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Journal of Dairy Science Oct 2019Transrectal palpation of the reproductive tract is the most common method for pregnancy determination in cattle and is considered a veterinary skill that new veterinary...
Transrectal palpation of the reproductive tract is the most common method for pregnancy determination in cattle and is considered a veterinary skill that new veterinary medicine (DVM) graduates should perform proficiently. However, using privately owned cattle to train students can be difficult because producers may believe that transrectal palpation by inexperienced students increases the risk of pregnancy wastage compared with examination by an experienced clinician. We used a randomized field trial of 1,216 healthy Holstein and Jersey cattle in 2 commercial dairy herds to estimate the effect of veterinary student transrectal palpation on early pregnancy loss. All cattle were determined to be pregnant using transrectal ultrasonography at approximately 37 d after artificial insemination. Cattle were then allocated into 2 groups based upon their ear tag number (study group = 598; control group = 618). Cattle in the study group were immediately palpated after ultrasonography by a fourth-year veterinary student, whereas control cattle were not subject to any additional pregnancy assessment. For analysis, the student palpators were divided into 2 groups: students who had previously had formal palpation training via an elective bovine palpation class (n = 30) and students who had not had palpation training (n = 134). All cattle were reevaluated using transrectal ultrasonography approximately 70 d after artificial insemination. A total of 53 (4.36%) animals lost their pregnancy between the first and second pregnancy assessments. Of the animals that lost their pregnancy, 26 (4.35%) were study group cows and 27 (4.37%) were control cows. Of the 26 cows documented to have had pregnancy loss within the study group, 20 out of 378 (5.3%) had been palpated by students who had not taken the palpation elective and 6 out of 220 (2.7%) had been palpated by students who had completed the elective. We found no difference in pregnancy loss between student-palpated and clinician-ultrasounded cattle, supporting the safety of using privately owned animals for student bovine palpation and pregnancy diagnosis training without affecting early pregnancy loss.
Topics: Animals; Cattle; Female; Humans; Pregnancy; Abortion, Veterinary; Education, Veterinary; Palpation; Pregnancy Tests; Students; Ultrasonography, Prenatal
PubMed: 31400904
DOI: 10.3168/jds.2019-16515 -
Urology Jun 2019
Topics: Female; Genitalia; Humans; Male; Medical Chaperones; Palpation; Physical Examination
PubMed: 30878683
DOI: 10.1016/j.urology.2019.02.029 -
Ophthalmic Surgery and Lasers Sep 1998Previous studies investigating the accuracy of digital palpation through the eyelids to estimate intraocular pressure (IOP) have shown disappointing results. In this... (Comparative Study)
Comparative Study
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.
Topics: Cadaver; Cornea; Humans; In Vitro Techniques; Intraocular Pressure; Palpation; Reproducibility of Results
PubMed: 9760612
DOI: No ID Found -
IEEE Transactions on Bio-medical... Jun 2024Robot-assisted minimally invasive surgery remains limited by the absence of haptic feedback, which surgeons routinely rely on to assess tissue stiffness. This limitation...
OBJECTIVE
Robot-assisted minimally invasive surgery remains limited by the absence of haptic feedback, which surgeons routinely rely on to assess tissue stiffness. This limitation hinders surgeons' ability to identify and treat abnormal tissues, such as tumors, during robotic surgery.
METHODS
To address this challenge, we developed a robotic tissue palpation device capable of rapidly and non-invasively quantifying the stiffness of soft tissues, allowing surgeons to make objective and data-driven decisions during minimally invasive procedures. We evaluated the effectiveness of our device by measuring the stiffness of phantoms as well as lung, heart, liver, and skin tissues obtained from both rats and swine.
RESULTS
Results demonstrated that our device can accurately determine tissue stiffness and identify tumor mimics. Specifically, in swine lung, we determined elastic modulus (E) values of 9.1 ± 2.3, 16.8 ± 1.8, and 26.0 ± 3.6 kPa under different internal pressure of the lungs (PIP) of 2, 25, and 45 cmHO, respectively. Using our device, we successfully located a 2-cm tumor mimic embedded at a depth of 5 mm in the lung subpleural region. Additionally, we measured E values of 33.0 ± 5.4, 19.2 ± 2.2, 33.5 ± 8.2, and 22.6 ± 6.0 kPa for swine heart, liver, abdominal skin, and muscle, respectively, which closely matched existing literature data.
CONCLUSION/SIGNIFICANCE
Results suggest that our robotic palpation device can be utilized during surgery, either as a stand-alone or additional tool integrated into existing robotic surgical systems, to enhance treatment outcomes by enabling accurate intraoperative identification of abnormal tissue.
Topics: Animals; Swine; Robotic Surgical Procedures; Rats; Palpation; Minimally Invasive Surgical Procedures; Equipment Design; Phantoms, Imaging; Lung; Elastic Modulus; Liver
PubMed: 38261510
DOI: 10.1109/TBME.2024.3357293 -
Medicina Intensiva Jul 2023
Topics: Catheterization; Arteries; Ultrasonography; Ultrasonography, Interventional; Palpation
PubMed: 36948926
DOI: 10.1016/j.medine.2023.03.010 -
Journal of Shoulder and Elbow Surgery Aug 2022Partial tears of the distal biceps tendon can be difficult to diagnose based on clinical examination and magnetic resonance imaging (MRI).
BACKGROUND
Partial tears of the distal biceps tendon can be difficult to diagnose based on clinical examination and magnetic resonance imaging (MRI).
METHODS
Patients from a single surgeon's practice from 2000 to 2018 with a partial distal biceps tendon tear were retrospectively reviewed to determine the utility of the distal biceps palpation-rotation test in the detection of partial tears. This test is performed by palpating the bicipital tuberosity at the lateral forearm while ranging the forearm from supination to pronation with the arm adducted at the patient's side and the elbow flexed to 90°. A positive test elicits tenderness at the tuberosity with the arm in pronation but not in supination. Examination findings were correlated with MRI reports confirming a partial tear. Twelve cadaveric arms were dissected to determine overall pronosupination range of motion, the degree of pronation at which the bicipital tuberosity is maximally palpable, and anatomic measurements of the bicipital tuberosity to guide the optimal technique when carrying out the maneuver.
RESULTS
Ninety-nine patients were diagnosed with a partial distal biceps tendon, of whom 34 had available MRI reports and complete physical examination documentation. Thirty-three of 34 patients (97%) had partial tears on MRI. The hook test was negative in all cases. All patients had tenderness with resisted supination. In those with MRI-confirmed partial tears, the palpation-rotation test was positive in all patients (100% sensitivity). The bicipital tuberosity was maximally palpated at the dorsolateral forearm at a mean 20° of pronation, and the proximal and distal boundaries of the radial tuberosity were 2.5 cm and 5.3 cm, on average, distal to the radial head, respectively.
CONCLUSION
A positive palpation-rotation test was seen in 33 of 33 patients (100% sensitivity), as correlated with MRI. The combination of an intact distal biceps tendon within the antecubital fossa, tenderness on resisted supination, and a positive palpation-rotation test are highly suggestive of a partial distal biceps tendon tear.
Topics: Arm; Elbow; Humans; Palpation; Retrospective Studies; Rotation; Rupture; Tendon Injuries; Tendons
PubMed: 35331856
DOI: 10.1016/j.jse.2022.02.012 -
Journal of Bodywork and Movement... Apr 2021Dry needling of the periscapular musculature is a procedure commonly performed by physical therapists. Needling of the deep musculature may be challenging, and use of a...
INTRODUCTION
Dry needling of the periscapular musculature is a procedure commonly performed by physical therapists. Needling of the deep musculature may be challenging, and use of a thoracic rib as a "backstop" is often applied to prevent inadvertent puncture of the pleura. The aim of this study was to: 1) To examine the accuracy rate of experienced physical therapists in identifying a mid-scapular thoracic rib using palpation, 2) to understand patient characteristics that affect the accuracy rate, and 3) to examine if therapist confidence levels were associated with palpatory accuracy.
METHODS
Two experienced physical therapists attempted to palpate a thoracic rib in the mid-scapular region of healthy participants (n = 101 subjects, 202 ribs), and self-reported their level of confidence in an accurate palpation. Their accuracy was verified with ultrasonography.
RESULTS
The two physical therapists were accurate on 73.3% of palpations and did not differ in accuracy (72.0% vs. 75.0%, p = 0.747). The only ultrasonographic or subject characteristic measurement that correlated with improved accuracy was a reduced muscle thickness (p = 0.032). Therapists' self-reported confidence levels did not correlate to actual accuracy (p = 0.153).
DISCUSSION
Physical therapists should be aware that palpation of a thoracic rib may not be as accurate as it may seem. The greater thickness of muscle in the area reduces the accuracy of accurate palpation.
CONCLUSION
Dry needling of the periscapular muscles should be done with caution if using a rib as a "blocking" technique.
Topics: Dry Needling; Healthy Volunteers; Humans; Palpation; Ribs; Ultrasonography
PubMed: 33992299
DOI: 10.1016/j.jbmt.2020.10.008 -
The Journal of Foot and Ankle Surgery :... 2021The medial branch of the medial dorsal cutaneous nerve is frequently encountered in medial column surgery. Postoperative sensory nerve symptoms can lead to...
Accuracy of Palpation to Identify the Medial Branch of the Medial Dorsal Cutaneous Nerve in Medial Column Surgery: Correlation of Preoperative Nerve Marking With Intraoperative Findings During Lapidus Fusion.
The medial branch of the medial dorsal cutaneous nerve is frequently encountered in medial column surgery. Postoperative sensory nerve symptoms can lead to dissatisfaction and suboptimal outcome. The purpose of this case series is to correlate intraoperative nerve location on direct viewing with preoperative nerve localization to assess the accuracy of a specific nerve palpation technique. Hundred consecutive patients undergoing elective Lapidus fusion were prospectively evaluated. Preoperative nerve localization and intraoperative comparison was performed along with assessment of nerve position in relation to the cuneiform and first tarsometatarsal joint. Preoperative nerve identification correlated with intraoperative findings in 99 of 100 consecutive cases. In 1 of 100 cases, the palpated nerve was proximal to the zone of dissection and was not visualized. The medial branch of the medial dorsal cutaneous nerve crossed the dorsal Lapidus incision at the medial cuneiform or first metatarsal base level in 95 of 100 cases; at the mid metatarsal level in 2 of 100 cases; and proximal to the medial cuneiform in 3 of 100 cases.
Topics: Arthrodesis; Hallux Valgus; Humans; Metatarsal Bones; Palpation; Tarsal Bones
PubMed: 33218859
DOI: 10.1053/j.jfas.2019.07.010 -
Theriogenology Jun 1999A palpation technique using both hands was developed by the author and used for examination of internal reproductive organs, pregnancy diagnosis, and assessment of... (Review)
Review
A palpation technique using both hands was developed by the author and used for examination of internal reproductive organs, pregnancy diagnosis, and assessment of approximate stages of gestation in small ruminants. The study was conducted in 4 stages on 87 female goats and 30 slaughterhouse source ewes First, 20 doelings and 15 does with no recent history of insemination were examined by two hand method for palpability and structural integrity of internal reproductive organs. Next 52 goats (28 doelings and 24 does) were examined at 28 to 30 d post insemination for pregnancy. Among those diagnosed pregnant, 20 goats were examined at 15 d intervals to assess the palpable changes of pregnancy. Preslaughter palpation followed by post-slaughter verification of the findings were performed in 30 ewes. The two hand method was effective for palpating the reproductive tract in the nonpregnant goats irrespective of parity status. Gross palpation of the ovaries was possible in 83% of the goats. Of the 52 goats examined for pregnancy at 28 to 30 d, 29 (56%) had clear distension of uterus while 23 (44%) did not. The results were confirmed by kidding date or returning to service. Changes of the reproductive tract were monitored in 20 goats at biweekly intervals and the findings categorized by the stage of gestation. Post slaughter verification of preslaughter findings based on two handed palpation indicates that this technique can be used for early pregnancy diagnosis and assessment of the stage of gestation in goats and ewes.
Topics: Animals; Female; Goats; Ovary; Palpation; Pregnancy; Pregnancy Tests; Sheep; Uterus
PubMed: 10729082
DOI: 10.1016/s0093-691x(99)00098-9 -
PloS One 2022Atrial fibrillation (AF) remain a prevalent undiagnosed condition frequently encountered in primary care.
BACKGROUND
Atrial fibrillation (AF) remain a prevalent undiagnosed condition frequently encountered in primary care.
OBJECTIVE
We aimed to find the parameters that optimize the diagnostic accuracy of pulse palpation to detect AF. We also aimed to create a simple algorithm for selecting which individuals would benefit from pulse palpation and, if positive, receive an ECG to detect AF.
METHODS
Nurses from four Cardiology outpatient clinics palpated 7,844 pulses according to a randomized list of arterial territories and durations of measure and immediately followed by a 12-lead ECG, which we used as the reference standard. We calculated the sensitivity and specificity of the palpation parameters. We also assessed whether diagnostic accuracy depended on the nurse's experience or on a list of clinical factors of the patients. With this information, we estimated the positive predictive values and false omission rates according to very few clinical factors readily available in primary care (age, sex, and diagnosis of heart failure) and used them to create the algorithm.
RESULTS
The parameters associated with the highest diagnostic accuracy were palpation of the radial artery and classifying as irregular those palpations in which the nurse was uncertain about pulse regularity or unable to palpate pulse (sensitivity = 79%; specificity = 86%). Specificity decreased with age. Neither the nurse's experience nor any investigated clinical factor influenced diagnostic accuracy. We provide the algorithm to select the ≥40 years old individuals that would benefit from a pulse palpation screening: a) do nothing in <60 years old individuals without heart failure; b) do ECG in ≥70 years old individuals with heart failure; c) do radial pulse palpation in the remaining individuals and do ECG if the pulse is irregular or you are uncertain about its regularity or unable to palpate it.
CONCLUSIONS
Opportunistic screening for AF using optimal pulse palpation in candidate individuals according to a simple algorithm may have high effectiveness in detecting AF in primary care.
Topics: Adult; Aged; Ambulatory Care Facilities; Atrial Fibrillation; Cardiology; Electrocardiography; Heart Failure; Humans; Mass Screening; Middle Aged; Palpation; Pulse
PubMed: 35446875
DOI: 10.1371/journal.pone.0266955