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At least 19 recordsLinked to original sources
PubMed2002

[Early detection and therapeutic rearing for children with mental retardation: I. Assessment of diagnosing examination and collaborative facilities assigned for children with mental retardation].

We assessed medical examinations and therapeutic rearing designed for diagnosing children with mental retardation (MR) taking three cases as an example. One hundred and seven physicians answered the questionnaire. Their tentative diagnoses were tuberous sclerosis, autistic disorder, and mental retardation, respectively. They planned medical examinations of blood cell count, urinalysis, blood biochemistry, developmental questionnaires, CT, MRI, and EEG. They chose speech and occupational therapy, nursery facilities, public health center, social welfare counselors, and parents' associations as their early intervention programs. To enrich social resources for MR children, a network of facilities and training for specialists are necessary.

Child Rearing↗
PubMed1997

Can the clinical examination diagnose left-sided heart failure in adults?

We systematically reviewed the literature to ascertain how well clinicians determine the probability and type of left-sided heart failure in their patients. Left-sided heart failure is characterized by decreased left ventricular ejection fraction or increased filling pressure. The type of heart failure determines optimal treatment. Systolic dysfunction exists when ejection fraction is reduced. Diastolic dysfunction is presumed to be present when filling pressure is increased with a normal ejection fraction and without another explanatory diagnosis. Many findings are associated with heart failure, and wide variation exists in clinicians' ability to detect these findings. The best findings for detecting increased filling pressure are jugular venous distention and radiographic redistribution. The best findings for detecting systolic dysfunction are abnormal apical impulse, radiographic cardiomegaly, and q waves or left bundle branch block on an electrocardiogram. Diastolic dysfunction is especially difficult to diagnose, but is associated with an elevated blood pressure during heart failure.

Clinical Competence↗
PubMed2007

Improving the reliability of autism diagnoses: examining the utility of adaptive behavior.

The classification agreement of the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) was examined in 129 children and adolescents (aged 7-18 years) who were evaluated for autism. Participants received a diagnosis of autism or non-autism based on the ADI-R. Linear discriminant analysis revealed adequate concordance between the ADI-R and ADOS, with 75% of the participants being correctly classified using the ADOS. Classification accuracy significantly improved to 84% when a measure of adaptive functioning (i.e., the Vineland Adaptive Behavior Scales) was included in the analysis. The findings suggest that when clinicians obtain discrepant information on the ADI-R and ADOS, assessment of an individual's adaptive functioning may reduce diagnostic errors.

Adaptation, Psychological↗
PubMed1993

The role of CA 125 and conventional examinations in diagnosing progressive carcinoma of the ovary.

The clinical significance of the serum marker CA 125 and conventional examinations in diagnosing progressive disease was evaluated in 98 patients. The examinations included CA 125, gynecologic and complete physical examination, abdominal computed tomography (CT), roentgenogram of the chest, second look operation and serum biochemistry profile. Progressive disease occurred in 49 patients and the time to progression was a median of 12 months (range of four to 52 months). At the time of progression, an elevated CA 125 was found in 73 percent of the patients, and in 63 percent of the patients, CA 125 increase preceded clinical progression for a median of four and one-half months (range of 0.5 to 29.5 months). A positive gynecologic examination at progression was found in 67 percent of the patients, physical examination and abdominal CT scan were positive in 30 percent, intervention operation in 14 percent and roentgenogram of the chest in 12 percent of the patients. With the combination of serum CA 125, gynecologic and general physical examination, progressive disease could be diagnosed in 92 percent of the patients. The false-positive rate in the 49 patients with no evidence of disease was 1.6 percent for CA 125, 2.0 percent for gynecologic examination, 4.0 percent for physical examination, 14.0 percent for CT scan and 2.0 percent for roentgenograms of the chest. Serum CA 125 is the most reliable examination to detect progressive disease early. With the combined use of serum CA 125 and the gynecologic and general physical examination, progression of the disease can be detected in about 90 percent of the patients.

Adenocarcinoma↗
PubMed1990

Help-seeking for AIDS-related concerns: a comparison of gay men with various HIV diagnoses.

Examined help-seeking and psychological distress among four groups of gay men (30 AIDS-diagnosed, 107 HIV-seropositive, 149 HIV-seronegative, 244 untested) in the AIDS Behavioral Research Project, a longitudinal survey of San Francisco gay men. The men reported high levels of anxiety, depression, and help-seeking from their social networks. AIDS-diagnosed and HIV-positives reported the most AIDS worry and were the most likely to seek help. High percentages of AIDS-diagnosed men sought help from all sources (peers, professionals, family), whereas nondiagnosed men were more likely to seek help from peers. Regardless of the men's HIV status, peers were perceived to be the most helpful source. Family members were less likely sought and perceived as least helpful. The strengths and limitations of peers as social support providers for AIDS-related concerns are discussed, including implications for the design of community programs to enhance the abilities of peer helpers.

Acquired Immunodeficiency Syndrome↗
PubMed2006

[The patient with chronic and/or complex orofacial pain: history taking and diagnostic examination].

Diagnosing chronic orofacial pain can be a time-consuming, complicated and challenging task. Therefore a structured interview and clinical examination are essential to capture all key elements of the evaluation. A thorough understanding of clinical conditions that can present in the orofacial region is obviously fundamental. Key elements of the history taking include questions about the location, onset, duration, frequency, quality and intensity of the pain, precipitating, aggravating and relieving factors, and associated symptoms. The goal of the clinical examinations is to elucidate the source of the pain. One should remember that the source of the pain does not always coincide with the site where the patient experiences the pain. A thorough examination should include a cranial nerve evaluation, evaluation of the cervical as well as masticatory musculature, the cervical spine, the temporomandibular joints and the intra-oral tissues. Additional diagnostic tests may include diagnostic injections with local anesthesia, radiographs or other imaging techniques, laboratory tests or psychologic/psychiatric evaluation.

Chronic Disease↗
PubMed1998

The validity of clinical examination for diagnosing anterior disk displacement with reduction.

OBJECTIVE: The objective of this study was to evaluate the diagnostic accuracy of a clinical examination for diagnosing anterior disk displacement with reduction. STUDY DESIGN: A series of 273 consecutive patients with temporomandibular disorders were clinically examined according to well-defined criteria. The patients were examined for clicking by digital palpation during maximal mouth opening and closing (the Clicking test). When clicking was identified, two additional tests were performed: one determined whether the clicking was eliminated at a protruded position, and the other determined whether the clicking became louder when the patient's mandible was manipulated toward the eminences. Bilateral magnetic resonance images were subsequently obtained from all patients; the clinical examination findings were then compared to the imaging-based diagnoses of the temporomandibular joint status to assess the diagnostic accuracy of the clinical findings. RESULTS: Although the predictability of identifying anterior disk displacement with reduction by clicking was relatively low, it increased to an acceptable level when the additional tests were used. The overall accuracy for the Clicking test combined with either of the other tests was about 90%. CONCLUSION: Our results suggest that anterior disk displacement with reduction can be diagnosed with considerable accuracy through the use of a clinical examination only.

Adolescent↗
PubMed1987

de Quervain's release in working women: a report of failures, complications, and associated diagnoses.

Examination of a series of 16 consecutively referred women patients who have had a de Quervain's release revealed 23 associated diagnoses and 14 complications. Also, 11 consecutive women patients were referred preoperatively and, even in this small group, there were eight associated diagnoses. The complexities of de Quervain's tendinitis and the diagnosis and treatment of associated diseases and complications are described to help prevent surgical failures and prolonged disabilities in these groups of working women.

Adult↗
PubMed1993

How accurate is clinical examination in diagnosing and quantifying pelvirectal disorders? A prospective study in a group of 50 patients complaining of defecatory difficulties.

We prospectively evaluated 50 patients (38 females and 12 males; mean age, 44.7 +/- 15 years) who complained of defecatory difficulties to determine the accuracy of the clinical examination in diagnosing and quantifying pelvirectal abnormalities. Each parameter was then compared with the features of anorectal manometry and evacuation proctography performed by two independent observers. Global agreement between clinical diagnosis and the reference method (radiology for rectoceles, rectal intussusceptions, and abnormal perineal descent; manometry for anismus) was observed in 80 percent of cases. In rectoceles, anismus, and rectal intussusceptions especially, excellent negative predictive values were obtained (96, 96, and 80 percent, respectively). Clinical examination always diagnosed high-grade intussusceptions. Nevertheless, abnormal perineal descent was poorly evaluated in 20 patients. When compared with anal manometry, digital assessment was able to quantify resting and squeeze pressures and length of the anal canal with excellent correlation and good global agreement as well as predicting a short or hypotonic anal canal. Clinical assessment is usually sufficient and accurate in most pelvirectal disorders encountered in patients complaining of defecatory difficulties. Both anorectal manometry and evacuation proctography retain a definite but limited place in investigating pelvirectal disorders.

Adult↗
PubMed2002

[Value of pH-metric examination in diagnosing gastroesophageal reflux in children and youth with typical and atypical clinical symptoms of gastroesophageal reflux disease].

AIM: The aim of work was an estimation of pH-metric examination in diagnosing of gastroesophageal reflux in children with typical and atypical symptoms of the gastroesophageal reflux disease. MATERIAL AND METHODS: 121 children were analysed with suspected to gastroesophageal reflux disease. Depending on reported ailments they were divided into 2 groups. Group I patients with typical symptoms of gastroesophageal reflux disease were including: heartburn, rebounding; while the second group consisted of those with atypical symptoms: nausea, vomiting, chest pain, abdominal pain. 24-hour pH-metric examination was performed in each patient. RESULTS: On the basis of pH-metric examination gastroesophageal reflux was diagnosed in 85.2% patients from I group and 44.8% patients from group II. CONCLUSION: The most important examination determining diagnosis of gastroesophageal reflux in children with both typical and atypical symptoms of this illness should be pH-metric examination of the esophagus. In children with atypical symptoms in consideration of differential diagnosis we should take into account a possibility of gastroesophageal reflux.

Adolescent↗
PubMed1983

Endometrial carcinoma diagnosed by examination of peritoneal dialysate.

Well-differentiated adenocarcinoma of the endometrium was diagnosed by cytologic examination of peritoneal dialysate during continuous ambulatory peritoneal dialysis in a 70-year-old woman. The patient had undergone estrogen therapy for 16 years. The carcinoma was localized, noninvasive, and apparently at an early stage of development. Surgical removal was followed by megestrol acetate chemotherapy and the patient currently remains on peritoneal dialysis, free of recurrence, at 14 months. This case suggests that cellular material from the endometrium can be retrieved from intraperitoneal dialysate in patients undergoing peritoneal dialysis. Therefore, cytologic examination should be performed on peritoneal fluid with elevated counts associated with sterile cultures or atypical features.

Adenocarcinoma↗
PubMed1998

The validity of clinical examination for diagnosing anterior disk displacement without reduction.

OBJECTIVE: The objective of this study was to evaluate the diagnostic accuracy of patient history and clinical signs as confirmed by magnetic resonance imaging examination for diagnosing anterior disk displacement without reduction. STUDY DESIGN: A series of 273 consecutive patients with temporomandibular disorders were clinically examined according to well-defined criteria. Patients were first asked if they had a history of clicking. The following clinical characteristics of anterior disk displacement without reduction were then assessed: (1) maximal mouth opening less than 40 mm; (2) deflection of the mandible to the affected side at the maximal mouth opening position; (3) limitation of condylar translation on palpation during maximal mouth opening; (4) preauricular pain during mandibular movements; and (5) crepitation. Bilateral magnetic resonance images were obtained for all patients, and the magnetic resonance imaging interpretation was compared with the clinical examination findings to assess the diagnostic accuracy of the clinical findings. RESULTS: The sensitivity was considerably low in contrast with the relatively high specificity for all six clinical parameters tested. The overall accuracies of the clinical parameters ranged from 71% to 81%. CONCLUSION: Our results suggest that the predictability of historical or clinical findings to differentiate anterior disk displacement without reduction from other diagnoses is not high.

Adolescent↗
PubMed1984

Breast self-examination among diagnosed breast cancer patients.

The practice of breast self-examination (BSE) was explored by personal interview in a sample of women with diagnosed breast cancer. Despite physician recommendations to practice BSE, only 43% of those interviewed were examining themselves regularly, a figure that is little different from that of the general population. Predictors of BSE were age (older women were less likely to practice) and practice of BSE before diagnosis. Factors contributing to nonpractice were judged to be: (1) the patients' beliefs that occasional examinations by physicians are a sufficient substitute for BSE; (2) the patients' perceptions that BSE is discretionary and not truly "medical"; and (3) the fact that BSE may raise patients' anxiety over cancer without affecting its likelihood. It was concluded that the practice of BSE among diagnosed patients could be increased if physicians stress its importance and provide systematic instruction or reinstruction in its practice.

Adult↗
PubMed1983

MMPI code types and DSM-III diagnoses.

Examined the relationship of the MMPI high-point codes and the diagnostic system of the Diagnostic Statistical Manual III of the American Psychiatric Association. Five psychiatrists reanalyzed the patients' records and rendered a DSM-III diagnosis. In all, 24 code types were identified from the private psychiatric clinic sample (N = 261). The resulting clusters of diagnostic classification are presented, and, additionally, a narrative summation for each code type is given.

Adolescent↗
PubMed1995

Examining ethnomedical diagnoses and treatment choices for diarrheal disorders in Lubumbashi Swahili.

This article examines the basis of ethnomedical classification of diarrheal disease among the Swahili speaking population of Lubumbashi, Zaire and the association of specific diagnoses with treatments given. Results from two research methods are reported: group interviews and large sample surveys. A series of group interviews with mothers of small children provided information about how they commonly diagnose illnesses related to childhood diarrheal disease as well as which symptoms, causes, and treatments they associate with those illnesses. Data from the interviews were used to formulate questions about the diagnosis of illness and treatments given for recent cases of diarrhea. A baseline and a follow-up survey provided information about the symptoms associated with reported episodes of illness and about the treatments given at home. The results provide evidence that ethnomedical diagnoses are based on observed symptoms, that they affect how and why oral rehydration therapy (ORT) is used or not used for diarrhea, and that the terms chosen by survey researchers to ask about diarrhea and ORT may affect survey results in predictable and systematic ways.

Child↗
PubMed2006

[Comparison between optical microscopic examination and phase contrast microscopic examination for diagnosing the origin of urinary bleeding].

PURPOSE: Phase contrast microscopy method is useful in the examination of urine sediment to differentiate glomerular(Gl) hematuria from non glomerular(nonGl) hematuria. In this study, we compared the diagnostic value of optical microscopy with that of phase contrast microscopy. METHOD: One hundred and sixty fresh urine samples of microscopic hematuria(5/HPF or more) from 118 patients with renal disease and 42 patients with urologic disease were analyzed. The erythrocytes referred to as Gl, are defined to have acanthocytes, target configuration, or finger ring shape, and a Gl cell/total erythrocyte ratio greater than 3% is defined as reliable marker for Gl bleeding. RESULT: Sensitivity and specificity of this criteria for Gl bleeding were 50.9% and 94.9% in acanthocytes, 69.6% and 89.1% in the target configuration, and 88.4% and 89.1% in the finger ring, respectively. As for the microscopic observation methods, the sensitivity and specificity of this criteria for GI bleeding were 88.1% and 81.0% with phase contrast microscopy, 74.6% and 90.9% with optical microscopy with no dyeing, and 74.6% and 88.6% with optical microscopy with dyeing, respectively. CONCLUSION: GI and nonGl hematuria were correctly diagnosed by counting the urinary Gl cells not only by phase contrast microscopy, but also by optical microscopy. This method seems to have important clinical usefulness by offering information on urinary bleeding.

Adolescent↗