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Results for “PHYSICAL EXAMINATION”

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At least 19 recordsLinked to original sources
PubMed2003

The hand-carried echocardiographic device as an aid to the physical examination.

Physical examination skills have been declining over the past several decades while technology has made diagnostic testing increasingly sophisticated. For patients with cardiovascular disease, the best approach to bedside diagnosis would be one that combines both physical examination and ready access to technology at the time of the patient encounter. Most cardiac testing is not performed at the bedside due to equipment size and time limitations for these tests. Small hand-carried echocardiographic devices are now available for rapid bedside examination. These devices compare well to full-featured systems when used in cardiology outpatient settings and in hospitalized patients who are not critically ill. Compared with physical examination by board certified cardiologists, these devices decrease diagnostic error. Early use of hand-carried echocardiographic devices after physical examination has been demonstrated to impact patient triage and treatment as well as uncover otherwise undetected cardiac disease. The degree of training required for responsible use of these devices is as yet unclear. However, organized training sessions have resulted in modest agreement with standard echocardiography and point-of-care echocardiography performed by expert echocardiographers. It is conceivable that the hand-carried echocardiographic devices will be used in medical school curriculum to enhance medical student education in the future.

Echocardiography↗
PubMed1996

Preparticipation physical examinations.

Preparticipation physical examinations are a prerequisite for competition at most levels of sports. This article discusses the unique opportunity that the health care team has to participate in the provision of sports assessment and screening services to a wide variety of individuals. In addition, this article reviews the purpose of the examination, organizational consideration, components of the examination, and special considerations that should be included.

Humans↗
PubMed1986

The physical examination.

The physical examination begins as soon as the patient enters the operatory and continues throughout the various stages of the diagnostic process. It includes an evaluation of the vital signs, head and neck, and other areas of the body readily observed by the astute clinician, and the structures of the oral cavity. A deliberate and systematic examination will permit the clinician maximum opportunity to detect and identify irregularities and abnormalities that will increase or decrease the diagnostic options.

Blood Pressure↗
PubMed2001

[Preoperative examination: anamnesis and physical examination mandatory].

Preoperative assessment has been subject to discussion for many years. What should be done and by whom? Fortunately there is a general consensus that routine laboratory and function tests are not only of no benefit to the patient but are also wasteful of resources. The Preoperative Assessment Commission of the Dutch Ministry of Health, Welfare and Sport, supports the initiative for preoperative assessment clinics run by anaesthesiologists. Yet in their advice, this Commission has proposed screening by means of an abridged questionnaire. Efforts to validate this questionnaire have demonstrated that in practice it was not helpful. Therefore it seems justified to conclude that preoperative screening should not fundamentally differ from that performed during a basic clinical examination.

Anesthesiology↗
PubMed1980

The physical examination in office practice.

Physical illness may first declare itself as a disturbance in thinking, mood, or behavior. Recognition of physical disorders is enhanced by informed use of the relevant procedures of physical examination. Objections to physical examination are based on the assumptions that it is overly timeconsuming, is psychotherapeutically contraindicated, or requires unusual skill, but observation and minimally intrusive procedures can provide much information that may exclude emergent organic conditions. Different patients, illnesses, and settings require different levels of examination; the author describes the appropriate procedure for psychotic patients, substance abusers, patients taking psychotropic medications, and other patients.

Humans↗
PubMed2004

Ultrasonography of the internal jugular vein in patients with dyspnea without jugular venous distention on physical examination.

STUDY OBJECTIVE: Accurate physical examination of patients with dyspnea is important. Jugular venous distention, however, can be difficult to assess in patients. The purpose of this case series is to serve as a pilot study of how ultrasonographic examination of the internal jugular vein compares with other measures of dyspnea. METHODS: This was a case series of 8 patients presenting with dyspnea without jugular venous distention on physical examination. Each patient underwent ultrasonographic examination of the internal jugular vein and inferior vena cava by an emergency physician sonographer blinded to all other clinical information after initial evaluation by another emergency physician for dyspnea. Results of ultrasonographic examination of the internal jugular vein and inferior vena cava were subsequently compared with initial emergency physician physical examination findings, initial chest radiography interpreted by radiologists, initial B-type natriuretic peptide levels, and final hospital discharge diagnosis. RESULTS: Ultrasonographic examination of the internal jugular vein compared more favorably with B-type natriuretic peptide levels and chest radiographic findings than ultrasonographic examination of the inferior vena cava in these patients with dyspnea but not jugular venous distention on physical examination. It was able to identify every patient diagnosed with cardiogenic pulmonary edema on hospital discharge. CONCLUSION: Ultrasonographic examination of the internal jugular vein appears to be helpful in patients who present with dyspnea but do not have evidence of jugular venous distention on physical examination.

Adult↗
PubMed2003

Impact of clinical experience on quantification of clinical signs at physical examination.

PURPOSE: Although physical examination is a fundamental component of medical decision making, relatively few studies have evaluated how physicians quantify clinical signs and whether different methods of assessment have different effects on clinical practice. OBJECTIVES: To evaluate a possible impact of clinical experience when attending physicians, medical residents and medical students quantify qualitative signs of physical examination in a teaching hospital. SETTING: Hospital das Clínicas, University of São Paulo, Brazil. SUBJECTS: A total of 244 randomly selected physicians and medical students completed a reliable and consistent eight-item questionnaire. MAIN OUTCOME MEASURES: To compare how they quantified clinical signs of cyanosis, anaemia, jaundice, oedema and dehydration, why they used the method(s) they described, and whether the method used could affect diagnosis, further testing or patient management. A chi-square test was used to calculate differences between the groups. RESULTS: Whilst the majority of those surveyed tended to use a four-level evaluation for these clinical signs, attending staff physicians were more likely to employ two-level evaluations than were residents or medical students. For all five signs, attending physicians' use of dichotomous evaluations was significantly higher than that of residents or medical students: anaemia (P = 0.004), cyanosis (P < 0.001), oedema (P = 0.005), dehydration (P < 0.001) and jaundice (P = 0.002). CONCLUSION: Although medical students and residents are routinely taught to use a four-level evaluation for these clinical signs, many of those surveyed tend to abandon this experience for a dichotomous approach. Given that the clinicians in this survey tended not to change their initial approach to a patient based on the intensity of this semi-quantitative method, increased emphasis on teaching dichotomous approach evaluations in medical school should be encouraged.

Brazil↗
PubMed1983

Cancer detection in the periodic physical examination.

The periodic physical exam is the ideal time for the primary physician to detect cancer at an early stage. With certain points in mind the physician can rapidly screen for suggestive signs of cancer during the physical examination. Certain procedures, laboratory and x-ray examinations, aid in this detection and should be part of the total examination.

Abdominal Neoplasms↗
PubMed2002

[Utility of the clinical history, physical examination and radiography in the localization of bleeding in patients with hemoptysis].

OBJECTIVE: We examined the medical history, physical examination and chest radiography utility to accurately identifying the site of pulmonary bleeding in patients with hemoptysis. METHODS: We prospectively reviewed and compared the suspected site of bleeding obtained with the medical history, physical examination and chest radiography (right or left) in 466 patients with hemoptysis after the confirmation with a bronchoscopy, computed chest tomography (CT) or bronchial arteriography, and separately analysing the more common etiologies and the volume of bleeding. RESULTS: Age 62.6 years (DS 14), 85% males, 80% smokers with a volume of bleeding of 42.5 ml/day (DS 86) and > or = 100 ml/day in 13.5%. Medical history localized the site of bleeding in 1-13% (p < 0.0001), clinical responses in 8-29% (p < 0.0001), physical examination in 13-47.5% (p < 0.0001) and chest radiography in 14.5-88% (p = 0.04), with a more frequent accurately location findings (p < 0.01) that gradually increased as the previous results with the lung carcinomas and decreased with bronchiectasis or chronic bronchitis. When the volume of bleeding was > or = 100 ml/day, clinical responses utility improved (p = 0.04) as when it was < 100 ml/day with the radiography (p = 0.0001). Specificity, sensitivity and predictive values were variable and better with the radiography than with the medical history or physical examination. CONCLUSIONS: We concluded that chest radiography was most useful than the medical history or physical examination to localize the site of bleeding in patients with hemoptysis. Almost all of the findings that suggests the site of bleeding were accurate and they increased with the radiography or decreased with the physical examination and specially with the medical history in patients with bronchiectasis or chronic bronchitis.

Adolescent↗
PubMed2004

The adult screening physical examination: what physicians do.

BACKGROUND: Patients expect a thorough physical examination. However, there is debate on the utility of the physical examination, and students are deficient in many common maneuvers. PURPOSES: (1) To estimate physician perceived utility of physical examination maneuvers in a routine adult screening examination. (2) To promote teaching of core physical examination competencies in student and resident education. METHODS: Primary care physicians at 2 academic medical centers were surveyed. Using a 5-category frequency scale, physicians estimated how often they perform and document 90 common physical examination maneuvers in a routine adult screening examination. RESULTS: Survey response rate was 56%. Physicians reported significant variation in frequency of use for individual physical examination maneuvers. Both common (blood pressure) and rarely performed (visual acuity) maneuvers were identified. CONCLUSION: This study helps define the adult screening physical examination by estimating which individual physical examination maneuvers physicians typically utilize. Educational resources and clinical research should focus on identifying an evidence-based approach to the physical examination.

Adult↗