant positive association with the calving interval. The interval to palpation was not associated with the probability of remaining in the herd to calve when controlling for the effects of herd, season of freshening, number of services, days to first service and mature equivalent milk production. Among cows diagnosed pregnant, 3.4% subsequently were bred and 1.5% were diagnosed open by palpation at a later date. About 5% of the cows diagnosed open calved at a time consistent with being pregnant when the diagnosis was made.

Journal Article↗
PubMed2006

Early pregnancy diagnosis by palpation per rectum: influence on embryo/fetal viability in dairy cattle.

The objective was to estimate the effect of palpation per rectum (for early pregnancy diagnosis) on embryo/fetal viability in dairy cattle. A controlled, randomized block-design experiment with two blocks, one by category, and the other by number of embryos, was conducted. Five-hundred-and-twenty pregnant dairy cows and heifers with a viable embryo detected by transrectal ultrasonography (TRUS) between days 29 and 32 after AI were included. The pregnant females were randomly allocated into two nearly equal groups: palpation per rectum (PAL group; n=258) and no palpation per rectum (NPAL group; n=262). The PAL group was submitted to palpation per rectum (PPR) using the fetal membrane slip (FMS) technique once between days 34 and 41 of pregnancy. The fetal membrane slip consisted of compressing the pregnant uterine horn and allowing the chorioallantoic membrane to slip between the fingers. Both groups were submitted to two additional TRUS at days 45 and 60 of pregnancy, to monitor the potential immediate and delayed deleterious effects of PPR on embryo and fetal viability, respectively. A diagnosis of embryo/fetal death was made when there was no embryo/fetal heart beat or the absence of positive signs of pregnancy in an animal previously diagnosed pregnant, or the presence of signs of embryo/fetal degeneration. The overall rate of embryo/fetal death was 14.0% (73/520). Embryonic death (10%; 52/520) was higher than fetal death (4.5%; 21/468; P<0.001). Embryo/fetal mortality was higher in cows (16.4%; 59/360) than in heifers (8.8%; 14/160; P<0.025) and in cattle with twin (25.5%; 12/47) versus singleton pregnancies (12.9%; 61/473; P<0.025), but was not different (P>0.05) between PAL (14.7%; 38/258) and NPAL (13.4%; 35/262). In conclusion, PPR between days 34 and 41 of pregnancy using the fetal membrane slip technique did not affect embryo/fetal viability.

Animals↗
PubMed1999

Detection of a corpus luteum in apparently anoestrous cows by manual palpation, transrectal ultrasonography and plasma progesterone concentration.

AIMS: To determine the level of agreement between transrectal ultrasonography, manual palpation and measurement of progesterone in the detection of corpora lutea in post-partum cows. To evaluate the reproductive performance of cows not detected in oestrus prior to mating, but detected with a corpus luteum at the start of mating. METHODS: Cows from seven herds which were not detected in oestrus were examined between 5 and 7 days before the herd's planned start of mating. Ovaries were examined by palpation and ultrasonography in 160 cows and plasma progesterone concentrations were also measured in 103 cows. Insemination dates and pregnancy data were recorded in 159 cows not detected in oestrus but having a corpus luteum and 1405 cycling herd mates. RESULTS: The level of agreement between ultrasonography and measurement of progesterone (kappa = 0.74) was higher than with manual palpation (kappa = 0.67) although it was significant for both techniques (p <0.001). Cows which were not detected in oestrus, but detected with a corpus luteum had a longer interval to first service (12 v. 10 days, p <0.05) and conception (19 v. 15 days, p = 0.01) than cycling herd mates and had a higher empty rate (9.7% v. 3.8%, p <0.001). CONCLUSIONS: These data indicate that ultrasonography may provide a better diagnostic tool for examining cows not detected in oestrus than manual palpation or measurement of progesterone concentration. Cows not detected in oestrus but having a corpus luteum were shown to have significantly poorer reproductive performance than cycling herd mates.

Journal Article↗
PubMed2001

Transxiphoid bilateral palpation in video-assisted thoracoscopic lung metastasectomy.

OBJECTIVE: To evaluate indications, limits, and merits of transxiphoid bilateral palpation during video-assisted thoracoscopy (VAT) lung metastasectomy. DESIGN: Survey retrospective study with a minimum follow-up of 1 year. SETTING: University hospital. PATIENTS: From December 1995 to September 1999, 29 of 45 patients operated on for pulmonary metastasectomy were approached through a transxiphoid VAT. Primary sites were colon-rectum (n = 13), kidney (n = 4), limb osteosarcoma (n = 3), uterus (n = 2), larynx (n = 2), breast (n = 1), skin melanoma (n = 1), prostate gland (n = 1), back fibrosarcoma (n = 1), and ovary (n = 1). Bilateral palpation was performed in 23 patients, although only 10 had radiological evidence of bilateral disease. RESULTS: No perioperative or 30-days postoperative mortality was recorded. Acute and chronic pain was similar to that of other VATs and significantly less than sternotomy. Mean +/- SD chest-drain time and hospital stay were 2.8 +/- 1.19 days and 4.3 +/- 1.78 days, respectively. Sixty-nine lesions, 60 of them metastatic, were resected by laser (n = 29) or stapler (n = 40). Bilateral exploration permitted the discovery of 15 radiologically undetected lesions, 11 of which were found to be malignant. Contralateral metastases were found in 5 patients predicted to have unilateral disease. Mean +/- SD follow-up was 22.89 +/- 10.87 months (range, 9-60 months). Six patients developed new pulmonary metastases after a mean interval of 13.6 months; 3 of these patients relapsed in the unexplored hemithorax after 6, 9, and 12 months, respectively. CONCLUSIONS: The use of the transxiphoid VAT approach was safe, applicable in many instances, and effective in detecting occult metastases by manual bilateral palpation. The advantages of a VAT procedure can be coupled with those provided by a radical operation.

Adult↗
PubMedDate not supplied

Palpation, ultrasound, and ultrasound-guided fine-needle aspiration cytology in the assessment of cervical lymph node status in head and neck cancer patients.

BACKGROUND: Lymph node status of the neck is the most important prognostic factor in head and neck cancer patients. Assessment of the lymph nodes status is still often based on palpation only, although the low accuracy of palpation is known. METHODS: Altogether 105 consecutive head and neck cancer patients were examined using ultrasound (US) and ultrasound-guided fine-needle aspiration cytology (FNAC) to evaluate the additional information obtained by these methods. RESULTS: Of the 86 patients with palpable normal necks, FNAC taken under US-guidance showed malignancy in 13. The US size criteria for malignancy were fulfilled in 7 of these patients, whereas the lymph nodes were of normal size in 6 of them. In the whole patient material, US-guided FNAC showed bilateral metastasis in 3 patients although only unilateral or no metastasis was found by palpation. CONCLUSION: US combined with US-guided FNAC can be recommended as a method for evaluating for regional metastases in head and neck cancer patients, both for those with and those without palpable metastasis.

Adolescent↗
PubMed1989

Rectal palpation and transrectal fine needle aspiration of the prostate in the monitoring of prostate cancer: a study of 59 patients during treatment with estramustine phosphate or estrogens.

Fifty-nine hormonally treated prostatic carcinoma patients were prospectively followed by rectal palpation and fine needle aspiration cytology (FNAC) at 6 month intervals for periods ranging from 6 to 120 months (median follow-up, 48 months). The cytologic impressions and palpatory findings were divided into four categories, respectively, ranging from benign to clearly malignant. Cytologic material and palpatory descriptions suitable for evaluation were available for 306 follow-up examinations, with a mean number of follow-up examinations per patient of five (range, 1-13). Tumor relapse was noted in 26 patients and was diagnosed at the same time by FNAC and palpation in six patients. In 16 of the patients tumor progression was first noted by cytology, and in four patients relapse was first detected by rectal palpation. Different patterns of cytologic and palpatory findings during the development of remission and progression of the tumors and drawbacks of the methods are discussed.

Aged↗
PubMed1988

Palpation of the axillary nodes in breast cancer: what does the surgeon feel?

The findings on routine pre-operative palpation of the axilla in patients with infiltrative breast carcinoma are compared to the results of histological quantitation of the nodal lymphoid tissue and its tumour deposits in 91 consecutive cases in which a standardized axillary dissection had been carried out. The study demonstrates that lymphoid tissue, even when present in large amounts (up to 6 cm2 on histology), is seldom palpable. What the clinician identifies in favourable cases is the tumour deposit itself. When little lymphoid tissue is present very small tumour deposits (0.2 cm2) may be found on palpation, but large deposits (1 cm2) may be missed when surrounded by sufficient lymphoid tissue. These findings go far to explain the well documented unreliability of the nodal findings on axillary palpation in breast cancer.

Axilla↗
PubMed1993

Accuracy of bimanual palpation versus vaginosonography in determination of the measurements of pelvic tumors.

In a prospective study the size of 157 pelvic tumors in 101 patients was measured preoperatively by bimanual palpation and vaginosonography, and the results were compared with measurements made at operation. In 72 uterine and 85 ovarian lesions the Spearman correlation coefficients (rs) between the three maximum diameters at right angles to each other measured at operation and by bimanual palpation ranged from 0.48 to 0.78. The correlation coefficients (rs) between measurements at operation and preoperative vaginosonography ranged from 0.91 to 0.97. The size of small lesions was overestimated by bimanual palpation; 44% of tumors smaller than 5 cm in diameter were only detected by vaginosonography.

Diagnosis, Differential↗
PubMed2003

[Detection of lymph node metastases of malignant melanoma by palpation and ultrasound].

BACKGROUND AND PURPOSE: Early detection of metastases of malignant melanoma has therapeutic implications. The aim of this study was to evaluate palpation and ultrasound examination in the diagnostics of lymph node metastases in locally advanced melanoma. PATIENTS AND METHODS: 83 patients suffering from melanoma (Clark level IV or V) were examined for lymph node metastases by palpation and sonography. Findings were compared to histopathologic results after lymph node extirpation if available or the findings at the next follow-up visit. RESULTS: Lymph node metastases were confirmed histopathologically in 14 patients at the first study visit, in three others at the control visit. Sensitivity, specificity, positive and negative predictive values of palpation for the detection of metastases or suspicious nodes with increasing volume at follow-up in this population were 65%, 81%, 48%, and 89%, and of ultrasound 100%, 66%, 45%, and 100%, respectively. CONCLUSION: Sonography of lymph nodes should be included as a standard procedure in the detection of metastases of locally advanced malignant melanoma.

Adult↗
PubMed2004

[The accuracy of palpation from orientation points for the navigated implantation of knee prostheses].

AIMS: Cinematic and pointing procedures are used for non-image based navigated implantation during total knee replacement. Pointing procedures require an exact knowledge of the landmarks. In this anatomical study, landmarks are defined and repeatedly referenced. Precision and reproducibility are evaluated by means of an inter- and an intra-observer study. The axes of the femur and tibia are calculated using the landmarks. MATERIAL AND METHODS: The specific landmarks of 30 femurs and 27 tibias were palpated by three surgeons and digitised by means of a photogrammetric system, as used intra-operatively. The recorded data were statistically evaluated. RESULTS: The specific landmarks can be referenced with great precision. The vectors that influence the implant position show a mean femoral deviation of 0.9 mm and a mean tibial deviation of 1.0 mm. The repeating accuracy of every observer was 1.5 mm femoral and 1.0 mm tibial. The calculated long axes at the femur and tibia thus reach a precision of 0.1 degrees (min.-max.: 0-0.9 degrees) at the femur and 0.2 degrees (.0-1.1 degrees) at the tibia. The short axes at the distal femur and proximal tibia exhibit an average deviation of from 0.7 degrees to 1.9 degrees (0-11.3 degrees). CONCLUSION: Long axes (mechanical axes) can be determined exactly but the precision of the short axes (rotational axes) is unsatisfactory, although palpation of landmarks was accurate. Therefore, palpation of more than one rotational axis at the femur and tibia is mandatory and should be visualized on the monitor during surgery.

Arthroplasty, Replacement, Knee↗