Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “AUSCULTATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,621 records · Page 90Linked to original sources
PubMed1999

Low incidence of significant valvar insufficiency following retrograde aortic radiofrequency catheter ablation in young patients.

The incidence of significant valvar insufficiency at late (<6 month) follow-up was retrospectively evaluated in 27 young patients (age 4. 0-18.0 years) undergoing 29 ablation procedures via the retrograde aortic approach for left-sided accessory connections in whom pre-ablation and post-ablation echocardiograms were available for review. Valvar insufficiency was graded using color flow techniques as absent, trivial, mild, moderate, or severe by blinded reviewers. Ablation was acutely successful via the retrograde approach in 25 of 29 procedures among these 27 patients. Successful ablation was ultimately achieved in all 27 patients. At baseline, 7 patients had evidence of trivial or mild mitral insufficiency, and no patient had aortic insufficiency. Three patients had evidence of impaired left ventricular systolic performance in the presence of manifest pre-excitation. At follow-up, pre-existing mitral insufficiency resolved in 5/7 patients, and persisted in 2 patients. New mitral insufficiency was evident in 3 patients, and new aortic insufficiency was transiently evident in 1 patient following ablation (all trivial). Institutional experience (mean rank 10 cases vs. 33 cases, p <.0005), and lower patient weight (29.7 vs. 56.3 kilograms, p =.01) were the only factors associated with the development of new valvar insufficiency. Valvar insufficiency could not be detected by careful auscultation in any patient and was deemed clinically insignificant in all patients. We conclude that ablation of left-sided accessory connections can be performed via the retrograde aortic approach without creating clinically significant valvar insufficiency.

Adolescent↗
PubMed2002

Two-dimensional positional mapping of gastrointestinal sounds in control and functional bowel syndrome patients.

Computerized auscultation of the abdomen provides a noninvasive and quantitative method to investigate gastrointestinal function. Two-dimensional mapping of bowel sound sites of origin, to the surface of the abdomen, was accomplished through simultaneous recording with three electronic stethoscopes. Control, irritable bowel syndrome, and nonulcer dyspepsia groups were studied. The predominant site of fasting sound production was the right lower quadrant in all except a subgroup of nonucler dyspepsia patients. The second most common site mapped to the area of the stomach. The region mapping to the small intestine was largely devoid of sound. The control group had a higher percentage of sounds in the 184- to 248-Hz range than the functional bowel patients (P < 0.001) for sounds mapping to the stomach region. We conclude that two-dimensional mapping may have the potential to allow for the meaningful and objective categorization of groups of functional bowel patients.

Adult↗
PubMed2004

Observations on the clinical examination of the camel (Camelus dromedarius) in the field.

Camels usually inhabit remote areas, where diagnostic facilities and laboratories are very scarce. The species differences between the camel and other domestic animals necessitate some specific examination techniques. The objective of this study was to describe the clinical examination methods and sources of common errors that require special consideration in the camel. Young camels are examined in the standing position, while adults require restraint. Restraining procedures, both standing and in sternal recumbency, are described. New equipment and a crush were designed. The body temperature of the camels examined fluctuated from 35.7 to 38.9 degrees C, being lowest in the morning and highest in the afternoon; high temperature in the morning is indicative of fever, while high afternoon temperatures could be hyperthermia. It was difficult to take the pulse rate for routine procedures. The heart rate ranged from 35 to 50 per min; there was no difference between the heart rate in the morning and in the afternoon. The mean respiratory rate was 11 per min and respiration was of thoracol-lumbar type. The mucous membranes of the eye were an important site for appreciating signs of discoloration, while those of the mouth, rectum and vagina were unsuitable. The left flank was the best site for determining the rate of rumen contractions, which was 3+/-1.2 every 5 min, as determined by auscultation; counting the contractions by the application of the fist was difficult. The palpable external lymph nodes were the parotid, maxillary, prescapular, inferior cervical, thoracic, cubital, ilial and popiteal; they are large and can be seen on inspection in healthy animals, so that was not indicative of disease. A list of diagnostic indicators for the rapid diagnosis of ten endemic camel diseases was generated from the empirical signs.

Animal Diseases↗
PubMed2003

Spontaneous vegetative endocarditis due to Enterococcus faecalis in a rottweiler puppy.

A 5-month-old female Rottweiler was referred because of a 5-week diarrhea and a sudden onset of a cardiac murmur auscultated by its veterinarian. Definitive diagnosis of bacterial endocarditis was based on ultrasonographic visualization of vegetative cardiac lesions and positive cultures of Enterococcus faecalis in blood and urine. Complicating findings were suppurative nephritis and renal infarction. Despite intensive supportive care, the endocarditis and clinical condition deteriorated and the dog had to be euthanized.

Animals↗
PubMed2004

[Congenital malformations of the tricuspid valve in domestic carnivores: a retrospective study of 50 cases].

A retrospective study was done on 14 cats and 36 dogs diagnosed with right atrioventricular valve malformations (RAVM), either tricuspid dysplasia (n = 38) or Ebstein's anomaly (n = 12). Comparison with a large reference population including 85 250 animals allowed an epidemiologic analysis of these RAVM, demonstrating that Labrador, Boxer and Chartreux cats had a 35, 7 and 11-fold higher risk respectively to be affected by one of these heart diseases than other breeds, without sexual predisposition. In 93% of cases, cardiac auscultation revealed a heart murmur, whose grade was not significantly correlated with the echographic stages of the valvular disease. The echocardiographic examination confirmed the frequent association between RAVM and other congenital anomalies, particularly mitral dysplasia, in 84% and 20% of tricuspid dysplasia and Ebstein anomaly respectively. Last, the prognosis of RAVM was worsened by atrial fibrillation and right-sided heart failure.

Age Factors↗
PubMed2006

[The clinical examination in cardiology].

The main manifestations of cardiac diseases are dyspnea, chest pain, palpitations, giddiness and syncope. A careful evaluation of subjective symptoms during history taking allows a rapid identification of an ischaemic heart disease, heart failure or cardiac arrhythmias. The additional clinical findings during bedside examination by inspection of the jugular veins, palpation of cardiac impulses and auscultation of heart sounds and murmurs are often sufficient to diagnose most of the frequent underlying disorders, such as valvular diseases, heart failure or pulmonary hypertension. The clinical assessment remains essential to select the most appropriate additional tests, such as echocardiography, scintigraphy, computer tomography or coronarography. Systematic teaching of the clinical skills should remain a central element in the formation of medical students and clinical fellows.

Cardiology↗
PubMed2006

[A 29-year-old man with Takayasu's arteritis].

We report on a 29-year-old male patient with collapse and recurrent vertigo. Physical examination showed a bruit of the left common carotid artery on auscultation and a pulselessness of both arms. The diagnosis of Takayasu's arteritis was based on the results of duplex sonography, MRI and angiography (stenosis and occlusion of extracranial arteries). Laboratory results did not reveal any specific changes. Combined treatment with prednisolone and azathioprine was initiated. After 12 days we saw an improvement of duplexsonographical and laboratory findings. Takayasu's disease should be considered as a differential diagnosis in patients with stenosis and occlusions of the aortic arch and its main branches (e.g. pulselessness). MRI is a valuable method in detection of wall abnormalities of the aorta, its branches and other large arteries.

Adult↗
PubMed2001

Temporomandibular joint sound evaluation with an electronic device and clinical evaluation.

Sound analysis to diagnose internal derangement has received much attention as an alternative to radiographic examination. The purpose of this study was to compare findings with an electronic device (sonography) and clinical examination to magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ). Twenty-three symptomatic patients (46 joints) were evaluated for this study. All patients had jaw joint pain and one or more of the following findings; limitation of jaw opening, painful mandibular movement with or without clicking or crepitation. The presence or absence of joint sounds was evaluated clinically by palpation and auscultation and with sonography. If sounds were present (clicking or crepitation) on either examination the patient was considered positive for disc displacement for that examination. Two by two tables were constructed comparing sonography and clinical examination with MRI findings. The sensitivity of the sonogram was 84% and the specificity was 33% when compared with MRI findings. The sensitivity of the clinical examination was 70% and the specificity was 40% when compared with MRI findings. This study suggests that clinical and sonographic examination has a high sensitivity (low false negative examinations) but low specificity (high false positive examinations).

Journal Article↗
PubMed2006

Accuracy of the 7-8-9 Rule for endotracheal tube placement in the neonate.

OBJECTIVE: To determine accuracy of the 7-8-9 Rule in a cohort of neonates. STUDY DESIGN: This study was cross-sectional in design. Seventy-five consecutive neonates who required oral intubation from June 2004 to November 2004 for cardiopulmonary failure, respiratory distress, or surfactant administration were the subjects of this study. The initial endotracheal tube (ETT) depth of insertion was determined using either an estimated birth weight or actual weight in the 7-8-9 Rule calculation followed by auscultation and subsequent adjustment if necessary. Midtracheal position was identified as the point halfway between the inferior clavicle and carina on a chest radiograph. The initial depth was compared to the midtracheal depth to determine clinical accuracy of the 7-8-9 Rule. The depth predicted by the 7-8-9 Rule was also calculated using only actual weights. This predicted depth was compared to the midtracheal depth to determine true accuracy of the 7-8-9 Rule. Accuracy was determined using mean paired differences with 95% confidence intervals (CI) between initial or predicted depth and ideal, midtracheal ETT depth. Linear regression was used to adjust for confounding variables. RESULTS: Mean (range) gestational age was 32 weeks (23 to 44 weeks) and weight was 2001 g (490 to 4400 g). Eighteen (24%) infants weighed 1000 g or less, 20 (27%) weighed between 1001 and 2000 g, 21 (28%) weighed between 2001 and 3000 g, 15 (20%) weighed between 3001 and 4000 g, and one (1%) weighed more than 4000 g. Thirteen of the 18 extremely low birth weight infants weighed <750 g. The initial depth of insertion was 0.004 cm above midtracheal position (95% CI -0.13 to 0.14, P = 0.96). After controlling for head position, the initial depth did not significantly differ from the midtracheal position among weight groups. Predicted depth using the 7-8-9 Rule placed the ETT 0.12 cm above midtracheal position (95% CI -0.30 to 0.06, P = 0.20). However, after controlling for head position, the 7-8-9 Rule positioned the ETT significantly below midtracheal position in infants weighing <750 g (mean 0.62 cm; 95% CI 0.30 to 0.93, P=0.002). CONCLUSIONS: The 7-8-9 Rule appears to be an accurate clinical method for endotracheal tube placement in neonates weighing more than 750 g. When the 7-8-9 Rule is applied to infants weighing <750 g, caution is warranted. The current rule may lead to an overestimated depth of insertion and potentially result in clinically significant consequences.

Body Weight↗
PubMed2003

Relapsing polychondritis.

A 43-year-old Chilean man presented with a 5-month history of progressive hypertrophy of the ears bilaterally. He was seen initially by a dermatologist in Chile for complaints of erythema and swelling of the ears, and had been treated unsuccessfully with topical steroids and antimicrobial ointments. On presentation to our clinic, the hypertrophy had stabilized and the erythema had resolved, but he complained of decreased hearing due to narrowing of the external auditory canal. Associated symptoms included occasional pruritus, but he denied any pain. He also denied a history of sinus problems, respiratory symptoms, ocular pain, chest pain, and arthralgias. Physical examination revealed firm hypertrophy of the collagenous areas of both ears, sparing the ear lobes (Fig. 1). No pain was elicited on palpation. No conjunctivitis was noted and the nasal passages were clear. His chest was clear to auscultation. Histologic examination revealed a minimal perivascular infiltrate of lymphocytes and plasma cells in the dermis with fibrosis of the subcutis (Fig. 2). Blood tests showed a normal complete blood count, antinuclear antibody, and rheumatoid factor. Anti-collagen II antibodies were elevated at 29.2 Eu/ml (normal, 0-20 Eu/ml; borderline, 20-25 Eu/ml; elevated, > 25 Eu/ml).

Adult↗
PubMed2003

A case of hypersensitivity pneumonitis caused by Humicola fuscoatra.

A 51-year-old housewife with hypersensitivity pneumonitis caused by Humicola fuscoatra is reported. The diagnosis was made by an inhalation challenge with H. fuscoatra antigen. She was admitted for diagnosis and treatment of a fever and productive cough. Auscultation of her lungs revealed inspiratory fine crackles. Her chest CT showed diffuse miliary nodules in a centri-lobular distribution with patchy ground glass opacities. Findings of transbronchial lung biopsy and BAL fluid were compatible with a hypersensitivity pneumonitis. Her symptoms worsened on returning home, which suggested the existence of some aetiological agent in the subject's house. H. fuscoatra, Penicillium decumbens and Aspergillus versicolor were isolated from a number of rooms. High titres of serum anti H. fuscoatra, P. decumbens and A. versicolor were detected. Inhalation challenge tests with both P. decumbens and A. versicolor antigen were negative, in contrast to that with H. fuscoatra which was positive. Based on these results, we advised the patient to cleanse her entire house. Since cleaning, her symptoms have not worsened upon returning home. This is the first report of hypersensitivity pneumonitis caused by H. fuscoatra antigen.

Alveolitis, Extrinsic Allergic↗
PubMed1996

Right bevelled tube for selective left bronchial intubation in a child undergoing right thoracotomy.

Left bronchial intubation was used to achieve selective left lung ventilation in a five-year-old child, undergoing thoracotomy for excision of a hydatid cyst of the right lung. Intubation of the left main stem bronchus was easily achieved from the first attempt by a right bevelled tracheal tube. Using a right bevelled tube facilitates left bronchial intubation, since the bevel of the tube faces the right side while its tip lies left to the axis of the trachea. Chest auscultation confirmed selective left lung ventilation. One lung ventilation using 1-2% halothane in 100% oxygen was associated with Spo2 that ranged between 95-97%, and endtidal PETCO2 ranging between 3.9-4.5 kPa (30-35 mmHg). Following excision of the hydatid cyst, the tube was withdrawn above the carina into the trachea, and two lung ventilation was continued until the end of surgery.

Bronchi↗
PubMed2001

Effects of i.v. metoclopramide, atropine and their combination on gastric insufflation in children anaesthetized with sevoflurane and nitrous oxide.

METHODS: To determine effects of i.v. metoclopramide, atropine and their combination on the airway pressures at which gastric insufflation occurs in children, 45 healthy infants and children (ASA I) received an inhalational induction of anaesthesia with sevoflurane, N2O and O2. A blinded observer used a stethoscope to auscultate over the upper abdomen for any air entry. First, proximal airway pressure was slowly increased by closing the pop-off valve of the anaesthesia machine until gas was heard entering the stomach (pop-off point, control measurement). If the peak inspiratory pressure reached 40 cm H2O, the patient was to be excluded from the study. Then, all subjects randomly received i.v. atropine 0.01 mg.kg-1, metoclopramide 0.2 mg.kg-1, or atropine 0.01 mg.kg-1 plus metoclopramide 0.2 mg.kg-1 (n=15 each), and determination of the pop-off point was repeated 5 min later. The stomach was evacuated before each measurement. RESULTS: Atropine significantly decreased the pop-off point [from 21 +/- 3 to 19 +/- 2 cm H2O (mean +/- SD), P < 0.05], while metoclopramide significantly increased the pop-off point (from 20 +/- 3 to 26 +/- 6 cm H2O, P < 0.05). The combination of metoclopramide and atropine did not alter the pop-off point (from 20 +/- 2 to 19 +/- 5 cm H2O). CONCLUSION: Since metoclopramide exerts only mild effect on the pop-off point, cricoid pressure still remains the standard anaesthetic practice to prevent gastric insufflation in children. Prophylactic i.v. metoclopramide may be restricted to, and its clinical usefulness should be determined in, symptomatic patients with gastro-oesophageal reflux.

Anesthesia, General↗
PubMed2000

Systemic effects of topical and subconjunctival ophthalmic atropine in the horse.

OBJECTIVE: To identify any systemic effects of topical and subconjunctival administration of atropine sulfate in the horse. Animals studied Six mature grade horses were treated hourly in one eye with topical ophthalmic atropine drops for 24 h. Five horses were treated subconjunctivally in one eye with 3 mg of atropine sulfate. Procedures Pupillary light reflexes, pupil size, electrocardiographic parameters, girth measurements, intestinal motility, and clinical signs of abdominal pain were monitored. RESULTS: Alteration in auscultated gut motility and clinical signs of abdominal pain were the most sensitive indicators of the systemic manifestations of the topically applied atropine. Gut motility was absent in all horses for periods of 2-18 h in all four abdominal quadrants in horses given topically administered atropine. Signs of abdominal pain were observed in four of six horses that received topical atropine. In the subconjunctival test study, gut motility was absent in three horses for periods of 3-7 h. Uniocular subconjunctival injection of 3 mg atropine sulfate produced signs of abdominal pain in one of six horses. Conclusion The ophthalmic administration of atropine can affect gut motility and induce signs of colic in selected horses.

Journal Article↗
PubMed2003

Oral health education for nursing personnel; experiences among specially trained oral care aides: one-year follow-up interviews with oral care aides at a nursing facility.

The improved dental health in most industrialized countries is not apparent among elderly and long-term care patients. Oral healthcare has been found to have low priority in nursing care. To create lasting positive effects in oral healthcare education, a new educational model was tested in an oral healthcare project. After approval from ethical committee, nursing assistant and nurses' aides took part in a dental auscultation period at a dental clinic to serve as oral care aides additional to traditional oral healthcare education. Following this period, the aides were given responsibility for the oral healthcare at their ward. After serving as oral care aides for 1 year, interviews were made and analysed based on the Grounded Theory methodology. The aim was to investigate how the oral care aides had experienced their new duties regarding oral healthcare. The results indicated that, despite several environmental changes, reluctant residents and occasional lack of commitment from colleagues, the oral care aides felt responsible for the oral healthcare provision. The oral care aides expressed courage, the capacity to cope with reality, confirmation and empathy, characteristics that propelled them from novices to oral care aides with an expert competence.

Adaptation, Psychological↗
PubMed2002

Assessing the calf pulmonary function during a long-term biventricular assist device study with a centrifugal blood pump.

Pulmonary congestion due to inappropriate pump flow management is one major problem necessary to avoid during long-term biventricular assist device (BVAD) implantation. Our objective was to assess the effects of pulmonary arterial flow rate and flow rates of both (right and left) bypass pumps. Six healthy calves, which had been implanted with a BVAD system, were selected for this retrospective study. Pulmonary artery flows, both pump flow rates, oxygen saturation of the arterial blood, and pulmonary arterial pressures were assessed as parameters of pulmonary function as was routine clinical evaluation of respiratory rate and character and chest auscultation. The average pulmonary artery flow rate (PAF), systolic pressure of pulmonary artery (sPAP), and oxygen saturation were 148.8 ml/kg per min, 35.1 mm Hg, and 95.3%, respectively. Pulmonary dysfunction occurred in one case, in which the mean PAF, sPAP, and oxygen saturation were 169 ml/kg per min, 66.1 mm Hg, and 90.9%, respectively. The ratio for the right/left pump flow rate (R/L ratio) for the case having pulmonary dysfunction was 1.57 even though the ratio for the other cases was less than 1. Maintaining an R/L ratio less than 1 and/or PAF less than 160 ml/kg per min and PAP less than 50 mm Hg is recommended as the initial conditions to target to avoid pulmonary dysfunction during a BVAD implantation with a beating heart condition.

Animals↗
PubMed2001

Healthy centenarians do not exist, but autonomous centenarians do: a population-based study of morbidity among Danish centenarians.

OBJECTIVE: To assess the prevalence of common illnesses in an unselected population of centenarians. DESIGN: A population-based survey. SETTING: Denmark. PARTICIPANTS: All Danes who celebrated their 100th anniversary between April 1, 1995 and May 31, 1996: 276 persons. MEASUREMENTS: All participants (including proxies) were visited at their domicile for an interview (sociodemographic characteristics, activities of daily living, living conditions, need of assistance from other people, former health and current diseases, current medication) and a clinical examination (dementia screening test, heart and lung auscultation, neurological assessment, height and weight, electrocardiogram, arm and ankle blood pressure, assessment of hearing and vision capacity, a short physical performance test, bio-impedance, lung function test, blood test). Further health information was retrieved from medical files and national health registers. RESULTS: Seventy-five percent (207) of eligible subjects participated in the study. Cardiovascular disease was present in 149 (72%) subjects. Osteoarthritis (major joints) was present in 54%, hypertension (> or =140/ > or =90) in 52%, dementia in 51%, and ischemic heart disease in 28%. The mean number of illness was 4.3 (standard deviation (SD) 1.86). Only one subject was identified as being free from any chronic condition or illness. Sixty percent had been treated for illness with high mortality. In 25 autonomous (nondemented, functioning well physically, living at home) and 182 nonautonomous centenarians, comorbidities were equivalent. CONCLUSION: Because they have a high prevalence of several common diseases and chronic conditions, Danish centenarians are not healthy. However, a minor proportion was identified as being cognitively intact and functioning well.

Activities of Daily Living↗
PubMed2002

Accidental pneumothorax from a nasogastric tube in a patient with severe hemineglect: a case report.

Nasogastric tubes are frequently used for nutrition of patients with neurologic diseases. We report an instance of inadvertant placement of a standard nasogastric tube into the left pleural space in a patient with right parietotemporal intracerebral hemorrhage and severe hemineglect on the left side. The 2 confirmatory maneuvers-aspiration of fluid and auscultating the abdomen on insufflating air-were false-positive. We conclude that only radiologic confirmation of the position of nasogastric tubes and the awareness of the associated dangers will help minimize the occurrence of such events in patients with disorders of perception or altered consciousness.

Aged↗